<![CDATA[ABSTRACT The transformation of healthcare services in Indonesia has emphasized promotive and preventive approaches through the implementation of the Free Health Check-Up Program (Program Pemeriksaan Kesehatan Gratis/PKG). However, previous evaluations of health programs have predominantly focused on quantitative outcomes and have not comprehensively examined operational barriers contributing to low program achievement. This issue is important to investigate because implementation challenges at the primary healthcare level may affect the overall effectiveness of Integrated Primary Healthcare Services (Integrasi Pelayanan Kesehatan Primer/ILP). This study aimed to analyze the implementation challenges of the Free Health Check-Up Program at UPTD BLUD Pringgarata Community Health Center and identify the root causes of low program performance. The study employed a qualitative descriptive approach using a case study design and Root Cause Analysis through Fishbone Analysis based on the 6M framework, consisting of Man, Money, Method, Machine, Material, and Mechanism. Data were collected from PKG achievement reports from January to April 2026 and observations of staff workflow processes. The findings revealed that adult participant registration only reached 1,441 individuals or 6.68% of the target population of 21,581. Major barriers were identified in the Method aspect, characterized by passive service approaches; the Machine aspect, related to limited laboratory equipment and Electronic Medical Record (EMR) support devices; and the Mechanism aspect, involving double administrative recording burdens. The study concludes that low PKG achievement is influenced by systemic operational management barriers, indicating the need to strengthen active case finding strategies, digitalize service recording systems, and optimize supporting infrastructure to improve program implementation effectiveness. Abstrak Transformasi pelayanan kesehatan di Indonesia menempatkan upaya promotif dan preventif sebagai prioritas melalui implementasi Program Pemeriksaan Kesehatan Gratis (PKG), namun evaluasi program kesehatan selama ini lebih banyak berfokus pada capaian kuantitatif dan belum mendalami hambatan operasional yang menyebabkan rendahnya pencapaian sasaran layanan. Kondisi tersebut penting dikaji karena kendala implementasi di tingkat puskesmas dapat memengaruhi efektivitas Integrasi Pelayanan Kesehatan Primer (ILP). Penelitian ini bertujuan menganalisis tantangan implementasi Program Pemeriksaan Kesehatan Gratis di UPTD BLUD Puskesmas Pringgarata serta mengidentifikasi akar penyebab rendahnya capaian program. Penelitian menggunakan pendekatan deskriptif kualitatif dengan desain studi kasus dan analisis Root Cause Analysis melalui Fishbone Analysis berbasis kerangka 6M, yaitu Man, Money, Method, Machine, Material, dan Mechanism. Data diperoleh dari laporan capaian PKG periode Januari–April 2026 dan telaah proses kerja petugas. Hasil penelitian menunjukkan bahwa capaian pendaftar kelompok usia dewasa hanya mencapai 1.441 orang atau 6,68% dari target 21.581 sasaran. Hambatan utama ditemukan pada aspek Method berupa pendekatan pelayanan pasif, Machine terkait keterbatasan perangkat laboratorium dan pendukung Rekam Medis Elektronik (RME), serta Mechanism akibat beban administrasi pencatatan ganda. Penelitian menyimpulkan bahwa rendahnya capaian PKG dipengaruhi hambatan sistemik tata kelola operasional, sehingga diperlukan penguatan strategi active case finding, digitalisasi pencatatan layanan, dan optimalisasi sarana pendukung untuk meningkatkan efektivitas implementasi program.]]>
