Desentralisasi dan Pengambilan Keputusan Kebijakan Peningkatan Gizi Balita di Kota Depok dan Kota Bogor Propinsi Jawa Barat

Background: Heywood and Choi ( 2010) found that there is only a slight increase of health system performance post decentralization. Low performance in decentralization of the health sector can be inferred from the high incidence of poor nutrition for U5 (under five) in the city of Bogor in West Java. However the city of Depok has a different situation in which they have successfully reduced poor U5 nutrient to 0% . Performance in a decentralized health system is affected by policy decisions that are influenced by decison space, institutional capacity and accountability of local government . Objective: This study aims to describe the decision-making processes for U5 nutrition based on decision space, capacity and accountability of local government institutions in the city of Depok and city of Bogor in West Java Province . Methods: This study is a qualitative case study design . In- depth understanding of the decision-making on health policy in the era of decentralization will be traced by means of in-depth interviews . Informants in this study include the Head of Department , Mayor , Chief Health Center and Head of Nutrition at the Provincial Health Office , Head of Bappeda. Results: Post Decentralization, nutrition policy decision-making process at the level of the city of Bogor and Depok conducted by larger decision space, the accountability of policy decisions in both regions showed an increase , but the capacity of public institutions and the level of participation of non- government actors as well as the institutional capacity is higher in the city of Depok than in the city of Bogor . Conclusion: Decentralization increases the decision space and accountability in health policy decision-making process. Increased institutional capacity, especially the capacity of human resources and increased levels of participation and non-government actors are needed to produce a more responsive policy decisions.