1. Introduction

Social capital is an interesting issue that discussed in many perspective, such as development, social, politic, economic and public administration. In public administrative science, social capital can be used as an alternative in making public policy. This is because social capital has very important role in the functioning and strengthening community life. Because of human are basically zoon politicoon who need communication and interaction each other. Their relation based on variety of interests that resulted the mutual benefit relationship. Relationship and interaction that are occured will compose social capital with the emotional bond, trust and sense of safe to achieve the goal. According to Putnam (1993) “social capital is the complex conceptualized as the network of associations, activities, or relations that bind people together as a community through norms and psychological capacities, trust, which are essential for society and produce of future action or goods in other forms of capital”.

In the context of health, social capital is very important to dig and create awareness the society to their health. According to Law Number 36 Year 2009 about Health, “Health is healthy condition, physically, mentally, spiritually and socially to enable more people live productive socially and economically”. To support the good health, needed a sustainable, creative and effective of health development. So that the health policy that is formed must to provide a scheme to tackle the health problems that occur and improve the quality of health care. Today, the implementation of health policy that exist in national level are make health card to reduce the costs for the poor and mother during childbirth and provide the health facilities and health workers in throughout the area. See this phenomenon, the policies sometimes tend to be curative rather than preventive. Although many health policies made by the government to improve the quality of health, but the independence of the community in maintaining health become the most crucial problem in the improvement of health.

See the phenomenon above, health can be defined into two concepts, namely in terms of medical and non-medical terms. In terms of medical, health is more focused on things related to modern medical equipment. While the non-medical health referred to as public health that focus on what to do to keep them healthy. According to Winslow (in Entjang, 1993) “Public health is the science and art that aims to prevent disease, prolong life and enhance the value of health”. From this opinion, can conclude that the socio-economic context has an important role for health, disease, and mortality (Pearce and Davey Smith, 2003). Public policies are made to represent what is needed by the community. This is because society as an object of the implementation of a policy. With the social capital, the government should be able to determine the characteristics, abilities and willingness of the community that based on the relationship, network, trust, values and norms that have by the community. Empirical evidence about the relationship between social capital and public health has the potential result to reduce health disparities and improve the quality of health in society. Multilevel Analysis in Sweden involving 11.175 men found that linking social capital related with health (Andersen, et.al, 2011). Individuals who live in the neighborhood with the low linking social capital indicates a higher risk for having poor health than individuals who live in the neighborhood with the high linking social capital, after controlling for the influence of individual characteristics.

One of the regency that have the crucial problem in health is Jombang Regency. Development can be said to be successful if there is a balance between human development and economic development. To measure human development using the Human Development Index (HDI) and Gross Regional Domestic Product (GRDP) to see economic development. In terms of HDI, based on the final report of HDI Jombang Regency in 2011, HDI values Jombang in 2011 amounted to 73.74. It consists of purchasing power variables 65.68, 92.92 the education variables, but the health of the variable rate has declined, it is 49,34. In terms of GRDP, based on the final report of HDI Jombang Regency in 2011, in 2010 GRDP Jombang include ADHB (cost that exist tn that area) for 14.060.872,14; ADHK (constant cost that have specified before) amounted to 6.327.278,13 and per capita ADHB at 11.693.937. Jombang’s GRDP also increased compared to the previous year which amounted 12.451.498,62 ADHB; ADHK amounted to 5.972.302,39 and per capita ADHB at 10.411.474.

Based on the HDI and GRDP Jombang Regency above, there are areas that the value of HDI and GRDP is lower than the HDI and GRDP in Jombang Regency, that is in Wonosalam Subdistrict. In the final report HDI Jombang Regency in 2011 states that HDI of Wonosalam Subdistrict only 66.59 lower than HDI of Jombang Regency that is 73.74, the 62,02 for life expectancy, 88.14 for education and 66.83 for purchasing power. According to this data that Wonosolam Subdistrict is the lowest subdistrict in the health sector. While the GRDP Wonosalam Subdistrict only 323,546.84 is still below the average of subdisrict is 463,637.49. Wonosalam Subdistrict is subdistrict in Jombang Regency with an area of 12.163 km². The population in this subdistrict of 35.561 inhabitants in 2009 as one of the subdistrict with the smallest population. Population density of Wonosalam Subdistrict also showed the lowest population density is 293 population/km².

