In e na ional Jou nal o Social Science and Human Resea ch
ISSN (p in ): 2644-0679, ISSN (online): 2644-0695
Volume 08 Issue 11 No embe 2025
DOI: 10.47191/ijssh / 8-i11-70, Impac ac o - 8.007
Page No: 9099-9102
IJSSHR, Volume 08 Issue 11 No embe 2025 www.ijssh .in Page 9099
Implemen a ion o he Minis e o Heal h Regula ion Policy Numbe 29 o
2017 in P e en ing B eas and Ce ical Cance a he Sungai Besa
Communi y Heal h Cen e , Ke apang Regency
Suha di
Pos g adua e P og am o Public Adminis a ion, Facul y o Social and Poli ical Sciences, Tanjungpu a Uni e si y
ABSTRACT: This s udy aims o analyze he implemen a ion o he Minis e o Heal h Regula ion No. 29 o 2017 conce ning B eas
and Ce ical Cance P e en ion a he Sungai Besa Communi y Heal h Cen e (Puskesmas), Ke apang Regency. The esea ch
me hod used a desc ip i e quali a i e app oach wi h Edwa d III's implemen a ion heo y, which encompasses communica ion,
esou ces, disposi ion, and bu eauc a ic s uc u e. The esul s indica e ha policy implemen a ion has p og essed qui e well,
especially in communica ion and disposi ion aspec s, bu aces challenges in human esou ces and acili ies. These indings imply
he need o s eng hened coo dina ion and budge suppo o s eng hen he sus ainabili y o he ea ly de ec ion p og am.
KEYWORDS: Policy Implemen a ion; Minis e o Heal h Regula ion No. 29 o 2017; B eas Cance ; Ce ical Cance .
INTRODUCTION
B eas and ce ical cance a e wo ypes o cance wi h he highes p e alence and mo ali y a es among women wo ldwide.
Acco ding o GLOBOCAN da a (2020), he e we e 2.2 million new cases o b eas cance and 604,000 cases o ce ical cance ,
wi h mo e han 80% o cases occu ing in de eloping coun ies, including Indonesia. In Indonesia, he cance incidence a e eached
136.2 pe 100,000 popula ion, wi h b eas cance (42.1/100,000) and ce ical cance (23.4/100,000) being he leading causes o
dea h in women.
To educe his incidence, he go e nmen issued Minis e o Heal h Regula ion No. 29 o 2017 conce ning Guidelines o B eas
and Ce ical Cance Managemen . This policy emphasizes he impo ance o ea ly de ec ion h ough he SADANIS and VIA
me hods in p ima y ca e acili ies. Howe e , sc eening implemen a ion in Indonesia s ill alls sho o he na ional a ge . A 2017
epo om he Indonesian Minis y o Heal h shows ha VIA sc eening co e age only eached 8.1% o he 80% a ge .
A simila si ua ion occu ed in Ke apang Regency, whe e SADANIS and VIA co e age in 2024 was only 4,059 ou o a a ge
o 92,597 women aged 30–50. A he Sungai Besa Communi y Heal h Cen e , only 225 indi iduals we e sc eened, wi h ou b eas
umo s and one posi i e VIA case ound. This indica es ha p og am implemen a ion emains low and subop imal.
Obs acles aced include limi ed ained pe sonnel, inadequa e in as uc u e, and low communi y pa icipa ion. Al hough he
Communi y Heal h Cen e has ecei ed ull acc edi a ion, policy implemen a ion has been subop imal due o ine ec i e
communica ion, esou ces, implemen e disposi ion, and bu eauc a ic s uc u e. Based on hese ac o s, his s udy is c ucial o
analyze he implemen a ion o Minis e o Heal h Regula ion No. 29 o 2017 in he b eas and ce ical cance ea ly de ec ion p og am
a he Sungai Besa Communi y Heal h Cen e , and o iden i y suppo ing and inhibi ing ac o s in i s implemen a ion o p o ide
ecommenda ions o imp o ing he p og am's e ec i eness in he u u e. The implemen a ion o b eas cance con ol p og ams
has inc easingly emphasized ea ly de ec ion, sys ema ic sc eening, and in eg a ed ea men pa hways as key s a egies o educe
mo ali y. Acco ding o he WHO Global B eas Cance Ini ia i e F amewo k (2021), coun ies a e encou aged o adop h ee co e
pilla s: (1) heal h p omo ion and ea ly diagnosis, (2) imely b eas imaging and pa hology, and (3) comp ehensi e ea men .
