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Abstrak :
[ABSTRAK
Diperkirakan 15-20% kehamilan dan persalinan akan mengalami komplikasi. Puskesmas mampu Pelayanan Obstetri Neonatal Emergensi Dasar (PONED) sebagai sarana untuk mendekatkan pelayanan terhadap ibu hamil, bersalin dan nifas. Kabupaten Bogor mempunyai 40 Puskesmas dan 22 diantaranya termasuk kategori Puskesmas PONED. Puskesmas mampu PONED Parung mempunyai cakupan penanganan komplikasi yang tinggi (77,7%) , sedangkan Puskesmas mampu PONED Cileungsi mempunyai cakupan penanganan komplikasi kebidanan yang rendah (50,7%). Menurut teori Edwards III , implementasi kebijakan berfokus pada 4 variabel yaitu : komunikasi, sumber daya, disposisi, dan struktur birokrasi.Rancangan penelitian yaitu penelitian kualitatif. Lokasi penelitian di Dinas Kesehatan Kabupaten Bogor, Puskesmas mampu PONED Parung dan Puskesmas mampu PONED Cileungsi. Hasil penelitian menunjukkan untuk variabel sumber daya, Faktor sumber daya manusia (kompetensi yang tidak merata) menjadi faktor dominan dalam penanganan komplikasi kebidanan di Puskesmas mampu PONED. Untuk variabel komunikasi Faktor koordinasi menjadi faktor dominan dalam penanganan komplikasi kebidanan di Puskesmas mampu PONED. Untuk variabel struktur birokrasi didapatkan, struktur organisasi di Puskesmas mampu PONED Parung dan Cileungsi belum lengkap karena tidak melibatkan perawat dan belum adanya pemisahan strukur organisasi PONED di Puskesmas Cileungsi. Untuk variabel disposisi diperlukan peningkatan komitmen petugas Puskesmas terutama di Puskesmas mampu PONED Cileungsi terkait dengan penanganan komplikasi kebidanan di PONED.

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ABSTRACT
An estimated 15-20% of pregnancies and childbirth can develop into complications. Basic Emergency Obstetric and Neonatal Care (BEONC) facilities as a means to bring services to mothers during pregnancy, labor or delivery, and post partum period. Bogor Regency has 40 Primary Health Cares (PHCs), 22 of them categorized as BEONC. Parung PHC is a BEONC facility with a high coverage in complication handling (77,7%), while Cileungsi PHC is a BEONC facility with a low coverage in complication handling (50,7%). According to the theory of Edwards III, policy implementation focuses on four variables, such as : communication, resources, disposition, and bureaucratic structure.The design of the research is a qualitative research. The location of the research in Bogor District?s Health Office , Parung and Cileungsi BEONC PHC . The results of the study showed that in the variables of Resources, the human resources (uneven competence) becomes the dominant factor in complications handling BEONC facilities. In the communication variables, the dominant factor in BEmOC facilities complications handling is coordination. In the variables of bureaucratic structure, the organization?s structure in both Parung and Cileungsi PHC is incomplete because it does not include nurses, and in Cileungsi PHC the BEONC structure has not separated yet. In the variables of disposition, an increased commitment of health officers in complication handling is required especially in Cileungsi PHC., An estimated 15-20% of pregnancies and childbirth can develop into complications. Basic Emergency Obstetric and Neonatal Care (BEONC) facilities as a means to bring services to mothers during pregnancy, labor or delivery, and post partum period. Bogor Regency has 40 Primary Health Cares (PHCs), 22 of them categorized as BEONC. Parung PHC is a BEONC facility with a high coverage in complication handling (77,7%), while Cileungsi PHC is a BEONC facility with a low coverage in complication handling (50,7%). According to the theory of Edwards III, policy implementation focuses on four variables, such as : communication, resources, disposition, and bureaucratic structure.The design of the research is a qualitative research. The location of the research in Bogor District’s Health Office , Parung and Cileungsi BEONC PHC . The results of the study showed that in the variables of Resources, the human resources (uneven competence) becomes the dominant factor in complications handling BEONC facilities. In the communication variables, the dominant factor in BEmOC facilities complications handling is coordination. In the variables of bureaucratic structure, the organization’s structure in both Parung and Cileungsi PHC is incomplete because it does not include nurses, and in Cileungsi PHC the BEONC structure has not separated yet. In the variables of disposition, an increased commitment of health officers in complication handling is required especially in Cileungsi PHC.]

Abstrak :
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). ......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.