Buletin Penelitian Sistem Kesehatan

Journal Information
ISSN / EISSN : 1410-2935 / 2354-8738
Total articles ≅ 170
Current Coverage
ESCI
DOAJ
Archived in
SHERPA/ROMEO
Filter:

Latest articles in this journal

Olwin Nainggolan, Ika Dharmayanti, A Yudi Kristanto
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 80-88; doi:10.22435/hsr.v23i2.3104

Abstract:
This study aimed to know the association and risk levels of household other members and adolescent smoking behaviors in Indonesia. As confounding variables of study involving Alcohol Consumption Behavior, Lived Area, and Social-Economics Status Variables. A study hypothesis declared that there was a signifi cant correlation between smoking behavior of household other members as a smoker with the smoking behavior of 15 to 18 years old after being controlled by other variables. Furthermore, this study using a Basic Health Research Secondary Data of 2018 aged 15 until 18 years and a multivariable analyzed uses logistic regression. The results showed a signifi cant correlation (p-value 0,000) between Household Other Members as a Smoker with smoking behavior of 15 to 18 years old after being controlled by confounding variables with OR 1,449 (95% CI 1,346-1,56-0). Smoker Variable not as a Head of Household was signifi cantly correlated (p-value 0,007) with OR 2,002 (95% CI 1,211-3,377), Alcohol Consumption Behavior was signifi cantly correlated (P-value 0,000) with OR 20,602 (95% CI 17,611-24,101), Lived Area with OR 1,129 (95% CI 1,051-1,212), also Social Economic Status with OR 1,098 (95%CI 1,024-1,178). An Alcohol Consumption Behavior Variable was the most dominant variable in determining Adolescent Smoking Behavior. We should focalize on areas identity is driven by health service providers, stakeholders, and policymakers. Accordingly, formulate awareness programs and education, particularly adolescents, to eliminate smoking initiation. Abstrak Penelitian ini bertujuan untuk mengetahui hubungan dan besaran risiko perilaku merokok anggota rumah tangga lain dengan perilaku merokok remaja berusia 15 sampai dengan 18 tahun di Indonesia. Variable perancu pada penelitian ini meliputi perilaku konsumsi alkohol, wilayah tempat tinggal, serta status sosial ekonomi responden. Hipotesis penelitian ini adalah ada hubungan yang bermakna antara perilaku merokok anggota rumah tangga lain sebagai perokok, dengan perilaku merokok remaja usia 15 sampai dengan 18 tahun setelah dikontrol oleh variabel lain. Penelitian ini menggunakan data sekunder Riset Kesehatan Dasar (Riskesdas) tahun 2018 dengan rentang usia 15-18 tahun dan data di analisis secara multivariabel menggunakan regresi logistik. Hasil penelitian diperoleh bahwa terdapat hubungan yang bermakna (p value 0,000) antara anggota rumah tangga lain sebagai perokok dengan dengan perilaku merokok pada remaja usia 15 sampai dengan 18 tahun setelah dikontrol oleh variabel perancu dengan OR 1,449 (95% CI 1,346-1,56-0). Variabel perokok bukan sebagai kepala rumah tangga berhubungan bermakna (p value 0,007) dengan OR 2,002 (95% CI 1,2113,377), perilaku minum alkohol berhubungan bermakna (p value 0,000) dengan OR 20,602 (95% CI 17,611-24,101), wilayah tempat tinggal responden dengan OR 1,129 (95% CI 1,051-1,212), serta status sosial ekonomi dengan OR 1,098 (95%CI 1,024-1,178). Variabel perilaku minum alkohol adalah variabel yang paling besar pengaruhnya terhadap perilaku merokok pada remaja. Perlu fokus identifi kasi area oleh penyedia layanan kesehatan serta para stake holder pembuat kebijakan dalam merumuskan program kesadaran dan pendidikan khususnya pada remaja untuk eliminasi inisiasi merokok.
Titik Maimanah, Thinni Nurul Rochmah
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 71-79; doi:10.22435/hsr.v23i2.1213

