ANALISIS PEMBIAYAAN PROGRAM KESEHATAN IBU DAN ANAK BERSUMBER PEMERINTAH DENGAN PENDEKATAN HEALTH ACCOUNT

Abstract

Background: The degree of Maternal and Child Health (MCH)
is still a major problem in health development in Indonesia. One
factor that may be an obstacle in solving this problem is the
limited cost. In this context, planning and cost utilization are
essential to improve so that they can produce a great impact
for the improvement of MCH. Therefore, in-depth information
about the MCH financing situation in regions as an input to
develop efficient activities in improving MCH status is needed.
Objective: To analyze health financing situation of MCH program
in 2010 which sourced from government and to make policy
recommendations related to the program in Sabu Raijua District,
East Nusa Tenggara Province. The situation in question is
availability, budget planning process, expenditure accuracy,
and fund flow rate.
Method: This was a descriptive research with a case study
strategy.
Result: The total cost of MCH program was IDR 450,787,500.
It was not sufficient to provide basic health services for
pregnant women from early pregnancy until postpartum period.
The budget proportion from the central, provincial, and district
governments amounted to 79.63%, 3.56%, and 16.78%,
respectively. Cost allocation of the district budget was 0.80%.
Planning activities of MCH program was from the district budget
through the development planning meeting (Musrenbang).
Proposed activities in Musrenbang were dominated by physical
activities. The cost of MCH program was spent more on direct
activities and operational cost in villages and sub districts. The
implementation of the activities was not supported by facilities
and adequate human resources. The MCH fund disbursement
from the central government was conducted in October-
November while from the provincial and district governments
were in July to August.
Conclusion: The government’s commitment was still low in
financing MCH program as a priority program due to budget
decentralization. Musrenbang activities had not demonstrated
significant impacts on quality activities improvement and budget
allocations from the district budget. Availability of personnel
and health facilities greatly affected the performance of MCH
program. Delays in funds disbursement disrupted the
implementation of activities and provided opportunities for
corruption. Therefore, the supervision function must be
improved both internal and external.
Keywords: financing, maternal and child health program,
health account, budget, government.