Restructuring Community Integrated Health Posts (Posyandu) to Enhance Public Healthcare Service Quality: A Participatory Action Study in Rural West Java

Abstract

Community Integrated Health Posts (Posyandu) play a pivotal role in strengthening primary healthcare in Indonesia, particularly for maternal and child health monitoring. However, inadequate spatial organization, unorganized equipment management, and limited facility maintenance frequently hinder operational efficiency and service quality in rural areas. This study evaluated the implementation of a participatory restructuring initiative to enhance healthcare service delivery at Posyandu Anyer 10 in Nyalindung Village, West Java. Employing a Participatory Rural Appraisal (PRA) framework, the intervention integrated observational assessments, cadre capacity building, participatory facility redesign following the standardized five-table system, and post-implementation mentoring. The results demonstrated substantial improvements in spatial organization, administrative clarity, and equipment accessibility, which significantly reduced service preparation time and streamlined the patient workflow. Furthermore, hands-on cadre training and active community involvement fostered a strong sense of ownership and heightened awareness regarding facility maintenance. These structural and operational enhancements directly contributed to a cleaner, safer, and more comfortable environment for mothers, infants, and healthcare providers. In conclusion, combining physical facility restructuring with cadre empowerment through a participatory approach offers a sustainable model for optimizing community-based primary healthcare infrastructure in rural settings. Future initiatives should incorporate quantitative metrics, such as visitor satisfaction scores and health monitoring outcomes, to measure long-term societal impacts.