Peran Kader Posyandu Sebagai Street Level Bureaucracy Dalam Pelayanan Kesehatan Desa Plintahan

Abstract

This study aims to examine the role of Posyandu cadres as street-level bureaucracy in delivering community-based health services in Plintahan Village, Pasuruan Regency. A qualitative case study approach was employed, utilizing in-depth interviews with Posyandu cadres and healthcare professionals, participant observation during Posyandu activities, and document analysis of activity reports collected from seven Posyandu units covering the period from 2023 to early 2026. The findings reveal that Posyandu cadres perform the functions of street-level bureaucracy by exercising discretion, managing resource limitations, and implementing adaptive service strategies in the execution of community health policies. These practices are reflected in their ability to tailor health information through multiple communication channels, provide flexible service schedules, and proactively reach vulnerable populations through home visits. The study extends the application of Street-Level Bureaucracy theory to the context of community-based healthcare by demonstrating that non-formal actors, such as Posyandu cadres, also play a significant role in policy implementation through the exercise of discretion, the mobilization of social capital, and adaptive service delivery strategies. From a practical perspective, the findings underscore the importance of strengthening cadres' capacities, improving incentive mechanisms, and enhancing institutional support to ensure that community-based health services can be delivered more effectively and sustained over time.