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"ABSTRAKRealisasi dana Bantuan Operasional Kesehatan BOK di Puskesmas Kota Serangdari tahun 2014-2016 selalu mencapai 100 setiap tahun dan 30 digunakanuntuk kegiatan KIA. Namun, capaian cakupan pelayanan kesehatan ibu dan anakkhususnya kunjungan antenatal K4 menunjukkan penurunan dan belum mencapaitarget 75 . Penelitian kualitatif ini dilakukan di Dinas Kesehatan, 2 dua Puskesmas dengan cakupan K4 tinggi dan 2 dua Puskesmas dengan cakupan K4rendah. Hasil penelitian menunjukkan bahwa Puskesmas kekurangan sumber dayamanusia dan sarana prasarana untuk program KIA, dana operasional untukkegiatan preventif dan promotif hanya mengandalkan dana BOK, pengawasanpencatatan pelaporan bidan masih lemah, serta frekuensi pergantian kader yangrelatif tinggi.Kata Kunci:Bantuan Operasional Kesehatan, Puskesmas, Kunjungan Antenatal K4 mbahas

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ABSTRACTThe Health Operational Aid Fund BOK has been 100 absorped during 2014 2016 in health centers in Serang city. Out of the total fund, 30 has been used forKIA program activities. However, coverage of maternal and child health servicesespecially K4 antenatal visit tend to decrease and has not reached the target 75 . This qualitative research was conducted in District Health Office, 2 two health centers with high K4 coverage and 2 two Puskesmas with low K4coverage. The result showed that Puskesmas has shortage in human resources andinfrastructure facilities for KIA program, while funding to support preventive andpromotive activities was only rely on BOK funds. In addition, midwife reportingwas found insufficient, and high turn over of cadres has lead to poor performance.Key words community health centre, health operational fund, K4 antenatalvisit."

"ABSTRAKRealisasi dana Bantuan Operasional Kesehatan (BOK) untuk Puskesmas di KotaDepok dari tahun 2012 sampai dengan tahun 2013 meningkat sebesar 25,56%.Tingginya serapan dana tersebut seharusnya diimbangi dengan peningkatancakupan kunjungan neonatal pertama (KN1). Hasil capaian KN1 di tahun 2013mengalami penurunan sebesar 6,11%, sehingga perlu dievaluasi. Penelitiandilakukan di Dinas Kesehatan dan 4 Puskesmas, yaitu Puskesmas Cipayung,Puskesmas Cinere, Puskesmas Cilodong dan Puskesmas Tapos dengan metodakualitatif dan mempertimbangkan variabel dana serta cakupan. Hasil penelitianmenunjukkan bahwa tidak semua Puskesmas kekurangan sumber daya manusiadan sarana prasarana dalam mengelola BOK dan program kesehatan anak. Namun,ketersediaan dana operasional rutin (BOP) untuk melakukan kunjungan luargedung relatif terbatas, sehingga Puskesmas mengutamakan dana BOK. Sebelumpelaksanaan kegiatan, tiap Puskesmas menetapkan rencana pelaksanaanberdasarkan capaian program tahun sebelumnya dengan melibatkan lintas programdi Puskesmas. Dana BOK dimanfaatkan untuk kunjungan neonatus resiko tinggi,penyuluhan dan pendataan sasaran oleh kader kesehatan

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ABSTRACTThe Health Operational Fund (BOK) to support programs in 2013 in Depok hasincreased 25,56% as compared to 2012. This should be followed by an increase incoverage of the first neonatal visit (KN1). Performance of KN1 in the year 2013decreased by 6,11%, so it is needed to evaluate the use of BOK. The study wasconducted at the District Health Office level and covering 4 health centers, namelyCipayung, Cinere, Cilodong and Tapos using qualitative approach and consideredcost and coverage variables. The results showed that there was no shortage onhuman resources and facility to manage the Puskesmas Operational funds (BOK)and neonatal health programs. The availability of routine operational funds (BOP)is limited so that the health center has been relying on BOK fund to supportoutreach programs. Each health center set up Plan of Action based on previousprograms achievement involving various relevant programs. The fund was used forhigh risk neonatal visit, counseling and mapping the target by cadres."

