Implementation of Community-Based Health Policy and Governance: A Qualitative Study of Posyandu Institutions in Rural Indonesia
Main Article Content
This study examines the implementation of community-based health policy and governance through Posyandu institutions in rural Indonesia. The research is motivated by the continuing challenges of unequal healthcare access, limited institutional capacity, and weak policy integration in rural areas despite the government’s decentralization efforts. The objective of this study is to analyze the implementation of Sragen Regent Regulation Number 48 of 2020 in strengthening Posyandu institutions, evaluate the effectiveness of policy implementation, identify factors influencing governance, and formulate a sustainable community-based health governance model. This research employed a qualitative case study approach conducted in three villages in Sragen Regency, Central Java. Data were collected through in-depth interviews, participatory observation, and document analysis involving village officials, Posyandu cadres, health workers, and community members. The findings reveal that Posyandu implementation remains highly dependent on social capital, local leadership, and community participation. Weak policy communication, limited resources, inadequate institutional integration, and the absence of technical operational guidelines were identified as major obstacles. Nevertheless, Posyandu continues to function adaptively through informal community-based mechanisms. The study concludes that community-based health governance in rural Indonesia operates through a hybrid governance model combining formal policy structures with bottom-up community participation, emphasizing the importance of institutional strengthening, collaborative governance, and sustainable community empowerment.
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