Background: Community Health Center (CHC) is hoped togive quality antenatal care. However, maternal and child healthcoverage in Bekasi District has not achieved the targetedstandard yet. First visit of pregnant mothers in 2006 was 87.5%and fourth visit coverage was 77.8%. There were 21 casesof maternal mortality in 2005 and only four out of 34 CHCsachieved the target of maternal and child coverage. Theseshow that maternal and child health care performance is notoptimal; therefore, improvement should be made. One ofperformance measurements is balanced scorecard whichincludes four perspectives, namely finance, costumers’satisfaction, internal business, and learning and growth.Objective: To evaluate antenatal care performance betweenhigh coverage CHC and low coverage CHC using balancedscorecard approach in Bekasi District.Method: This was an observational study with cross sectionalstudy design. Qualitative data were used in this study. Thesubjects were the head of CHCs, the midwives responsiblefor the implementation of antenatal care in maternal and childhealth room, and all pregnant mothers receiving forth visit care.The study was performed in Mekarmukti and Cibarusah CHCs.Study instruments were questionnaire, checklist, and interviewguide. Univariate analysis and bivariate analysis with chi-squaretest and stratification were used.Results: There was an association between providers’education/training and antenatal coverage (χ² = 10.015; p =0.002; PR = 4.026; CI 95% = 1.667-9.724), and patients’satisfaction (χ2 = 4.607; p = 0.032; PR = 2.516; CI 95% = 1.080-6.348), while standardized care was not related to antenatalcare coverage. Stratification analysis showed that antenatalcare coverage in Mekarmukti CHC was better than that inCibarusah CHC (χ2 = 5.662; p = 0.017; PR = 4.407; CI 95% =1.082-18.789), patients’ satisfaction in Mekarmukti CHC wasbetter than that in Cibarusah CHC (χ2 = 6.935; p = 0.008; PR =8; CI 95% = 1.256-84.624). Based on the qualitative data, therewas no difference in finance performance in both CHCs.Conclusions: There is a difference between providers’education/training and the level of patients’ satisfaction inMekarmukti and Cibarusah CHCs. There is no difference inMekarmukti and Cibarusah CHCs operational fund and standardantenatal care.Keywords: balanced scorecard, performance, antenatalcoverage

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