To improve the quality of public health in Wonosalam Subdistrict, Jombang Government has also issued various policies such as health card for poor and mothers who want to childbirth. In addition, the implementation of policy to change hygienic behavior with the provision of clean public latrines in every village. There is another program, it is the alert village to increase the trust of society to keep their environment healthier. By looking at the various policies made and the facts above, why the quality of public health in the Wonosalam Subdistrict is still low. Therefore, development of public health in Wonosalam Subdistrict must be prioritized. So, to make policy about public health, policy makers must to see the implementation of social capital in Wonosalam Subdistrict.

2. Literatur Review

2.1. Social Capital

Pierre Bourdieu (1986) defines social capital as “The aggregate of the actual or potential resources which are linked to possession of a durable network of more or less institutionalized relationships of mutual acquaintance or recognition”. By this definition, Bourdieu emphasises that social capital is a product of durable relationships and that it is upheld by these relationships. James Coleman (1990) has defined social capital in a way that emphasises its relational component. He states that “Social capital is defined by its function. It is not a single entity, but a variety of different entities having two characteristics in common. They all consist of a social structure and they facilitate certain actions of individuals who are within the structure” (Coleman, 1990). Contrary to Coleman, who writes in the same strand of reciprocity-based research as Bourdieu, Robert Putnam perceives of social capital as stationary and measurable. He defines social capital as “features of social organization such as networks, norms, and social trust that facilitate coordination and cooperation for mutual benefit” (Putnam, 2000).

Newton (in Pratikno) argues that the social capital embodied in the three kinds of elements, namely (1) Norms and values, (2) networks or organizational/institutional and (3) a consequence or result. Benefits of social capital by Portes (1998) is for the creation of a strong public relations and useful for parents, teachers and politicians in charge, just as they try to maintain the discipline and obedience. According to Hasbullah (2006), there are two types of social capital, those are bonding social capital and bridging social capital. But, then Woolcock (1998) adds another called linking social capital. In a social group occur the bond between the members included of the trust, reciprocity collective action in its activities:

a. Trust

Trust is “... the expectation that arises within the community of regular, honest and cooperative behavior, based on community shared norms, on the part of other members of the community ...” (Fukuyama, 1999).

b. Networks

According to Hasbullah (2006), the core dimensions of social capital lies in how the ability of society to work together to build a network in order to achieve a common goal.

c. Norm and Value

According to Burt (2002), the ability of this association is very dependent on a condition in which the community is willing to share to figure intersection norms and shared values.

2.2. Public Health

Public health by Winslow (in Entjang, 1993) is “a science and art that aims to prevent the onset of disease, prolong life and enhance the value of health. With this definition, it is understood that health is not only seen as a task that is the responsibility of doctors and other paramedics. But the actual health is influenced by external factors of health institutions, such as the policies issued by the government, as well as environmental, social, economic and political. There is a new approach that is used in public health, namely:

a. Focus on improving health infrastructure and supported by social life, behavior and healthy lifestyle community.

b. Legislation and policies pursued into an important instrument in public health.

c. There is a cross-sector cooperation, the medical profession to be one of the supporters of this cooperation.

d. Emphasizes community participation in health development.

e. Research in the field of health through a variety of disciplinary approaches such as anthropology, economics, law, sociology, psychology and communication.

f. Programs are more focused on disease prevention and health promotion. Restrictions more comprehensive healthy and positive.

g. Draw attention to all aspects of threats that can damage the health of humans, also on the physical environment that can ensure human survival.

h. Justice is the ultimate goal.

