Abstract
Integrated Health Post for Child Health (Posyandu) has been endorsed since 1984 as a community-based health program in Indonesia. Despite its potential in improving child health outcomes, evidence related to its current implementation is lacking. This study aimed to explore the current implementation of posyandu in the country. Data of 638 posyandu surveyed in the 5th wave of Indonesia Family Life Survey (IFLS-5) located in urban and rural areas were analyzed, applying chi-square and independent t-test method. Posyandu surveyed run a number of activities (mean type of activities=8.1 in rural vs. 7.4 in urban areas, p<0.001), focusing on weight monitoring, supplementary food provision, and vitamin A supplementation. Approximately 38% of Community Health Workers (CHWs) has never been trained in posyandu’s management nor child health care. Financial barriers, medicine and equipment supplies, and location to conduct posyandu’s activities remained as challenges in the implementation. While posyandu has been implemented for decades, the study found that its implementation has not been optimal. Actions should be taken to improve posyandu’s implementation. These include strengthening collaboration to address the problems and improving CHWs activities. Keywords: posyandu, child health, community-based health program
Highlights
In the past decades, child and infant health status in Indonesia have been improved significantly
A total of 638 posyandu surveyed in IFLS-5 were included in the analysis (67% are located in urban, and 33% are located in rural areas), with 50% of posyandu in both areas were firstly operated between the year 1981 to 1995
The proportion of posyandu that provide services for child health care – except for those related with therapy and medication was ranging from 82% to 99.5%
Summary
Child and infant health status in Indonesia have been improved significantly. World Bank estimated that the IMR in 2015 was 23 per 1,000 live births (The World Bank, 2016), meeting the target of MDGs IMR goal for Indonesia. Despite of this achievement, there are inequalities in child health status between subgroup of population. Socioeconomic factors operate through the proximate determinants in affecting mortality These proximate determinants that directly affect child and infant mortality in developing countries include maternal characteristics (age, parity, birth interval), environmental contamination, nutrition, injury, personal illness, as well as health service availability and its utilization (Li, et al, 2017; Macinko, de Fátima Marinho de Souza, Guanais, & da Silva Simões, 2007; Mosley & Chen, 1984)
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