IMPLEMENTASI KEBIJAKAN KESEHATAN “LIBAS 2+” SEBAGAI UPAYA MENURUNKAN ANGKA KEMATIAN IBU DAN BAYI DI KABUPATEN SAMPANG

Abstract

Introduction: The issue of MDGs 4 and 5 that targets reducing the AKI and AKB by three-quarters between 1990 and 2015 seems difficult to achieve if there are no immediate concrete steps. Areas with the highest AKI and AKB are Sampang Regency. Looking at the empirical conditions, it is necessary to identify the factors that led to the high AKI and AKB in Sampang Regency. There is an existing health policy in Sampang district through LIBAS (Lima Bebas) 2+, but it needs to be monitored and evaluated to ensure policy implementation went well. This study aims to assess the implementation of the Libas programs and identify socio-cultural factors that influence health policy implementation. Methods: This study used qualitative methods that took place at the Puskesmas Camplong, Sampang Regency. Informants were selected purposively. The research data was collected by participating observation, in-depth interviews, and focus group discussions. The finding was analyzed using descriptive analysis. Results: Sociologically, the implementation of policy to reduce AKI and AKB in Sampang Regency is one of which is influenced by the shaman midwife partnerships, especially in the delivery process. Increasing public confidence in midwives indicates strengthening social relations. 5T programs (weigh, tension, tablet Fe, weigh abdominal size, and height) is helpful to control the development of maternal pregnancy. “Healthy Babies 24 Hours” SMS number serves as a control and monitoring in delivery care. Nonetheless, culturally, traditional cultural construction of Madura, particularly the coastal communities, still entrenched so that the construction of knowledge about reproductive health is still weak. Shaman massage, herbal medicine, pregnancy myths, and charismatic central figure are prominent. Social relation between local actors is still weak, so is the local actors support. Conclusion: Strong local culture values and weak social relationship and support of local actors as a result of program implementation LIBAS2+ reduce AKI and AKB efforts in Sampang Regency had not been effective. Keywords: health policy, LIBAS 2+, social relationship, local culture