"Tujuan dari penelitian ini adalah untuk mengetahui (1) implementasi program bantuan operasional kesehatan (BOK) di Puskesmas Kota Bekasi, (2) ukuran dan tujuan kebijakan, (3) pelaksanaan program cakupan penanganan komplikasi kebidanan, (4) ketersediaan SDM, (5) disposisi pelaksana dan (6) lingkungan sosial, ekonomi dan politik yang mempengaruhi implementasi bantuan operasional kesehatan (BOK) dengan cakupan penanganan komplikasi kebidanan di puskesmas kota bekasi tahun 2019. Variabel penelitian meliputi sumber daya manusia, anggaran, pedoman, fasilitas, perencanaan, pelaksanaan, monitoring dan evaluasi. Sampel yang terlibat dalam pelaksanaan program bantuan operasional kesehatan di Puskesmas Kota Bekasi terdiri dari 9 responden. Hasil penelitian mengungkapkan bahwa perencanaan anggaran sudah sesuai dengan juknis, kebijakan sumber daya manusia belum memadai, jumlah dana sudah mencukupi dan proses akuntabilitasnya memerlukan pengawasan dan penyederhanaan pelaporan. Pada tingkat capaian program penanganan komplikasi kebidanan, cakupan layanan ada yang telah meningkat, tetapi ada beberapa layanan yang tidak memenuhi target Standar Pelayanan Minimal (SPM).

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The aims of the research are to find out (1) the implementation of health operational assistance (BOK) at Bekasi City Health Center, (2) the size and objectives of the policy, (3) implementation of coverage programs for obstetric complications management, (4) the availability of human resources, (5) implementation disposition and (6) social, economic and political environment that affect the implementation of health operational assistance (BOK) with coverage of obstetric complications management in the Bekasi City Health Center in 2019. Research variables include human resources, budget, guidelines, facilities, planning, implementation, monitoring and evaluation. The sample involved in implemention of health operational assistance (BOK) with coverage of obstetric complications management in the Bekasi City Health Center consisted of 9 respondents. The results of the research revealed that budget planning was in accordance with technical guidelines, human resource policies were inadequate, the amount of funds was sufficient and the accountability process needed supervision and simplification of reporting. At the level of achievement of the obstetric complications management program, service coverage has increased, but there are some services that do not meet the Minimum Service Standards (MSS) targets."

"ABSTRAKNama : FitriProgram Studi : Ilmu Kesehatan MasyarakatJudul : Analisis Implementasi Bantuan Operasional Kesehatan melaluiDana Alokasi Khusus Non Fisik di Kabupaten Serang Tahun 2016Pembimbing : Prastuti Soewondo, SE, MPH, PhDMulai tahun 2016, mekanisme penyaluran Biaya Operasional Kesehatan BOK dialihkanpenyaluran dananya dari Tugas Pembantuan yang alokasinya pada anggaran KementerianKesehatan menjadi DAK non-fisik yang di transfer langsung dari Kementerian Keuangandan dicatat sebagai bagian dari pendapatan daerah. BOK merupakan dana yang digunakanuntuk menunjang kegiatan promotif-preventif di luar gedung Puskesmas. Penelitiankualitatif ini bertujuan untuk mendapatkan gambaran implementasi BOK melaluimekanime DAK non-fisik serta diketahui hambatan yang dihadapi di Kabupaten Serang.Capaian realisasi dana BOK di Kabupaten Serang mengalami penurunan menjadi 85,87 di tahun 2016. dibanding tahun 2015 yang menggunakan mekanisme TP yaitu 96,49 .Hasil penelitian mengungkapkan adanya keterlambatan penerbitan juknis, keterbatasanfasilitas berupa komputer, printer dan gudang, keterbatasan staf sehingga merangkapbeberapa tugas, keterlambatan pencairan dana, kesulitan dalam penyesuaian kode rekeningdengan kegiatan BOK, banyaknya syarat dokumen pertanggungjawaban yang harusdilengkapi untuk pencairan dana serta masih lemahnya perencanaan kegiatan, komitmen,dan koordinasi antara para pengelola BOK.Kata kunci : Bantuan Operasional Kesehatan; Puskesmas; DAK non-fisik

