Imam Syafari Dwi Handono Sulistyo Kristiani(1*)

(*) Corresponding Author


Background: Geographical condition of Natuna Islands which
is not in accordance with health development affects the
quantity and availability of midwives distributed in villages in
the District of Natuna. In fact, the ratio between the number of
villages and the number of midwives in the district has not met
the standard proposed by the Ministry of Health. Unfortunately,
there are still around 13 villages from 51 villages that have no
midwives serving in those villages. The location of 13 villages
are separate Island, and it caused lack of provide access to
quality health care services. One of efforts done by the local
government is to attract midwives’ interest through a variety
of strategies and policies in several fields such as financing,
incentive, regulation, organization, and stakeholders’ behaviors.
Method: This was a descriptive study with study-case design
by using qualitative method. Study case in this study was a
single holistic study case. The informants were head of health
office, head of health empowerment and promotion division,
head of general affairs and employment sub division, head of
BKD, head of Local Development Planning Agency, the
Commission Two of Local Legislative, heads of community
health centers, and village midwives. The study case design
aimed to know policies in overcoming the lack of midwives in
the District of Natuna.
Results: The local government financing policy allocated the
budget or health less than 15%, which was only 3-4% used
for improving the health workers’ capacity. The incentive giving
for midwives was relatively small compared to the incentive
regulated by the Ministry of Health. There was no specific
regulation from the local government, so that the policy was
considered not optimal. In the organizational level, the role of
stakeholders was in accordance with their duty and provision;
however, the f inal decision was dependent upon Local
Legislative and the local government’s leader. Lastly, midwives’
low interest to work in Natuna was caused by its geographical
Conclusion: Local government’s policy in the field of financing,
incentive, organization, regulation, and behavior in overcoming
the lack of village midwives was considered not optimal
because of the absence of specific policy from the local
government in this matter. In addition, midwives’ low interest to
work in Natuna contributed the lack of midwives in this district.
Keywords: policy analysis, the lack of village midwives

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