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Jurnal Manajemen Pelayanan Kesehatan
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PRAKTIK PERAWAT KELILING: STUDI KASUS TIGA PERAWAT DI KABUPATEN INDRAGIRI HULU PROVINSI RIAU Afril, Zul Afril
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Abstract

Background: Professional service in isolated areas is verylimited because the policy on the placement of doctors tendsto put priority on urban areas. Nurses are health staff mostcommonly available at isolated areas and utilized by thecommunity as medical staff in Indonesia for a long time. Theyhave been working on mobile basis from one village to anotherbecause the community needs express and affordableservices. Legally, mobile nurses have infringed regulationsbecause they do not have permit for their practice and theyprovide services beyond their expertise. Meanwhile, thepresence of mobile nurses greatly helps the government insolving health problems in the community.Objective:  The study aimed to describe health servicesprovided by mobile nurses at District of Indragiri Hulu.Method: This case study was carried out in February – April2008. Data were obtained through participative observationand in depth interview. The researcher followed the nursesobserved with open agreement from respondents and studiedthe activities they carried out in their work.Result: The result of the study showed that types of servicesprovided by mobile services at District of Indragiri Hulu wererelatively complete, comprising service of care to medication.The service was accessible and inexpensive and paymentmethod was flexible. These nurses were willing to providehealth services as demanded by patients. They provided mobileservice because health staff available in marginal areas wasnurses. This caused high demand for health service providedby nurses; however this mobile service was not protected byregulations because so fan there was no regulation whichconcerned with practicing nurses at District of Indragiri Hulu.The only regulation that protected them was issued by nationalassociation of nurses. Absence of regulation on nurses causedcontrol to practice of mobile nurses could not be enacted. Thecontrol was needed to protect the community and the serviceof mobile nurses itself.Conclusion: The study proved that unavailability of doctorshad put nurses in a central position as medication providers inisolated areas. Besides, proactive approaches made by thenurses had become major factor of acceptance to theirpresence in the community. Considering their control role, itwas suggested that the government issued administrative andprofessional act on nurses order that control to quality ofnurses could ensured.Keywords: availability of health staff, mobile nurses, socialmotivation, isolated areas
KEMAMPUAN SOFT SKILL SUMBER DAYA MANUSIA KESEHATAN DI KABUPATEN BOJONEGORO DAN MAGETAN PROVINSI JAWA TIMUR Astuti, Wahyu Dwi
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
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Background: The implementation of regional autonomy inhealth care, Human Resources (HR) are required to have healthentrepreneurship ability, leadership and managerial. In fact,until now information about the capabilities are not yet clearlyknown.Purpose: This study aims to know the capabilities soft skills(entrepreneurship, managerial, leadership) of health workersin the District of Bojonegoro and Magetan.Method: Research design that is used is descriptive researchon the location of Health Dander, Baureno Health, and dr.Sosodiro Hospital District of Bojonegoro. Health Candirejo,Health Ngariboyo, Plaosan Health, Health Kawedanan Dr.Sayidiman Hospital Magetan District. Research target is thehead office staff and health, and director of the hospital staff,health staff and the head. Large target is 82 people. Variableinvolved is the ability of soft skills aspects of entrepreneurship,leadership, change management and conflict management.Collecting data is done by giving a ranking scale with the contentof the medium on the aspects of konatif attitude. Data analysiswould be conducted descriptive.Result: Result of research showed that entrepreneurial abilityis less 56.1%, 50.0% less in leadership and managerial 41.5%less. Attributes such as entrepreneurial marketing 48.1% less,self-confidence 57.3% less, task orientation and 58.5% poorresults. Courage risk taking 56.1% less; lobby and negotiate47.5% less. Attributes such as leadership ability 36.6% lessdirective, less supportive 82.9%, 48.8% less participative,achievement orientation, and 52.5% less. While the ability tomanage changes to 13.4% less, manage conflict 74.3% less.Conclusion: The situation above can be concluded that theability entrepreneurship aspects of soft skills, leadership andmanagerial health still needs to be done so that lessimprovement and development of these skills.Keywords: soft skills, entrepreneurship, leadership,managerial
PENETAPAN PAKET PELAYANAN KESEHATAN DAN PERHITUNGAN PREMI PROGRAM PEMELIHARAAN KESEHATAN MAHASISWA UNIVERSITAS JENDERAL SOEDIRMAN TAHUN 2007 Intiasari, Arih Diyaning