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ABSTRACTName FitriStudy Program Ilmu Kesehatan MasyarakatTitle Analysis of the Implementation of Operational Budget for Health BOK through Special Allocation Fund DAK NonPhysic in Serang Regency in 2016Counsellor Prastuti Soewondo, SE, MPH, PhDStarting in 2016, fund channeling mechanism of Operational Budget for Health BOK hasshifted from Tugas Perbantuan in which allocated through the Ministry of Health to SpecialAllocation Fund DAK non physic that is directly transferred from Ministry of Financeand recorded as part of the local government revenues. BOK is for funds allocated tosupport preventif and promotive activities outside the building of Puskesmas. Thisqualitative approach aims to obtain an overview on the implementation of BOK usingmechanism of DAK non physic and identify obstacles faced by Kabupaten Serang. Thebudget realization has reduced from its previous achievement, from 96.49 in 2015 usingTP mechanism to 85.87 in 2016. The study result demonstrates that there are severalmain issues that need to be tackled in the future, including delays on issuing technicalguidelines, limited supporting infrastructure and technology such as computers, printersand warehouses , limitations in human resources that are forced to multitask different jobdescriptions, continued delay on disbursement of funds, difficulties in adjusting code ofaccount under BOK activities, the excessive amount of documentation required as prerequestedfor fund disbursement, and ineffective planning activities, commitment, andcoordination among BOK managers.Key words Operational Budget for Health BOK , Community Health Center Health toSpecial Allocation Fund DAK non physic"

"Program Bantuan Operasional Kesehatan atau BOK melalui mekanisme DAK Non Fisik merupakan upaya penyalurkan dana operasional untuk kegiatan Puskesmas. Dana tersebut merupakan yang digunakan untuk kegiatan UKM di Puskesmas. Namun masih banyak kendala yang yang menyebabkan efektifitas dana ini menjadi belum maksimal. Tujuan penelitian ini adalah untuk melihat efektifitas implementasi dana BOK melalui mekanisme DAK Non fisik untuk menunjang kegiatan UKM di Puskesmas dilihat dari waktu pencairan, anggaran, sumber daya manusia, sarana, beban kerja serta proses pengelolaan dana tersebut. Penelitian dilakukan dengan metode kualitatif dandilakukan di antara bulan Januari sampai Mei 2019. Dana BOK ini sangat membantu kegiatan operasional puskesmas, namun cakupan SPM di kabupaten Bogor belum begitusignifikan. Hal ini dikarenakan masih banyak faktor yang membuat jalannya dana tersebut belum efektif dan efisien.

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The Health Operational Assistance Program or BOK through the Non-Physical DAK mechanism is an effort to channel operational funds to Public Health Centre activities.The fund is used for the activities of UKM in the Public Health Centre. But there are still many obstacles that have caused the effectiveness of these funds to be not optimal. The purpose of this study was to see the effectiveness of the implementation of BOK fundsthrough the non-physical DAK mechanism to support UKM activities in Public Health Centre viewed from the time of disbursement, budget, human resources, facilities,workload and the process of managing the funds. The research was conducted with qualitative methods and was carried out between January and May 2019. This BOK fundgreatly helped the operational activities of the Public Health Centre, but the SPM coverage in Bogor district was not so significant. This is because there are still manyfactors that make the way the funds have not been effective and efficient."

"Penelitian ini membahas tentang hubungan pemanfaatan dana bantuan operasional kesehatan (BOK) terhadap utilisasi pelayanan kesehatan balita di posyandu di Indonesia. Tujuan dari penelitian ini adalah agar dapat diketahuinya distribusi frekuensi faktor pelayanan kesehatan balita dengan utilisasi pelayanan kesehatan balita di osyandu di Indonesia, berdasarkan data Indonesia Family Life Survey (IFLS) tahun 2014. Diketahuinya hubungan kesesuaian pemanfaatan dana BOK dengan utilisasi pelayanan kesehatan balita di posyandu di Indonesia setelah dikontrol dengan variabel lain, berdasarkan data Indonesia Family Life Survey (IFLS) tahun 2014. Unit analisis penelitian ini adalah wilayah kerja kecamatan, dengan jumlah sampel yang memenuhi kriteria inklusi sebanyak 168 kecamatan. Analisis Multivariat dilakukan dengan pendekatan model Ordinary Least Square (OLS) dengan metode BackwardBerdasarkan hasil penelitian ini didapatkan bahwa proporsi Puskesmas penerima BOK sebesar 76,48%, proporsi kesesuaian pemanfaatan BOK sebesar 68,56%, dan rata-rata BOK perkapita adalah sebesar 4.226 rupiah yang berasal dari 15 propinsi, 115 kab/kota dan 168 kecamatan. Faktor-faktor yang berhubungan signifikan dengan utilisasi pelayanan kesehatan balita meliputi alokasi dana BOK perkapita, Manajerial Kepala Puskesmas, Jumlah Bidan,Jumlah Perawat, dan Sumbangan dana dari Puskesmas. Dari hasil penelitian ini juga didapatkan bahwa Puskesmas yang menerima BOK dan kesesuaian pemanfaatan Dana BOK tidakmempengaruhi utilisasi pelayanan kesehatan balita di posyandu di Indonesia sedangkan alokasi dana BOK perkapita meningkatkan utilisasi pelayanan kesehatan balita di posyandu di Indonesia.

