Muhamad Syaiful Bachri Al Yunus, Bambang Budi Raharjo, Intan Zainafree

Evaluation of the Implementation of Antenatal Care Services at the Grobogan Regency Health Center

Introduction

Evaluation of the implementation of antenatal care services at the grobogan regency health center. Evaluasi implementasi layanan Antenatal Care (ANC) di Puskesmas Grobogan. Mengidentifikasi tantangan di Wirosari II (data, pelatihan) & beri rekomendasi untuk tingkatkan kesehatan ibu.

Abstract

The Maternal Mortality Rate (MMR) in Grobogan Regency remains high, with Antenatal Care (ANC) coverage falling short of national targets. The Wirosari II Health Center reports particularly low K6 coverage at 37.92%. This study evaluates ANC service implementation at Purwodadi I and Wirosari II Health Centers to provide improvement recommendations. Using a descriptive qualitative approach with a phenomenological design, data were collected through in-depth interviews, observations, and documentation with midwives, maternal and child health workers, and pregnant women. Data validation was conducted via triangulation, and analysis followed the Miles and Huberman model. Findings reveal adequate human resources, but uneven health worker training. Infrastructure is sufficient, though equipment damage hinders Wirosari II. Service procedures align with standards, but SOP violations and limited nutrition personnel were noted in Purwodadi I. While K1 and K4 targets are achieved in Purwodadi I, Wirosari II struggles with recording and networking issues. Overall, ANC implementation in Purwodadi I is effective, while Wirosari II requires improvements in data recording, health worker training, and resource management. These findings provide actionable recommendations to enhance maternal health services in Grobogan Regency.

Review

This study tackles a crucial public health challenge: the persistently high Maternal Mortality Rate (MMR) in Grobogan Regency, directly linked to inadequate Antenatal Care (ANC) coverage. By focusing on two distinct health centers, Purwodadi I and Wirosari II, the research employs a descriptive qualitative approach with a phenomenological design to evaluate the nuances of ANC service implementation. The abstract effectively highlights the urgency of the problem, particularly the concerningly low K6 coverage in Wirosari II, setting the stage for a pertinent and much-needed assessment of operational challenges within the regional health system. A significant strength of this evaluation lies in its robust qualitative methodology, utilizing in-depth interviews, observations, and documentation, further enhanced by triangulation for data validation. This approach allows for a detailed and nuanced understanding of the implementation barriers from the perspectives of both healthcare providers and service users. The findings are particularly insightful, clearly delineating the disparities between the two centers: Purwodadi I generally demonstrates effective implementation despite minor procedural issues, while Wirosari II struggles significantly with recording accuracy, networking, and critical resource management challenges such as equipment damage and uneven health worker training. The identification of these specific, actionable problems provides a solid foundation for the promised improvement recommendations. While the study successfully identifies critical operational gaps, a potential area for further consideration could involve a more explicit discussion of the broader systemic or policy-level factors contributing to the observed disparities, particularly given the mention of "adequate human resources" alongside uneven training. A purely descriptive phenomenological approach, while excellent for capturing lived experiences, might benefit from complementing with a deeper structural analysis to understand *why* certain issues persist despite apparent resource availability. Future research could also consider outlining the *types* of recommendations proposed (e.g., policy adjustments, specific training modules, infrastructure funding) to further underscore their practical utility, and perhaps incorporating quantitative process metrics in a follow-up study to track the impact of these interventions over time.

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