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Jurnal Manajemen Pelayanan Kesehatan
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HUBUNGAN AKSES AIR BERSIH DENGAN PERILAKU CUCI TANGAN PAKAI SABUN PADA RUMAH TANGGA YANG MEMPUNYAI BALITA DI INDONESIA Sopacua, Evie
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Background: Washing hands with soap on right a time is aneffort to change bad attitudes which does not support theexpected health’s status. Washing hands with soap couldn’tsucceeded if there was not clean water access. This analysispurposed to know the relation between clean water accesswith washing hands with soap’s attitudes on household withchildren under 5 years based on region’s type in Indonesia.Method: This analysis used chi-square’s and log-regression’stest with Riskesdas 2007 data as analysis units. It showedthat 243.396 children under 5 years on 104.109 urban’shouseholds and 139.287 rural’s households.Result: The result showed that the clean water access 90%either in urban or rural was good, but the attitude washinghands with soap were still low, under 60%. Chi-square testshowed there was a relation between the clean water accessand the outcome level with washing hands with soap’s attitude.Log-regression test showed that tended based on the outcomelevel in avarege and poor households, and did not differsbetween urban and rural.Conclusion: There were relations between the clean wateraccess and outcome levels with washing hands with soap.Washing hands with soap ‘s attitude with clean water or notstill on the low level, either on urban or rural. Household withpoor economic’s and avarege’s status tended to low washinghands with soap’s attitude againts the wealthy one. This studyrecommended to improve health’s education to all community,to understand the importance of washing hands with soapusing clean water for all activities, especially before eating,before preparing the food, after loosen the bowels/babies’care, and after holding the animals.Keywords: clean water access, washing hands with soap,household with children under 5 years
RANCANGAN UNDANG-UNDANG PENDIDIKAN KEDOKTERAN: PERLUKAH? Trisnantoro, Laksono
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Saat ini terdapat keluhan mengenai mutupendidikan dokter Indonesia, masalahpenyebarannya, serta biaya pendidikan. Keluhan initidak terbatas pada pendidikan dokter umum, namunjuga pendidikan spesialis (residen di rumahsakit).Dalam konteks ini memang dirasakan ada sesuatuyang salah dalam pendidikan kedokteran Indonesia.Oleh karena itu Komisi X DPR melakukan inisiatifdengan mengajukan Rancangan Undang-Undang(RUU) Pendidikan Kedokteran. Saat ini RUU tersebuttelah masuk ke pembahasan materi olehpemerintah. Diharapkan akhir bulan Juni 2011pemerintah telah selesai menyusun tanggapannyauntuk kembali dibahas oleh DPR. Pertanyaanpenting yang sering timbul adalah apakah memangperlu RUU tersebut. Apa masalah kebijakannya?Dalam tulisan ini ada dua kebijakan yang disorotiyaotu kebijakan pemerintah di pendidiakn dokterumum dan kebijakan di pendidikan spesialis.Berbagai kebijakan yang terkait denganpendidikan dokter umum berada dalam berbagaikonteks menarik. Pertama ada berbagai kesulitandalam memasukkan lulusan SMA dari daerah sulitke Fakultas Kedokteran (FK) negeri, dalam suasanakebutuhan daerah akan dokter. Dalam situasi inieforia desentralisasi mendorong berbagai pemerintahdaerah mendirikan FK dengan modal keuangan dansumber daya manusia (SDM) yang terbatas.Akibatnya mutu pendidikan kedokteran di berbagaifakultas dipertanyakan. Kedua, kurikulum pendidikandokter di Indonesia terlihat berusaha mengejarkemajuan teknologi sementara itu kesesuaiandengan kebutuhan lokal terlihat kurang diperhatikan.Ketiga. dalam suasana permintaan tinggi lulusanSMA untuk menjadi peserta Pendidikan kedokteran, berdampak pada situasi dimana fakultaskedokteran menghasilkan pendapatan besar untukperguruan tinggi. Terjadi peningkatan tarif ataupunsumbangan dari mahasiswa termasuk mahasiswaasing. Terjadi fenomena buruk yang tidak dapatdielakkan, fakultas kedokteran di berbagai universitasnegeri dan swasta menjadi penyumbang untukpendidikan di fakultas lain.Di sisi pendidikan profesi selama bertahun-tahunterjadi ketidak jelasan domain rs pendidikan apakahberada di Kementerian Kesehatan atau pendidikandengan konsekuensi sumber anggarannya.Kementerian Kesehatan merupakan pemiliksebagian besar rumahsakit pendidikan yang tidakmempunyai anggaran khusus untuk pendidikandokter umum. Akan tetapi kerjasama antara duakementerian ini belum jelas.Kebijakan pemerintah di Dokter