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This study discusses associaton between the use of Health Operational Assistance and Utilization Under Five Childs Health Services in Posyandu in Indonesia. The purpose of this study is to know the frequency distribution of under five childs health service facilities with the utilization of under five childs health services in posyandu in Indonesia based on the 2014 Indonesian Family Life Survey (IFLS) data, knowing the relationship between the suitability of BOK funds utilization and the utilization of under five health services at posyandu in Indonesia is based on the Indonesian Family Life Survey (IFLS) data in 2014, and it is known that the influence of BOK funds with the utilization of under-five health services after being controlled by other variables is based on the 2014 Indonesian Family Life Survey (IFLS) data. with the number of samples meeting the inclusion criteria as many as 168 sub-districts. Multivariateanalysis was carried out using the Ordinary Least Square (OLS) model approach with the backward method. Based on the results of this study it was found that the proportion of Puskesmas receiving BOK was 76.48%, the proportion of the suitability of BOK utilization was 68.56%, and the average BAP per capita was 4,226 rupiah from 15 provinces, 115 districts/cities and 168 sub-districts. The factors that significantly correlated with the utilization of under five childs health services included the allocation of BOK per capita funds, Managerial Head of Puskesmas, Number of Midwives, Number of Nurses, and Donations from Puskesmas. From the results of this study it was also found that the Puskesmas that received BOK and the suitability of the use of the BOK Fund did not affect the utilization of under-five health services at the posyandu in Indonesia while the allocation of the BOK per capita increased the utilization of under five health services in posyandu in Indonesia."

"Program BOK di Kabupaten Kuningan meningkatan dana operasional Puskesmas tahun 2011 dan 2012 menjadi 2 kali lipat, tetapi hal tersebut tidak berbanding positif dengan pencapaian cakupan indikator SPM bidang kesehatan. Ini mengindikasikan bahwa implementasi program BOK di Puskesmas Kabupaten Kuningan belum berjalan sesuai harapan. Tujuan penelitian ini untuk menganalisis faktor-faktor yang mempengaruhi implementasi kebijakan BOK di Puskesmas Kabupaten Kuningan berdasarkan variabel kondisi lingkungan, hubungan antar organisasi, sumber daya organisasi, serta karakteristik dan kapabilitas instansi pelaksana. Penelitian ini menggunakan metode kualitatif dan dilakukan antara Bulan Maret-April 2013 berlokasi di 4 Puskesmas dan Dinas Kesehatan dengan jumlah informan 23 orang. Pelaksanaan BOK di Kabupaten Kuningan tahun 2011?2012 memberikan banyak manfaat kepada Puskesmas khususnya operasional kegiatan preventif dan promotif. Tetapi ini tidak berpengaruh positif terhadap pencapaian SPM bidang kesehatan. SPM cenderung menurun dan item tidak mencapai target cenderung meningkat.

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BOK programs in Kuningan District to improve operational funds of public health centers in 2011 and 2012 to 2-fold, but it is not comparable positive with the achievement coverage of health SPM indicators. This indicates that the implementation of BOK programs in public health centers of Kuningan District has not run as expected. The purpose of this study to analyze the factors that influence implementation of the BOK policy in public health centers of Kuningan District, based on variable environmental conditions, inter-organizational relationships, organizational resources, as well as the characteristics and capabilities of executing agencies. This study uses a qualitative method and conducted between March-April 2013 and is located at 4 public health centers with the Health Department informant number 23. Implementation of BOK programs in Kuningan district in 2011-2012 provides many benefits to the public health center especially operational to preventive and to promotive activities. But this is not a positive influence on the achievement in health SPM. SPM tends to decrease and the item does not reach the target is likely to increase."

