Analysis on the Implementation of Delivery Assurance Programme by Village Midwives in Lumajang District

Implementation of delivery assurance (Jampersal) program in Lumajang district was not doneaccording to the technical guideline; it was not done by way of the implementation of KB afterdelivery program was done. Objective of this study was to explain the implementation of deliveryassurance program by village midwives in Lumajang district.This was an explanatory study. Main informants were two village midwives from PONED and nonPONED primary healthcare centers (puskesmas) with the highest delivery coverage, and two villagemidwives from each puskesmas with the lowest delivery coverage. Triangulation informants were 12 people. Those people were one jampersal manager from district health office, one jampersalverification person, two heads of puskesmas, and 8 jampersal patients. Data were collected throughin-depth interview and observation to polindes (village polyclinic) facility. Content analysis methodwas applied in the data analysis.Results of the study showed that activities of delivery assurance service were conducted usingminimal standard service. Delivery assurance policy was a right policy to solve health cost problems.Executors of the policy were village midwives who had competency that suited with programpurposes. Target and environment supported the program implementation. Basic indicator andpurpose of the policy were clear and understandable for village midwives. However, funding wasnot maximal, and it caused many complaints from midwives. Communication and coordinationwere adequate; however social condition and community economy did not completely support theimplementation of post-delivery KB (family planning). Funding for jampersal was very small forboth delivery assistance and consumable materials. This condition made the implementation ofprogram was only for fulfilling the responsibility.Recommended suggestions for Lumajang district health office are to provide regulations related topost-delivery KB, to do proper planning regarding resources requirement to support serviceimplementation. Monitoring on the USAge of KIA book should be done by puskesmas to minimizetechnical problems such as double claim due to using double KIA book