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
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Background: In an effort to provide health service access toits students, University of Jenderal Soedirman develops ascheme of health insurance in the program of student healthcare assistance during academic year 2006/2007. During thisperiod there were some problems which caused the schemeunable to cover all needs of students for health services. It isexpected that next time there is development in health servicepackage and premi calculation in order that the program ofstudent health care assistance can operate better.Objective: To develop alternative health service package andrational premi calculation for the implementation of student healthcare assistance based on the coverage of participation at theUniversity of Jenderal Soedirman in the future.Method: This case study used complementary qualitative andquantitative approach. Major research design was quantitative.Result: Service package of Soedirman Health Center for theprogram of student health care assistance included primaryoutpatient, continuing outpatient and inpatient health serviceswith particular limitation either on cost or length of stay. Unitcost calculation of primary outpatient health service at StudentHealth Center for Medication clinic was Rp24,423 and for DentalMedication clinic was Rp96,387. Premi calculation was madeusing actual utilization for Student Health Center as much asRp6.180/student/semester and for Purbalingga CommunityHealth Care Insurance was Rp67.062/student/semester.Conclusion: The establishment of health service packageand rational premi calculation should enable the developmentof health insurance program for students of the University ofJenderal Soedirman and become an instrument for advocacyfor the policy makers in developing the program in the future.Keywords:  health service packages, premi calculation, unitcost
KAWASAN TANPA ROKOK SEBAGAI ALTERNATIF PENGENDALIAN TEMBAKAU STUDI EFEKTIVITAS PENERAPAN KEBIJAKAN KAMPUS BEBAS ROKOK TERHADAP PERILAKU DAN STATUS MEROKOK MAHASISWA DI FAKULTAS KEDOKTERAN UGM, YOGYAKARTA Prabandari, Yayi Suryo
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
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Background: In favor of the economic value of tobacco,Indonesia has minimal anti-smoking policies and regulations.Even though smoking is not permitted in the government offices,health facilities, and schools, the regulation has not yet beenfully implemented, particularly in tertiary education institutionssuch as universities. Faculty of medicine, as institutioneducating future medical professional, should be role model inimplementing the tobacco free campus policy.Objective: The present study examines the effectiveness oftobacco free campus policy in the Faculty of Medicine,University of Gadjah Mada (FM UGM) in Yogyakarta Province.Method: Two cross-sectional surveys on medical studentsmoking behaviors were conducted in 2003 (n=734) and 2007(n=463), respectively. The prevalence of smoking and quittingeffort were measured in both surveys. Student’s opinion ontobacco free campus policy was measured in 2007.Result: The percentage of male non-smoker has increased19.1%, while among female was 1.2%. While 11.9% studentsstopped smoking when they were admitted in FM UGM, 6%quitted smoking following the tobacco free campusimplementation and 7% reduced the number of cigarettessmoked. Moreover, ninety percent of male and 94% of femalestudents at public schools supported the implementation oftobacco free campus policy.Conclusion: The implementation of tobacco free campuspolicy has positive impact on reducing smoking behavior andpromoting quitting behavior among students in FM UGM. Bothmale and female students unanimously support the tobaccofree area.Keywords: smoke free area, smoking status, smoking behavior,university student
REVIEW KEBIJAKAN PADA INDIKATOR PENGEMBANGAN DESA SIAGA DI PROVINSI JAWA TIMUR Sopacua, Evie
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
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This article is a policy review that analyze the indicators indeveloping alert villages which was build by Province HealthOffice of East Java. Using normatif approach the core problemand its characteristics was identified. Fulfilment of the indicatorsin developing alert villages in East Java Province and estimatingthe scores to rank the development of an alert village was thecore problem. Analyzing it’s consequencies, resistance andtrade-off was done using predictive approach.Conclusion of the analysis is that using the indicators willfaced obstacles in deciding the development rank which wasreach by the alert villages. Suggestion of this analysis is touse the main steps in developing alert villages which wasstated in Kepmenkes 564/2006 as indicators. Usingpercentages in estimating indicators to fixed the rank of alertvillages was suggest also.Keywords: indicator, alert villages development, policy review
EKSISTENSI UNIT PENGELOLA OBAT DI BEBERAPA KABUPATEN/KOTA SUATU ANALISIS PASKA DESENTRALISASI Herman, Max Joseph