"Departemen Kesehatan telah menggariskan suatu kebijaksanaan yang disebut: Panca Karya Husada, dimana "Karya" yang pertamanya adalah: "Peningkatan dan Pemantapan upaya kesehatan." Keberhasilan karya pertama ini ditentukan antara lain melalui upaya kesehatan di puskesmas. Sehingga sewajarnyalah peranan dan fungsi puskesmas perlu dibina dan ditingkatkan. Di Indonesia, puskesmas merupakan ujung tombak pelayanan kesehatan dan diketahui bahwa produktivitas dan kinerja cakupan puskesmas masih rendah, serta banyak faktor yang mempengaruhi hal tersebut. Penelitian ini bertujuan ingin mendapatkan gambaran tentang kinerja cakupan puskesmas di Kabupatan Serang Propinsi Jawa Barat. Kabupatan Serang dipilih menjadi daerah penelitian disebabkan karena Kabupaten Serang mempunyai angka kematian bayi yang tertinggi diantara Kabupaten dan Kotamadya se-propinsi Jawa Barat. Dengan angka kematian bayi sebesar 123,77/1000 kelahiran. Penelitian ini merupakan penelitian deskriptif analitik dengan pendekatan "Cross sectional." Unit analisanya yaitu Puskesmas dengan respondennya: Kepala Puskesmas beserta stafnya yang memegang program KB-KES. Hipotesa yang diajukan adalah faktor Lingkungan, Pembinaan Organisasi Puskesmas, Manajemen Internal Puskesmas serta Faktor Input Puskesmas mempunyai hubungan searah dengan Kinerja Cakupan Puskesmas. Hasil analisa bivariat didapatkan dari keempat variabel independen korelasi yang paling tinggi adalah manajemen internal puskesmas {0,66) kemudian diikuti oleh pembinaan organisasi puskesmas (0,54), lingkungan umum (0,53) dan yang korelasi terkecil adalah faktor input (0,32). Hasil analisis dengan menggunakan regresi ganda didapatkan persamaan: Kinerja Cakupan Puskesmas: 5,28 + 0,63 (Manaje) + 0,21 (Lingk) + 0,13 (Input) + 0,11 (Bins). Kesimpulan dari analisis di atas menunjukkan manajemen internal puskesmas merupakan variabel utama yang mempengaruhi cakupan kinerja puskesmas disusul lingkungan umum. Disarankan perlu adanya peningkatan kemampuan dan keterampilan tenaga puskesmas yang difokuskan pada manajemen internal.

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Health Ministry had underscored a wisdom, which is coiled: Panca Karya Husada, where the first "Karya (work)" is "Improvement and Stabilization of Health conditions." The success of this first work is determined among others, through the health efforts in Health Center. So that it's natural that the role and the function of health center need to be constructed and increased. In Indonesia, health center is one center of health servicing and is known that the productivity and the coverage performance of health center still low, and so many factors influence them.

The aim of this observation want to get image about coverage performance of health center in Serang regency, West Java Province. Serang Regency is choice become observation region it is caused that Serang Regency has a highest infant mortality rate between Regency and Municipality in all west Java Provinces. With the infant mortality rate is 123,77/1000.

This observation is a analytic description observation with approaching "Cross sectional". The Unit of it's analysis is the health center isn?t responder: The chairman of health center with his staff who kept KB-KES Program. The Hypothesis with is proposed is environment factor, Establishment Organization of health center, Management Internal of health center and Input Factor has the same way direction of connection with coverage performance of health center.

The Result of bivariat analysis is gotten from the fourth variable independent of highest correlation are management internal of health center (0,66), and then followed by Establishment Organization of health center (0,54), environment factor (0,53), and smallest, correlation is input factor (0,32). The result of analysis with using multiple regressions is obtained similarity coverage performance of health center: 5,28 + 0,63 (manage) + 0,21 (environment) + 0,13 (input) + 0,11 (establishment) + e.

The conclusion of analysis above showed that the management internal of health center is the main variable which influence coverage performance of health center is followed by environment factor. It's suggested that it need something to increase the ability and the skill of health center power, which is focused on management internal of health center."