Spesialismerupakan faktor kedua penting untuk menyusunRUU ini. Jumlah lulusan dokter spesialis setiap tahunsangat tidak signifikan jika dibandingkan dengankebutuhannya. Hal ini disebabkan karena pendidikankedokteran spesialis hanya ada di perguruan tingginegeri dan tidak ada dukungan pemerintah dalamanggaran. Data menunjukkan fakta bahwapertumbuhan tenaga dokter spesialis sangat lambatdibandingkan dengan kenaikan jumlah penduduk.Oleh karena itu, perlu dirancang sistem pendidikanspesialis dengan harapan, jumlah dan mutu spesialissegera dapat memenuhi kebutuhan masyarakat Indonesia.Di pendidikan spesialis dibutuhkan campurtangan pemerintah, termasuk pendanaanya. Dengandemikian biaya yang ditanggung oleh masyarakatdapat berkurang. Salahsatu inovasi dalam pendidikanspesialis adalah memberi kesempatan ke sistempendidikan yang berdasarkan rumah sakit (hospitalbased) pemerintah dan swasta dalam lingkup sistemperguruan tinggi, dengan ujian nasional untukstandarisasi kompetensi mereka. Oleh karena itukebijakan terhadap peserta pendidikan dokterspesialis perlu diubah. Peserta pendidikan (residen)adalah bukan hanya peserta didik, namun jugamerupakan pemberi pelayanan di rumahsakit yangmempunyai hak dan kewajiban, termasuk menerimapendapatan dari kegiatannya di rumahsakit.Kebijakan-kebijakan pemerintah di pendidikankedokteran ini perlu dilakukan dengan alat kebijakanpublik yang kuat, dalam bentuk Undang-Undang,tidak cukup dengan Peraturan Pemerintah. Olehkarena itu dibutuhkan RUU pendidikan kedokteran.Ketika membahas RUU Pendidikan Kedokteranmaka perlu analisis dengan menggunakanpendekatan reformasi dalam pendidikan kedokteran.Dalam konteks sejarah, reform bisa berulang-ulangsesuai kebutuhan jamannya. Reformasi pendidikankedokteran yang dituliskan oleh Frenk dkk (Lancet2010) berfokus pada reform medical education diabad 20 kemarin. Menurut Frenk ada tiga reformpendidikan kedokteran di abad ke 2-0: (1) The firstgeneration, launched at the beginning of the 20thcentury, instilled a science-based curriculum; (2)Around mid-century, the second generation introducedproblem-based instructional innovations; dan(3) A third generation is now needed that should besystems based.Dengan pendekatan pemikiran reformasipendidikan kedokteran terlihat bahwa RUUPendidikan kedokteran merupakan sebuah reformasidi pendidikan kedokteran. RUU ini merupakankebijakan reformis dalam pendidikan kedokteran,yang merupakan reformasi generasi ke tiga. LaksonoTrisnantoro (trisnantoro@yahoo.com)
KEPUASAN KERJA DAN PERSEPSI PERAWAT TENTANG KEPEMIMPINAN DENGAN KINERJA PERAWAT PASCA SERTIFIKASI ISO 9001/2008 Suryanto, Suryanto
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Background: Job satisfaction will improve the nurseperformance in hospital. This occurs when the nurses perceiveintrinsic rewards (e.g. feel something has achieved) andextrinsic rewards (e.g. salary/incentives) which have beenreceived were fair and reasonable. The job satisfaction innurses will raise motivation in the workplace so that the numbersof absence will be decreased. The job satisfaction can alsoimprove physical and mental health status that has impact onphysical fitness, high work morale and motivation so that thenurse performance will be increased.Objective: To identify relationship between job satisfactionand nurses perceptions about leadership with the nurseperformance of post certification ISO 9001/2008 in PKUMuhammadiyah Hospital Gombong.Method: Explanatory quantitative research methods withsurvey and cross-sectional approach. Data analysis wasperformed with linear regression test. The independentvariables were job satisfaction and nurse perceptions aboutleadership and dependent variable was the nurse performance.Samples were 95 nurses who worked in PKU MuhammadiyahHospital Gombong. The research instruments use modifiedLikert’s scale, questionnaires and interview guides. The datasources are nurses, patients and several informants.Result: The analysis result of ANOVA test was found F count26.44, significance level of 0.000. With relationship value of0.44. There was a significant positive relationship betweenjob satisfaction and nurse perceptions about leadership withthe nurse performance of post certification ISO 9001/2008 inPKU Muhammadiyah Hospital Gombong. The closeness ofrelationship is moderate category while R Square value(determination coefficient) was 36.5%. This means that thejob satisfaction of nurses and nurse perceptions aboutleadership is jointly affect the nurse performance about 36.5%Conclusion: There was a significant positive relationshipbetween job satisfaction and nurse perception about leadershipwith the nurse performance of post certification ISO 9001/2008 in PKU Muhammadiyah Hospital Gombong. To improvethe nurse performance, nurses should make some innovationsin their work. The management of hospital should improve thecontrol function and the comfort of work environment in thehospital.Keywords: job satisfaction, leadership, performance