Abstract:
The Net Death Rate (NDR) of low birth weight neonates have signifi cantly increased from 2014 to 2017 at Neonatal Intensive Care Units (NICU) of Gresik Ibnu Sina Hospital. And it has faced high demands and unbalances to readiness and availability of Comprehensive Emergency Neonatal and Obstetric Services (PONEK). This study aims to analyze the readiness of neonate’s patient service with a low birth weight case. This study was observational with a cross-sectional design. Subjects were medical professionals, including paramedics and medical facilities at NICU of Gresik Ibnu Sina Hospital from December 2017 until June 2018. Data gathering methods conducted with an interview, checklist, and document review of NICU services. It also conducted a gap analysis to assess service needs of 2021 and service reality of 2018. The Number of human resources has still lacked, mainly consultant pediatricians and nurses. 4 of 15 nurses are duty at NICU, clinical working experience less than fourth years. Furthermore, physician and nurse competencies, some facilities, and standard operating procedures regarding NICU services were still incompleted. In order to improve NICU services, hospital management has to develop human resource capacity, facilities, and complete the standard operating procedure to fulfi ll service needs that estimated in 2021. Its necessity managed capacity planning, planning, and development to accomplish standards and needs. Abstrak Net death rate neonatus bayi berat lahir rendah di ruang NICU Rumah Sakit Ibnu Sina Gresik terus meningkat selama tahun 2014-2017. Rumah sakit mengalami permintaan yang tinggi serta terjadi ketidakseimbangan antara kesiapan dan ketersediaan PONEK. Penelitian ini bertujuan untuk menganalisis kesiapan layanan pasien neonatus kasus bayi berat lahir rendah. Penelitian observasional deskriptif dengan rancangan cross sectional. Subyek penelitian meliputi petugas medis, paramedis, dan fasilitas medis di NICU Rumah Sakit Ibnu Sina pada bulan Desember 2017 – Juni 2018. Pengambilan data dilakukan dengan wawancara, pengisian checklist, dan telaah dokumen pelayanan NICU Rumah Sakit Ibnu Sina. Data dianalisis dengan analisis kesenjangan kebutuhan pelayanan pada Tahun 2021 dan kondisi pelayanan Tahun 2018. Jumlah sumber daya yang dibutuhkan masih kurang terutama dokter konsultan anak dan perawat. Sebagian perawat yang ditugaskan belum memiliki lama kerja klinik lebih dari empat tahun. Kompetensi sumber daya perawat dan dokter serta beberapa fasilitas dan standar operasional prosedur pelayanan NICU belum lengkap. Untuk meningkatkan pelayanan NICU maka manajemen RS harus menambah kapasitas sumber daya, fasilitas, dan melengkapi standar operasional prosedur untuk memenuhi kebutuhan pelayanan yang diproyeksikan pada Tahun 2021. Rumah sakit diharapkan menyusun capacity planning dan perencanaan pengembangan untuk memenuhi standar dan kebutuhan.
Andri Ruliansyah, Firda Yanuar Pradani
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 115-125; doi:10.22435/hsr.v23i2.2797

Abstract:
Malaria is still a public health problem in Pangandaran Regency. Increasing imported malaria cases from year to year become the main problem since Pangandaran is a tourist destination and is currently doing development in the tourism sector. This study aimed to look at socio-cultural factors in the community that contribute to the increased risk of malaria transmission. This research was conducted with interviews and environmental observations. Respondents were randomly selected from the population living in the District of Pangandaran. The results showed that the habit of going out at night, traveling to endemic areas, and choosing potential breeding places around settlements or tourist attractions would increase the risk of malaria transmission in Pangandaran. In this context, health workers need to discuss and provide understanding to the community about the dangers of malaria transmission so that people become more concerned and make independent prevention eff orts. The development of tourist destinations must also consider environmental factors sMalaria merupakan masalah kesehatan masyarakat yang ditemukan di wilayah Kabupaten Pangandaran. Peningkatan kasus malaria impor dari tahun ke tahun menjadi masalah terutama karena Pangandaran merupakan daerah tujuan wisata dan sedang melakukan pengembangan di sektor pariwisata. Penelitian ini bertujuan untuk melihat faktor sosial budaya di masyarakat yang memiliki potensi meningkatkan risiko penularan malaria. Penelitian ini dilakukan dengan wawancara dan pengamatan lingkungan. Responden dipilih secara acak dari penduduk yang tinggal di wilayah Kecamatan Pangandaran. Hasil penelitian menunjukkan bahwa kebiasaan keluar malam, kebiasaan bepergian/merantau ke luar kota termasuk ke daerah endemis dan keberadaan tempat perindukan potensial di sekitar pemukiman atau objek wisata akan meningkatkan risiko penularan malaria di Pangandaran. Dalam konteks ini, para petugas kesehatan perlu melakukan pendekatan menyeluruh dan memberikan pengertian kepada masyarakat tentang bahaya penularan malaria sehingga masyarakat menjadi lebih peduli dan melakukan upaya pencegahan secara mandiri. Pengembangan daerah wisata pun harus memperhatikan faktor-faktor lingkungan seperti letak tempat perindukan potensial Anopheles spp. uch as potential places for Anopheles spp brood. Abstrak
Tumaji Tumaji, Rukmini Rukmini, Oktarina Oktarina, Nailul Izza
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 89-98; doi:10.22435/hsr.v23i2.3238

