EFEKTIVITAS PROGRAM PELAYANAN OBSTETRI NEONATAL EMERGENSI DASAR (PONED) DI KABUPATEN KEBUMEN

Abstract

Public health services play a crucial role in improving population health outcomes, including efforts to reduce the Maternal Mortality Ratio (MMR). Kebumen Regency has implemented the Basic Emergency Obstetric and Neonatal Care (BEmONC) program as a strategy to strengthen maternal emergency services at the primary healthcare level. This study aims to analyze the effectiveness of the BEmONC program and to identify the supporting and inhibiting factors influencing its implementation. The analysis employs a public policy implementation effectiveness framework comprising five key dimensions: policy appropriateness, implementer appropriateness, target appropriateness, environmental appropriateness, and process appropriateness. A qualitative descriptive approach was adopted, with data collected through in-depth interviews, observation, and documentation involving program implementers and service users and analyzed using the Miles–Huberman interactive model with the assistance of ATLAS.ti. The findings indicate that the BEmONC program in Kebumen Regency is appropriate in terms of policy orientation. However, its overall effectiveness has not been fully achieved, particularly with regard to the implementer, target, environment, and process dimensions. These conditions are influenced by several implementation constraints, including the limited number of primary healthcare centers capable of delivering BEmONC services, the readiness of trained health personnel, insufficient facilities and infrastructure, geographical challenges, coordination and referral system issues, and uneven community understanding of BEmONC services. On the other hand, local government commitment, regulatory support, and the dedication of healthcare workers serve as key supporting factors. Therefore, strengthening implementer capacity, ensuring equitable service distribution, and enhancing coordination and referral systems are essential to support the sustainable effectiveness of the BEmONC program.