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AKSEPTABILITAS, UTILISASI DAN ADOPSI UPAYA PENANGGULANGAN HIV MELALUI KADER DESA PEDULI AIDS DARI PERSPEKTIF MASYARAKAT DI KOTA DENPASAR

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

Jurnal Kesehatan Masyarakat Nasional Vol 9 No. 2 November 2014
Publisher : Faculty of Public Health Universitas Indonesia

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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.

ASSESSMENT OF LIFE QUALITY OF CERVICAL CANCER PATIENTS DELIVERED BLEOMYCIN ONCOVIN MITOCYN PLATINUM (BOMP) CHEMOTHERAPY REGIMENS IN SANGLAH DENPASAR

International Journal of Biosciences and Biotechnology Vol 2, No 2 (2015)
Publisher : International Journal of Biosciences and Biotechnology

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Abstract

Cervical cancer disease is one of cancers that attack many women in the world and ranks second afterbreast cancer. Symptoms of cervical cancer may cause degradation quality of patients life.Chemotherapy is one of treatments of cervical cancer patients. Chemotherapy provides therapeuticeffects, however, it can causes a decrease in life quality due to its side effects. BOMP is one ofregimens that can be used as one of the management of cervical cancer. Assessment of quality ofpatients life with cervical cancer are needed to see the changes in the quality of life in patients besidesknowing the functional status changes from time to time. Monitoring the effects of treatment, andcollecting the data on quality of life can be used as initial data for consideration in formulating theappropriate action for the patient, And also assist physicians in selecting an effective and welltolerated drug for patients.The study was conducted in February to June 2014 in Obstetrics Clinic andCempaka Timur Room General Hospital (RSUP) Sanglah in observational design with cross sectionalprospective. The sample selection is done by consecutive sampling. The methods used for datacollection using questionnaires EORTC QLQ with interview techniques before and afterchemotherapy in patients suffering cervical cancer of squamous cell stage IIB - IIIB who had BOMPchemotherapy regimens for 3 series in RSUP Sanglah. Research for quality of life is conducted ingeneral and the 15 domains that affect the quality of life of patients. In this study, 12 patients indicatedthe inclusion criteria. There were significant differences in the value of the quality of life of patientswith cervical cancer squamous cell stage IIB - IIIB before and after BOMP chemotherapy with 0.001p value. BOMP chemotherapy regimens can improved the quality of life of cervical cancer patientsincreasing from 44.833 ± 6.235 to 60.333 ± 9.168. In 15 ratings domain included decrease the qualityof life of pain domain, nausea domain, vomiting domain, decreased appetite domains, fatigue domain,physical function domain, functional role domain, social functioning domain, sleeplessness domain,constipation domain and domain of financial difficulties and on the other hand emotional domainincrease.

Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan

Jurnal Kesehatan Masyarakat Nasional Vol. 9 No. 4 Mei 2015
Publisher : Faculty of Public Health Universitas Indonesia

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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.

PERSEPSI PENGGUNA LAYANAN KESEHATAN PRIMER MENGENAI KUALITAS PELAYANAN PADA PUSKESMAS BADAN LAYANAN UMUM DI KABUPATEN GIANYAR

ARCHIVE OF COMMUNITY HEALTH Vol 3, No 1 (2016)
Publisher : ARCHIVE OF COMMUNITY HEALTH

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Abstract

One of the reasons for establishing Public Service Agency (BLU) policy at Community Health Care Centers is the number of complaints for poor quality services. This policy was implemented in January 2010 by the Gianyar Government in every Community Health Care Center in Gianyar.  This is the realization of the Gianyar Governments attention in improving the quality of the Community Health Care Center Services.  This study aims to determine the public perception of the quality of services provided by the Community Health Care Center in Gianyar District. This study was a cross-sectional analytic study and conducted at four Community Health Care Centers with BLUD’s status in Gianyar District with 105 respondents selected by multistage random sampling method. The data collection included survey questionnaires and analyzed descriptively by chi square test. The results showed that overall the respondents had a "good" perception towards the elements of Community Health Care Center services with BLU status in Gianyar District. However, there are three elements that were "perceived as poor" comprising responsiveness (14.3%), accuracy (11.4%) and environmental comfort (12.4%). The results of the chi square test showed that there were significant differences between the age factors with the respondent perceptions of service quality in Community Health Care Center with BLU status (p = 0.004), but gender, education level and occupation did not have a meaningful relationship. This research suggests that the Health Office should increase the intensity of coaching and facilitation of procedures related to the Community Health Care Center so that the expected performance of attendant care becomes more patterned.