Abstract:
Uterine myoma is a reproductive health problem that causes serious morbidity and can affect the quality of life of suff erers. Many factors cause uterine myoma. This study aims to analyze the factors related to reproductive health history that can influence the occurrence of uterine myoma in women in urban Indonesia. This study is a non-intervention analysis which is a further analysis of the 2016 PTM Research results. The 2016 PTM research design is cross-sectional. The population is all women aged 25-64 years in urban Indonesia. Data collection was carried out by interview. In this paper, the data analyzed were respondent characteristics, reproductive health history and the incidence of uterine myomas. Data were analyzed univariate, bivariate, and multivariate. The results showed that the age of menarche and parity did not aff ect the incidence of uterine myoma (p= 0.861 and p= 0.424). Meanwhile, giving birth to a child for the fi rst time under the age of 30 reduced the risk by 48% (95% CI: 0.439-0.607). Having children 1-2 has a risk of 1.3 times greater than those who have more than 2 children (95% CI: 1.126-1.463). Use of contraceptives decreases risk by 30% (95% CI: 0.613-0808). The use of hormonal drugs for infertility treatment increases the risk 3.2 times greater (95% CI: 2.562-4.013). Women who did not use hormone replacement therapy were reduced by around 74% (95% CI: 0.114-0.608). The incidence of uterine myoma is influenced by the age of fi rst birth, number of children, use of contraceptives, use of hormonal drugs for infertility treatment, and hormone replacement therapy drugs. Health promotion is needed so that risk factors that can be prevented/modifi ed can be minimized to reduce the chance of developing uterine myoma. Abstrak Mioma uteri merupakan masalah kesehatan reproduksi yang menyebabkan morbiditas yang cukup serius serta dapat mempengaruhi kualitas hidup penderitanya. Banyak faktor yang menjadi penyebab mioma uteri. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang terkait riwayat kesehatan reproduksi yang dapat mempengaruhi terjadinya mioma uteri pada perempuan di perkotaan Indonesia. Penelitian ini adalah analisis non-intervensi yang merupakan analisis lanjut dari data hasil riset PTM 2016. Desain riset PTM 2016 adalah potong lintang dengan populasi seluruh perempuan usia 25–64 tahun di perkotaan Indonesia. Pengumpulan data dilakukan dengan wawancara. Dalam tulisan ini, data yang dianalisis adalah karakteristik responden, riwayat kesehatan reproduksi serta kejadian mioma uteri. Data dianalisis secara univariat, bivariat, dan multivariat. Hasil menunjukkan umur menarche dan paritas tidak berpengaruh terhadap kejadian mioma uteri (p= 0,861 dan p= 0,424). Sementara itu, melahirkan anak pertama kali di bawah umur 30 tahun menurunkan risiko sebesar 48% (95%CI: 0,439–0,607). Memiliki anak 1–2 memiliki risiko 1,3 kali lebih besar dibandingkan dengan yang memiliki anak lebih dari 2 (95%CI: 1,126–1,463). Penggunaan alat kontrasepsi menurunkan risiko sebesar 30% (95%CI: 0,613–0,808). Penggunaan obat-obatan hormonal pengobatan infertilitas meningkatkan risiko 3,2 kali lebih besar (95%CI: 2,562–4,013). Perempuan yang tidak menggunakan obat-obatan terapi sulih hormon risikonya berkurang sekitar 74% (95%CI: 0,114–0,608). Kejadian mioma uteri dipengaruhi oleh umur pertama kali melahirkan, jumlah anak, penggunaan alat kontrasepsi, penggunaan obat-obatan hormonal pengobatan infertilitas, dan obat-obatan terapi sulih hormon. Diperlukan promosi kesehatan sehingga faktor risiko yang dapat dicegah/dimodifi kasi dapat diminimalkan untuk mengurangi peluang terkena mioma uteri.
Diyan Ermawan Effendi, Arief Priyo Nugroho, Suharmiati Suharmiati, Lestari Handayani
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 99-107; doi:10.22435/hsr.v23i2.3086

