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Jurnal Manajemen Pelayanan Kesehatan
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HUBUNGAN KINERJA BIDAN DALAM PENATALAKSANAAN ANTENATAL CARE DENGAN QUALITY WORK LIFE DI KOTA TASIKMALAYA TAHUN 2007 Ayuningtyas, Dumilah
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
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Abstract

Background: There exist a general relation between the healthof mother and child and midwives’ roles. Midwives havesignificant roles such as health provider, disseminator ofinformation, conductor and counsellor of mother and childhealthy. In Tasikmalaya city, the health of mother and child is animportant matter considering the death rate amongst motherand child in the city is still high in year 2005 and 2006.Purpose: This study is designed to observe the linkagebetween Quality Work Life (QWL) and Antenatal Care (ANC)implementation of midwifery in Tasikmalaya by the year 2007.Method: A descriptive analysis through cross sectional wasused in this study. Population target were all of midwifery in 14health service centers in Tasikmalaya city with the samplewere all of population target (53 persons). All of the data wereanalyzed by quantitative and qualitative approach betweenQWL and ANC operational. It is also associated with the increaseof target program as the outcome.Result: Productivities of the midwifery in health service centerswith good planning process, mobilization of implementationprogram, and controlling evaluation were established in 7 healthservice centers. Eight health service centers possess a goodQWL and however, there still exist 6 health service centerswith bad QWL in KIA unit. Three from nine components of QWLhave significant relations with ANC operational of midwifery.They are equity of reward, safety work environment, andproud feeling with the institution.Conclusion: Quality Work Life (QWL) of the midwifery inTasikmalaya city was not wholly supported the escalation ofmidwives’ productivity yet.Keywords: midwife, ANC, QWL
PENGENDALIAN FAKTOR DETERMINAN SEBAGAI UPAYA PENATALAKSANAAN HIPERTENSI DI TINGKAT PUSKESMAS Nugraheni, S.A.
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
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Background: Obesity is the one of hypertension risk factorswhich is influenced by food intake and physical exercise. Theaim of this study was to know the correlation between thedeterminant factors and the systolic blood pressure to managehypertension cases especially at primary health care level.Method: This study used survey method with cross sectionalapproach. The population were the adult men between 40 –60 years old who live in The Bina Marga complex in Semarang.The sample 32 adult men who were chosen purposively. Thedata were collected by interviews, recall method 2 x 24 hournot in sequence, anthropometrics measure and examinationblood pressure. The data were analyzed by pearson productmoment test and multiplied linear regression.Result: Result of the study were: respondents with possibilityof risked waist hip ratio (3,1%), over body mass index (43,8%),less physical exercise (56,3%), over fat intake (40,6%),enough natrium intake (12,5%), less fibre intake (53,1%), lesspotassium intake (81,3%), less calcium intake (43,8%) andhigh blood pressure (46,9%). Statistic analysis showed thatthere were correlation between physical exercise, fat intake,natrium intake, fibre intake, potassium intake and systolic bloodpressure.Conclusions: Suggestions for the prevention of hypertensionin primary health care level are doing physical exercise,decreasing fat intake less than 30% of the total energy,decreasing natrium intake less than 2300 mg/day, increasingfibre intake more than 25 gram/day, increasing potassium intakeuntil 2500 mg/day and checking the blood pressure regularly.Keywords: waist hip ratio, body mass index, physical exercise,fat, natrium, fibre, potassium, calcium, systolic blood pressure
PERANAN LEMBAGA SWADAYA MASYARAKAT DAN YAYASAN KEAGAMAAN DALAM MEMBERIKAN PELAYANAN KESEHATAN DI DAERAH TERPENCIL Trisnantoro, Laksono
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
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Abstract

Berbagai pengalaman menunjukkan bahwapelayanan kesehatan di daerah terpencil sulitdilakukan oleh pemerintah. Kontrak bidan dan dokterperorangan masih belum dapat memberikan jawabantentang penyelesaian masalah daerah terpencil ini.Laporan dari Pusrengun tahun 20071 menyatakanbahwa: 30% dari 7.500 Puskesmas di daerahterpencil tidak mempunyai tenaga dokter. Surveiyang dilakukan Pusrengun di 78 kabupaten di 17propinsi di Indonesia menemukan hal menarik. Dari1.165 Puskesmas di daerah tersebut, 364Puskesmas (31%) berada di daerah terpencil/belumberkembang/perbatasan/ konflik dan bencana ataudi daerah yang buruk situasinya. Sekitar 50% dari364 Puskesmas dilaporkan tidak mempunyai dokter.,18% tanpa perawat, 12% tanpa bidan, 42% tanpatenaga sanitarian, dan 64% tanpa tenaga ahli gizi.Dibandingkan dengan daerah biasa, gambaran inisangat buruk. Sebagai contoh, di daerah biasa hanya5% Puskesmas yang tanpa dokter. Dalam haltenaga spesialis juga terlihat ketimpangan. Menurutdata