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Jurnal Manajemen Pelayanan Kesehatan
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TINJAUAN PELAKSANAAN STRATEGIC LEADERSHIP AND LEARNING ORGANIZATION TERHADAP PERUBAHAN INDIVIDU DAN INSTITUSI DI CIANJUR DAN BOGOR TAHUN 2004 - 2006 Ayuningtyas, Dumilah
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
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Background: Reformation’s journey made the Indonesiangovernment system changed from centralistic to decentralist.Those were pushed health program’s handling changed too.Unfortunately, the majority of health sector reformation focusedfor finance aspect and organization structure only and forgetedhuman resources which is the key of sources and a leadershipability. Therefore, Decentralization Unit of The Department ofHealth anticipated transition with created learning organizationthrough Strategic Leadership and Learning Organizationtrainings (SLLO). Those studies have been started on January2004 in The Faculty of Public Health, The University of Indonesia,with experiment area is Cianjur and control area is Bogor.Methods: Methods research is action research and usingquasi-experiment, pre and post test design for control. Thecontrol’s characteristic is unequal.Result: Generally, individual changes have been occurred ashave a desire and care to discuss and action together in theirproblem (RCA about IPM). Institutional changes have beenoccurred as created local’s policy and work climate better.Conclusion: Preferable SLLO have been implemented thetop leader before others to set an example for and reward forthe staff that is implemented SLLO better than others.Keywords: Strategic Leadership and Learning Organization(SLLO), individual changes, and institutional changes
EVALUASI PROGRAM PEMBERIAN MAKANAN TAMBAHAN ANAK BALITA Handayani, Lina
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
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Background: In a way to increase status of children lessthan five years old nutrition at Puskesmas Mungkid, one ofway was to heal supplement feeding’s programmed (PMT)children under five years old. To see the successful of PMTprogrammed has been needed evaluation to program. Thepurpose of the research has to evaluated the development ofextra nutrition programmed for children under five years old(PMT) at Puskesmas Mungkid. The research need to dobecause many malnutricious still founded and also to knowthe work of manager to run the programmed with use thestandard technical guidelines programmed legally by healthydepartment.Method: Descriptive qualitative with use summative planning.Subjects are the leader of health public service and managerof PMT children under five years old. The untility to collect dataon the research are interview guideline, tape recorder andstationary. The analysis use descriptive qualitative.Result: The result consist of evaluation to: (1) Input evaluationconsist of force raw material, fund, facilities, material, andmethod. Force evaluation had fit with standard technicalguidelines programmed from healthy department, there wasno hard problem with fund evaluation consider with the budget.Facilities evaluation there was no standard technical guidelinesprogrammed yet from healthy department. Material and methodhad fit with standard technical guidelines programmed fromhealthy department (2) Process evaluation not fit with standardtechnical guidelines programmed from healthy departmentspecially planning on target of acceptance PMT programmed.(3) Output evaluation, not fit yet with purpose of PMT becausestill many children under five years old on malnutricious status.Resume: Input evaluation has facilities not complete yet.Process evaluation was not every target programmed hadunhealthy family card (Gakin), still there is target programmedhave not been tooked the packed as schedule also not everymeals packed had been eated by children which is seatled astarget programmed. Output evaluation was have increasenutrition status after PMT children under five years oldprogrammed although still found many malnutrition status.Keywords: evaluation, supplement feeding’s programmed(PMT), children under five years old
BAGAIMANA STRATEGI PENGEMBANGAN SISTEM SURVEILANS DALAM ERA DESENTRALISASI? Trisnantoro, Laksono
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
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Abstract