3. Research Methodology

In this research, researcher using a type of qualitative research with the descriptive research. This is because this research will examine the things that are phenomenologically with a qualitative approach, researcher are able to uncover and describe the hidden facts behind the phenomenon. According to Bogdan and Taylor in Arikunto (2006) defines the qualitative methods is “as a method of qualitative research procedures which produce descriptive data in the form of words written or spoken of the people and behaviors that can be observed”. From this research, researcher can see the implementation of social capital in the public health context that exist in Wonosalam Subdistrict that can seen from the network, trust, value and norm to improve public health in Wonosalam Subdistrict.

4. Result and Discussion

4.1. Result

Health is a main factor to do the national development. But, in this context, policymaker sometimes forget to solve the health problem that faced by society. In addition, the policy is not suitable with the health problem. So, in the recently research, there is a new concept that called social capital that can give the solution to the health problem. With social capital, the government can learn the characteristic and behaviour of society than can combine with policy to solve the health problem. In this research, the implementation of social capital in the context of public health in Wonosalam Subdistrict can be seen from:

a. Social Network

Network concept is based on the agreement, informal norms, not in authority relations. So, by having strong social network also indicated that there are interaction and communication among members of society to raise mutual need and give the priority to the public interest rather than self-interest. In social capital, the strong social network indicates that the society had a high social capital. In improving the quality of the public health in Wonosalam Subdistrict, some actions can be seen in their daily activities, among others:

1) In Maintaining the Environment

In terms of maintaining the environment, it can be seen from maintain the water resources. The provision of clean water in Wonosalam Subdistrict is getting from nature. Clean water is a major daily needs for bathing, drinking, cooking and other essentials need. In Wonosalam Subdistrict, access to take clean water directly from fountains. In the past, the condition of water is very clean and the quality had been maintained. This is because the society is still very environmentally friendly, it can be seen from their behaviour to keep the fountains that support their sustainability lives. However, heavy conditions such as road uphill and the far distance between the house and water sources causes the society must be struggled to get the water.

Other factors that influence of good environmental conditions in Wonosalam Subdistrict is local society culture that still strong in keeping their environment. The willingness of each individual to keep this water resource to get the benefit from the strong social networks. So that, raising the proactive attitude in each individuals to undertaken activities which can be beneficial to himself and others. Recently, there is a problem faced by government and society, they are the contaminated the fountain, damaged of forest and lack the infrastructure in distributing water. In addition, this subdistrict is the area that often experienced flood and landslide. For anticipating this condition, the society with its own initiative work together to oversee the existing sources of water. This activities can be seen, like:

a) To improve the accessing of clean water, society using pipes that distributed to all the houses. However, the obstacles faced were the technical problems such as the geographic condition and infrastructure. For anticipating this situation, the society with its own initiative held the picket to maintain this pipes. This showed that they assume for anything related to public interests not always wait decision from the government.

b) Good networking is also can be seen in how the society are anticipating their environment from disaster. It has been known that Wonosalam Subdistrict is subdistrict which sensitive happened many disasters such as flood and landslide. With limited resources from the government to cope this problem, they are working together to make a disaster prevention, for example activities may include plant the bamboo in side of the river for anticipating flood. It was done to prevent more damage of the environment. Based on this condition, it is understood that the society is also aware the importance of maintaining the sustainability nature. When they feel there are many changes in natural conditions such as changes in river water capacity where the rivers increasingly shallow and wide and the water is also thinning not flow swiftly. It makes the society worry because almost all of society in Wonosalam Subdistrict use this water to household needs such as bathing, cooking, drinking and washing.

c) To Maintain the Forest

Wonosalam has amazing potential natural resources, combination between the biodiversity and the amiability of the local society make Wonosalam is an interesting place to be recreation area. In this condition, formed an organization that called Wonosalam Lestari which want to do the conservation efforts to preserve biodiversity and sustainability the potential fountain in Wonosalam. Wonosalam Lestari is a group from the society to participate in the rescue efforts of the environment, the preservation of forests and the conservation of water resources in the Wonosalam Subdistrict.

