Analisis Pembiayaan Kesehatan Program Kesehatan Ibu dan Anak (KIA) Berdasarkan Standar Pelayanan Minimal (SPM) di Kabupaten Nunukan

Mustaqim Hariyadi(1*), Julita Hendrartini(2), M.Arief Budiarto(3)

(1) Dinas Kesehatan Kabupaten Nunukan Propinsi Kalimantan Utara
(2) Pasca Sarjana Ilmu Kesehatan Masyarakat Fakultas Kedokteran UGM
(3) Pasca Sarjana Ilmu Kesehatan Masyarakat Fakultas Kedokteran UGM
(*) Corresponding Author


Background: The role of regional government in decentralization period is very important to the health sector particularly in financing. This is because health is one of the sectors that was decentralized. Minimum service standard is the obligatory responsibility for the region that is the right of every citizen at a minimum level, and one of many basic services is Maternal and Child Health programs. Objectives: To asses the financing sufficiency for Maternal and Child Health Programs based on Minimum Service Standard cost calculation and the effectivity of financing for Maternal and Child Health programs to achieve program’s objectives and goals. Methods: This research is a descriptive study conducted in Nunukan in 2013 with quantitative data. Sufficiency analysis is done by calculating the cost of Maternal and Child Health program to the result of cost calculation based on Minimum Service Standard. Performance effectivity of the Maternal and Child Health Programs was analyzed by the achievement of Minimum Service Standard according to the national indicator target and Maternal Mortality and Infant Mortality to the target of RPJMN of 2010-2014. Results: The cost of Maternal and Child Health program that was available was Rp. 2.530.038.761, and the calculation result of the cost based on Minimum Service Standard at Rp. 3.707.719.364, thus there was fund deficit about Rp 1.177.680.603. The percentage of MCH programs financing by the central government was still hight that was about 75%. There are financing MCH programs for direct activities amounted to 74%, and indirect activities amounted to 26%. The financing performance of MCH program was not effective yet to achieve the target of national Minimum Service Standard indicator and maternal mortality was still high at 173 per 100.000 life birts and infant mortality at 14 per 1000 live births. Conclusion: The financing of MCH programs was not sufficient to perform activities in MCH programs, as there was fund deficit about Rp 1.177.680.603. There was high financing dependency to the central government at 75% because of the low regional government commitment to financing priority programs such as MCH programs.



Maternal and child health; Cost analysis; SPM

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Pemerintah RI. Peraturan Presiden Republik Indonesia Nomor/ : 72 Tahun 2012 tentang Sistem Kesehatan Nasional. Jakarta; 2012.

WHO/WPRO. Health Economyc and Financing, Regional office for the Western Pacipic. 2005.

Dinas Kesehatan Kabupaten Nunukan. Profil Kesehatan Kabupaten Nunukan Tahun 2012. Nunukan; 2013.

Bappenas. Peraturan Presiden Republik Indo- nesia Nomor: 5 Tahun 2010 Tentang Perenca- naan Pembangunan Jangka Menengah Tahun 2010-2014. Jakarta; 2010.

Mandl U, Dierx A, Ilzkovitz F. The Effectiveness and Efficiency of Public Spending [Internet]. Economic Papers EU. Belgia; 2008. Available from: 0301.html

Mardiasmo. Akuntansi Sektor Publik. 4th ed. Yogyakarta: Andi; 2009. 4 p.

Sugiyono. Metode Penelitian Kuantitatif, Kua- litatif dan R&D. Bandung: CV. Alfabeta; 2009.

Pemerintah RI. Undang-Undang Republik Indonesia Nomor: 36 Tahun 2009 Tentang Kesehatan. Jakarta; 2009.

Pemerintah. RI. Permendagri No. 37 Tahun 2012 Tentang Pedoman Penyusunan Anggaran Dan Belanja daerah Tahun Anggaran 2013. Jakarta; 2012.

Trisnantoro L. Pelaksanaan Desentralisasi Kesehatan di Indonesia 2000-2007. Mengkaji Pengalaman dan Skenario Masa Depan. Trisnantoro L, editor. Yogyakarta: BPFE; 2009.

Dodo D, Riyarto S. Analisis Pembiayaan Program Ibu Dan Anak Bersumber Pemerintah Dengan Pendekatan Health Account. Kebijak Kesehat Indones. 2012;01(01):13–23.

Kurniawan M, Harbianto D, Purwaningrum D, Marthias T. Evidence-based budgeting policy in maternal and child health programme: do they work? BMC Public Health [Internet]. BioMed Central Ltd; 2012 [cited 2014 Dec 31];12(Suppl 2):A31. Available f rom: http://

Gani A. Pedoman dan Modul Pelatihan District Health Account (DHA) untuk Tingkat Kabupaten/ Kota. Jakarta: Pusat Kajian Ekonomi dan Kebijakan Kesehatan FKMUI, AusAID-Jakarta, PPJK Depkes; 2009.

Ali AA a, Osman MM, Abbaker AO, Adam I. Use of antenatal care services in Kassala, eastern Sudan. BMC Pregnancy Childbirth [Internet]. BioMed Central Ltd; 2010 Jan [cited 2014 Oct 7];10(1):67. Available from: http://www. 2987884&tool=pmcentrez&rendertype=abstract

Trisnantoro L, Atmawikarta A, Marhaeni D, Harbianto D. Desentralisasi Fiskal di Sektor Kesehatan dan Reposisi Peran Pusat dan Dae- rah Dalam Pelaksanaan Desentralisasi Kese- hatan di Indonesia 2000-2007- Mengkaji Peng- alamam dan Skenario Masa Depan. 2nd ed. Trisnantoro L, editor. Yogyakarta: BPFE; 2009.

Witter, Sophie; Garshong, Bertha; Ridde V. An exploratory study of the policy process and early implementation of the free NHIS coverage for pregnant women in Ghana. Int J Equity Health. 2013;12(1):16.

Kemenkes RI. Peraturan Menteri Kesehatan RI Nomor 75 Tahun 2014 Tentang Pusat Kesehatan Masyarakat. Jakarta; 2014.

Kemenkes RI. Peran Pembiayaan Kesehatan Dalam Membangun Kualitas Hidup Manusia di Indonesia [Internet]. 2015 [cited 2015 Jun 4]. Available from: update-terms-of-reference-2nd-indonesian health-economics-association-inahea-congress- and-world-health-day-2015.html

Toure K. Save Lives/ : Invest in Midwives Knowledge Summary/ : Women ’ S and Children ’ S Health. World Health. 2011;1–4.

Depkes.RI. Rencana Strategis Kementerian Kesehatan Tahun 2010-2014. Jakarta: Kementerian Kesehatan; 2010.

Mohammed A a, Elnour MH, Mohammed EE, Ahmed S a, Abdelfattah AI. Maternal mortality in Kassala State - Eastern Sudan: community- based study using Reproductive age mortality survey (RAMOS). BMC Pregnancy Childbirth [Internet]. BioMed Central Ltd; 2011;11(1):102. Available from: 1471-2393/11/102


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