Abstract:
The high rate of maternal (MMR) and infant mortalities (IMR) is a detrimental health development challenge in Indonesia. The use of the Maternal and Child Health (MCH) handbook and MCH service guidelines are the government’s eff orts in reducing the MMR and IMR. However, the reduction of MMR and IMR is still slow. The fi nding of the previous study asserts the need for MCH handbook and MCH service guidelines modifi cations to be suited to the needs of users, both health workers, and expectant mothers. Therefore, this study mainly aims to analyze the needs and use of MCH handbook and service guidelines by doctors and midwives in the primary health centers. The method was qualitative needs analysis with 137 informants from 12 health centers in three regions of Indonesia. The results revealed that the needs of health workers were clustered in three signifi cant aspects; instrumental (language and book-making materials), managerial (procurement, distribution, and dissemination) and operational (ease of access to MCH handbook and service guidelines as well as the availability of SOP). The fulfi llment of these three aspects is expected to improve the MCH program’s achievement, especially in cities where the research took place and other areas with similar characteristics. Abstrak Tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi masalah dalam pembangunan kesehatan di Indonesia. Penggunaan buku Kesehatan Ibu dan Anak (KIA) serta pedoman pelayanan KIA merupakan upaya pemerintah dalam penurunan AKI dan AKB. Meskipun demikian, penurunan AKI dan AKB dinilai masih lambat. Hasil penelitian sebelumnya menunjukkan perlunya modifi kasi buku dan pedoman pelayanan KIA disesuaikan dengan kebutuhan pengguna, baik tenaga kesehatan maupun ibu hamil. Oleh sebab itu, penelitian ini bermaksud menganalisis kebutuhan dan pemanfaatan buku dan pedoman pelayanan KIA oleh dokter dan bidan di puskesmas. Metode yang digunakan adalah analisis kebutuhan kualitatif dengan 137 informan dari 12 puskesmas di tiga Kabupaten/kota di Indonesia. Hasil analisis menunjukkan kebutuhan nakes terkelompok pada tiga aspek utama, yaitu instrumental (bahasa dan bahan pembuat buku), manajerial (pengadaan, pemerataan distribusi dan sosialisasi) dan operasional (kemudahan akses pada buku dan pedoman layanan KIA dan ketersediaan SOP). Pemenuhan terhadap tiga aspek tersebut diharapkan mampu memperbaiki capaian program pelayanan KIA khususnya di wilayah tempat penelitian.
Mazda Novi Mukhlisa, Windy Haryani, Indra Yoga, Rosa Estetika, Wahyu Pudji Nugraheni
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 108-114; doi:10.22435/hsr.v23i2.2632

