Ni Made Sri Nopiyani, Ni Made Sri
Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Udayana

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AKSEPTABILITAS, UTILISASI DAN ADOPSI UPAYA PENANGGULANGAN HIV MELALUI KADER DESA PEDULI AIDS DARI PERSPEKTIF MASYARAKAT DI KOTA DENPASAR Nopiyani, Ni Made Sri; Kurniati, Desak Putu Yuli; Indrayathi, Putu Ayu; Listryowati, Rina
ARCHIVE OF COMMUNITY HEALTH Vol 2, No 2 (2013)
Publisher : ARCHIVE OF COMMUNITY HEALTH

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Abstract

Village AIDS Cadres (KDPA) Program has been conducted in Denpasar district since 2010. Despite the importance of community participation for a successful community based program, no research has been conducted to explore community perception regarding KDPA program.This research is aimed to explore community perceptions regarding acceptability, utilization, and adoption of the KDPA program from community perspective.The design used in this research is descriptive with qualitative data collection method through six focus group discussions in six villages in Denpasar. Data was analysed using thematic analysis.KDPA is well-accepted as it is perceived as an important issue to be tackled in the community. However, many opinions arise concerning who should be given the role "cadre". Lack of program introduction to the community, also high stigma and discrimination resulted in low utilization of the program. Villages with active KDPA have conducted a variety of HIV-related activities rarely carried out by the less active villages. There is Lack of community participation on HIV-related activities. Inequity of access to HIV information exists between adults and teenagers, between men and women, and between the member of traditional and non-traditional hamlets. Program adoption is hampered by the lack of commitment of village authorities and limited resources of KDPA program.The utilization and adoption of KDPA program are sub-optimal. Introduction of KDPA program to the community and provision of program resources should be improved.
Mutu Pelayanan Puskesmas Perawatan yang Berstatus Badan Layanan Umum Daerah Indrayathi, Putu Ayu; Listyowati, Rina; Nopiyani, Ni Made Sri; Ulandari, Luh Putu Sinthya
Jurnal Kesehatan Masyarakat Nasional Vol 9 No. 2 November 2014
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (539.955 KB) | DOI: 10.21109/kesmas.v9i2.519

Abstract

Kebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan cara multistage random sampling. Data kualitatif dikumpulkan melalui wawancara mendalam kepada 13 penyedia pelayanan kesehatan yang dipilih secara purposive sampling. Data kuantitatif dianalisis secara deskriptif dan data kualitatif dianalisis dengan analisis tematik. Dari hasil penelitian, pelayanan di puskesmas perawatan berstatus BLUD di Gianyar dinilai kurang memuaskan karena keterbatasan peralatan medis dan kurangnya tenaga yang kompeten dalam pengelolaan keuangan. Pelatihan pengelolaan keuangan pada staf puskesmas dan perekrutan tenaga berlatar belakang akuntansi penting untuk dilakukan. Quality of Services in Health Care Center with General Services Agency StatusThe policy of primary health care as local public service agencies (BLUD) was established to improve the quality of basic health care services. The public service agencies primary health care policy has been implemented to all primary health care in Gianyar district since 2010. The implementation does not always improving health service quality. This research was aimed to overview the quality of services in primary health care with general services agency status in Gianyar district. This research was a crosssectional study with mixed of quantitative and qualitative approaches.This research was conducted in Gianyar between August and December 2013. The quantitative data was collected through questionaire survey to 105 patients in four primary health care who were chosen with multistage random sampling technique. The qualitative data was collected through in-depth interviews to 13 health care providers in primary health care who were chosen with pusposive sampling. The quantitative data was analysed descriptively and the qualitative data was analysed using thematic analysis. The result of the study was primary health care quality in BLUD puskesmas with inpatient services was perceived as poor due to the limited availability of medical equipment and lack of staff who major in financial management. Training on financial management and recruitment of staff with accounting background should be conducted.
Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan Nopiyani, Ni Made Sri; Indrayathi, Putu Ayu; Listyowati, Rina; Suarjana, I Ketut; Januraga, Pande Putu
Jurnal Kesehatan Masyarakat Nasional Vol. 9 No. 4 Mei 2015
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (138.866 KB) | DOI: 10.21109/kesmas.v9i4.734

