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Buletin Penelitian Sistem Kesehatan
Buletin Penelitian Sistem Kesehatan diterbitkan sejak 1994 dan sejak tahun 2006 terbit dengan frekuensi 4 kali setahun. Redaksi menerima naskah ilmiah tentang hasil-hasil penelitian, survei, dan tinjauan pustaka yang erat hubungannya dengan bidang sistem dan kebijakan kesehatan. Jurnal ini telah terakreditasi Lembaga Ilmu Pengetahuan Indonesia (LIPI)
Articles
544
Articles
Kajian Pelaksanaan Kebijakan Penanggulangan HIV/AIDS di Kabupaten Tanah Bumbu

Juhairiyah, Juhairiyah ( Balai Litbang P2B2 Tanah Bumbu Kawasan Perkantoran Pemda Kabupaten Tanah Bumbu, Gunung Tinggi Tanah Bumbu, Kalimantan Selatan ) , Marlinae, Lenie ( Program Studi Kesehatan Masyarakat Fakultas Kedokteran Universitas Lambung Mangkurat )

Buletin Penelitian Sistem Kesehatan Vol 19, No 4 (2016)
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

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Abstract

In order to provide legal certainty and legal protection against HIV/AIDS prevention and control in districts, the Tanah Bumbu District government has issued district regulation Number 7 year 2013 on HIV/AIDS prevention and control. By the district regulation, increasing of HIV/AIDS epidemic in Tanah Bumbu District could be minimezed but HIV cases ranked the highest and AIDS cases ranked the second highest among all districts in South Kalimantan Province. So, the study aimed to implementation the policies of HIV/AIDS control in Tanah Bumbu District. It was an observational study with acros sectional design. Data were collected by in-depth interviews to policy actors and also collection of secondairy data of policy documents on HIV/AIDS prevention and control, data of HIV/AIDS cases from KPA Tanah Bumbu. The highest HIV/AIDS cases in Tanah Bumbu district were among direct sex workers. Policy analysis by gap analysis on implementation the HIV/AIDS control in Tanah Bumbu District. Data were analyzed descriptively. The implementation of the HIV/AIDS control was not optimal, including promotive and preventive efforts that were still not maximal as lck of coordination and facilitation. Tanah Bumbu District Hospital as a people living with HIV (ODHA) hospital referral was not optimum, to provide services of counseling and voluntary testing, health care, treatment and support for people living with HIV. It needs coordinationon on HIV/AIDS control program among related institutions and Non Government Organization so that did not conduct the program individually.ABSTRAK Dalam rangka memberikan kepastian hukum dan perlindungan hukum terhadap pencegahan dan penanggulangan HIV/AIDS di daerah, Pemerintah Kabupaten Tanah Bumbu telah mengeluarkan peraturan daerah nomor 7 tahun 2013 tentang Pencegahan dan Penanggulangan HIV/AIDS. Dengan Perda tersebut seharusnya epidemi HIV/AIDS di Kabupaten Tanah Bumbu dapat ditekan perkembangan namun kasus HIV menempati urutan tertinggi dan kasus yang merupakan tertinggi kedua di antara semua Kabupaten di Provinsi Kalimantan Selatan. Sehingga penelitian ini bertujuan mengkaji pelaksanaan kebijakan penanggulangan HIV/AIDS di Kabupaten Tanah Bumbu. Jenis penelitian adalah observasional dengan desain potong lintang. Pengumpulan data dengan wawancara mendalam kepada pelaku kebijakan serta penumpulan data sekunder yaitu dokumen kebijakan tentang pencegahan dan penanggulangan HIV/AIDS serta data kasus HIV/AIDS dari KPA Kabupaten Tanah Bumbu. Analisis kebijakan dengan analisis kesenjangan antara kebijakan dan dengan pelaksanaan pencegahan HIV/AIDS di Kabupaten Tanah Bumbu. Analisis data secara deskriptif. Kasus HIV/AIDS tertinggi di Kabupaten Tanah Bumbu pada Wanita Penjaja Seks Langsung. Pelaksanaan kebijakan masih belum optimal, diantaranya upaya promotif dan preventif yang masih belum maksimal seperti kurangnya koordinasi dan fasilitas. Rumah sakit pemerintah Kabupaten Tanah Bumbu sebagai rumah sakit rujukan ODHA, belum berjalan maksimal untuk menyediakan layanan konsultasi dan tes sukarela, perawatan, pengobatan dan dukungan bagi ODHA. Perlu koordinasi rencana terhadap program penanggulangan dari instansi terkait serta LSM agar tidak berjalan masing-masing.