PEMETAAN BERDASARKAN LOKASI DAN JUMLAH PESAING PUSKESMAS PERAWATAN DI KABUPATEN GIANYAR YANG BERSTATUS BLUD SEBAGAI DASAR PENYUSUNAN STRATEGI BISNIS

ARCHIVE OF COMMUNITY HEALTH Vol 3, No 1 (2016)
Publisher : ARCHIVE OF COMMUNITY HEALTH

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Abstract

Community health care center (Puskesmas) as gate keeper is the first level of health care that is closest to the people. Since January 2010, several puskesmas which provide inpatient care in Kabupaten Gianyar has become public service agencies (BLUD) to improve quality and access to health care services for community During the implementation of such policy, it is important to review its effectiveness especially with so many competitors in the community. This study was a cross-sectional descriptive study. Research carried out in existing health facilities competitors in the work area BLUD community health care centers in Gianyar.  Mapping was conducted using GIS and processed by the Epi Info system. The results showed that the four community health care centers in Gianyar treatments have different levels of competition. Puskesmas Ubud I has a very high density of competition, while Puskesmas Tegallalang II has very little of competition. The implementation of such policy in Puskesmas Payangan and Puskesmas Tegallalang II is considered very effective because far from city and rarely finding a competitor health facilities. This research recommend the community health care center to improve the promotion about existence of health care centers and quality of health care services so that communities in the solid area of competitor can switch utilize community health care center services.

The Implementation of Credentialing for First-Level Health Facilities of Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan Denpasar

Jurnal Kesehatan Masyarakat Vol 12, No 1 (2016): JURNAL KESEHATAN MASYARAKAT (KEMAS) JULY 2016
Publisher : Jurusan Ilmu Kesehatan Masyarakat Fakultas Ilmu Keolahragaan

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Abstract

The implementation of credentialing program in JKN is different from the previous era, particularly for new medical facilities and medical provider of PT. Jamsostek and ASABRI. Therefore, this study aims at finding out the description associated with the process of credentialing implementation of the first-level health facilities from the perspective of PPK 1 and BPJS Kesehatan, Denpasar Branch. This research was conducted in January 2014 using qualitative approach. Data was collected through in-depth interviews to 11 medical facilities, as well as 2 executive credentialing teams from BPJS Kesehatan, Denpasar Branch. The subjects were selected purposively and the data was analyzed using thematic analysis. There are still some obstacles in the implementation of such credentialing program: there are still existing providers, especially TNI/Polri, which have the value below standard but are still contracted to serve JKN participants because the number is still relatively small. The new medical facilities have difficulty in self-assessment because there are many indicators that must be met, but the budget is limited. The study concludes that credentialing program has not yet fully applied the concept of managed care, thus regular monitoring to improve medical quality is needed.

EVIDENCE OF HARM REDUCTION EFFECTIVENESS IN PREVENTING HIV SPREAD AMONG INJECTING DRUG USERS

Jurnal Ilmu Kesehatan Masyarakat Vol 1, No 3 (2010): Jurnal Ilmu Kesehatan Masyarakat
Publisher : Faculty of Public Health Universitas Sriwijaya

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Abstract

Latar Belakang: Jumlah pemakai narkoba suntik (penasun) senantiasa meningkat di hampir semua belahan dunia. Penasun merupakan salah satu faktor penyebab meningkatnya penyebaran virus HIV. Oleh karena itu,stategi untuk menanggulangi penyebaran virus HIV diantara penasun harus segera dikembangkan untukmeminimalkan penyebaran virus HIV dan dampak negatif lainnya. Salah satu metode yang bisa dipakai untuk meminimalkan penyebaran virus HIV adalah dengan program harm reduction.Metode: Metode yang dipakai dalam makalah ini adalah review dari literatur yang ada untuk menganalisa keefektifan program harm reduction untuk mencegah penyebaran virus HIV pada penasun.Hasil Penelitian: Intisari dari program harm reduction adalah untuk meminimalkan dampak negatif dari penggunaan obatobatan terlarang melalui jarum suntik seperti penyakit yang menular melalui darah,overdosis, komplikasi mediskarena menggunakan obat-obat terlarang dan dampak sosial lainnya tanpa harus menghentikan penggunaan obat secara seketika.Tujuan dari program harm reduction adalah menjaga agar penasun tetap bisa hidup sehatdan produktif sampai program ini dapat mengurangi ketergantungan penasun akan narkoba. Dalam prakteknya,ada beberapa strategi yang dipakai dalam program harm reduction yaitu needle syringe programs (NSP), drugreplacement therapy, voluntary counselling and testing (VCT) and HIV Outreach Program and Education.Pendekatan harm reduction telah terbukti efektif mampu mengurangi perilaku beresiko para penasun sehinggamampu mencegah penyebaran virus HIV. Pelaksanaan program harm reduction secara menyeluruh sangatmendesak untuk dilaksanakan, terutama di Negara-negara yang menghadapi peliknya permasalahan HIV/AIDS.Kesimpulan: Harm reduction bertujuan untuk meminimalkan permasalahan yang timbul karena penggunaan obat-obatan terlarang terutama pengguna narkoba suntik. Program ini aman untuk diterapkan dan tetap menjunjung harkat,martabat dan hak asasi para penasun.Kata kunci: harm reduction, HIV, penasun, needle syringe program and VCT.

