The Management of Posyandu Services in Providing Mealseas Rubella Vaccine at UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener

This study examines the management of posyandu services in administering mealseas rubella vaccine. The research objective was to understand how posyandu service management in administering mealseas rubella vaccine at UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency and its obstacles. The theoretical perspective used is the theory of public service management. The research method used is a qualitative research method. The results showed that the functions and principles of management have not been implemented optimally, especially in relation to service strategy indicators, while other indicators have become obstacles in the implementation of health service delivery, namely the provision of the mealseas rubella vaccine at the UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency. necessitating an increase in the active participation of puskesmas cadres in providing counseling, and a service system that must readjust to the applicable SOP. Meanwhile, the external obstacle is customers, namely recipients of the mealseas rubella vaccine, namely the public / parents who still do not want to give their children the vaccine because they are worried about the halal and haram content of the mealseas rubella vaccine.


Introduction
The health sector is a sector that must be a top priority considering that it is so important for every human being, from various existing service fields. Law No. 23 of 1992 concerning health explains that health as an element of public welfare must be realized in accordance with the ideals of the Indonesian people as referred to in the Preamble to the 1945 Constitution through sustainable national development based on Pancasila and the 1945 Constitution.
For this reason, based on the Health Law, the government is obliged to strive for health development which aims to increase the awareness, ability and ability to live a healthy life for everyone in order to realize an optimal degree of public health. The government, in this case, has the duty and responsibility to organize health efforts that are evenly distributed and affordable to the community.
It is known that all this time the posyandu has been serving vaccines for children under five. Since 2017 there have been rumors that there are vaccines that contain dangerous ingredients, one of which is the mealseas rubella vaccine, which has been considered to have dangerous ingredients in its composition. Many people are worried about vaccinating their children. Mealseas rubella is one of the immunizations given to babies to adolescents with a maximum age of 15 years, with the aim of protecting children from congenital disorders such as hearing loss, vision problems, heart defects, and mental retardation caused by rubella infection during pregnancy by the mother the childs.
This circulating issue affects the services provided by the posyandu so that the Indonesian Ulama Council has also issued a fatwa that the rubella mealseas immunization is halal and allowed for children, but in reality the community is still too afraid to carry out and immunize their children and there has been a decrease in the number of service recipients. mealseas rubella vaccine, such as the posyandu at the UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency. This issue has an impact on the management of posyandu services that must be improved in administering the mealseas rubella vaccine so that people want to bring their children back to be vaccinated. So that researchers are interested in

Literature Review
Theory is a very important foundation in understanding, interpreting and interpreting data, therefore to facilitate the interpretation of the data in this study, the authors use several theories as follows:

Public Service Management
Manullang and Siagian (2015: 80) state that management is the art and science of planning, organizing, arranging, directing and assigning human resources to achieve predetermined goals. Meanwhile, Gibson, Donelly and Ivancevich (2015: 80) define management as a process carried out by one or more individuals to coordinate various other activities to achieve results that cannot be achieved if one individual acts alone. Ivancevich, Lorensi, Skinner and Crosby (2015: 80) define service as an invisible (intangible) product that involves human efforts and uses equipment. Meanwhile, Groonros (2015: 80) states that service is an activity or a series of invisible activities that occur as a result of interactions between consumers and employees or other things provided by service providers that are intended to solve consumer/customer problems.
From the above definitions, service management can be defined as the process of applying science and art to formulate plans, implement plans, coordinate and complete service activities in order to achieve service goals.

Methods
This research uses qualitative research with a descriptive analysis approach, because the problem is very comprehensive, in-depth and very broad. Data collection was carried out by observation, interviews and documentation.