Surveilans merupakan kegiatan yang sampaisekarang masih belum berjalan secara baik diIndonesia. Dengan diterbitkannya PeraturanPemerintah (PP) No. 38/2007 yang salah satu isinyamengatur mengenai wewenang pemerintah pusatdan daerah dalam pengelolaan dan penyelenggaraansistem surveillance maka ada momentum baru untukpengembangan. Kehadiran PP No. 38/2003 menjadijembatan yang baik mengenai pengelolaan danpenyelenggaraan sistem surveilans karena dapatmeneguhkan standar dan uniformitas sistemsurveilans di tingkat pusat maupun daerah,menegaskan implementasi surveilans di eradesentralisasi, memperhatikan kondisi spesifiklokal, dan dapat meningkatkan compliance dalamsistem surveilans.Pada tahun 2004 WHO1 mengajukan beberaparekomendasi untuk pengembangan surveilans:Integrasikan beberapa surveilans penyakit khusus;bentuk badan koordinasi kegiatan surveilans ditingkat pusat dan provinsi; kaji ulang penyakitpenyakitprioritas, melibatkan klinisi, ahli mikrobiologidan epidemiologi; bagi peran surveilans dalam sisteminformasi kesehatan nasional dengan semua pihakyang berkepentingan; kembangkan perananlaboratorium dalam surveilans; mengembangkanumpan balik dan supervisi efektif; implementasikanrencana kesiapan respons terhadap wabah di semuatingkat pelayanan; mengimplementasikan pelatihanberkesinambungan.Adanya rekomendasi dari WHO, perluditindaklanjuti dan direspon guna perbaikan sistemsurveilans yang ada dilapangan. Tindak lanjut yangdilaksanakan dapat berupa perbaikan sistempencatatan dan pelaporan baik di level Puskesmasmaupun dinas kesehatan, penggalangan komitmenuntuk pemerintah daerah menyediankan anggaranpelaksanaan sistem surveilans, penyediaan danasewaktu-waktu jika terjadi kejadian luar biasa, danperbaikan sistem organisasi surveilans.Isu-isu penting dalam pengembangan surveilansdi masa mendatang adalah: Adanya dasar akademikyang mantap dimana sebaiknya surveilans harusterkait dengan respons; dukungan sisteminformatika, tersedianya penganggaran surveilansdari berbagai sumber; dukungan regulasi, dan adanyaperbaikan struktur organisasi surveilans di daerahdan pusat. Salah satu hal penting dalam masa depansurveilans adalah penggunaan prinsip surveilansyang dihubungkan dengan respon. Berdasarkananalisis situasi saat ini, sebagai salah satu halpenting dalam pengembangan surveilans, perluditegaskan bahwa surveilans bukan hanya urusankelompok yang mengurusi penyakit menular.Surveilans tidak terbatas pada tugasepidemiolog, namun juga menjadi tugas paramanajer dan pengambil keputusan di pemerintahpusat dan daerah untuk melaksanakan. Kesan inimuncul karena di Indonesia surveilans secara tradisiberada pada Direktorat Jendral P2M dan Seksi P2di Dinas Kesehatan. Hal ini perlu diperbaiki denganmengacu pada prinsip delapan Fungsi Pokok SistemSurveilans Respon yaitu: deteksi kasus, registrasi,konfirmasi epidemiologis atau/dan laboratoris;pelaporan, analisis dan interpretasi, kesiapanmenghadapi wabah, respons dan pengendalian, sertafeedback. Laksono Trisnantoro (trisnantoro@yahoo.com)Kepustakaan1. WHO. WHO comprehensive assessment of theNational Disease Surveilan in Indonesia. 2004
POTRET PELAKSANAAN REVITALISASI PUSKESMAS Sopacua, Evie
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
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Background: Health services by Public Health Centres (PHC)in the era of decentralization experienced a decline in someregion. The important role of PHC in health development is thereason to optimize its performance. PHC’s revitalization whichproclaimed by Health Department has the intend to returningPHC to its concepts, health manpower and facility accordingto based values in Kepmenkes 128/2004. The aim of PHC’srevitalization is to increase PHC’s performance in supportinghealth development.Method: The objective of this study was to describe theimplementation of PHC’s revitalization in supporting healthdevelopment. Study area was elect using purposive samplingdesign that is Jombang and Bojonegoro Districts in East JavaProvince, Cianjur District in West Java province and Sikkadistrict in East Nusa Tenggara Province. Data was collectthrough in-depth interview and focus group discussion andwas analyzed descriptive.Result: The result showed that although socialization of PHC’srevitalization has been done, but not yet understood asexpected by Health Department with priority returning PHC’sfunctions according to Kepmenkes 128/2004. Several effortshas been done by several PHCs in this study to improve PHC’sservices using government funding. Kinds of proposals aboutthe form of PHC’s revitalization were the potrait of the PHC’scondition nowadays. This is the reflection of the localspecification of each region.Conclusion: The recommendation of this study is to implementrevitalization of PHC on public health services with attention onthe PHC’s principals wich describe in Kepmenkes 128/2004Keywords : revitalisation, public health centre
