Implementation of ILP Through Posyandu: Gap in Life Cycle Group Coverage at Tirtomoyo I Wonogiri Health Center

Abstract

Integrasi Layanan Primer (ILP), or Primary Health Care Integration, expands Posyandu (integrated community health post) services through a life-course approach; however, expanding the target population does not necessarily ensure equitable service utilization. This study examined ILP implementation through Posyandu in terms of communication, resources, implementers' disposition, and bureaucratic structure, while identifying disparities in service coverage across life-course groups. A mixed-methods sequential explanatory design was employed. Quantitative data on Posyandu ILP visit coverage in 2025 across nine villages and urban wards within the Tirtomoyo I Community Health Center service area, Wonogiri Regency, were analyzed descriptively. Subsequently, in-depth interviews were conducted with eight informants purposively selected from two villages or urban wards. Quantitative and qualitative findings were integrated using the Edwards III policy implementation framework. The results indicated an average visit coverage rate of 61.67%, with the highest coverage among infants and toddlers (97.22%) and the lowest among adolescents (31.67%), representing a disparity of 65.55 percentage points. Qualitative findings suggested that these disparities were associated with limitations in communication, resources, and bureaucratic structure, whereas implementers generally demonstrated positive attitudes toward the program. Overall, ILP implementation through Posyandu had not achieved equitable service coverage across life-course groups. Improving coverage equity requires strengthening resource availability, developing communication strategies tailored to specific target groups, enhancing community health volunteer (kader) competencies, improving intersectoral coordination, and reinforcing organizational structures supporting program implementation.