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Karsana Karsana
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Analysis of JKN Policy Implementation in Improving Access and Equity of Community Health Services in North Sumatra, Medan Karsana Karsana; Cahya Aisyah Daulay
Journal of Innovative and Creativity Vol. 6 No. 1 (2026)
Publisher : Fakultas Ilmu Pendidikan Universitas Pahlawan Tuanku Tambusai

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Abstract

Background: The National Health Insurance program (Jaminan Kesehatan Nasional/JKN), launched in January 2014 under the Social Security Administering Body (BPJS Kesehatan), represents Indonesia's most ambitious universal health coverage initiative. Despite over a decade of implementation, significant disparities in healthcare access and quality persist, particularly in North Sumatra, where socioeconomic heterogeneity, geographic diversity, and administrative complexities create unique challenges to equitable health service delivery. Methods: This study employed a qualitative phenomenological approach using the Colaizzi method to explore lived experiences of JKN implementation stakeholders. Data were collected from September to December 2025 in Medan, North Sumatra, through in-depth interviews and focus group discussions with 32 purposively selected participants including BPJS Kesehatan administrators (n=6), primary healthcare center (Puskesmas) staff (n=10), JKN beneficiaries (n=12), and health policymakers (n=4). Data saturation was achieved at the 28th participant. Thematic analysis was supported by NVivo 12 software, and trustworthiness was ensured through triangulation, member checking, and peer debriefing. Results: Three core themes emerged: (1) Structural and Administrative Barriers to Access, encompassing bureaucratic complexity, referral system bottlenecks, and digital literacy gaps among rural populations; (2) Equity Gaps in Service Distribution, reflecting disparities between urban Medan and peri-urban districts in specialist availability and facility quality; and (3) Stakeholder Perceptions of JKN Efficacy, revealing mixed experiences among beneficiaries with financial protection acknowledged but service quality concerns prominent. Conclusion: While JKN has achieved substantial coverage expansion in Medan, structural inequities, administrative bottlenecks, and geographic disparities continue to undermine equitable health service access. Targeted policy reforms addressing referral system efficiency, healthcare workforce distribution, and digital health integration are urgently needed to realize the program's universal health coverage objectives
Pemberdayaan Masyarakat Dalam Keikutsertaan Pasangan Usia Subur Menjadi Aseptor KB di Kelurahan Ladang Bambu Kecamatan Medan Tuntungan Karsana Karsana; Widia Astuti Tanjung
Journal of Community Development Vol. 3 No. 3 (2023): April
Publisher : Indonesian Journal Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47134/comdev.v3i3.218

Abstract

The use of family planning (KB) methods by couples of childbearing age is an important step in regulating pregnancy and maintaining reproductive health. However, the successful use of family planning relies heavily on the knowledge of PUS about contraceptive methods as well as their participation in using contraceptives consistently. Lack of knowledge and proper participation can lead to unwanted pregnancies and even trigger abortions.To improve the understanding of PUS about family planning, a health education program was implemented in Kelurahan Ladang Bambu, Medan Tuntungan sub-district in 2023. This education provided information on various contraceptive methods and how to use them correctly, so that PUS can make the right decision in family planning.The results of the education activities showed an increase in PUS knowledge about contraceptives. Comparison of test results before and after the intervention showed a significant increase in knowledge by 0.37 (p<0.05). That is, there was a difference in the average pretest and posttest scores after the health education was conducted, indicating the effectiveness of the program in improving the understanding of PUS related to contraceptive methods. In conclusion, this health education program succeeded in increasing the knowledge of PUS about contraceptive methods. With better understanding, PUS can use family planning more effectively and consistently, reducing the risk of unwanted pregnancy and its implications such as abortion. This program contributes positively to family welfare and reproductive health in the community.
Pemberdayaan Masyarakat Dalam Perilaku Ibu Primigravida Trimester III Terhadap Teknik Menyusui Yang Benar di Kelurahan Ladang Bambu Kecamatan Medan Tuntungan Widia Astuti Tanjung; Karsana Karsana
Journal of Community Development Vol. 3 No. 2 (2022): December
Publisher : Indonesian Journal Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47134/comdev.v3i2.232

Abstract

Breast milk is one of the perfect and best foods for babies because it contains the nutritional elements needed by babies and is very beneficial for the baby's growth and development. Breastfeeding is one way to provide the best nutrition for babies and strengthen the bond between mother and baby. Breast milk contains immune-forming antibodies which can help fight viral bacteria so that breastfed babies are at less risk of developing diseases such as: diarrhea, asthma, allergies, ear infections, respiratory tract infections, constipation, sudden infant death syndrome and meningitis. The aim of this health education for community empowerment is to increase the knowledge of TM III pregnant women about the importance of exclusive breastfeeding. The method used in this counseling is by presenting material using lecture and demonstration methods using communication media such as leaflets. The number of respondents was 12 people, carried out on October 18 2023. Pretest and posttest were carried out to evaluate the mother's knowledge before and after counseling. The results of the evaluation of mothers' knowledge before the counseling was carried out showed that 5 people (20%) were in the good category and there was an increase in mothers' knowledge to 12 people (88%) after the counseling was in the good category.
Co-Authors Cahya Aisyah Daulay Widia Astuti Tanjung