Implementasi Posyandu Integrasi Layanan Primer di Wilayah Kerja Puskesmas Lalang Kecamatan Medang Deras Kabupaten Batubara Tahun 2025

Abstract

The Posyandu, as the frontline of community-based health services, is currently being revitalized through the implementation of the Integrated Primary Care Services (ILP). Although the transformation of primary care services at the puskesmas and its network has progressed, its implementation continues to face various challenges. This study aims to examine the implementation of ILP posyandu in the working area of Puskesmas Lalang, Medang Deras Subdistrict, Batubara Regency, and to assess the input, process, and output components, as well as the challenges encountered.This research employed a qualitative design with a case study approach. Eight informants were selected using purposive sampling, ensuring their relevance to the research objectives. Data were collected through in-depth interviews, observations, and document reviews, and analyzed using the Miles and Huberman interactive model.The findings show that ILP posyandu implementation remains partial and uneven. Although life-cycle services have been initiated, the tiered integrated system between the puskesmas, auxiliary health posts, and posyandu has not been optimally established. Coordination of recording and reporting, as well as the use of digital systems, remains limited. In terms of input, challenges stem from limited health personnel, insufficient cadre skills, inadequate funding, and incomplete facilities such as posyandu buildings and cadre kits. In terms of process, posyandu activities follow the five-table workflow with life-cycle services, but coverage remains inconsistent across target groups, particularly adolescents. In terms of output, posyandu attendance increased following ILP implementation, although home visit coverage remains low. Services meet standards but remain suboptimal for adolescents and the elderly. Key challenges include the complexity of the integrated system, limited resources, and low community participation. Strengthening cadre capacity, increasing village funding support, improving infrastructure, optimizing digital system utilization, and enhancing community engagement are necessary to ensure the sustainability of the ILP program.