Abstract

AbstrakPekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun sebagian PSP memiliki kemauan untuk menjadi peserta JKN dan memiliki kemampuan membayar iuran JKN. Faktor penghambat akses JKN pada PSP adalah rendahnya pengetahuan mengenai prosedur pendaftaran dan portabilitas JKN, kekhawatiran keberlanjutan pembayaran iuran, persepsi buruk mengenai kualitas layanan yang akan diterima jika menggunakan JKN, ketidaklengkapan administrasi kependudukan serta kebijakan yang mengharuskan peserta bukan penerima bantuan iuran (Non-PBI) Mandiri untuk mendaftarkan seluruh anggota keluarga. Akses JKN pada PSP terhambat oleh faktor-faktor individual, layanan dan kebijakan yang perlu diatasi untuk meningkatkan cakupan JKN pada PSP. AbstractFemale sex workers (FSW) is marginalized social group having a high vulnerability of health problems. Effort to expand national health insurance on FSW is still limited, so it is necessarily performed in order to support the achievement of universal health coverage. This study aimed to obtain the depiction of the insurance access among FSW in Denpasar. This study was qualitative. Data was collected through in-depth interview of 15 FSW and four pimps in Denpasar from August to October 2014. The interview result was analyzed using thematic analysis. The analysis framework used was The Health Access Livelihood Framework. The insurance ownership among FSW in Denpasar was low, even though some FSW were willing to be participants and afford to pay the premium. Factors inhibiting the insurance access were the lack of knowledge regarding registration procedures and portability, fear of premium payment sustainability, negative perceptions of quality of services that would be received if using the insurance, incomplete population administration and policy requiring independent non-premium support receiver participants to register all of their family members. The insurance access among FSW was hindered by individual, service and policy factors that need to be conquered to increase the insurance coverage among FSW.
Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan Nopiyani, Ni Made Sri; Indrayathi, Putu Ayu; Listyowati, Rina; Suarjana, I Ketut; Januraga, Pande Putu
Jurnal Kesehatan Masyarakat Nasional Vol. 9 No. 4 Mei 2015
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (138.866 KB) | DOI: 10.21109/kesmas.v9i4.734

Abstract

AbstrakPekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun sebagian PSP memiliki kemauan untuk menjadi peserta JKN dan memiliki kemampuan membayar iuran JKN. Faktor penghambat akses JKN pada PSP adalah rendahnya pengetahuan mengenai prosedur pendaftaran dan portabilitas JKN, kekhawatiran keberlanjutan pembayaran iuran, persepsi buruk mengenai kualitas layanan yang akan diterima jika menggunakan JKN, ketidaklengkapan administrasi kependudukan serta kebijakan yang mengharuskan peserta bukan penerima bantuan iuran (Non-PBI) Mandiri untuk mendaftarkan seluruh anggota keluarga. Akses JKN pada PSP terhambat oleh faktor-faktor individual, layanan dan kebijakan yang perlu diatasi untuk meningkatkan cakupan JKN pada PSP. AbstractFemale sex workers (FSW) is marginalized social group having a high vulnerability of health problems. Effort to expand national health insurance on FSW is still limited, so it is necessarily performed in order to support the achievement of universal health coverage. This study aimed to obtain the depiction of the insurance access among FSW in Denpasar. This study was qualitative. Data was collected through in-depth interview of 15 FSW and four pimps in Denpasar from August to October 2014. The interview result was analyzed using thematic analysis. The analysis framework used was The Health Access Livelihood Framework. The insurance ownership among FSW in Denpasar was low, even though some FSW were willing to be participants and afford to pay the premium. Factors inhibiting the insurance access were the lack of knowledge regarding registration procedures and portability, fear of premium payment sustainability, negative perceptions of quality of services that would be received if using the insurance, incomplete population administration and policy requiring independent non-premium support receiver participants to register all of their family members. The insurance access among FSW was hindered by individual, service and policy factors that need to be conquered to increase the insurance coverage among FSW.
Impact of Budget Increase on Primary Health Care Performance in the Era of National Health Insurance: Case Study in Buleleng District Suranugraha, Kadek; Nopiyani, Ni Made Sri; Januraga, Pande Putu
Jurnal Kesehatan Masyarakat Nasional Volume 13, Issue 2, November 2018
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1230.049 KB) | DOI: 10.21109/kesmas.v13i2.1875

Abstract

Since 2014, there has been an increase in funds for primary health care (PHC) coming from the National Health Insurance program capitation funds and the Health Operational Assistance Fund. This study aimed to explore the effect of this budget increase on the health care services at PHC. The case study used a qualitative approach and interviews from 19 PHC health workers with the highest and lowest budget. Data were analyzed using thematic analysis and supported by quantitative data. The positive impact of the increasing PHC budget was felt by PHC staff due to the addition of operational equipment and incentives provided. Nevertheless, there was also a negative impact such as feeling overwhelmed due to an increase in the quantity of PHC activities and additional administrative affairs. It also triggered a negative interaction between staff due to the number of incentives received. The regulation on the use of budget empowers PHC to better arrange the schedule of activities and manage human resources. However, these regulations are considered restrictive and the administrative flow of funds is too long that hinder the optimal use of the budget.
The Opportunity Implementation HIV Prevention Infection Program from Mother to Child in Bali Giri, Ketut Espana; Nopiyani, Ni Made Sri; Merati, Tuti Parwati
Journal of Global Research in Public Health Vol 3 No 2 (2018)
Publisher : Program Studi Ilmu Kesehatan Masyarakat Stikes Surya mitra Husada Kediri