dari KKI (2007), DKI Jakarta mempunyai 2890spesialis (23,92%). Jawa Timur 1980 (16.39%), JawaBarat 1881 (15,57%). Sementara itu, di SumateraBarat hanya 167 (1.38%).Ketidaktersediaan tenaga medik dan kesehatanini menjadi semakin berat implikasinya karena adanyaJaminan Kesehatan Masyarakat. Ketimpanganpenyebaran spesialis ini merupakan hal yang tidakadil, terutama dalam konteks kebijakan nasional yangmenggunakan pembayaran penuh untuk masyarakatmiskin. Di daerah yang jarang dokter spesialisnya,masyarakat miskin atau setengah miskin akankesulitan mendapatkan akses ke pelayanan medik.Sebaliknya di tempat yang banyak dokternya akansangat mudah. Akibatnya dana pusat untukmasyarakat miskin dikhawatirkan terpakai lebihbanyak di kota-kota besar dan di pulau Jawa.Problem kontrak perorangan memangkompleks. Untuk daerah-daerah terpencil dapatdibayangkan betapa sulitnya seorang dokter mudaatau bidan muda untuk berangkat sendiri, bekerja dilingkungan yang baru tanpa ada dukungan tim kerjayang baik. Akhirnya di beberapa daerah dilaporkanbahwa dokter kontrak di daerah sangat terpenciltidak pernah sampai atau jarang berada di tempat.Pengalaman di Kabupaten Aceh Barat seperti yangdilaporkan dalam JMPK edisi lalu menunjukkanbahwa pengiriman tim merupakan hal yang baikwalaupun biaya menjadi lebih besar.Pertanyaan penting dalam hal ini adalahbagaimana mengatasi masalah pengiriman tenaga kedaerah. Tanpa ada pengiriman maka berbagai fasilitasfisik dan peralatan yang ada di daerah akan sia-siakarena tidak ada yang menjalankan. Dalam hal ini adapertanyaan mengenai peranan Lembaga SwadayaMasyarakat dan Yayasan Keagamaan: Apakah LSMdan Yayasan keagamaan dapat dimobilisir untukmengatasi masalah ini? Dalam konteks pengadaantenaga, LSM yang baik dan Yayasan Keagamaanmerupakan pihak yang dapat memobilisir, mengirimkandan menjamin mutu pelayanan. Kerjasama antarapemerintah dengan LSM dan Yayasan Keagamaandapat berupa kontrak kerja.Pertanyaan tersebut menarik untuk dijawab karenaselama ini belum ada hubungan yang terjadi antaraPemerintah dan Pemerintah Daerah dengan LembagaSwadaya dan Yayasan Kemanusiaan. Masih adastigma bahwa LSM merupakan lembaga yang seringberbeda pendapat dengan pemerintah. Di samping itu,juga diakui bahwa kemampuan LSM untukmemberikan pelayanan kesehatan, terutama di daerahsulit dan terpencil masih belum banyak. Pengalamansukarelawan di dalam bencana alam di Aceh tahun2005-05 menunjukkan bahwa bantuan pemberianpelayanan didominasi oleh LSM luar negeri.Pertanyaan ini sebenarya merupakan ide yangperlu dicoba. Diharapka ada eksperimen mengenaihal ini. Jika berhasil uji-cobanya, di masa depan,diharapkan pemerintah dapat menjalin kerja samadengan LSM dan Yayasan Keagamaan untukpengiriman tenaga di daerah terpencil. LaksonoTrisnantoro (trisnantoro@yahoo.com)KEPUSTAKAAN1. Kurniati, Anna. Incentives for Medical Workersand Midwives in Very Remote Areas AnExperience from Indonesia. Mimeo. 2007
HUBUNGAN KEPUASAN PASIEN DENGAN MINAT PASIEN DALAM PEMANFAATAN ULANG PELAYANAN PENGOBATAN Solikhah, Solikhah
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
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Background: Puskesmas represent one of public sectorservice majoring accomplishment of society satisfactionthrough implementation of quality health service withoutimpinging code of ethics and standar of professional qualityservice. This service quality in the end will give some benefit,among of them are intertwining of harmonious relation betweenservice provider (Puskesmas) with customers (patient), givinggood base to create of patient loyalty and form anrecommendation by mouth to mouth (worth of mouth) whichgive the advantage to Puskesmas. Society behaviors to utilizeprimary health service still high (60% - 70%), because they’renot have others choice. Having some medicines to cure themillness was the most important factor and giving the base to itsutilization of service pattern.Objective: This research was aimed to know the correlationbetween patient satisfaction and patient enthusiasm in utilizationrepeat of the medication service in Puskesmas. Patientsatisfaction is measure the patient perception to service quality(performance Puskesmas).Method: This was an observational study with cross sectionaldesign. Population and sample was patient of clinical centreservice, sample size are 97 patients by random samplingtechnique. Data collected through interview by questionnairesto analyses data using product moment statistical test.Result: In general, satisfied responder to medication servicein Puskesmas equal to 88,7%, while responder whichdissatisfy equal to 10,3%. satisfied patient to service inadministration section equal to 84,5%, followed with the patientsatisfaction to nurse service equal to 82,5%, lower satisfactionto hygiene, accuration and room freshment equal to 67%. visitenthusiasm return to medication service in Puskesmas feelsatisfaction (90,7%) to service exist in Puskesmas, whileresponder which dissatisfy equal to 6,2%. statistical test resultby using analysis of product moment test, showing there wasa means positive relation between service quality with the patientsatisfaction (p = 0,000), with strong correlation (r = 0,620).Conclusion: There was a means positive relation betweenservice quality with patient satisfaction (p = 0,000) with strongcorrelation (r = 0,620)Keywords: patient enthusiasm, patient satisfaction,Puskesmas