The Contribution of Public Health Center to Reducing Maternal Mortality

Irianto, Joko, Suharjo, Suharjo

Buletin Penelitian Sistem Kesehatan Vol 19, No 1 (2016)
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

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Abstract

Backgroud: The health problems can be described on the number of Maternal Mortality (MMR), the higher of MMR toindication of so many health problems. Maternal mortality is closely related to access of quality health care. Quality access willprovide opportunities for mothers to get prenatal care, aid delivery, and good treatment. Public health care is health facilitiesearly referral of maternal care in villages, and then Public health care will be referred to a PONEK hospital if necessary.Objective: To knows the difference that maternal health services are carried out in PONED and non PONED Public healthcenters. Methods: To combine datas of Village Potential 2011, Maternal Mortality Follow-Up Study of Population Census2012 and Research Health Facilities 2011 for analysis. Field confi rmation in two health centers and two hospitals in Bekasiand Bogor cities for cases maternal death of during pregnancy, during childbirth, miscarriage, and after birth (postnatal).Results: The hospitals can prevent maternal death during pregnancy or during childbirth. At public health care, the risk formaternal death during childbirth is higher than postnatal OR = 1.9 (CI: 1.22 to 3.0), maternal death during pregnancy andmiscarriage in PONED is higher than Non PONED but not signifi cant (p > 0.05). At public health care not PONED, birthattendants is a factor in the recommendation to referral (p < 0.05). Conclution: The hospital facilities are able to PONEKthe best services for mothers who need obstetric treatment. The midwives are important to reducing maternal mortality,they should be closer access to birth attendants and to perform appropriate referrals. Recommendation: The hospitalsare need to be reinforced services capable PONEK and within easy reach from public health centers.

Analysis of First Level Health Care Facility (FKTP) Readiness as ‘Gatekeeper’ on The JKN Implementation in East Kalimantan and Central Java Year 2014

Budiarto, Wasis ( Puslitbang Humaniora dan Manajemen Kesehatan, Badan Litbang Kesehatan, Kemenkes RI ) , Oktarina, Oktarina ( Puslitbang Humaniora dan Manajemen Kesehatan, Badan Litbang Kesehatan, Kemenkes RI )

Buletin Penelitian Sistem Kesehatan Vol 19, No 1 (2016)
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

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Abstract

Background: FKTP as a gatekeeperhas four function such us: the fi rst contact, sustainability, comprehensive healthcare and coordination. Readiness from input aspects on health care involves health care facilities, fi nance, humanresources, medicines and medical devices. This research is to identify the FKTP readiness as a gatekeeper in the inthe implementationof JKN in East Kalimantan and Central Java. Methods: Data collection wasby conducting interviews,observation and documents’ review. The data analysis techniques were descriptive statistics for quantitative and Miles,Huberman and Spradley concept qualitative. There were 6 health centers, 2 primary clinics, 6 doctors and 3 private dentistryclinics for each province. Results: The numbers of FKTP availability were 23.7 health centers and 3.2 primary clinics perdistrict/city. The average was 51.7 FKTP per district/city. Not all of primary clinics facilited by inpatient care. There were44% primary clinics facilitated by laboratory and 56% in collaboration with privatelaboratory. The highest ratio of numberof members by the population was Surakarta i. e. 1 member by 1.98 population. While, the lowest was East Kutai with 1member by 4.65 population. All health centres had been implementing gatekeeper functions. Most of primary clinics had beendone the functions while less of them had not already implemented excellent service yet. Phycisians had implemented theirfunctions as the fi rst contact and coordination very well. Moreover, dentist did the same as the fi rst contact. Conclusion:Availability of health centers as FKTP was adequate. Health centers were also ready to function as a gatekeeper for JKNimplementation. Primary clinics were ready for the fi rst contact and coordination; and dentist as the fi rst contact were allready. Recomendation: The numbers of health facilities need to be build and improved according to district/city’s capability.Moreover, health workers’ distribution should be focussed to primary health care.