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/jgrph.v3i2.65

Abstract

Women infected with HIV can transmit HIV from mother to child during pregnancy, childbirth and lactation. Implementation of programs to prevent HIV transmission from mother to child (PPIA) in Bangli not been implemented optimally. The study was conducted to determine the chances of program implementation PPIA, faced viewed from the perspective of users and service providers. The study is a qualitative case study approach. Collecting data with in-depth interviews using interview guide to users and service providers. Informants were selected purposively as many as 18 people of 10 pregnant women, two counselors, two laboratory workers, 2 heads of health centers, 1 holder of program P2, and 1 Sekretais KPA Bangli regency. Data collection was conducted April-May 2016 in Puskesmas Losses Tembuku I and II health center in Bangli regency. Analysis of data using thematic analysis. Opportunities from service users say that husbands and health professionals strongly support pregnant women to take the test. Service providers revealed no support from the public, especially health workers and community leaders in collecting pregnant women.Opportunities users is the support of their husbands and health professionals, while opportunities are providers of community support and cooperation within the team
The Opportunity Implementation HIV Prevention Infection Program from Mother to Child in Bali Giri, Ketut Espana; Nopiyani, Ni Made Sri; Merati, Tuti Parwati
Journal of Global Research in Public Health Vol 3 No 2 (2018)
Publisher : Program Studi Ilmu Kesehatan Masyarakat Stikes Surya mitra Husada Kediri

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/jgrph.v3i2.65

Abstract

Women infected with HIV can transmit HIV from mother to child during pregnancy, childbirth and lactation. Implementation of programs to prevent HIV transmission from mother to child (PPIA) in Bangli not been implemented optimally. The study was conducted to determine the chances of program implementation PPIA, faced viewed from the perspective of users and service providers. The study is a qualitative case study approach. Collecting data with in-depth interviews using interview guide to users and service providers. Informants were selected purposively as many as 18 people of 10 pregnant women, two counselors, two laboratory workers, 2 heads of health centers, 1 holder of program P2, and 1 Sekretais KPA Bangli regency. Data collection was conducted April-May 2016 in Puskesmas Losses Tembuku I and II health center in Bangli regency. Analysis of data using thematic analysis. Opportunities from service users say that husbands and health professionals strongly support pregnant women to take the test. Service providers revealed no support from the public, especially health workers and community leaders in collecting pregnant women.Opportunities users is the support of their husbands and health professionals, while opportunities are providers of community support and cooperation within the team
Mutu Pelayanan Puskesmas Perawatan yang Berstatus Badan Layanan Umum Daerah Indrayathi, Putu Ayu; Listyowati, Rina; Nopiyani, Ni Made Sri; Ulandari, Luh Putu Sinthya
Jurnal Kesehatan Masyarakat Nasional Vol 9 No. 2 November 2014
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (539.955 KB) | DOI: 10.21109/kesmas.v9i2.519

Abstract

Kebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan cara multistage random sampling. Data kualitatif dikumpulkan melalui wawancara mendalam kepada 13 penyedia pelayanan kesehatan yang dipilih secara purposive sampling. Data kuantitatif dianalisis secara deskriptif dan data kualitatif dianalisis dengan analisis tematik. Dari hasil penelitian, pelayanan di puskesmas perawatan berstatus BLUD di Gianyar dinilai kurang memuaskan karena keterbatasan peralatan medis dan kurangnya tenaga yang kompeten dalam pengelolaan keuangan. Pelatihan pengelolaan keuangan pada staf puskesmas dan perekrutan tenaga berlatar belakang akuntansi penting untuk dilakukan. Quality of Services in Health Care Center with General Services Agency StatusThe policy of primary health care as local public service agencies (BLUD) was established to improve the quality of basic health care services. The public service agencies primary health care policy has been implemented to all primary health care in Gianyar district since 2010. The implementation does not always improving health service quality. This research was aimed to overview the quality of services in primary health care with general services agency status in Gianyar district. This research was a crosssectional study with mixed of quantitative and qualitative approaches.This research was conducted in Gianyar between August and December 2013. The quantitative data was collected through questionaire survey to 105 patients in four primary health care who were chosen with multistage random sampling technique. The qualitative data was collected through in-depth interviews to 13 health care providers in primary health care who were chosen with pusposive sampling. The quantitative data was analysed descriptively and the qualitative data was analysed using thematic analysis. The result of the study was primary health care quality in BLUD puskesmas with inpatient services was perceived as poor due to the limited availability of medical equipment and lack of staff who major in financial management. Training on financial management and recruitment of staff with accounting background should be conducted.