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Summary Table

Feature	Detail
Definition	A community-level integrated health service post (Lembaga Kemasyarakatan Desa/Kelurahan) managed from, by, for, and together with the community
Legal Basis	Permendagri No. 13/2024 (newest regulation); UU No. 6/2014 on Villages
Primary Targets	Infants, children under five (balita), pregnant women, postpartum/lactating mothers, couples of reproductive age (PUS/WUS), and elderly
5 Core Programs	KIA (Maternal-Child Health), KB (Family Planning), Immunization, Nutrition, Diarrhea control
Operational System	Sistem 5 Meja (5-Table System)
Personnel	Minimum 5 trained volunteer cadres (kader) per Posyandu; Table 5 staffed by Puskesmas health workers
Frequency	Once monthly at minimum; held at accessible community locations (balai desa, community hall, etc.)
Performance Indicator	SKDN system
Strata	Pratama (Red), Madya (Yellow), Purnama (Green), Mandiri (Blue)
Keywords	"Sistem 5 Meja," "SKDN," "kader Posyandu," "dari, oleh, untuk, dan bersama masyarakat," "UKBM," "dana sehat," "KMS," "Strata Posyandu," "Permendagri 13/2024"

1. Conceptual Foundation and Regulatory Framework

Posyandu originated from the 1975 PKMD (Pembangunan Kesehatan Masyarakat Desa) policy and was formally established in 1984 through a joint instruction by the Minister of Health, the Head of BKKBN, and the Minister of Home Affairs. The foundational principle is community empowerment: health services are not merely delivered to the community but are organized and run by the community itself, with technical guidance from the Puskesmas.

Under the newest regulation, Permendagri No. 13 Tahun 2024, Posyandu has undergone a notable transformation. It is now formally defined as part of the Lembaga Kemasyarakatan Desa/Kelurahan (LKD/LKK), serving as a partner of the village/kelurahan government in planning, implementing, and supervising development while improving community services. The scope of Posyandu under the 2024 regulation is broader than the traditional health-only focus. Posyandu now covers six areas aligned with the Standar Pelayanan Minimal (SPM): health, education, public works, public housing, public order and community protection, and social welfare.

This is the critical conceptual shift for exam purposes: under the old framework, Posyandu was classified as an UKBM (Upaya Kesehatan Bersumber Daya Masyarakat) focused purely on health. Under Permendagri 13/2024, it retains its health role but is embedded in a wider village governance and community empowerment structure. For the exam, expect the classic health-oriented questions (5 Meja, SKDN, Strata), but know that the regulatory umbrella has expanded.

2. The Sistem 5 Meja (5-Table System)

This is one of the most frequently tested components. It refers to 5 sequential activities carried out on Posyandu service days.

Table (Meja)	Activity	Performed By
Meja 1	Registration of balita, pregnant women, PUS/WUS	Kader
Meja 2	Weighing and anthropometric measurement (weight, height/length)	Kader
Meja 3	Recording results into KMS (Kartu Menuju Sehat) / Buku KIA	Kader
Meja 4	Individual counseling based on KMS findings (nutrition education, growth trajectory interpretation)	Kader
Meja 5	Health services: immunization, Vitamin A distribution, KB (contraceptive pills/condoms), minor treatment, referral to Puskesmas	Health worker (Nakes) from Puskesmas + Kader

Key teaching point for exams: Tables 1 through 4 are entirely kader-run. Only Table 5 involves a professional health worker (bidan desa, nurse, or Puskesmas staff). If a vignette asks who performs immunization at a Posyandu, the answer is the health worker at Table 5, not the kader alone.

The flow is strictly sequential: a mother and child arrive, register (Meja 1), get weighed/measured (Meja 2), the data is charted on the KMS (Meja 3), the kader provides personalized counseling (Meja 4), and finally the professional health worker delivers immunization, supplements, or KB services (Meja 5). Any child found to have BGM (Bawah Garis Merah) on the KMS, or whose weight fails to rise for two consecutive months, should be referred to the Puskesmas.

3. SKDN: Performance Indicators

SKDN is the standard monitoring and reporting system for Posyandu, built around balita weighing data. Each letter represents a population count:

Symbol	Meaning
S	Total number of balita (under-five children) in the entire Posyandu working area
K	Number of balita who are registered and possess a KMS / Buku KIA
D	Number of balita who actually came and were weighed during the session
N	Number of weighed balita whose weight increased (naik) compared to the previous month

From these four numbers, several proportions are derived. This is where the exam loves to test:

Indicator (Formula)	What It Measures	Target
K/S x 100%	Program coverage (Cakupan Program): how well the Posyandu reaches all balita in the area	100%
D/S x 100%	Community participation (Partisipasi Masyarakat): what proportion of all balita in the area actually come to be weighed	≥ 80%
D/K x 100%	Continuity / motivation of registered families: among those who have KMS, how many actually show up	≥ 60% (historical target)
N/D x 100%	Program success (Keberhasilan Program): among those weighed, what proportion gained weight	≥ 80%
N/S x 100%	Overall program impact: among all balita in the area, how many gained weight	Derived
(S-K)/S x 100%	Lost opportunity (Tingkat Kehilangan Kesempatan): proportion of balita who do not even have a KMS	As low as possible
(K-D)/K x 100%	Drop-out rate: balita who have KMS but no longer come for weighing	As low as possible

The relationship $S \geq K \geq D \geq N$ must always hold true. If a question provides numbers that violate this hierarchy, the data set is internally inconsistent.