E idence shows ha popula ion-based mammog aphy sc eening when implemen ed alongside s eng hened p ima y ca e e e al
sys ems signi ican ly imp o es s age-a -diagnosis and long- e m su i al in low-, middle-, and high-income se ings (Wo ld Heal h
O ganiza ion, 2021). Addi ionally, he In e na ional Agency o Resea ch on Cance (IARC) epo s ha o ganized sc eening
p og ams a e mo e e ec i e han oppo unis ic sc eening due o be e co e age, equi y, and quali y assu ance mechanisms (IARC,
2016). These p og amma ic elemen s highligh he impo ance o go e nance, esou ce alloca ion, and quali y con ol in
implemen ing e ec i e b eas cance con ol s a egies.
Implemen a ion o he Minis e o Heal h Regula ion Policy Numbe 29 o 2017 in P e en ing B eas and Ce ical
Cance a he Sungai Besa Communi y Heal h Cen e , Ke apang Regency
IJSSHR, Volume 08 Issue 11 No embe 2025 www.ijssh .in Page 9100
Simila ly, ce ical cance con ol p og ams ely hea ily on he in eg a ion o HPV accina ion, e idence-based sc eening, and
imely ea men o p ecance ous lesions. The WHO Global S a egy o Accele a e he Elimina ion o Ce ical Cance (2020)
ecommends a “90-70-90” app oach: 90% HPV accina ion co e age, 70% sc eening co e age wi h high pe o mance es s, and
90% access o ea men o de ec ed lesions. S udies highligh ha HPV accina ion pa icula ly when deli e ed h ough
schoolbased o communi y ou each p og ams subs an ially educes he incidence o high- isk HPV in ec ions and ce ical
in aepi helial neoplasia (WHO, 2020). Meanwhile, scale-up o HPV DNA es ing has been shown o inc ease de ec ion o
p ecance ous condi ions compa ed o adi ional Pap smea s, especially in low- esou ce con ex s (Wo ld Heal h O ganiza ion, 2020).
E ec i e implemen a ion he e o e depends on c oss-sec o coo dina ion, ained heal h wo ke s, communi y engagemen , and
sus ainable inancing o ensu e accina ion, sc eening, and ea men se ices each he in ended popula ions.
METHOD
This esea ch employed a quali a i e app oach wi h desc ip i e me hods. The esea ch loca ion was he Sungai Besa Communi y
Heal h Cen e (Puskesmas) in Ke apang Regency. The in o man s included he Head o he Communi y Heal h Cen e , he
Coo dina ing Midwi e, he Doc o in Cha ge o he P og am, cad es, and communi y ep esen a i es. Da a collec ion echniques
included in-dep h in e iews, di ec obse a ion, and documen a ion s udies.
This a ea was selec ed because i has an ac i e ea ly cance de ec ion p og am, ye s ill aces policy implemen a ion challenges.
Da a analysis was conduc ed using Edwa d III's implemen a ion heo y, which encompasses ou main a iables:
communica ion, esou ces, disposi ion, and bu eauc a ic s uc u e.
RESULT AND DISCUSSION
Communica ion in P e en ing B eas and Ce ical Cance a he Sungai Besa Communi y Heal h Cen e
The implemen a ion o b eas and ce ical cance p e en ion p og ams can be analyzed h ough he lens o Edwa d III’s policy
communica ion dimension, which emphasizes cla i y, consis ency, accu acy, and con inui y o in o ma ion deli e ed o
implemen e s and a ge g oups. In he con ex o cance p e en ion, e ec i e communica ion de e mines whe he HPV accina ion
campaigns, ce ical sc eening ini ia i es, and b eas cance ea ly de ec ion p og ams a e unde s ood and accep ed by bo h heal h
wo ke s and he communi y. When policy messages a e con eyed clea ly om na ional guidelines o local heal h cen e s
implemen e s can be e ansla e p o ocols in o ac ionable s eps, such as scheduling sc eening, educa ing women abou isk ac o s,
o managing pa ien ollow-up. Con e sely, agmen ed o inconsis en communica ion, such as unclea e e al pa hways o
con adic o y messages abou sc eening me hods, o en leads o low pa icipa ion a es, delayed diagnosis, and educed p og am
e ec i eness. The e o e, aligning communica ion ac oss s akeholde s go e nmen agencies, public heal h o ice s, midwi es,
communi y o ganiza ions, and media channels is essen ial o ensu e ha cance p e en ion policies a e no only dissemina ed
e ec i ely bu also in e p e ed uni o mly. This unde sco es Edwa d III’s a gumen ha communica ion is a ounda ional de e minan
o success ul policy implemen a ion, shaping how p e en i e p og ams a e pe cei ed, execu ed, and sus ained wi hin he heal h
sys em.