Dental Health Behavior in the Prevention of Pulmonary TB at Health Centre in Several Provinces

Notohartojo, Indirawati Tjahja ( Pusat Teknologi Terapan Kesehatan dan Epidemiologi Klinik, Badan Penelitian dan Pengembangan Kesehatan, Jl. Percetakan Negara 29 Jakarta ) , Tana, Lusianawaty ( Pusat Teknologi Terapan Kesehatan dan Epidemiologi Klinik, Badan Penelitian dan Pengembangan Kesehatan, Jl. Percetakan Negara 29 Jakarta )

Buletin Penelitian Sistem Kesehatan Vol 18, No 4 Okt (2015)
Publisher : Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat

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Abstract

Background: Pulmonary TB is an infectious disease of the respiratory tract caused by bacteria. Dental health professionals such as dentists and dental nurses are in charge of health personnel to prevent, treat, cure, teeth the mouth, so as not to arise or aggravate toothache. In doing their job as dental health workers is expected to use gloves or masks, and always wash their hands to avoid the transmission of pulmonary TB disease. Methods: A cross sectional study was conducted involving 78 dental health professionals in 50 primary health centers that were chosen in six districts in three provinces of Banten, South Kalimantan and Gorontalo. Data were obtained by interviews and processed using SPSSResults: More than 90% dental health workers in work wore masks gloves and washed their hands after work. There was a signifi cant relationship between exercise with dental health professionals with a p value of 0.007, which means a signifi cant. Conclusion: In performing their duties, dental health workers have already used personal protective equipment such asmasks, gloves, and washed their hands and did enough exercise. Recommendation: need to increase knowledge about pulmonary TB in dental health professionals.

Herbal Therapy Assessment Study in Holistic at Jamu Registry

Widowati, Lucie ( Pusat Teknologi Terapan dan Epidemiologi Klinik, Badan Litbang Kesehatan, Jl. Percetakan Negara 29 Jakarta ) , Siswanto, Siswanto ( Pusat Teknologi Terapan dan Epidemiologi Klinik, Badan Litbang Kesehatan, Jl. Percetakan Negara 29 Jakarta )

Buletin Penelitian Sistem Kesehatan Vol 18, No 4 (2015)
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

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Abstract

Background: The Study of Jamu Registry has been done, which is an observational longitudinal study to record the treatment of herbal medicine by physician practices. Respondents are a network of physicians who practice herbal medicine as complementary services. Methods: As researchers did not introduce any interventions, the study is basically observational study. Result: From patient’s jamu medical data records, wich is delivered to Registry Center, there were 1452 patients visited, divided into 908 initial visits and 544 follow-up visits. The most usage of the modalities was jamu (63.5%), followed by combination of jamu and conventional drug (22.26%) and jamu combined body-based therapy (5.2%). Assessment holistic therapy can be enhanced by the patient’s symptoms (anamnesis) and scores of Quality of Life (QoL) on the second visit (372 patients). There were a decrease of all the symptoms, the most decrease was common symptom (30%), respiratory tract (21.3%), musculoskeletal (15.5%), neurological (11.4%), gastrointestinal (10.2%), cardio vascular (1.5%) and urinary tract symptoms (3.8%). Based on the modalities given to the patient, who stands out is that the administration of jamu, lowering the general, musculoskeletal and neurological symptom. The combination of herbal medicine and conventional drug lowers the common and neurological symptom. Improvement of Quality of life patients can described as Qol “improved” category rising 20.1%, Qol “settled” category decreased 20.0% and “worsten” category decreased 1%. Conclusion: Based on type of modality used, there was increasing the value of improved QoL categories, respectively: the combination of herbal and conventional drugs, a combination of herbs and body based therapy, and combination jamu, body based therapy and conventional drugs. Recommendation: improvement of holistic therapy in the registry jamu can be used as a baseline formula of jamu, which can be developed for clinical observational studies or clinical trials.

Traditions Infl uence Into Behavior in Health Care (Ethnographic Case Study on Health Workers Muyu Tribe)

Laksono, Agung Dwi ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kemenkes RI, Jl. Indrapura 17 Surabaya ) , Faizin, Khoirul ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kemenkes RI, Jl. Indrapura 17 Surabaya )

Buletin Penelitian Sistem Kesehatan Vol 18, No 4 (2015)
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