In this organization, can learn some knowledge about environment. Such as water conservation and water quality monitoring methods by using insects, water quality monitoring training routine done once every 3 months, sanitation training, training research for food plants and medicinal plants and training to increasing public participation in the monitoring of water quality.

d) Role of Young Generation to Take Care the Quality of Water and Forest

It looks like what has been done by the students of Senior High School 1 Wonosalam are starting to realize that many domestic waste pollutes the rivers and then causes the river stained. They realize the importance of maintaining the quality of the water in their area because of water quality upstream will have an effect on water quality in downstream areas, in addition, all of the society dependent their life to this good water. Therefore, these students develop water police activities, namely the monitoring of the quality of the river and then make report results.

In addition has many fountains, Wonosalam Subdistrict also has the potential of large forest. However, at this time, deforestation happened and damaged the environment of forest. Another behavior also praticed by the society like hunted the wildlife in that forest such as birds, monkeys and deers. The low knowledge in society and the lack of information about the importance to take care their environment are the factor that causes deforestation forest in Wonosalam Subdistrict.

To maintain the sustainability of the forest which also contain many fountains, the young generation in this subdistrict with their own initiatives started inventory the fountains and various of plants that existed around the forest in this subdistrict. With their knowledge, they make these forests as a kind of information media to know the endemic plants in the forest of Wonosalam. An inventory is also accompanied by an appeal to preserve forests, conserving the fountains and the prohibition for hunting wildlife.

2) Using the Health Facilities by Society

Participation of the Wonosalam’s society to improve the quality of public health can be seen in their participation to come in place for health care each month. This condition indicates that the society realize and doing checkup for maintain their health and anticipate the disease in each particular period is very important. The high participation of society come to place for health care was also influenced by the activities of the organization of mothers who actively guiding and providing information to the society about the importance of public health in particular starts with health of family.

In addition, strong network in Wonosalam Subdistrict is not only in society, but also in the medical officer in the place of health care had come down directly to the field. This activity can be seen in terms of giving the medical treatment to elderly that their house are located on top of the mountain with the hard access to come the health facilities. So, health workers who take the initiative to go to their houses. The network of communication that occurs within the society and coordination between government and society indicate that each individual feel has responsibility to solve a specific issue that exists around them. With the social organization and high participation, various of public health program can developed more independent and better. The society can identify their needs to take care their health, planning the activities, make a priority, implementation, even process of evaluation. That management can be done by collective and according to their local condition.

b) Trust

Trust is an important factor in a social capital. This is because with that trust, will raising the attitudes such as the high participation of society, proactive action, even strong social network. This trust can be used as capital to improve the quality of public health in Wonosalam Subdistrict. To improve the quality of public health in Kecamatan Wonosalam, trust can be viewed from several society’s activities below:

1) In Term of Treating the Disease

In terms of treating the disease, the society in Wonosalam Subdistrict generally still using traditional ways. Wonosalam’s society confidence that treats the disease using traditional way or herbal medicine more effective if compared with generic drugs. The price was relatively cheap even for free, it is because of their habit that take many advantages of the wide yard for cultivated pharmacies plants. With this culture, thus they are rarely suffer the chronic diseases such as coronary heart, diabetes or hypertention.

It can also be seen from the healthy living habits such as walk to go to the field every day, or any other activity that makes their bodies healthy. When they are sick, usually treated with the recipes from their parents. Or if the disease is rather badly they just go or call the shaman to provide treatment. Sometimes, for a treatment of diseases such as rheumatic, the society just come to the masseur.

2) In Term of Eating Pattern

In terms of eating pattern, the menu which is usually eaten are vegetables that exist at their house or farm like eggplant, krokot, simbukan and long beans that can be cooked as various food such as lodeh, bening and urap-urap (seasoned vegetable with the stew coconut). It was not inferior to modern food types that are currently developing. With the trust of food sources that are around them, they take to preserve wild plants that are sometimes not considered by the society, while strengthening food security and malnutrition to be the urgent problems.

According to the customs of society, by eating papaya leaves can add the amount of blood, so they don't need to buy vitamin or medicine to increasing the amount of blood. That eating patterns and menu of food can makes them have a relatively strong immune and spared from diseases such as diabetes and hypertention. The old person in this subdistrict is still has the energy to go to the rice fields and even lifting the heavy goods.