Communica ion is a key ac o in policy implemen a ion. Based on esea ch indings, communica ion om he Ke apang
Regency Heal h O ice o he Sungai Besa Communi y Heal h Cen e is conduc ed h ough ci cula s, coo dina ion mee ings, and
echnical aining. Howe e , in o ma ion dissemina ion o he public emains limi ed due o a lack o p omo ional media and heal h
educa o s.
Cad es and midwi es a e a he o e on o dissemina ing in o ma ion abou ea ly cance de ec ion, bu he wide co e age a ea
means ha in o ma ion has no ye eached all le els o socie y. The cla i y o he policy message is qui e good, bu consis ency in
implemen a ion a he ield le el s ill needs o be s eng hened h ough echnical guidance and egula supe ision.
Resou ces in P e en ing B eas and Ce ical Cance a he Sungai Besa Communi y Heal h Cen e
The implemen a ion o b eas and ce ical cance p e en ion p og ams wi hin he policy esou ces aspec o Edwa d III’s heo y
highligh s he c i ical ole o adequa e inancial, human, and in as uc u al esou ces in ansla ing policy objec i es in o e ec i e
ac ion. In many con ex s, he success o HPV accina ion campaigns, ce ical cance sc eening wi h VIA o HPV-DNA es s, and
b eas cance ea ly de ec ion se ices depends hea ily on he a ailabili y o ained heal h pe sonnel, su icien medical supplies,
and unc ioning diagnos ic equipmen . When esou ces a e limi ed such as sho ages o accines, inadequa e labo a o y capaci y, o
insu icien unding o communi y ou each p og am implemen a ion becomes inconsis en and co e age a es emain low.
Con e sely, when go e nmen s alloca e s able budge s, p o ide con inuous aining o midwi es and public heal h wo ke s, and
ensu e he a ailabili y o sc eening ools and ea men acili ies, p e en ion p og ams demons a e highe e ec i eness and
communi y each. Thus, he esou ce dimension unde sco es Edwa d III’s asse ion ha e en well-designed policies canno be
success ully implemen ed wi hou he ma e ial, echnical, and o ganiza ional capaci ies needed o suppo hem, making esou ce
adequacy a decisi e ac o in educing mo bidi y and mo ali y om b eas and ce ical cance .
Implemen a ion o he Minis e o Heal h Regula ion Policy Numbe 29 o 2017 in P e en ing B eas and Ce ical
Cance a he Sungai Besa Communi y Heal h Cen e , Ke apang Regency
IJSSHR, Volume 08 Issue 11 No embe 2025 www.ijssh .in Page 9101
Limi ed esou ces a e a majo challenge in policy implemen a ion. The numbe o heal h wo ke s in ol ed in he ea ly de ec ion
p og am is s ill small and hei wo kload is qui e high. Fu he mo e, suppo ing acili ies, such as VIA es ki s, a e insu icien o
mee se ice needs.
F om a inancial pe spec i e, he p og am budge elies on suppo om he local go e nmen and Heal h Ope a ional Assis ance
(BOK) unds, which a e s ill limi ed. The e o e, inc easing he capaci y o heal h wo ke s and p o iding adequa e in as uc u e a e
key o acili a ing policy implemen a ion.
Disposi ion (Implemen e A i ude) in P e en ing B eas and Ce ical Cance a he Sungai Besa Communi y Heal h Cen e
The implemen a ion o b eas and ce ical cance p e en ion p og ams wi hin he policy disposi ion aspec o Edwa d III’s
heo y emphasizes he a i udes, commi men , and willingness o on line implemen e s o ca y ou policy di ec i es e ec i ely.
In his con ex , he success o HPV accina ion, VIA o HPV-DNA sc eening, and b eas cance ea ly de ec ion ini ia i es elies no
only on o mal guidelines bu also on he mo i a ion and belie s o heal h wo ke s, including midwi es, nu ses, physicians, and
communi y heal h olun ee s. When implemen e s hold posi i e a i udes such as belie ing in he impo ance o ea ly de ec ion,
us ing he e ec i eness o HPV accines, and eeling esponsible o communi y heal h hey a e mo e p oac i e in ou each, pa ien
educa ion, and ollow-up se ices. Con e sely, hesi ancy, lack o con idence in sc eening me hods, o low mo i a ion due o
wo kload o insu icien incen i es can weaken p og am execu ion, esul ing in poo communi y pa icipa ion and gaps in p e en ion
e o s. Thus, disposi ion shapes how policies a e in e nalized and p ac iced on he g ound, demons a ing Edwa d III’s a gumen
ha implemen e s’ alues and commi men signi ican ly in luence whe he b eas and ce ical cance p e en ion policies achie e
meaning ul heal h ou comes.