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Abstract

Background: Muyu Tribes have an open mind toward modernization, while still holding fast to some beliefs that often collide with each other, not to mentional so the case in the original Muyu health workers. For health workers who came from the tribe Muyu, in daily life, it seems as if stuck on the pull two poles of different beliefs, and even sometimes the opposite.Medical concepts are studied and are believed to be a health worker was overlap and collide with the belief in the concept as part of the cultural tradition of his tribe. This study was conducted to explore in depth the pull of tradition surrounding the Muyu health workers. Methods: This research is a case study carried out in depth on indigenous health workers Muyutribe. This ethnography research was conducted in Mindiptana, District Digoel. Data collection was performed by means of participant observation, in-depth interviews and document searches. Result: The research results showed the infl uence of western and migrants in some ways helped change the mindset or perspective of health workers to be able to receivethe pattern rationalistic offered. But within certain limits if health workers are stuck in the old tradition of Muyu who tend to be irrational and mystical. Conclusion: Empirical fact that their tradition Muyu Tribe (indigenous health workers Tribe Muyu) believe, they often receive repetitive, making them not to circumvent these beliefs. Although, rationalistic culture completely different they have learned indifferent practice. Recommendation: Appropriate supervision can be a task thatshould be done by health personnel.

Assessment Study of Motivation and Commitment Midwives Puskesmas in Utilization MCH Handbook in Indonesia (A case study in Batu, Cianjur and East Belitung Regency)

Suharmiati, Suharmiati ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kesehatan, Jl. Indrapura 17 Surabaya ) , Handayani, Lestari ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kesehatan, Jl. Indrapura 17 Surabaya ) , Rukmini, Rukmini ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kesehatan, Jl. Indrapura 17 Surabaya ) , Effendi, Diyan E ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kesehatan, Jl. Indrapura 17 Surabaya ) , Nugroho, Arief P ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kesehatan, Jl. Indrapura 17 Surabaya )

Buletin Penelitian Sistem Kesehatan Vol 18, No 4 Okt (2015)
Publisher : Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat

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Abstract

Background: Utilization of KIA guidebook in health centers not maximum eventhough there are enough books published Ministry of Health as a reference and has given training especially to midwives. This study aims to assess the motivation and commitment of midwives in the use of the KIA guidebook in Indonesia. Methods: The study was conducted in three districts and four health centers purposively determined from each district, each consisting of 2 health centers PONED and Non PONED. In each health center will be taken up to 10 midwives in both MCH services in health centers or its networks proportionally selected that have been works at least 2 years in a health center or its network. If the number of midwives<10 person, it will be taken entirely. Data collected through interviews using a questionnaire and a check list. Results: The number of samples were 113 midwives consisted of Kota Batu (35), East Belitung(37 people) and Cianjur Regency as many as 41 person. Motivation midwifes in Batu and Cianjur district in the utilization of MCH guidebook were quite well, whereas in East Belitung province was well motivation. Commitment midwives in three districts/cities mostly had good commitment. Conclusion: This study concluded that the motivation and commitment of midwives in applying the guidebook were considered quite good. Recommendation: Need to improve supervision, technical guidance and providing feedback to increase the motivation of midwives. Giving a clear assignment and guidance as well as the availability of SOP composedof guidebook need to be realized as a shared commitment to implement the appropriate service guidebook.

Implementation of Maternal Reference System at Tambakrejo and Tanah Kali Kedinding Health Centres in Surabaya City

Rukmini, Rukmini ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kesehatan, Jl. Indrapura 17 Surabaya ) , Ristrini, Ristrini ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Litbang Kesehatan, Jl. Indrapura 17 Surabaya )

Buletin Penelitian Sistem Kesehatan Vol 18, No 4 Okt (2015)
Publisher : Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat

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Abstract

Background: In an effort to reduce maternal mortality rate required an effective referral system, especially for cases of complications. One of the fundamental aspects of primary health care is a good relationship among levels especially with above level that refl ects as an effective referral system. Method: An observational study with cross sectional design carriedout in Tambakrejo and Tanah Kali Kedinding health centers Surabaya in 2013. Respondent were head of the health center and the midwives’ coordinator. Collecting data with in depth interviews, structured questionnaires and study documents of maternity referral cases period of 2010 - June 2013. Data were analyzed descriptively. Result: The implementation of maternity referral cases in Tambakrejo and Tanah Kali Kedinding health centers consisted of clinical and administrative procedures. Clinical procedures have been implemented well, on the other hand, there were some administrative procedures that had not been implemented yet, these were 1) record for patients in register books; 2) giving a referral feedback letter to health facility and worker that refer the patient; 3) There is no procedure of receiving back referred. Coordination for maternal referral among health facilities has been implemented with limitations. Implementation of maternity referral cases and childbirth cases’ handling are in accordance with medical indication primary health care authority. Conclusion: Maternity referral cases in Tambakrejo and Tanah Kali Kedinding health centers has been implementing well enough with limitations, i.e. there is no referral back from hospital to primary health care facility. Recommendation: To implement the policy of back referral, the hospital should make a written standard procedures for the return of referrals. In addition, public health centers have to make standard procedures for receiving back referred patient from hospital and returning back them to other primary health care, sub health centers or midwife.