"Puskesmas adalah organisasi kesehatan fungsional yang merupakan pusat pengembangan kesehatan masyarakat yang juga membina peran serta masyarakat disamping memberikan pelayanan secara menyeluruh dan terpadu kepada masyarakat di wilayah kerjanya dalam bentuk program pokok. Program kesehatan ibu dan anak (IQA) merupakan salah satu program pokok di puskesmas yang mendapat prioritas tinggi, mengingat kelompok ibu hamil, menyusui , bayi dan anak merupakan kelompok yang sangat rentan terhadap kesakitan dan kematian (Departemen Kesehatan, 1992). Dalam mengayomi kelompok rentan ini banyak kegiatan yang dilakukan oleh puskesmas dalam upaya menurunkan angka kesakitan dan kematian, salah satunya melalui kegiatan antenatal care (ANC) yang adekuat. ANC yang adekuat ditunjukkan dengan salah satu indikator yang terdapat dalam suatu sistem pemantauan wilayah setempat program KIA yaitu indikator K4 ibu hamil.Diduga rendahnya cakupan K4 ibu hamil ini mungkin dipengaruhi oleh somber daya yang tersedia di puskesmas, peran lintas sektor, luas wilayah kerja, status puskesmas, jumlah penduduk, rencana kerja tahunan (POA) puskesmas, rencana kerja petugas pelaksana program, pemantauan dan penilaian. Oleh karena itu peneliti ingin mengetahui bagaimana gambaran karakteristik puskesmas yang berhubungan dengan cakupan K4 ibu hamil. Penelitian ini dilakukan di Kabupaten Aceh Besar tahun 1999 dengan menggunakan pendekatan kualitatif. Pengumpulan data diperoleh melalui wawancara mendalam terhadap pimpinan puskesmas dan bidan pengelola KIA di 6 (enam) puskesmas terpilih dalam Kabupaten Aceh Besar. Selain itu informasi dari bidan di desa sebagai pengelola MA di pedesaan diperoleh melalui diskusi kelompok terarah. Dengan demikian, untuk meningkatkan validitas data peneliti telah melakukan triangulasi sumber data, triangulasi metode.Hasil penelitian menunjukkan bahwa karakteristik puskesmas ternyata mempunyai peran terhadap pencapaian cakupan K4 ibu hamil antara lain tenaga pelaksana ANC, baik jumlah maupun mutunya masih kurang, ketersediaan sarana pelayanan yang belum memadai, dukungan/peran lintas sektor belum berjalan, serta rencana kerja petugas pelaksana program puskesmas yang belum dibuat (tidak ada). Berdasarkan hasil yang didapat pada penelitian ini, maka disimpulkan bahwa puskesmas dengan karakteristik sumber daya dan dukungan lintas sektoral yang memadai mempunyai cakupan K4=60%. Berdasarkan simpulan tersebut pula, peneliti menyarankan antara lain diperlukan upaya peningkatan mutu tenaga pelaksana program melalui pelatihan teknis fungsional, pemanfaatan sumber daya yang tersedia di puskesmas secara optimal, membuat rencana kerja puskesmas secara menyeluruh serta pimpinan puskesmas harus lebih bersifat proaktif untuk mendapatkan dukungan peran lintas sektor. Sebagai alat manajerial program MA, pemantauan wilayah setempat-kesehatan ibu dan anak (PWS-KIA) hendaknya terus dapat, digunakan dalam upaya melakukan pemantauan dan evaluasi program.

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Health center is a functional health organization designed as a development center for public health, aimed to build community participation in addition to delivering comprehensive and integrated community services in its region in the form of basic health services. Maternal and child health is one of basic services in health center, with a high priority. It is to say that pregnant and lactating mothers, babies and children are high-risk groups of morbidity and mortality (MOH, 1992). In order to protect these mothers and their coming babies, mothers should adequately do antenatal care. Adequate antenatal care is pointed out by an indicator, in a local visit area monitoring system of maternal and child health program (MCH), namely K4. K4 is the fourth ANC visit with a certain criteria.By hypothesis, a low coverage of K4 of pregnant mothers maybe influenced by the available power resources of health center, participation of inter-sector, working area, health center status, public population, plan of action of health center, plan of action officer program, monitoring and evaluation. Therefore, the researcher want to know how health center characteristics influence K4 coverage of pregnant mothers. This study was conducted in Aceh Besar District in 1999 using qualitative approach. The data was collected through in depth interviews to the chief of health center and senior midwives of 6 (six) selected health centers in Aceh Besar District. While information from midwives in village was obtained through focus group discussions (FGDs). In order to get valid data, the researcher applied triangulation on data resources and data collection method. Through the method the data were rechecked not only once.The results of this study show that the health center characteristics actually have roles toward K4 coverage of pregnant mothers, ANC staff lack off in number and quality, the availability of service facility is not sufficient, the role of inter-sector is not well run yet, and the plan of action of health center program of officer is not produced. Thus it can be concluded that health centers with sufficient resources and inter-sector support have K4 coverage more than 60 %. Based on the conclusion, the author suggests some improvement effort of through a functional technique training, the available optimal utilization of resource of the health center, production and improvement of the plan of action of health center more proactive action of and the chief of health center to have inter-sector support. As managerial tools of maternal and child health program, local area monitoring-maternal and child health (LAM-MCH) should be permanently used in monitoring and evaluating the program."