Development of Local Policy Capacity For Maternal And Child Health Services in Raja Ampat Regency

Abstract

Introduction: This study aims to analyze the policy capacity of the Raja Ampat Regency Government in delivering maternal and child health (MCH) services and to formulate capacity-building strategies suited to the region's archipelagic characteristics. A qualitative approach with a case study design was employed. Data were gathered through in-depth interviews, observation, documentation, and secondary data analysis. The analysis utilized a policy capacity framework encompassing analytical, operational/managerial, and political capacities at the individual, organizational, and system levels. This framework was expanded to include "geographic-adaptive capacity," as MCH service delivery in Raja Ampat is influenced by inter-island distances, marine transportation, weather conditions, communication, and unequal resource distribution. The findings indicate that Raja Ampat Regency possesses capacity assets for MCH services—including 23 community health centers (Puskesmas), health personnel, MCH programs, referral systems, political support, and a strengthened regional general hospital (RSUD). However, these assets have not been optimally translated into service delivery capacity due to disparities in health workforce distribution, data delays, uneven training, obstacles related to marine transport, weather, and communication, and a lack of institutionalized policy learning. The study reinforces the analysis by Wu, Ramesh, and Howlett—that policy success requires a combination of analytical, operational, and political capacities—and supports the findings of Mukherjee, Coban, and Bali regarding how the interplay between capacity types, design levels, and temporality influences effectiveness. Ultimately, the study proposes a "Geography-Adjusted Maternal and Child Health Policy Capacity" model that integrates analytical, managerial, political, organizational, networking, and geographic-adaptive capacities.