The Implementation of Credentialing for First-Level Health Facilities of Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan Denpasar

KEMAS: Jurnal Kesehatan Masyarakat Vol 12, No 1 (2016)
Publisher : Department of Public Health, Faculty of Sport Science, Universitas Negeri Semarang

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Abstract

The implementation of credentialing program in JKN is different from the previous era, particularly for new medical facilities and medical provider of PT. Jamsostek and ASABRI. Therefore, this study aims at finding out the description associated with the process of credentialing implementation of the first-level health facilities from the perspective of PPK 1 and BPJS Kesehatan, Denpasar Branch. This research was conducted in January 2014 using qualitative approach. Data was collected through in-depth interviews to 11 medical facilities, as well as 2 executive credentialing teams from BPJS Kesehatan, Denpasar Branch. The subjects were selected purposively and the data was analyzed using thematic analysis. There are still some obstacles in the implementation of such credentialing program: there are still existing providers, especially TNI/Polri, which have the value below standard but are still contracted to serve JKN participants because the number is still relatively small. The new medical facilities have difficulty in self-assessment because there are many indicators that must be met, but the budget is limited. The study concludes that credentialing program has not yet fully applied the concept of managed care, thus regular monitoring to improve medical quality is needed.

Basis for Development of Business Strategic Plan Primary Health Care with Local Public Service Entity Status in Gianyar District

Jurnal Kesehatan Masyarakat Nasional Volume 11, Issue 2, November 2016
Publisher : Faculty of Public Health Universitas Indonesia

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Abstract

Primary health care as Local Public Service Entity needs to make the right business strategic plan. Arranging business plan needs to pay attention to its competitors operating around its working area. This study aimed to determine internal and external environmental factors in Ubud 1 and Tegallalang 1 Primary Health Care and develop model of business strategic plan development in both primary health cares with Local Public Service Entity status. This study was descriptive explorative conducted in 2014. Data were collected through questionnaires, and documentation study. Samples were determined purposively or taken non-proportionally, consisting of Ubud 1 and Tegallalang 1 Primary Health Care heads and staff. Data were analyzed by descriptive quantitative analysis. Results of internal and external factor analysis in both primary health cares showed similar findings. Most indicators of internal variable were strength, only quantities of medical and non-medical workers were the weaknesses in program development. Meanwhile, external factor analysis showed that most indicators of external variable were opportunities and it was only people’s lifestyle toward environment as the threat in program development. In conclusion, the development strategic position in Ubud 1 Tegallalang 1 was growth strategy.AbstrakPuskesmas yang berbentuk Badan Layanan Umum Daerah (BLUD) perlu membuat rencana strategi bisnis yang tepat. Penyusunan rencana strategi bisnis perlu memerhatikan pesaing yang beroperasi di sekitar wilayah kerja. Penelitian ini bertujuan untuk mempelajari aspek lingkungan internal dan eksternal di Puskesmas Ubud 1 dan Tegallalang 1 serta mengembangkan model pengembangan rencana strategi bisnis di kedua puskesmas yang berstatus BLUD tersebut. Penelitian ini merupakan penelitian deskriptif eksploratif yang dilakukan pada tahun 2014. Data dikumpulkan melalui penyebaran kuesioner dan studi dokumentasi. Sampel penelitian ditentukan secara purposif dan diambil secara non proporsional, terdiri dari kepala dan staf Puskesmas Ubud 1 dan Tegallalalng 1. Data dianalisis secara deskriptif kuantitatif. Hasil analisis faktor internal dan eksternal kedua puskesmas menunjukkan hasil yang sama. Sebagian besar indikator variabel internal merupakan kekuatan, hanya kuantitas tenaga kerja bidang medis dan nonmedis sebagai kelemahan dalam pengembangan program. Sedangkan hasil analisis faktor eksternal menunjukkan sebagian besar indikator variabel eksternal merupakan peluang dan hanya perilaku masyarakat terhadap lingkungan yang merupakan ancaman dalam pengembangan program. Sebagai kesimpulan, posisi strategis pengembangan di Puskesmas Ubud 1 dan Tegallalang 1 adalah strategi pertumbuhan.