Abstract:
Health Operational Aid for promotive and preventive programs increases year by year. Despite that, health outcomes remain low. The objective of our study was to measure the technical efficiency of public health programs. We conducted a quantitative approach using Health Production Model to measure the efficiency of 315 districts across 34 provinces in Indonesia. To measure the efficiency score, we run the Data Envelopment Analysis. We also conducted a qualitative one to explore the source of inefficiency by managing interviews and focus group discussion to informants from six districts. The results indicated a wide variation in efficiency among districts. The average efficiency score was 63% with minimal and maximal scores were 15% and 100%, respectively. The high performing districts were in affluent or accessible areas. The qualitative analysis resulted in districts with the mixed planning process and the exact basis for budget distribution, as well as various criteria for priority setting, have higher performance than those which have not. Moreover, there were specific cases played a role in the low performing districts, such as the high-risk population in remote areas and the vaccines issues on halal status. In conclusion, districts still can improve their efficiency in achieving health output using their health resources. Abstrak Bantuan Opersional Kesehatan (BOK) yang digunakan untuk membantu upaya program promotif dan preventif meningkat setiap tahunnya. Akan tetapi, keluaran kesehatan tetap rendah. Tujuan analisis ini adalah menilai efi siensi teknis pada program kesehatan masyarakat yang menggunakan BOK. Dengan menggunakan Model Produksi Kesehatan, kami melakukan pendekatan kuantitatif untuk mengukur skor efi siensi di 315 kabupaten/kota di Indonesia. Skor tersebut diukur dengan Data Envelopment Analysis. Kami juga melakukan pendekatan kualitatif untuk menggali lebih dalam tentang sumber inefi siensi dengan melakukan wawancara dan diskusi kelompok terarah kepada informan di enam kabupaten/ kota. Hasil analisis menunjukkan bahwa terdapat variasi skor efi siensi antar kabupaten/kota. Rata-rata efi siensi adalah 63% dengan skor minimal sebesar 15% dan maksimal sebesar 100%. Kabupaten/kota dengan skor efi siensi tinggi berada di area kaya atau mudah diakses. Hasil kualitatif menunjukkan bahwa kabupaten/kota dengan perencanaan bottom-up yang dikombinasikan dengan top-down, kepastian dasar pembagian distribusi, dan beberapa kriteria untuk setting prioritas memiliki skor efi siensi yang tinggi. Masalah khusus yang dihadapi kabupaten/kota juga berperan dalam inefi siensi, seperti populasi berisiko tinggi di daerah terpencil atau isu halal/haram vaksin. Secara garis besar, kabupaten/ kota masih berpotensi meningkatan efi siensi dalam mencapai output kesehatan dengan menggunakan sumber daya kesehatan yang dimilikinya.
Rukmini Rukmini, Oktarina Oktarina
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 135-144; doi:10.22435/hsr.v23i2.3101

Abstract:
Traditional health services (Yankestrad) are part of the health care subsystem in the National Health System, aiming to change the curative treatment paradigm to be promotive and preventive. The study was conducted in 2019, collecting data through in-depth interviews with the Head of Puskesmas and FGD with related cross sectors. The implementation of traditional health services at the Surabaya Made Health Center had been in line with central and regional policies and regulations. The types of complementary traditional health services provided are acupuncture, acupressure, baby massage, and herbal medicine. Most cases of traditional health services for the elderly are relaxation, for non-communicable diseases, stroke, diabetes mellitus, hypertension, and obesity. Yankestrad’s innovation in building with the integration of internal referrals from other polyclinics such as general poly, wound care poly, dental poly, and nutrition poly to yankestrad poly. Innovation outside the building in the form of fostering independent Toga care and acupressure integration with the independent care group (Asman) Acupressure Toga and Elderly Posyandu. Conclusion Yankestrad at the Puskesmas is very potential as an alternative health service for the elderly. This study recommends improving coordination across programs and sectors so that traditional health services can work well and support other programs’ achievement, especially non-communicable diseases and the elderly program. Abstrak Pelayanan kesehatan tradisional (Yankestrad) merupakan bagian subsistem upaya kesehatan dalam Sistem Kesehatan Nasional, bertujuan untuk merubah paradigma pengobatan kuratif menjadi promotif dan preventif. Tulisan ini bertujuan mengkaji inovasi program pelayanan kesehatan tradisional pada lansia di Puskesmas Made Kota Surabaya. Studi dilakukan tahun 2019, pengumpulan data melalui wawancara mendalam kepada Kepala Puskesmas dan FGD dengan lintas sektor terkait. Pelaksanaan pelayanan kesehatan tradisional di Puskesmas Made Kota Surabaya telah sesuai dengan kebijakan dan regulasi pusat dan daerah. Jenis pelayanan kesehatan tradisional komplementer yang diselenggarakan adalah akupunktur, akupressure, pijat bayi dan herbal medik. Kasus terbanyak pelayanan kesehatan tradisional untuk lansia adalah relaksasi, untuk penyakit tidak menular stroke,diabetes mellitus,hipertensi,dan obesitas. Inovasi Yankestrad dalam gedung dengan integrasi rujukan internal dari poliklinik lainnya seperti Poli umum, Poli rawat luka, Poli Gigi dan Poli Gizi ke Poli Yankestrad. Inovasi luar gedung berupa pembinaan asuhan mandiri Toga dan akupressure integrasi dengan kelompok asuhan mandiri (Asman) Toga akupressure dan Posyandu lansia. Kesimpulan Yankestrad di Puskesmas sangat berpotensi sebagai salah satu alternatif pelayanan kesehatan pada lansia. Disarankan untuk meningkatkan koordinasi lintas program dan lintas sektor agar pelayanan kesehatan tradisional dapat berjalan baik dan dapat mendukung pencapaian program lain, terutama program penyakit tidak menular dan lansia.
Suharmiati Suharmiati, Lestari Handayani, Zainul Khaqiqi Nantabah
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 126-134; doi:10.22435/hsr.v23i2.2361