3) In Terms of Giving the Exclusive Breast Milk

In terms of giving the Exclusive Breast Milk, the society of Wonosalam also have discovered since from their ancestors that giving the Exclusive Breast Milk to the infant is obligatory. The Exclusive Breast milk is the main food of infants who are in the process of growth. Currently, sometimes many mothers who gave her infants by the milk cans. In Wonosalam Subdistrict, the mothers from past to present are still believe to giving their infant with Exclusive Breast Milk. Sometimes when the Exclusive Breast Milk is coming out just a little, enough with eaten the vegetables is sufficient to carry out the producing of Exclusive Breast Milk.

4) In terms of Childbirth Process

The existing trust in Wonosalam’s society related with public health can also be seen in the process of childbirth are mostly using the shaman services. This is due to go to clinics or midwife can spend the high cost. In addition, the number of health facilities that are available also few, so it should be reach far distance and a heavy field to go to a midwife or health centers. For the care of her infant any more, they believe in the old people or a shaman rather than having to go to health facilities every month. According to their assumption that they can do it without the helping of medical personnel so that less of considering the risk will occur.

5) The Attitude of Society to Government Policy

This trust can be seen in the relationship between society and the government. The trust of society on the government’s policies such as healthcare programs for the poor with providing the health card is used very well by the society. With this trust then the government can implement the health policy for improving the quality of public health that exist in Wonosalam Subdistrict.

c) Norm and Value

Norms and values as a guide to how should society act and behave. Important elements in action and possible values are very dependent on trust and reciprocity. These norms and values deriving from the existence of the trust is believed by a certain society in a long period of time and can be proven by the strong social network that is formed. The society that usually live in this situation have the good self management. In an effort to improve the quality of public health, norms and values can become a capital for the formation of a healthy community.

In Wonosalam Subdistrict, norms and values that can be used as a way to improve the quality of health care can be seen from some of their activities. Mostly, the society still implement what their ancestors done in the past. This can be seen with a still functioning services of the shamans to help the society in childbirth, infant care and treatment. In terms of keeping the fountains from damage, the society still believe the advice of the ancestors or even their religious advice still trusted by the society until now.

Based on these culture, it is understood that society of Wonosalam still believed to the local culture. In addition, it supports the development of health with a sense of tolerance and respect for each other. This is reflected from the harmony between religious community in this subdistrict. Based on the profile of the Wonosalam Subdistrict, assume that the society devided into five religions, namely Islam, Catholicism, Christian, Buddhist and Hindhu. This condition is important with many religious conflicts that occurred in this country.

Another social capital that can dig in Wonosalam Subdistrict is mutual safeguarding of the natural environment. So they feel there are close links between their survival with nature. This is reflected by the presence of Kenduren Durian Wonosalam event. Kenduri Durian is a party of durian harvest from Wonosalam societies. This ceremony was done to express gratitude towards nature which gives them a blessing. This is because when nature is angry like the uncertain weather it will be badly for their life. The event was held by society without any financial assistance from the government of Jombang Regency. With this understanding, then the norms and values that are reflected in every community behaviour that can be used as a consideration in policy making, especially public health policy.

4.2. Discussion

Social capital as one of the social aspects is the foundation of sociological people can keep up society to collaborate and interact in the efforts of getting the benefit together. It is same with what is said by Pierre Bourdieu (1986) that assumes that social capital reflects localities shown through how people respond externality from outside their community. Social capital did not only load how interaction and communication among members of the society that caused of trust, but also how accommodate all their activities into a social organization. Social organization can be shaped to formal and informal organization. In this social organization society will able to exchange their idea and interests that can be resolved together. In terms of public health, a Religious Organization, Young Organization, Women’s Organization could be a place sharing about various things to improve the public health. It was because public health “a science and art that aims to prevent the onset of disease, prolong life and enhance the value of health” (Winslow in Entjang, 1993). That elements can not only seen in terms of medical sides, but social dynamics were also influenced to improve the quality of public health.

