Implementation of Government Policy to Improve Midwife Competence Through CTU (Contraceptive Technology Update) Training in Palembang City

Abstract

The Contraceptive Technology Update (CTU) training is a policy instrument aimed at strengthening midwives’ competencies in family planning services. This study analyzes the implementation of the CTU training policy in Palembang City and identifies its supporting and inhibiting factors. A qualitative case study approach was employed. Data were collected through in-depth interviews, observation, and document review involving 11 informants from relevant government agencies, health facilities, and trained midwives. Data were analyzed using Miles and Huberman’s interactive model, guided by George C. Edward III’s policy implementation framework, which includes communication, resources, disposition, and bureaucratic structure. The findings indicate that the CTU training policy has been implemented but not yet optimally. Policy communication has not reached all midwives evenly; resources remain limited, particularly in terms of trainers, facilities, and budget; implementers generally demonstrate positive attitudes, yet lack strong incentives and supervision mechanisms; and bureaucratic structures reveal overlapping mandates and weak inter-agency coordination. The study highlights the need for strengthened cross-sector coordination, improved resource allocation, and integrated post-training monitoring and evaluation to ensure sustainable competency development and enhanced quality of family planning services.