Abstract:
Nowadays, Traditional Health Services increasingly in demand by the Indonesian Community. According to the National Basic Health Research data of 2018, 31.4% of the population utilized THS. Moreover, the practice of traditional medicine has widely provided in several places. Traditional health services at public hospitals are known as integrated traditional health services (ITHS). This study aims at analyzing the utilization of integrated traditional health services at public hospitals by the community in fi ve provinces. This study, a descriptive with a cross-sectional design, involved ten public hospitals. It selected according to the availability of traditional health services, which is before or since 2014. The number of patients (called respondents) interviewed was determined purposively as many as fi ve patients per hospital; therefore, there were fi fty people. The results of this study indicated that Integrated Traditional Health Services has utilized by most patients aged 20 to 50 years. Information sources regarding the availability of Traditional Health Services mainly from physicians or health professionals. Most respondents lived not far from hospitals so that access to the hospitals can be reachable. Most respondents are satisfi ed with the services accepted. Manager of Traditional Health Services is a physician. Even though most respondents said that not only the cost of treatment for Traditional Health Services is expensive, but also is not covered in benefi t packages of the National Health Insurance Scheme (JKN). Therefore, they remain seeking Traditional Health Services practicing out of pocket payment method. It is recommended that the financing of Traditional Health Services should be covered by Social Security Administration Body (BPJSK) through
Agung Dwi Laksono, Christyana Sandra
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 1-9; doi:10.22435/hsr.v23i1.2323

