Evaluation of Antenatal Care Implementation by Midwives at the Public Health Centers in Paniai Regency, Papua Province

  • Oktovina Kayame Postgraduate Master Program of Public Health, Faculty of Public Health, Cenderawasih University
  • Hasmi Faculty of Public Health, Cenderawasih University, Jayapura Papua, Indonesia, 99351
  • Rosmin M. Tingginehe Faculty of Public Health, Cenderawasih University, Jayapura Papua, Indonesia, 99351
  • Yacob Ruru Department of Statistics, Faculty of Mathematics and Natural Sciences, Cenderawasih University
Keywords: Evaluation, Implementation, ANC, Public Health Center, Paniai Regency


Background: The antenatal care (ANC) services in the working area of Puskemas in Paniai Regency are still less than optimal compared to the predetermined standards. This is due to the influence of the service system that includes input, process, output, supervision and feedback that are not optimal. Research Objectives: To access the ANC service system that include of the input, process, output, supervision and feedback aspect at the Puskesmas in Paniai Regency, Papua Province. Research method: The research method used in this study was qualitative research using a case study approach. The study was conducted in April-May 2020 at five Public Health Centers in the work area of the Paniai Regency Health Department. A total of 11 informants were taken using a method of purposive sampling. The main methods of data collection are in-depth interviews and participatory observation. The data were qualitatively analyzed. Results: The overview of the input aspect: 1) Most health workers (midwives) in ANC services have not met the standards for the provision of the ANC services. There were still many midwives who did not have STR (Registration Certificate) as evidence of midwife competence. Many midwives also never attended ANC training to increase their competence. There were 2 midwives who has followed the training, but it was 10 years ago. In addition, the placement of midwives in all public health centers (Puskesmas) services were still unequal; 2) Funds, the availability of budgets for ANC services at Puskesmas in Paniai Regency cannot support the operational services needed; 3) Inadequate and incomplete facilities and infrastructure make it impossible to operate the service as expected. The existing Standard Operating Procedures (SOP) can not therefore be followed by ANC services. The overview of the process aspect: the service flow system did not comply with the integrated guidelines of the Ministry of Health. The ANC service process has not been carried out by midwives according to the standards. The overview in the output aspect: inadequacy of ANC services according to the predetermined targets could be due to poor input, including: not good service due to insufficient number of staff / midwives in the Puskesmas, lack of adequate facilities, such as UGS, laboratory and others. The overview in the supervision aspect: The head of the Puskesmas from each Puskesmas did not supervise properly; he did not perform a workshop to evaluate every activity that had been carried out by each program. The overview in the feedback aspect: Many pregnant women in the work area of the Puskesmas prefer to go to other health services such as hospitals or Puskesmas. This is a benchmark for Puskesmas, both in terms of input, service process, and output itself, to improve the service system. 


. Kemenkes RI. Pedoman Pelayanan Antenatal Terpadu. Edisi kedua. Dirjen Bina Gizi dan Kesehatan Ibu dan Anak. Jakarta. 2012.

. Walyani. Kebidanan Komunitas. EGC, Jakarta. 2015.

. Y. Orboi, Y. Msen, Y. Ruru, and A. Mallongi. The factors influencing four visited antenatal care in primary health centre in Sanggeng Manokari district, West Papua province. International Journal of Science & Healthcare Research. Vol. pp. 202-210. 2019.

. R. Erlina, T.A. Larasati, and B. Kurniawan. Faktor-Faktor Yang Mempengaruhi Ibu Hamil Terhadap Kunjungan Pemeriksaan Kehamilan Di Puskesmas Rawat Inap Panjang Bandar Lampung. Medical Journal of Lampung University Volume 2 No 4 Februari 2013

. S.H. Yewun, A. Pongtiku, S. Makaba, and A. Mallongi. The factors affecting to antenatal care mother's pregnant visit in public health centre district of Mimika. International Journal of Science & Healthcare Research, vol. 3(3), pp. 55-67. 2018.

. Kemenkes RI. Buku Ajar Kesehatan Ibu dan Anak. Kemenkes RI, Jakarta. 2015.

. Kemenkes RI. Riset Kesehatan Dasar Tahun 2018. Kemenkes RI. Jakarta. 2019.

. Dinas Kesehatan Provinsi Papua. Profil Dinas Kesehatan Provinsi Papua Tahun 2018. Jayapura. 2019.

. Dinas Kesehatan Kabupaten Paniai. Profil Dinas Kesehatan Kabupaten Paniai Tahun 2019. Enarotali. 2020.

. A. Azwar. Pengantar Administrasi Kesehatan. Binarupa Aksara. Jakarta. 2013.

. M.T.E. Hariandja. Manajemen Sumber Daya Manusia. Grasindo, Gramedia. Jakarta. 2002.

. A.S. Munandar. Stress dan Keselamatan Kerja. Universitas Indonesia. 2001.

. C. Ermiati, dan T. Sembiring. “Pengaruh Fasilitas dan Pengembangan Sumber Daya manusia Terhadap Produktivitas Kerja Karyawan: Studi Kasus PTPN II Kebun Sampali Medan”, Jurnal Darma Agung, vol.1. 2012.

. A.I. Wanma, Y. Ruru, A.L. Rantetampang, and A. Mallongi. The Factors Influence with Midwife Performance to Antenatal Care at Public Health Centre Wania sub Province Mimika. International Journal of Science & Healthcare Research. 2018; 3(3): 15-26.

. Obano Puskesmas. Laporan Tahun Puskesmas Obano Kabupaten Paiai Tahun 2019 dan 2020. Obano. 2020.

. Enarotali Puskesmas. Laporan Tahun Puskesmas Enarotali Kabupaten Paiai Tahun 2019 dan 2020. Enarotali. 2020.

. S. Abebe, A. Alemayehu, A. Gebremariam, and A. Dirar. “Quality of antenatal care service in public health facilities of chencha district, gamo gofa zone, southern Ethiopia.” MOJ Womens Health. Vol. 4(3), pp. 57‒64. 2017.

. A.M. Murante, M. Vainieri, D. Rojas, and S. Nuti. Does feedback influence patient-professional communication? Empirical evidence from Italy. Health Policy, vol. 116(2–3), pp. 273–280. 2014.

. A. Coulter, R. Fitzpatrick, and J. Cornwell. Measures of patients’ experience in hospital: purpose, methods and uses. London: King’s Fund. 2009.