PERAN STAKEHOLDERS DI TINGKAT PEMERINTAH DAERAH PROPINSI DAN KABUPATEN DALAM PENINGKATAN KUALITAS PELAYANAN KESEHATAN DI ERA DESENTRALISASI (Studi Kasus Penerapan SPMKK Di 8 Propinsi)

Background: The implementation of Act No. 22 and 25/1999 as amended by Act. No. 33 and 34/2004 had wider influence and implication to authority and management of the government at central, provincial, and district/municipal level. The act transfers part of the central government's authority to provinces and districts including responsibility to provide health service. Good governance and stewardship are important pre-requisite to get optimum result in the implementation of decentralization. In 2001 SPMKK was introduced as an approach to improve quality of health service especially nursing and midwifery services. The implementation in 8 provinces shows that SPMKK begins to be adopted by local government at provincial and district/municipal level that aims to improve quality of services in their region. Objective: First, to identify stakeholders that had the greatest role in efforts to improve quality of health service in their region. Second, to identify the role of stakeholders to maintain sustainability of SPMKK as one of innovative approaches in improving quality of health service and human resources for health. Method: The study was descriptive qualitative that used case study design and was undertaken in 8 provinces implementing SPMK