Understanding the Challenges of Cadres in Supporting Integrated Primary Healthcare Policy
Yuditha Nindya Kartika Rizqi, Lu^lu Nafisah, Leni Maryati, Eri Wahyuningsih, Agnes Fitria Widiyanto, Iik Sartika, Nabela Putri Yanuari, Nur Intan Kartika Sari

Public Health Department, Faculty of Health Sciences, Universitas Jenderal Soedirman

Abstract

Introduction: Integrated Primary Healthcare (IPHC) policy aims to strengthen community-based health services through a life-cycle approach. Community health cadres serve as frontline implementers, particularly in organizing Integrated Service Posts (ISP) under the supervision of public health centers. Despite their pivotal role, cadres face challenges that may hinder policy implementation. This study aims to identify and explore the challenges faced by community health cadres in implementing IPHC policy.
Method: A qualitative study with a phenomenological design was conducted. Data were collected through focus group discussions (FGDs) with active cadres across several ISPs Panembangan Village, Cilongok, Banyumas. Thematic analysis was applied to identify recurring issues and challenges.
Result: Cadres were generally experienced and trained by the District Health Office, functioning as the first gatekeepers in monthly ISP activities. While they acknowledged the benefits of IPHC, several challenges emerged. Reporting was burdensome as cadres were required to submit both online reports using personal gadgets and internet, as well as written hard-file reports. ISP facilities were inadequate, with many activities conducted at cadres^ houses due to the absence of designated buildings. This limited space often led to long queues and discomfort for community members. Although cadres received incentives, financial support from village funds remained insufficient to provide essential infrastructure such as tables, chairs, and digital tools for reporting.
Conclusion: Cadres play a crucial role in IPHC, but their work is constrained by reporting burdens, limited infrastructure, and insufficient funding. Recommendations include simplifying reporting systems, strengthening financial and facility support through village and local government budgets, and enhancing cadres^ capacity to sustain effective IPHC implementation.

Keywords: Integrated Primary Healthcare, Community Health Cadres, Integrated Service Post

Topic: Public Health Sciences