From Policy to Practice: Implementing Special Autonomy–Funded Health Services in South Papua, Indonesia

The equitable distribution of health services in rural South Papua still faces geographical challenges, as well as limitations in health personnel, facilities, and resource distribution, despite support from the Special Autonomy Fund policy. This study aims to analyze the implementation of health service policies through the Special Autonomy Fund in Kurik District, Merauke Regency, focusing on health service programs, resource strengthening, service governance, as well as factors supporting and hindering implementation. This study employs a qualitative descriptive design with informants selected through purposive sampling. Data were collected through in-depth interviews, observations, and documentation, and were then analyzed using the Miles, Huberman, and Saldaña interactive model through data condensation, data presentation, and the drawing and verification of conclusions. Data validity was strengthened through triangulation of sources, techniques, and time. The results of the study indicate that the policy has been implemented through primary health care, maternal and child health services, Posyandu (community health posts), immunization, promotive and preventive activities, outreach services, the provision of medicines and medical equipment, facility strengthening, community empowerment, and monitoring and evaluation. However, implementation has not been fully optimal due to limitations in health personnel, infrastructure, medication distribution, geographic conditions, transportation, communication, budget flexibility, and bureaucratic procedures. Government support, dedicated funding, the commitment of implementers, and community participation serve as factors that strengthen implementation. The study concludes that affirmative funding must be accompanied by the strengthening of local implementation capacity so that health services are more accessible, sustainable, and responsive to the needs of rural communities.