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
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Background: Accessibility to essential drugs is a public right,therefore it’s the government responsibility to make themavailable. Previously before the era of regional autonomy, publicdrug management in all districts/cities was performed by theso-called District Pharmaceutical Warehouses (GFK). However,nowadays the situation has changed because of the differencein vision and perception of each regional government on theformer warehouses. Some public drug management units incertain districts/cities are not functioning optimally. Inefficientdrug procurement regarding the number and kind of drugs aswell as timeliness results in gap between drug need andprocurement. Furthermore, loosening in drug supply proceduremakes essential drugs more unavailable to public.On the other hand, decentralization policy in drugmanagement also undeniably brings advantages to the districts,for example capacity building in drug procurement, increasingcapability in budget management and negotiation with districtdecision makers as well as enhancing regional economicactivity. In revitalizing district pharmaceutical warehouses soas to attain minimal health care standards in districts/cities,baseline data in drug management and financing in severaldistricts/cities should make a valuable contribution.Methods: A cross sectional descriptive study had been carriedout during July-December 2006 in 26 districts/cities out of 11provinces. Samples were 26 district health offices (DinasKesehatan Kabupaten/Kota) and 26 District PharmaceuticalWarehouses (GFK) where as respondents were head of drugsection and head of warehousing respectively. Data werecollected by means of structured questionnaires and in-depthinterviews as well as the collection of secondary data of druglogistics. Qualitative and quantitative analysis was performed.Results: The study shows that: 1) although health budget ingeneral had risen, the average percentage of drug budgetallocation from 21 district health authorities was only 12.06%,reflecting the low drug priority in district health policy becausedrug expenditures may amount up to 40% of the total healthbudget. 2) Public drug management was mostly performed bythe so-called regional technical provider unit (UPTD) with somelimitations concerning human resources and material inachieving an effective and efficient drug management, and 3)there was still lack of pharmacist assistants to manage drugsin primary health care (Puskesmas) up to 20% and even morepiteously the lack of pharmacist in district drug managementunit (GF/UPOP Kabupaten/Kota, 12,5%).Conclusions: Apart from the achievement of predeterminedindicators stated in minimal health care standards in districts/cities, especially regarding essential and generic drugs, drugmanagement in general has been well performed concerningplanning and drug availability. More support and commitmentfrom the district government is a must considering that regionaldevelopment can not be separated from the health developmentof the subject themselves.Keywords: decentralization, District PharmaceuticalWarehouse, public drugs, drug management
BERBAGAI MASUKAN UNTUK KEBIJAKAN KESEHATAN BERDASARKAN PERTEMUAN PUNCAK NASIONAL BIDANG KESEJAHTERAAN RAKYAT TANGGAL 30 OKTOBER 2009 Trisnantoro, Laksono
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
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Pada tanggal 30 Oktober 2009 diselenggarakanPertemuan Nasional untuk mencari masukan strategipembangunan kesehatan. Kabinet baru telahmempunyai empat agenda pembangunan kesehatanyang diharapkan diberi masukan oleh berbagai pihak.Empat agenda tersebut adalah: (1) Isu peningkatanpembiayaan kesehatan untuk memberikan jaminankesehatan masyarakat; (2) Isu peningkatankesehatan masyarakat untuk mempercepatpencapaian target MDGs; (3) Isu pengendalianpenyakit dan penanggulangan masalah kesehatanakibat bencana; dan (4) Isu peningkatanketersediaan, pemerataan dan kualitas tenagakesehatan terutama di daerah terpencil, tertinggal,perbatasan dan kepulauan (DTPK).Untuk mendukung upaya peningkatan isu-isupokok di atas, perlu diperhatikan kegiatan-kegiatanyang mempunyai dampak cepat dan kegiatan yangmempunyai dampak lama namun sebaiknyadilakukan. Kedua jenis kegiatan tersebut perludimasukkan sebagai agenda nyata pembangunankesehatan.Kegiatan-kegiatan yang mempunyai dampakcepat, antara lain: (1) menghilangkan hambatan(bottle-neck) seperti keterlambatan pencairan APBNdi daerah. Hambatan ini dapat dihilangkan denganperbaikan proses pengelolaan anggaran pemerintahsehingga dapat direalisasikan pada awal tahunanggaran. Bottle-neck – bottle-neck lain perludiidentifikasi misalnya penggunaan Dana AlokasiKhusus yang kaku perlu dicari pemecahannya,ataupun kurangnya data untuk perencanaan. (2)Dalam konteks alokasi anggaran pemerintah pusatdiharapkan ada pelaksanaan Standar PelayananMinimal (SPM) bidang kesehatan di kabupaten/kota.Pemerintah provinsi dan kabupaten diharapkanmendanai kegiatan kesehatan sesuai indikator