According to James Coleman (1990), social capital consisting of social structures and facilitating every act of individual in this social structure. In this case, it facilitates individuals to participate in society. So that, the norms and values that exists in society is a guidance of social capital that forms social structures. With this social structures, creates readiness and bravery from society to exchange ideas, thought or even public health problems so that they create a social network that can bridge them in solve all the problems. In Wonosalam Subdistrict, the benefits of social capital in improving the health of the community can be seen by the existence of public participation activities, proactive action, strong social networks, trust, norms and values that exist in society. This is similar to what is being said by Putnam (2000) which states that social capital is complexly conceptualized as the network of associations, activities, or relations that binds people together as a community via certain norms and psychological capacities, notably trusts, which are essential for civil society and productive of future collective action or goods, in the manner of other forms of capital. Thus, social capital can be used as capital to establish mutually beneficial cooperation. And also what is said by Hasbullah that dimensions of social capital emphasizes the potential of the group and between groups within the attention on social networks, norms, values and trust among the members of the group and was born from a group norm (Hasbullah, 2006).

Hasbullah (2006) stated that social capital is not built by one individual, but rather lies in the growing tendency within a group to socialize as a vital part of the inherent values. This thinking agree with what is said by Allin that “public health is more focused on achieving a population health rather than individual health” (Allin, 2004). Social capital depends on the capacity of community groups to build the associations and its network. The key to success lies in the ability of people in the association in involved in a network of social relations. In improving the quality of public health in Wonosalam Subdistrict, the ability of each individual to be creative and initiative in doing activities for public interest can be seen through from how they keep the environment of forests and water sources. Also seen at any age level, namely the young generation and old generation, they mutually understanding the knowledge of the importance of maintaining health.

A tools of social capital such as groups or organisations that exist in the community and a variety of participation that occur can be an external input and capital in the attainment of public health programs through community development processes. The emphasis of this process is the increasing capacity of communities to become self-sufficient and able to manage a wide range of factors that affect their lives as well as the utilization of the resources owned by the communities where structures are developed must be able to continue in the long term. Just like the previous research by Marlin Wibowo (2007) about “the importance of identification and analysis of social conditions and structures that can support the formation of social capital, the pattern of interrelationships among economic and political factors and the factors that strengthen or weaken the existence of social capital in the future”. The existence of a strong social bond, the attitude of cooperative, and the process of transferring information between the citizens of the capital in the program of improvement public health.

From the understanding of social capital above, social development, which in this case is public health not merely about provision of medical services by the government, but more than focused on social capital as a form of network at community level and globally to investigate one tool is very promising, and relatively uncharted, to advance health development is desirable. With social capital, the government mapped out to make an understanding of preventive methods with healthy paradigm rather than understanding the sick paradigm with curative methods.

5. Conclusions and Recommendations

5.1. Conclusions

From the description of implementation of social capital in the public health context in Wonosalam Subdistrict can conclude that in this research the social capital related with public health is still good, it can be seen from social network such as in terms of maintaining the environment: to improve the accessing of clean water, good networking in how the society are anticipating their environment from disaster, to maintain the forest and role of young generation to take care the quality of water and forest and in terms of willingness to come to health facilities, from trust, it can be seen such as in term of treating the disease, in term of eating pattern, in term of giving the Exclusive Breast Milk, in terms of childbirth process and good relationships between government and societies and from the values and norms such as public confidence towards the local wisdom and belief that their anchestor said.

5.2. Recommendations

From the explanation above and see some of the obstacles that exist in the Wonosalam Subdistrict in implementation social capital in the public health context, the researchers give some suggestions as follows:

1. The Government of Jombang Regency through the health service should try to utilization of the social capital that can create community self-sufficiency in maintaining health so that government can save budget for use on the needs of the other. In addition, it also needs to expand the network of cross-cutting policy. This is because in making public health policy, expert who not only in the field of health.

2. To equalize results universal development health, Jombang Regency should add facilities of health, and worker especially of health in the fields in Wonosalam Subdistrict. Besides, Jombang Regency also need to improve the condition of economic and educational society in Wonosalam Subdistrict. It was because these two factors were also affected the way how people to maintain the health.