Health Seeking Behaviour of Non Communicable Disease in Sulaho Village, Lasusua Sub District, North Kolaka Regency

Martiyana, Cati ( Balai Penelitian dan Pengembangan Gangguan Akibat Kekurangan Iodium (Balai Litbang GAKI) Kavling Jayan, Borobudur, Magelang ) , Handayani, Lestari ( Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat Jl Indrapura No. 17 Surabaya )

Buletin Penelitian Sistem Kesehatan Vol 18, No 4 Okt (2015)
Publisher : Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat

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Abstract

Background: Non communicable diseases is a chronic disease that is not spread from person to person. Public knowledge about type of non communicable disease is quite good, but generally they don’t understand about effect of non communicable disease risk factors, impacts and consider non communicable disease due to genetic factors, disease ofolder or rich people. This research to describe the fi ndings of non communicable diseases and health seeking behavior for these types of disease. Method: This study is a qualitative study used ethnographic methods. The research location at Sulaho village, Lasusua sub district, North Kolaka regency. Informants selected with snowball sampling methods. Participant observation and indepth interviews supported with documentation as data collection methods. Analysis of qualitative data with domain analysis, taxonomic analysis, komponensial analysis and analysis of the cultural theme supported with triangulation of sources and data collection methods. Results: Non communicable disease founded at Sulaho were cases of hypertension, stroke, diseases caused by workplace accidents and iodine defi ciency disorders (IDD). Informan knows name of diseases, but they did not know good knowledge of caused, impact and prevention of it. Traditional healer (sanro) is still the main reference before went to the health worker when someone sick, this indicates that people still have the will to take advantage of health care of health seeking behaviour. Conclusion: Traditional healer (sanro) generally become the main reference for health seeking behaviour of non communicable diseases before someone went to the health workers.Recommendation: Health workers has to be practice to approach the community through community leaders or kinship based.

Relationship Between Nutritional Status of Children Under Five with Parents Who Work

Sukoco, Noor Edi Widya ( Pusat Humaniora Kebijakan Kesehatan dan Pemberdayaan Masyarakat, Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan RI, Jalan Percetakan Negara 23 A Jakarta ) , Pambudi, Joko ( Pusat Teknologi Terapan Kesehatan dan Epidemiologi Klinik, Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan RI, Jalan Percetakan Negara 29 Jakarta ) , Herawati, Maria Holly ( Pusat Teknologi Terapan Kesehatan dan Epidemiologi Klinik, Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan RI, Jalan Percetakan Negara 29 Jakarta )

Buletin Penelitian Sistem Kesehatan Vol 18, No 4 (2015)
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

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Abstract

Background: Indonesia is one of 117 countries which has three crucial nutritional problems in children under fives, such as stunting, wasting and overweight. This study is important because nutritional status of children under fi ve years old was closely related with economic factors. While economic conditions of families depend on the work of both parents.Methods: The study design was cross sectional based on health research “Riskesdas 2007 and 2013”. Type of research was quantitative and qualitative methods. Samples consisted of children under fi ves years old of whom their parents were still alive and have completed the information for the questionnaires. The informants of the qualitative research came from caregivers, district nutrition offi cer, sub-district nutrition offi cer, district labor offi ce, and parliament at district. Quantitative data was processed and analyzed by SPSS version 15 under the licensed of NIHRD MOH RI. While primary data was explored by indepth interview and analyzed using content analyses. Result: There was no relationship between parents who were both working with the nutritional status of children under fi ves based on indicators: weight/age p= 0,77 (2007), p = 0,92 (2013); height/age p = 0,58 (2007), p = 0,71 (2013); weight/height p = 0,77 (2007), p =,33 (2013). These qualitative results were confi rmed by informants’ opinions that the nutritional status of children under fi ves years were not differ between those whose parents are working and not working. Conclusion: The analysis whether quantitative or qualitative found there was no signifi cant relationship between the nutritional status of children under fi ves to those both of the parents working. Recommendation: Nutritional problems should be solved inter-sectoraly, it does not guarantee that only the economic capacity to bring about positive impacts the nutritional status of children under five.