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The Importance and Challenges of Posyandu Cadres in Public Health

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Posyandu cadres measure the height of a child at Posyandu Mawar, South Larangan, Larangan, Tangerang City, Banten, Friday (10/3/2023).

The role of posyandu or integrated service posts is increasingly being strengthened. Posyandu, which is the closest health service provider in the community, is now not limited to providing services for mothers and children, but for all life cycles.

Posyandu is responsible for ensuring that people remain healthy, from the womb, babies, children, teenagers, adults, to the elderly, both women and men. This is certainly not an easy thing, especially for health cadres who provide services at posyandu.

The increasing responsibility for posyandu cadres has not been accompanied by an increase in the number of available human resources. The Ministry of Health noted that the number of active posyandu cadres is around 780,000 people with the total number of posyandu in Indonesia currently around 300,000 posyandu. This means that each posyandu has less than three cadres on duty.

Elsita Lisnawati (35). Community empowerment is increasingly being expanded to provide services at every age according to the life cycle.

“(Criteria) Cadres are being expanded so that each age group can have its own cadre. Cadres were taken from the elderly from young mothers, while teenagers were also taken from youth youth organizations in the village. “These cadres receive guidance from sub-districts and community health centers,” he said when contacted from Jakarta, Tuesday (12/9/2023).

KOMPAS/PRIYOMBODO

Posyandu cadres weigh babies at Posyandu Mawar in RW 004 Bulak Wareng Village, South Larangan, Larangan, Tangerang City, Banten, Friday (8/4/2022).

In accordance with the duties and functions determined by the government through the Ministry of Health, posyandu services are not only provided on posyandu open days. Services are also carried out outside posyandu open days by conducting home visits and community empowerment.

The services provided by posyandu include, among other things, health education efforts, health screening according to the life cycle, as well as disease prevention efforts in the form of providing immunizations and providing additional food. When the posyandu opens, cadres are expected to encourage community involvement to obtain comprehensive services. Currently, the number of visits to posyandu is still minimal, namely less than 50 percent.

The services provided by posyandu include, among other things, health education efforts, health screening according to the life cycle, as well as disease prevention efforts in the form of providing immunizations and providing additional food.

Elsita added that the posyandu’s open day is no longer only once a month, which is usually for services for mothers and children. At least two days the posyandu is open every month, namely every 16th for the elderly posyandu and every Saturday in the second week for posyandu for toddlers and pregnant women. Meanwhile, the youth posyandu is carried out around the same time and location of youth meetings held every month.

Also read: The Big Task of Posyandu Cadres in the Midst of Limitations

In accordance with guidelines from the Ministry of Health, posyandu services for babies and toddlers are carried out by providing complete basic and advanced immunization, as well as monitoring growth and development and providing additional food. Meanwhile, services for pregnant women, postpartum women and postpartum women are provided by providing education on pregnancy checks and holding classes for pregnant women. Education is also provided to mothers who have not had postpartum visits.

Posyandu services for school age and adolescents are provided through education and counseling regarding adolescent health issues, such as reproduction and mental health. In young women, monitoring the consumption of blood supplement tablets also needs to be carried out.

KOMPAS/WISNU WIDIANTORO

Posyandu cadres measure the arm circumference of pregnant women during the Teratai Posyandu activity, RW 015 Larangan Selatan Subdistrict, Larangan, Tangerang, Banten, Saturday (18/7/2020).

Meanwhile, in the productive and elderly groups, basic health monitoring as a health screening is also carried out. This includes checking blood pressure, blood sugar, height and weight. During home visits, the condition of at-risk groups, especially groups of people with comorbidities, needs to be monitored so that their illnesses remain under control.

Previously, Minister of Health Budi Gunadi Sadikin at the National Launch of Integration of Primary Health Services and Strengthening Health Development Planning in Jakarta, Thursday (31/8/2023), said that strengthening services at posyandu for the entire life cycle is part of efforts to transform primary health services in Indonesia. It is hoped that these strengthening efforts can realize the concept of health in primary health services. Primary health care facilities must focus more on community health efforts so that people can be prevented from various diseases. That is why, the services provided are more related to promotion and prevention.

“Posyandu cadres will receive re-education regarding their role in health promotion. “The task of cadres is not only to hold activities at the posyandu once a month, but cadres must actively come from house to house to educate about clean and healthy living behavior,” said Budi.

There is no support for posyandu cadres yet

With great responsibility, posyandu cadres are now the spearhead and foundation for public health. Services at posyandu really determine the success of reducing the burden of health costs in Indonesia because more and more people can maintain their health so they don’t get sick.

Also read: Those Who Serve Without Limits

However, the increasingly heavy responsibilities for posyandu cadres have not been accompanied by strong support from various stakeholders. Health cadres in primary health care facilities, including posyandu, are still faced with welfare problems, unequal distribution, lack of training and capacity development, as well as a lack of supporting facilities for services.

KOMPAS/WISNU WIDIANTORO

Officers serve residents who come to monitor their children’s health at Posyandu Matius 25, Pondok Karya, South Tangerang, Banten, Sunday (16/6/2019).

This is at least what was reported in the 2022 Primary Health Services Foresight study by the Indonesian Academy of Sciences (AIPI) and the Center for Indonesia’s Strategic Development Initiatives (CISDI). In the study, it was also stated that there were still regional governments that were less committed to allocating budgets to improve posyandu facilities and infrastructure. Incentives for posyandu cadres have not been provided properly.

According to Elsita, incentives need to be given to posyandu cadres as a form of appreciation for the services provided to the community. “Cadres also support the government and community health centers in carrying out their duties in the field. Cadres who better understand the conditions of the people in their area. “So the welfare of cadres also needs to be considered,” he said.

That was also conveyed by Rikha Rumadas (59), a posyandu cadre in an area in Manokwari, West Papua. When met at an award ceremony for health workers from the Ministry of Health in mid-August 2023, Rikha said that the incentives given to posyandu cadres were still minimal. In fact, it is not uncommon for the costs required for the service to be paid personally by him.

However, for Rikha, more important support is the availability of better medical equipment. “We need good medical equipment. “We need digital scales because so far we have had to carry heavy hanging scales when there are posyandu services,” he said.

Founder and Chief Executive Officer of CISDI, Diah Satyani Saminarsih, said that health cadres have a wide reach and are more trusted by the public. That is why it is very important to strengthen the capacity of health cadres to become trained and certified health workers.

Also read: Solve the Basic Problems of Primary Health Care First

“Cadres also need to receive proper appreciation according to their performance and duties. “It is hoped that the government can provide cadres as health support workers and cadres will be able to get appropriate incentives,” he said.

2023-09-12 19:05:40
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