Results and Discussion
UPTD Puskesmas DTP Buntul Kemumu, Permata Subdistrict, Bener Meriah Regency, in administering melaseas rubella vaccine, carries out service management for posyandu that provides vaccines to the community. In its implementation, there are obstacles. Researchers analyzed the problems that occurred using the Allbrechy and Bradford public service triangle management model with the public service triangle indicators including service strategies, human resources, service systems, and customers.
The problem that occurs is that the circulating issue affects the services provided by the posyandu so that the Indonesian Ulema Council has also issued a fatwa that immunization of rubella is halal and allowed for children, but in fact the community is still too afraid to pass and immunize their children and it happens a lot a decrease in the number of recipients of the rubella mealseas vaccine service, such as the posyandu at the UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency. This issue has an impact on the management of posyandu services that must be improved in administering the mealseas rubella vaccine so that people want to bring their children back to be vaccinated.
Based on the research results it is known that the functions and principles of service management, one of which is service strategy, service strategy has not been maximally implemented. UPTD Puskesmas DTP Buntul Kemumu implements a service strategy in various ways including socialization, counseling, immunization campaigns for the mealseas rubella vaccine, running the BIAS program for school children, even though it is known that there are still very few children who get the mealseas rubella vaccine in Permata District. As well as the main obstacle in implementing the service strategy is related to hoax information circulating in the community which is still fussing about the halal and haram of vaccines.
Allbrechy and Bradford's public service triangle management model means that organizations engaged in services that are successful and optimal in providing services have three important elements as a driving force, including a well-structured service strategy, customer-oriented front lines, service systems a friendly one. Each service provider organization must manage these three factors to achieve customer satisfaction. The interaction of these three factors with customers will determine the success of management and service performance of the organization.
Based on the research results, it is known that the service strategy has been implemented maximally by the UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency. Human resources that are owned, namely cadres are required to participate more actively in providing counseling so that the community understands better the benefits of giving the mealseas rubella vaccine to children. The next indicator is a service system based on SOP and implemented using simple, participatory, fair, sustainable and transparent public service management principles by the UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency.
Based on the research results, it is known that the internal obstacles originate from human resources at the UPTD Puskesmas DTP Buntul Kemumu. Human resources at the UPTD Puskesmas DTP Buntul Kemumu, Permata Subdistrict, Bener Meriah Regency are not the obstacles that give the biggest cause of the decline in the number of recipients of the rubella mealseas vaccine, but the active role of cadres who have not been maximal in providing counseling has made human resource indicators fall into service management barriers health namely giving mealseas rubella vaccine to the public.
The next public service management indicator is the service system. Based on the results of the study, it is known that the service system for administering mealseas rubella vaccine by the UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency is carried out based on the applicable standard operating procedures. Then the service system for administering the mealseas rubella vaccine to the community uses the principles of public service management including simple, participatory, sustainable, transparent, and adhering to the principles of justice.
External barriers that make the mealseas rubella vaccine not optimal are indicators of customers. Customers are health service users, namely the people of Permata District, Bener Meriah Regency. Based on the results of the study, it is known that customers or recipients of health services themselves, namely people who refuse to give their children the mealseas rubella vaccine because they are considered haram, even though the health office and MUI have explained that this vaccine is halal and recommended to be given to children.

Conclusions
Based on the research results above, it can be concluded as follows: 1. The functions and principles of public service management at UPTD Puskesmas DTP Buntul Kemumu, Permata District, Bener Meriah Regency are still not maximally implemented, especially in their service strategies. 2. Internal barriers include human resources and service systems at UPTD Puskesmas DTP Buntul Kemumu.
Human resources at the UPTD Puskesmas DTP Buntul Kemumu, Permata Subdistrict, Bener Meriah Regency are not the obstacles that give the biggest cause of the decline in the number of recipients of the rubella mealseas vaccine, but the active role of cadres who have not been maximal in providing counseling has made human resource indicators fall into service management barriers health namely giving mealseas rubella vaccine to the public. The service system for administering the mealseas rubella vaccine is carried out based on applicable standard operating procedures. Then the service system for administering the mealseas rubella vaccine to the community uses the principles of public service management including simple, participatory, sustainable, transparent, and adhering to the principles of justice. 3. External barriers that make the mealseas rubella vaccine not optimal are indicators of customers.
Customers are health service users, namely the people of Permata District, Bener Meriah Regency. Customers or recipients of health services, namely people who refuse their children to be given the rubella mealseas vaccine because they think the vaccine is haram, even though the health office and MUI have explained that this vaccine is lawful and it is recommended to be given to children.

Recommendations
1. It is hoped that the UPTD Puskesmas DTP Buntul Kemumu, Permata Subdistrict, Bener Meriah Regency can continue to maximize service strategies so that the functions and principles of service management at Puskesmas can continue to be improved, and there will no longer be a decrease in the use of mealseas rubella vaccine. 2. It is hoped that the UPTD Puskesmas DTP Buntul Kemumu, Permata Subdistrict, Bener Meriah Regency can continue to provide counseling to the community about the importance of immunization for the mealseas rubella vaccine to the community, and can increase health knowledge for cadres in order to maximize active participation as immunization cadres both at the health center and at the posyandu.