KEBIJAKAN KESEHATAN MASYARAKAT BERBASIS BUKTI Kusnanto, Hari
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
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Evidence-based public health policy is not a linear extrapolationof evidence-based medicine to the public health arena. Relevanttypologies,  rather  than  hierarchies,  of  evidence,  should  beapplied  to  support  public  health  policy.  There  are  multipledimensions of evidence used for health policy formulation in aspecific  political,  social  and  cultural  context. Typologies  ofevidence  for  public  health  policy  are  broader  than  clinicalpractices.  Methods  for  evidence  production,  appraisal  andsystematic  reviews  for  public  health  policy  need  to  bedeveloped  and  applied  to  solve  major  public  health  issues,such as tobacco use and exposure to environmental tobaccosmoke.Keywords: evidence, public health, policy
SIMULASI PENGHITUNGAN TARIF PREMI SEBAGAI UPAYA ADVOKASI REALOKASI SUBSIDI PREMI PPK I JAMINAN KESEHATAN JEMBRANA Januraga, Pande Putu
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
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Background: Program of Jembrana Health Insurance (JHI) isintended to provide health insurance at first level (PPK I) forinhabitants of Jembrana District. Up till now, financing of JHIdepends on subsidy in which it is growing up and has a trendto be out of the target. Therefore, it needs to increase themember participants by implementing the premium payment.Aim of this research was to analyze premium of JHIcomprehensively to advocate the reallocation of premiumsubsidy of JHI.Methods: Type of this research was case study throughanalyzing secondary data. Data on members, utilization,operational cost and claim cost data was collected using format Bapel JKJ, Jembrana District Health Office and NegaraHospital.Results: The first Premium tariff scheme of JHI is free for 40 %inhabitants who earn low income, Rp48.171,00 for 40%inhabitants who earn medium income, and Rp96.341,00 for20% inhabitants who earn high income. The second Premiumtariff scheme of JHI is free for 40% inhabitants who earn lowincome, Rp89.595 for 40 % inhabitants who earn mediumincome, and Rp96.341,00 for 20% inhabitants who earn highincome.Conclusions: Local government could develop JHIcomprehensively by relocating premium subsidy of PPK I for40% inhabitants who earn low income, besides that localgovernment should apply principles of managed care bycontrolling cost and quality in terms of comprehensive healthinsurance.Keywords: health insurance, premium
ESTIMASI DAMPAK PROGRAM ASURANSI KESEHATAN PADA JUMLAH KUNJUNGAN RAWAT JALAN DI INDONESIA Hidayat, Budi
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 01 (2008)
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Background and method: This research aimed to selectthe best methods to predict the effect of health insuranceprogram on the numbers of outpatient visits in Indonesia. Theanalysis was applied to the second round of the IndonesianFamily Life Survey data (IFLS2).Result: The author compares the estimation results derivedfrom 6(six) econometrics technique count data model and selectthe best alternatives based on several statistics tests. Theresults confirm that Generalized Method of Moments (GMM)estimator is best to model the number of visits to public outpatient,whilst Hurdle Negative Binomial (HNB) is superior to model thenumber of visits to private one. It is proved that the insuredhave higher probability in the number of visits for outpatientservices then uninsured (p<1%). Supplies induce demandphenomena was not detected among the insured, howeverthis behaviour was likely happen where provider’s competitionare relatively high.Conclusions: This study concludes that estimates of healthcare demand given insurance have been shown to depend onthe empirical specification used in the analysis. Not controllingthe existence endogeneity of insurance leads to lower theparameter estimates. This study supports a national healthinsurance policy as an instrument to increase access to formalhealth care services.Keywords: health insurance, modeling, demand for health careservices

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