When a vignette gives you SKDN data and asks "what is the problem?", apply this logic: if D/S is low, the problem is poor community participation (people are not coming). If N/D is low, the problem is program effectiveness (people come but their children are not gaining weight, suggesting a nutritional or disease burden despite services being available).

4. Strata Posyandu

The strata system classifies each Posyandu by organizational maturity and service output. This is determined through a process called Telaah Kemandirian Posyandu (Posyandu self-reliance assessment).

Strata	Color Code	Frequency	Kader Count	Coverage of 5 Core Programs	Additional Programs	Dana Sehat
Pratama	Red	< 8x/year, irregular	< 5	Low, not all programs running	No	No
Madya	Yellow	≥ 8x/year	≥ 5	≤ 50%	No	No
Purnama	Green	> 8x/year	≥ 5	> 50%	Yes (e.g., elderly health, nutrition classes)	Yes, but membership < 50% of KK in the area
Mandiri	Blue	> 8x/year	≥ 5	> 50% (comprehensive)	Yes	Yes, with membership ≥ 50% of KK in the area

The differentiator between Purnama and Mandiri is not the presence of dana sehat itself (both have it), but the proportion of households (KK) enrolled in the dana sehat scheme: < 50% = Purnama, ≥ 50% = Mandiri. Test-writers exploit this by offering answer choices that make both Purnama and Mandiri appear correct if you only check for the existence of dana sehat.

The differentiator between Pratama and Madya is primarily the number of cadres (< 5 vs. ≥ 5) and regularity of activities.

The intervention approach also differs by strata. Pratama needs the most intensive external support (kader recruitment, training from Puskesmas). Mandiri, on the other hand, needs only maintenance-level supervision to sustain its independence.

5. The 5 Core Programs (Kegiatan Pokok) and Expanded Scope

Classic 5 Core Programs (these remain the backbone of exam questions):

Program	Key Activities at Posyandu
KIA (Kesehatan Ibu dan Anak)	ANC monitoring for pregnant women, postpartum checks, growth monitoring of balita, referral for high-risk pregnancies
KB (Keluarga Berencana)	Distribution of contraceptive pills, condoms; referral for IUD/implant to Puskesmas
Immunization	Basic immunization schedule (BCG, DPT, Polio, Hepatitis B, Measles); Vitamin A high-dose drops (February and August)
Nutrition	Growth monitoring via KMS, Pemberian Makanan Tambahan (PMT) for underweight children, nutrition counseling
Diarrhea Control	Oral Rehydration Salt (oralit) distribution, hygiene education, referral for dehydrated children

Expanded programs (kegiatan tambahan/pengembangan) that Purnama and Mandiri level Posyandu may run include: Posyandu Lansia (elderly health screening for hypertension, diabetes), Bina Keluarga Balita (BKB), early childhood education (PAUD integration), clean water and sanitation programs, and dana sehat/JPKM.

Under Permendagri 13/2024, the expanded role now also formally includes education-related community activities, public infrastructure coordination, housing support, community safety, and social welfare.

6. Related Community Health Terms and Structures

Concept (Distractor)	Why It Looks Similar	Key Discriminator
Puskesmas	Both provide primary health care services at community level	Puskesmas is a government-run health facility with professional staff; Posyandu is a community-managed volunteer post that relies on kader, with Puskesmas providing only technical oversight at Meja 5
Polindes / Poskesdes	Village-level health service delivery points	Polindes/Poskesdes are staffed by a bidan desa as a resident health worker; Posyandu is staffed by volunteer kader and operates only on scheduled service days, not continuously
Desa Siaga	A village-level community health empowerment concept	Desa Siaga is the broader village readiness framework (alert village) that encompasses multiple health elements; Posyandu is one component within the Desa Siaga structure
Pos Kesehatan Pesantren (Poskestren)	Community-based health activity	Poskestren operates within Islamic boarding schools; Posyandu is a general population-based post at village/kelurahan level
UKBM (Upaya Kesehatan Bersumber Daya Masyarakat)	Posyandu was historically classified under UKBM	UKBM is the umbrella category of community-sourced health efforts. Under the 2024 regulation, Posyandu is reclassified as part of the LKD/LKK structure, though it still functions as a UKBM in practice

7. Traps and High-Yield Pearls

The most common way students lose points on Posyandu questions is by confusing the Strata criteria, particularly swapping Purnama and Mandiri. The trap is designed around dana sehat: both Purnama and Mandiri have it, but the discriminator is the enrollment rate (< 50% vs. ≥ 50% of KK). If a vignette describes a Posyandu with ≥ 5 kader, > 8 sessions/year, > 50% coverage of all five programs, additional programs running, and dana sehat with 60% of KK enrolled, the answer is Mandiri, not Purnama.

The second common trap involves the SKDN proportions. Students frequently confuse D/S (community participation) with N/D (program success). If the question states "many mothers bring their children to Posyandu, but most children are not gaining weight," the problematic indicator is N/D, not D/S. Conversely, if children in the area are malnourished but nobody is coming to Posyandu, the problem is D/S.

A third trap: the question asks "who performs immunization at Posyandu?" and provides kader as one option. The answer is the health professional (nakes) from Puskesmas at Meja 5. Kader handle Meja 1 through 4. Despite kader doing the bulk of work at Posyandu, they do not administer vaccines or medications.

Finally, remember the hierarchy of $S \geq K \geq D \geq N$. Any calculation question that gives you a scenario where D > K or N > D is testing whether you understand the logical nesting of these populations. The test-writer may embed one inconsistent number to see if you catch it.

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