The a i ude and commi men o policy implemen e s a he Sungai Besa Communi y Heal h Cen e a e conside ed good. The
Head o he Communi y Heal h Cen e demons a es leade ship ha suppo s policy implemen a ion, while heal h wo ke s a e highly
awa e o he impo ance o ea ly cance de ec ion. Howe e , he wo k mo i a ion o some implemen e s is s ill in luenced by ex e nal
ac o s such as incen i es and wo kload.
Rewa ds and mo i a ional ein o cemen a e needed o main ain he en husiasm o implemen e s o consis en ly implemen he
policy. In gene al, he implemen e 's disposi ion demons a es a alignmen be ween he policy objec i es and he implemen e s'
alues.
Bu eauc a ic S uc u e in P e en ing B eas and Ce ical Cance a he Sungai Besa Communi y Heal h Cen e
The implemen a ion o b eas and ce ical cance p e en ion p og ams wi hin he bu eauc a ic s uc u e aspec o Edwa d III’s
heo y highligh s how o ganiza ional a angemen s, lines o au ho i y, and s anda d ope a ing p ocedu es shape he e ec i eness o
p og am deli e y. In p ac ice, p e en ion e o s such as HPV accina ion, VIA o HPV-DNA sc eening, and b eas cance ea ly
de ec ion ely on a coo dina ed s uc u e ha links na ional heal h au ho i ies, p o incial heal h o ices, dis ic heal h agencies, and
on line heal h acili ies. A clea bu eauc a ic s uc u e wi h well-de ined oles, s eamlined e e al pa hways, and in eg a ed
epo ing sys ems enables e icien coo dina ion o esou ces, moni o ing, and se ice deli e y. Howe e , o e ly igid hie a chies,
agmen ed esponsibili ies, o unclea decision-making channels can c ea e bo lenecks, slow esponses o supply sho ages, and
p oduce inconsis encies be ween policy in en and local implemen a ion. S eng hening e ical and ho izon al coo dina ion,
imp o ing in e ope abili y o heal h in o ma ion sys ems, and simpli ying adminis a i e p ocedu es he e o e become essen ial o
ensu e ha p e en ion p og ams ope a e smoo hly. This illus a es Edwa d III’s a gumen ha bu eauc a ic s uc u e di ec ly
in luences policy ou comes, as he abili y o ins i u ions o wo k cohesi ely de e mines he each, quali y, and sus ainabili y o b eas
and ce ical cance p e en ion e o s.
The bu eauc a ic s uc u e a he Sungai Besa Communi y Heal h Cen e suppo s policy implemen a ion. The di ision o du ies
be ween doc o s, midwi es, and cad es is clea , and is suppo ed by S anda d Ope a ing P ocedu es (SOPs) ha go e n ac i i y
implemen a ion. Howe e , coo dina ion ac oss p og ams such as ma e nal and child heal h (MCH), heal h p omo ion, and labo a o y
se ices s ill needs o be s eng hened.
Fu he mo e, he epo ing mechanism o he esul s o ea ly cance de ec ion ac i i ies is no op imal due o limi ed in o ma ion
sys ems and high adminis a i e bu dens. Da a in eg a ion and simpli ica ion o he epo ing sys em a e needed o imp o e he
e ec i eness o policy implemen a ion.
CONCLUSIONS
The implemen a ion o Minis e o Heal h Regula ion No. 29 o 2017 a he Sungai Besa Communi y Heal h Cen e has
gene ally gone well. Communica ion and he disposi ion o implemen e s a e key s eng hs, while limi ed esou ces and bu eauc a ic
coo dina ion emain majo obs acles.
To imp o e he e ec i eness o he policy, he ollowing is needed:
1. Capaci y building and aining o heal hca e wo ke s
2. S eng hening c oss-sec o communica ion and ou each media
Implemen a ion o he Minis e o Heal h Regula ion Policy Numbe 29 o 2017 in P e en ing B eas and Ce ical
Cance a he Sungai Besa Communi y Heal h Cen e , Ke apang Regency
IJSSHR, Volume 08 Issue 11 No embe 2025 www.ijssh .in Page 9102
3. Sus ainable budge suppo om local go e nmen s
4. Imp o emen o SOPs and digi al-based epo ing sys ems
Wi h hese e o s, i is hoped ha he ea ly de ec ion p og am o b eas and ce ical cance can un mo e op imally and
sus ainably, and educe cance mo ali y among women in Indonesia.
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