IMPLEMENTASI PROGRAM DAN ALTERNATIF STRATEGI MENURUNKAN ANGKA KEMATIAN BAYI BERBASIS SOSIAL BUDAYA

Abstract

Abstract Background: One of the problems and strategic issues of regional development in West Sumatra Province is the high infant mortality rate (IMR). Objective: an overview of the implementation of programs and constraints related to maternal and child health services and the formulation of alternative strategies for reducing socio-cultural based IMR. Methods: The study was conducted in 10 districts/cities in West Sumatra Province with qualitative methods. Research informants: mothers with infant mortality cases; pregnant women/child; traditional birth attendant; public figure; stake holders. Research themes; program implementation; performance coverage and constraints; alternative strategies to reduce IMR based on social culture. Data analysis with content analysis and SWOT analysis. Results: Barriers to the implementation of programs/activities to reduce IMR are: low access to health services; socio-cultural problems in the utilization of health services. Alternative efforts to reduce IMR based on socio-culture through health promotion strategies and community empowerment as well as strengthening the capacity of health resources that have the competency and based on local socio-culture. Conclusion: Socio-cultural barriers in West Sumatra are still limited knowledge, the existence of habits and community beliefs related to maternal/child health. The results of the SWOT analysis as an alternative strategy are health promotion and community empowerment and strengthening the capacity of health resources that have the competence and are based on local socio-culture. Key words: strategy, social culture, infant mortality Abstrak Latar Belakang: Salah satu masalah dan isu srategis pembangunan daerah Provinsi Sumatera Barat adalah masih tingginya Angka Kematian Bayi (AKB). Tujuan: gambaran pelaksanaan program dan hambatan terkait pelayanan kesehatan ibu dan anak serta perumusan alternatif strategi upaya penurunan AKB berbasis sosial budaya. Metode: Penelitian dilaksanakan pada 10 Kabupaten/Kota di Provinsi Sumatera Barat dengan metode kualitatif (Focus Group Discussion, wawancara mendalam dan observasi). Informan penelitian: ibu dengan kasus kematian bayi; ibu hamil/balita; dukun beranak; tokoh masyarakat; dan pemegang program. Tema penelitian; pelaksanaan program/kegiatan; output kinerja program dan hambatannya; alternatif strategi dalam upaya menurunkan AKB berbasis sosial budaya. Analisis data dengan content analysis dan analisis SWOT. Hasil: Hambatan pelaksanaan program/kegiatan penurunan AKB adalah: belum optimalnya akses layanan kesehatan; masalah sosial budaya dalam pemanfaatan pelayanan kesehatan ibu dan anak. Alternatif upaya penurunan AKB berbasis sosial budaya melalui strategi promosi kesehatan dan pemberdayaan masyarakat serta penguatan kapasitas sumber daya kesehatan yang mempunyai kompetensi dan berbasis sosial budaya lokal. Kesimpulan: Hambatan sosial budaya di Sumatera Barat adalah masih terbatasnya pengetahuan, adanya kebiasaan serta kepercayaan masyarakat terkait dengan kesehatan ibu/bayi. Hasil analisis SWOT sebagai strategi alternatif adalah promosi kesehatan dan pemberdayaan masyarakat dan penguatan kapasitas sumber daya kesehatan yang mempunyai kompetensi serta berbasis sosial budaya lokal.   Kata kunci: strategi, sosial budaya, kematian bayi