Exploring the Dynamics of School Health Unit Implementation: A QCA-Based Qualitative Study in Islamic Junior High Schools in Jambi

Abstract

The School Health Unit (UKS) program plays a crucial role in fostering clean and healthy living behaviors among students; however, its implementation across madrasahs often yields varying outcomes depending on the level of institutional support and involvement. This study aims to identify the combination of factors influencing the success or challenges of UKS implementation in two State Islamic Junior High Schools (Madrasah Tsanawiyah Negeri) in Municipality of Jambi. A qualitative approach employing Qualitative Comparative Analysis (QCA) was used to explore the interactions among six key factors: school leadership support, teacher involvement, student participation, external support, availability of resources, and school culture. Fifty students participated in this study and were divided into two Focus Group Discussion (FGD) groups. Data were analyzed thematically and compared across cases to identify dominant patterns. The findings reveal that students in the school with an active UKS perceive health unit activities as an engaging and meaningful part of daily learning, characterized by high participation in cleanliness programs, health education, and peer-led initiatives. In contrast, students from the school with limited UKS facilities tend to be less involved due to the absence of routine activities and inadequate resources. Although external support from community health centers (Puskesmas) is consistent in both schools, its impact varies depending on how the school follows up and integrates these activities into internal programs. The QCA findings suggest that the success of UKS implementation is not determined by a single factor but rather by a combination of teacher involvement, active student participation, supportive leadership, and a school culture that fosters commitment to health. Schools exhibiting this configuration demonstrate more effective, sustainable implementation of UKS, aligned with Islamic values that promote clean and healthy living behaviors within the school environment.