ABSTRAKOne important indicator in the achievement of the MDGs to improve health of maternal and child (KIA) that is contained in the fourth and fifth goals. indonesia's commitment to achieve the MDGs in 2015 through efforts to reduce MMR from 359 to 102 per 100.000 live births and IMR from 32 to 23 per 1.000 live births is still far from the target of achieving the MDGs, as well as in Mandailing Natal.The research used qualitative method. the informants were all personnel that were involved in the planning and budgeting process of KIA program. they consisted of informants in this study are all elements analyzed qualitatively with Spradley analysis technique.The result of the research showed that the planning and budgeting process of KIA program in the Health Office of Mandailing Natal District did not use fully implement the planning and performance-based budgeting. situation analysis, problem formulation , and goal setting program uses methods that can not accommodate the needs of the real, still planning and budgeting processes are still using incremental.That could be all applying the planning and budgeting for performance's based, advocacy and socialization intense to local governments to increase APBD budget allocated by the Healt Office of Mandailing Natal District, need for education and technical training program development KIA well as the need for active role midwife program coordinator KIA, and managerial need to increase leadership on all health fronts.