EVALUATING THE IMPLEMENTATION OF MATERNAL AND CHILD HEALTH PROGRAMS IN REMOTE AREAS THROUGH A HEALTH SYSTEM STRENGTHENING APPROACH

Abstract

This study aims to analyze the role of nurses’ clinical competence in the This study aims to evaluate the implementation of the Maternal and Child Health (MCH) Program in remote areas through a Health System Strengthening approach, with particular emphasis on the capacity of the health system to support program sustainability. A qualitative method with a descriptive–analytical design was employed, as this approach enables an in-depth exploration of policy implementation dynamics, interactions among actors, and structural challenges within the health system that cannot be adequately captured through quantitative methods. The study was conducted in a remote region of Indonesia characterized by limited geographical accessibility and relatively low maternal and child health indicators. Ten informants were purposively selected based on their direct involvement and strategic roles in program planning, implementation, and supervision. These informants included MCH program managers at the health office level, leaders of healthcare facilities, frontline health workers delivering MCH services, and personnel involved in monitoring and evaluation systems. The findings indicate that the implementation of the MCH program continues to face systemic structural challenges, particularly related to human resource constraints, healthcare facility limitations, governance issues, and the suboptimal utilization of health information systems. This study recommends integrated and sustainable health system strengthening as a key strategy to enhance the effectiveness of MCH programs in remote settings.