SPM.Dengan menggunakan SPM, dalam alokasi anggaranini diharapkan ada pemihakan dukunganpengembangan kapasitas dan pembiayaan bagidaerah yang kapasitas fiskalnya rendah dan tingkatkemiskinannya tinggi. (3) Melakukan percepatankegiatan pembangunan kesehatan denganpenggalian, pengalokasian dan pemanfaatanberbagai sumber pembiayaan kesehatan daripemerintah maupun masyarakat termasuk swasta.Kerja sama dengan pihak swasta perludikembangkan untuk memperluas jangkauanpelayanan kesehatan. Kerja sama ini termasukpemberian insentif pajak dan subsidi bagi lembagaswasta yang melayani masyarakat miskin berdasarprogram pemerintah; (4) Memperkuat sistempenanggulangan bencana, sejak dari fasepreparedness, kesiapan untuk emergency danrecovery, dengan standar prosedur yang jelas.Kegiatan-kegiatan yang mempunyai dampak lebihlama namun sebaiknya dilakukan, antara lain: (1)Memperkuat berbagai infrastruktur sistemkesehatan, antara lain: pengembangan sistemsurveilans-respons di daerah agar masalah kesehatanlebih diperhatikan dan menjadi dasar untukMusrenbang tahunan dan limatahunan. Hal inimenjadi isu strategis untuk alokasi anggaran didaerah guna mendapatkan dana kesehatan tidakhanya dari Dinas Kesehatan, namun juga dinas-dinaslainnya, terutama untuk menangani Social-Determinants of Health. Penataan sistem informasikesehatan termasuk pemetaan status kesehatan,faktor risiko, fasilitas, dan berbagai hal lainnya untukkeperluan monitoring, evaluasi, dan perencanaan;(2) Penguatan Dinas Kesehatan sebagai pengawassistem pelayanan kesehatan, termasuk mutupelayanan klinik; (3) Penguatan DepartemenKesehatan untuk menyusun berbagai standarnasional sektor kesehatan, peraturan pemerintah,dan kemampuan fasilitasi bagi pemerintah daerah.Pengembangan penelitian kesehatan biomedik,klinis, dan kesehatan masyarakat secara sistematisdan terintegrasi (bersifat translasional). (4)Pengembangan tehnical assistance (konsultan)kesehatan secara terintegrasi dengan prinsipmengatasi masalah dalam sistem kesehatan.Hal lain yang diperlukan adalah memperkuatpenggunaan kebijakan desentralisasi di sektorkesehatan, antara lain menyangkut pembagian urusanantara pemerintah, pemerintah provinsi dan pemerintahkabupaten/kota diberbagai aspek kesehatan (LaksonoTrisnantoro, trisnantoro@yahoo. com).
PRAKTIK PERAWAT KELILING: STUDI KASUS TIGA PERAWAT DI KABUPATEN INDRAGIRI HULU PROVINSI RIAU Afril, Zul; Hasanbasri, Mubasysyir; Trisnantoro, Laksono
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 04 (2009)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (161.822 KB)

Abstract

Background: Professional service in isolated areas is verylimited because the policy on the placement of doctors tendsto put priority on urban areas. Nurses are health staff mostcommonly available at isolated areas and utilized by thecommunity as medical staff in Indonesia for a long time. Theyhave been working on mobile basis from one village to anotherbecause the community needs express and affordableservices. Legally, mobile nurses have infringed regulationsbecause they do not have permit for their practice and theyprovide services beyond their expertise. Meanwhile, thepresence of mobile nurses greatly helps the government insolving health problems in the community.Objective:  The study aimed to describe health servicesprovided by mobile nurses at District of Indragiri Hulu.Method: This case study was carried out in February – April2008. Data were obtained through participative observationand in depth interview. The researcher followed the nursesobserved with open agreement from respondents and studiedthe activities they carried out in their work.Result: The result of the study showed that types of servicesprovided by mobile services at District of Indragiri Hulu wererelatively complete, comprising service of care to medication.The service was accessible and inexpensive and paymentmethod was flexible. These nurses were willing to providehealth services as demanded by patients. They provided mobileservice because health staff available in marginal areas wasnurses. This caused high demand for health service providedby nurses; however this mobile service was not protected byregulations because so fan there was no regulation whichconcerned with practicing nurses at District of Indragiri Hulu.The only regulation that protected them was issued by nationalassociation of nurses. Absence of regulation on nurses causedcontrol to practice of mobile nurses could not be enacted. Thecontrol was needed to protect the community and the serviceof mobile nurses itself.Conclusion: The study proved that unavailability of doctorshad put nurses in a central position as medication providers inisolated areas. Besides, proactive approaches made by thenurses had become major factor of acceptance to theirpresence in the community. Considering their control role, itwas suggested that the government issued administrative andprofessional act on nurses order that control to quality ofnurses could ensured.Keywords: availability of health staff, mobile nurses, socialmotivation, isolated areas

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