Evaluation of the implementation of primary health care integration: A case study of public health center in Denpasar City, Bali Province, Indonesia
DOI:
https://doi.org/10.53638/phpma.2025.v13.i1.p05Keywords:
Public Health Center, Primary Health Care Transformation, Primary Health Care IntegrationAbstract
Background and purpose: Primary health care integration, as one of the pillars of health
system transformation, has been piloted in one of the Public Health Center in
Denpasar since 2023. This study aims to evaluate the implementation of primary
health care integration in Denpasar.
Methods: This was a qualitative study with a case study design. The study consisted
of in-depth interviews with 18 informants whom were recruited purposively. The
informants consisted of policymakers from the Denpasar City Health Office, Head
of Public Health Center, and Head of one Sub-district, person in charge, nurse,
cadres, service recipients from each life cycle. A focus group discussion was also
conducted with eight integrated health post cadres. We also conducted
document reviews to obtain service coverage data and observation of the
supporting infrastructure Data were analyzed using thematic analysis.
Results: Primary health care integration has yet to fully meet the established
implementation standards, particularly in home visits coverage. The health
service package for cluster three, and service coverage for all life cycles and
screening has not reached the target. Inhibiting factors of the implementation
were lack of regulations, fundings, increased workload, insufficient cadre
inadequate training. While, political support, firm policies, quality
infrastructure, and digital technology were significant supporting factors.
Conclusion: Primary health care integration yet to meet completely the established
implementation standards. Efforts are required to address inhibiting factors and
utilizing the supporting factors.
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