THE IMPORTANCE OF BUREAUCRACY STRUCTURE FACTOR IN THE IMPLEMENTATION OF MINIMUM STANDARD OF HEALTH SERVICE IN CENTRAL JAVA PROVINCE, INDONESIA

Abstract

This paper examines the phenomenon of incompatibility of the institutional structure of Regional Public Hospital which causes the disruption of the achievement of Minimum Service Standards (MSS) indicator in the health sector, especially maternal health in the Provincial Government of Central Java. In Central Java, the largest number of maternal mortality rate was in the hospital in 2015 amounted to 85.71%. Meanwhile, the coverage rate of delivery assisted by health personnel in accordance with the indicator of MSS is 98.09%. In 2015, Central Java is the province with the second highest national of maternal mortality rate case amounted to 619 cases. The Provincial Government as the coordinator of MSS implementation in the region through the Bureau of Pemotda and the Cooperation of Regional Secretariat of Central Java has a significant role in the successful implementation of the Regulation of Minister of Health 43/2016 on MSS in Health Sector. In which MSS has a function to observe the implementation of health program in the region. This research uses a qualitative approach, the type of research is a case study and interactive model analysis from Miles, Huberman, and Saldana. The results of the analysis show that the implementation process of the policy in Bureau of Pemotda and the Cooperation of Regional Secretariat of Central Java has not run well obstructed by bureaucratic structure factor. It can be seen from the unfulfilled policy objective which is to provide convenience to local government in the preparation of planning document on the achievement of health MSS indicator. Although health MSS is achieved, it will not be able to reduce the maternal mortality rate.

Keywords

• Bureaucracy structure
• minimum service standards
• health