Abstract:
Policies to encourage childbirth in health care facilities were emphasized to reduce maternal mortality rates that are still high in Indonesia. The study was aimed at analyzing population, socio-economic, and resource input variables related to childbirth in health care facilities. This study used an ecological study approach (an aggregate study) sourced from the 2018 Indonesia Health Profi le. Bivariate analysis was performed using scatter plots and Pearson correlation tests. The results showed a wide disparity in terms of childbirth in health care facilities coverage. Maluku was the province with the lowest coverage (45.18%), while the highest coverage was achieved by DKI Jakarta (100%). The results of scatter plots and bivariate tests showed that the more population in a province, the higher the coverage of delivery in health care facilities, the deeper and worse the poverty in a province, the lower the coverage of delivery in health care facilities. The more obstetrician and hospitals in a province, there was a tendency for coverage of births in health care facilities to be higher. In conclusion, population, the ratio of obstetricians, and the ratio of hospitals have a positive relationship with deliveries in healthcare facilities. In contrast, the Poverty Depth and Severity Index has a tendency to had a negative relationship with the coverage of deliveries in health care facilities. It was recommended that the government formulate specifi c policies to target regions with a small population, poor and have a small number of obstetricians and hospitals. Abstrak Kebijakan mendorong persalinan di fasilitas pelayanan kesehatan ditekankan untuk menurunkan angka kematian ibu yang masih tinggi di Indonesia. Studi ditujukan untuk menganalisis variabel kependudukan, sosial-ekonomi dan input sumber daya yang berhubungan dengan persalinan di fasilitas pelayanan kesehatan. Desain studi menggunakan pendekatan studi ekologi (studi agregat) bersumber data Profi l Kesehatan Indonesia Tahun 2018. Analisis bivariat dilakukan dengan menggunakan scatter plot dan uji korelasi Pearson. Hasil penelitian menunjukkan disparitas persentase cakupan persalinan ke fasilitas pelayanan kesehatan yang sangat lebar, Provinsi Maluku memiliki cakupan paling rendah (45,18%), sementara cakupan tertinggi dicapai Provinsi DKI Jakarta (100%). Hasil scatter plot dan uji bivariat menunjukkan bahwa semakin banyak jumlah penduduk pada suatu provinsi maka ada kecenderungan cakupan persalinan di fasilitas pelayanan kesehatan menjadi semakin tinggi. Semakin dalam dan parah kemiskinan pada suatu provinsi maka ada kecenderungan cakupan persalinan di fasilitas pelayanan kesehatan menjadi semakin rendah. Semakin banyak dokter spesialis obgyn dan rumah sakit pada suatu provinsi maka ada kecenderungan cakupan persalinan di fasilitas pelayanan kesehatan menjadi semakin tinggi. Disimpulkan bahwa jumlah penduduk, rasio dokter spesialis obgyn dan rasio rumah sakit (RS) memiliki hubungan positif, sementara Indeks Kedalaman dan Keparahan Kemiskinan memiliki kecenderungan hubungan negatif dengan cakupan persalinan di fasilitas pelayanan kesehatan. Disarankan pemerintah menyusun kebijakan khusus pada sasaran wilayah dengan jumlah penduduk sedikit, miskin dan memiliki dokter spesialis obgyn dan RS yang sedikit.
Sri Idaiani, Tince Arniati Jovina, Widianto Pancaharjono, Danny Fajar Mogsa
Buletin Penelitian Sistem Kesehatan, Volume 23, pp 37-45; doi:10.22435/hsr.v23i1.2513

Abstract:
Treatment services for people with mental disorders at the community health care center (CHC) still have problems even though supporting policies are available. The purpose of this study was to provide recommendations on policies related to the treatment for people with mental disorders in CHC. This study was conducted in 2018. Data collection was carried out through the review of relevant regulatory documents and in-depth interviews with eleven informants. The results of the study showed that the type of mental disorders diagnosis was less appropriate to the needs. Moreover, the doctors prioritized services than the content of regulations. Problems also occurred on the unavailability of mental disorders medicine because of the insignifi cant number of cases and poor medicine needs planning. There was no sanction when the policy was not implemented. In conclusion, revision of the Minister of Health (MOH) decree number 514 is needed on the aspect of mental disorders diagnosis and competency level of the general practitioner. Dissemination of policies on mental health is needed for general practitioners. Abstrak Pelayanan pengobatan penderita gangguan jiwa di Puskesmas masih mengalami berbagai masalah meskipun kebijakan yang mendukung telah tersedia. Tujuan dari kajian ini adalah untuk memberikan rekomendasi kebijakan tentang pengobatan penderita gangguan jiwa di Puskesmas. Kajian dilaksanakan pada tahun 2018. Pengumpulan data dilakukan melalui telaah dokumen peraturan yang relevan serta wawancara mendalam terhadap sebelas informan. Hasil kajian menunjukkan jenis diagnosis gangguan jiwa yang kurang sesuai kebutuhan. Hal-hal lain yaitu dokter lebih mengutamakan pelayanan dibandingkan isi peraturan, ada masalah ketidaktersediaan obat gangguan jiwa karena kasusnya kecil dan perencanaan kurang baik. Tidak ada sanksi bila kebijakan tidak dijalankan. Kesimpulannya bahwa diperlukan perbaikan tentang jenis gangguan jiwa, tingkat kompetensi dokter umum pada Keputusan Menteri Kesehatan (KMK) nomor 514 tahun 2015 dan diperlukan sosialisasi bagi dokter tentang kebijakan kesehatan yang berlaku.
Back to Top Top