PELEMBAGAAN SISTEM PEMANTAUAN DAN EVALUASI: PELAJARAN DARI BERBAGAI NEGARA Hidayat, Budi
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
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This article provides lessons learned on the experience ofseveral countries that have succeeded in building a wellfunctioning government monitoring and evaluation (M&E)system. Discussions on this article are focused on: terms andconcepts in the field of M&E, outputs of M&E, utilization of M&Einformation, key success and pre-requisite to succes ininstitutionalizing M&E as well as actors M&E. The result indicatesthat ouputs of M&E system are used oftenly for: (i) supportingpolicy making, performance budgeting and national planning;(ii) helping ministries in their policy development and policyanalysis work, and in program development; (iii) managingactivities at the sector, program and project levels; and (iv)enhancing transparency and support accountabilityrelationships. The successful institutionalization of M&E involvesthe creation of a sustainable, wellfunctioning M&E system withina government, where good quality M&E information is usedintensively. This implies that key success for institutionalizingM&E system depends on: utilization of M&E information, qualityof M&E information and sustainability. Meanwhile prerequisiteto successful in institutionalizing of the M&E system must besupported by a substantive demand from the government,insentive mechanisms, powerful champion, and provision oftraining in a range of M&E tools, methods, approaches andconcepts. Actors involved in M&E system are not onlygovernment. Civil society (i.e., universities, NGOs, researchinstitutes, think tanks and the media) also can play a role inM&E in several ways, including as a user and producer ofM&E information.Keywords: monitoring, evaluation, policy, program, project
ANALISIS POLA MUSIM KELAHIRAN UNTUK KEBIJAKAN PENINGKATAN SARANA PELAYANAN KESEHATAN IBU DAN ANAK Lestari, Weny
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
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Seasonality of births in Surabaya Municipality and in privatehospital Rumkital dr.Ramelan Surabaya in five years from 1994to 1998 are analysed using chi square statistics analysis, withdegree of freedom (df)=1 and signification (P)=0,05. Bothpatterns either on Surabaya or on Rumkital dr.RamelanSurabaya showed that minor peak of birth happened onNovember and December. In 9 months time lag before, theseasonality of conception showed on February and March. InMessiah’s year (based on solar calendar system) the patterndid not have any meaning, but when we conserved to Hijriyah’syear (based on lunar calender system), February and Marchin 1994 to 1998 were iftar on Ramadhan and Moslem’s holidayon Syawal. These patterns were consisted in five years. Themajor peak of birth in both patterns either on Surabaya or onRumkital dr.Ramelan Surabaya showed differences in theseasonality of births. Practically there were also differenceson seasonality of conception. Seasonality of births analysiscould be a policy adviced to increase the healthcares forpregnant women and babies.Keywords : seasonality of births, seasonality of conception
INTERVENSI POLITIK DALAM PROSES PENGANGGARAN DEPARTEMEN KESEHATAN TAHUN 2006-2007 Marhaeni, Dewi
Jurnal Manajemen Pelayanan Kesehatan Vol 11, No 04 (2008)
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Background: The budget transfer from the Ministry of Healthto the local includes deconcentrated fund, assisting tasks andthe fund of the Ministry of Health sectors, although Law 33/2004 only specifies deconcentrated fund and assisting task.The regulation enforcing deconcentrated fund and assistingtask is just issued in 2008 by the publication of PP No.7/2008,where as the fund of the Ministry of Health sectors has notgained any legal form. The process of budget allocation hasnot been based on any technical rationale. Consequently, thepolitical intervention becomes a dominant variable in thebudgetting process, especially for that of the physical programs.Objective: To analyse the budgetting process ofdeconcentrated fund, assisting tasks and MoH sectors’ fund.Method: The research design applied an explorativeqaulitativemethod. The research setting was the central. Theanalyzed units were budgetting processes of thedeconcentrated fund, assisting tasks and MoH sectors.Result: Among the five programs studied, namely: maternalhealth, TB, hospital, drugs and impoverished household, it wasobvious that the hospital received the greatest politicalintervention from the House of Legislatives.Conclusion: The political intervention from the House ofLegislatives played a dominant budgetting role in MoH, especiallyin hospital’s physical budgetting. Political intervention occuredbecause the budget trasnfer from the central to the local hasnot been supported by legal forms and rational technicalmeasurement.Keywords: politic, health budget process

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