KEBIJAKAN NASIONAL DALAM KONTEKS LOKAL: TANTANGAN IMPLEMENTASI KEBIJAKAN DESA SIAGA DAN RUJUKAN PELAYANAN KESEHATAN DI KABUPATEN

Background:One of the policies in health to achieve Indonesia Sehat 2010 was the development of desa siaga that was based on Decree of Ministry of Health number 564/MENKES/ SK/VIII/2006 regarding the guidance on the implementation of Desa Siaga. Desa Siaga is a community based health effort that involved community self funding agency such as PKK, religious organization, and private sector. Method:This was a qualitative descriptive research that used explanatory analysis with case study design. The research informant was district government, health office, community leaders and public figure as well as health care provider. The data was collected with interview, observation and documentation. Data analysis was conducted with case study analysis. Result: This research showed that the implementation of Desa Siaga was with top–down method that used social mobilization approach. The district government and community was very much supporting the policy of Desa Siaga. Difficult geographic location, limited human resources in health and limited funding were the main obstacles in the implementation of Desa Siaga policy and health service referral. The main problem of referral implementation was transportation and funding. The readiness of community and village aparatur to assist the poor community was still very minimum. Conclusion: This research proven that Desa Siaga program was very important for community in the district of Yapen archipelago. Nevertheless, difficulties in geographiccondition, limited human resources in health as well as limited funding has resulted in difficulties in the implementation of Desa Siaga policy and health service referral in the district of Yapen archipelago. The regional and central government have not been able to respond to the needs of Desa Siaga. Keyword: Policy Implementation, Desa siaga, Papua.