IMPROVING ACCESS TO NARCOTIC ANALGESICS: THE INTERNATIONAL CONTROL SYSTEM AND OPTIONS FOR QUANTIFICATION METHOD Suryawati, Sri
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Narkotika lebih dikenal masyarakat karena masalahpenyalahgunaannya, padahal salah satu kelompok narkotikayang digunakan dalam bidang medis adalah analgetika narkotika,utamanya tablet morfin, yang merupakan obat esensial.Penghitungan kebutuhan yang akurat untuk analgetika narkotikasangat penting untuk memastikan ketersediaannya bagipelayanan kesehatan pasien. Saat ini data global menunjukkanbahwa penggunaan morfin lebih terkonsentrasi di beberapanegara di Eropa dan Amerika Utara saja, sedangkan di negaranegaralain termasuk Indonesia, konsumsinya sangat minim.Morfin bahkan tak tersedia di 70 negara dan teritori.Penyebabnya bisa karena kurang akuratnya penghitungankebutuhan, kurang digunakan atau karena kebocoran distribusi.Di lain pihak, ketidakakuratan penghitungan juga bisamenyebabkan surplus persediaan yang bisa menyebabkankebocoran distribusi dan dapat mengarah ke penyalahgunaan.Oleh karena itu, sangatlah penting untuk memilih metodepenghitungan kebutuhan morfin yang paling tepat, agarkebutuhan medis terpenuhi secara optimal. Makalah inimenyajikan sistem pengawasan internasional untuk penyediaannarkotika bagi kebutuhan medis, dan langkah-langkah untukmeningkatkan keakuratan penghitungan kebutuhan analgetikanarkotika, dengan tetap memperhatikan langkah-langkahpengamanan distribusinya.Kata Kunci: sistem pengawasan internasional, analgetikanarcotika, morfin, estimasi, metode kuantifikasi
ANALISIS PENGARUH KEPEMILIKAN ASURANSI KESEHATAN TERHADAP KEMAUAN MEMBAYAR PRODUK PELAYANAN LABORATORIUM Maharani, Asri
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Background: The willingness to pay of society for theproducts of laboratory services as one of the healthprecautions need to be improved. Ownership of healthinsurance is one factor that wants to study its effect onwillingness to pay for laboratory services because healthinsurance is expected to have a society can allocate funds forpreventive healthObjective: The purpose of this study is to determine the effectof health insurance ownership of willingness to pay forlaboratory services.Methods: A cross sectional study design using the 100respondents who were taken proportionally from eight selecteddistricts in Banyuwangi. Variables that were examined includethe willingness to pay as measured by the method of contingentvaluation and ownership of health insurance. The datacollection tool is a questionnaire. Data were analyzed usinglogistic regression.Results: The results showed that the level of willingness topay of respondents for all types of laboratory examinations isstill low. Most respondents (76%) did not have health insurance.Only about 50% of respondents who do not have healthinsurance are willing to pay for laboratory examination.Respondents who have health insurance tend to want to payfor laboratory services. From 24 respondents who have healthinsurance, more than 50% of respondents (15 respondents)were willing to pay for laboratory services. The ownership ofhealth insurance of respondents did not significantly affectthe willingness to pay for laboratory examination product(sig. = 0.287, B =- 0.511). This may be due to the BanyuwangiRegency society has not so familiar with health insurance andstill less has it, so most of the out-of-pocket payments.Conclusion: The ownership of health insurance respondentsdid not significantly affect the willingness to pay for productslaboratory examination. It is need to introduce more productslaboratory services and health insurance benefits to theBanyuwangi community.Keywords: willingness to pay, laboratory services, ownershipof health insurance
PENGUKURAN INDEKS KEPUASAN MASYARAKAT TERHADAP PELAYANAN KESEHATAN Nurrizka, Rahmah Hida
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Background and Method: This research measured SocietySatisfaction Index (SSI) toward health service at AchmadMochtar Hospital West Sumatera. Society Satisfaction Index(SSI) is one of indicators for measuring public service providedby govermental institution for society. This is stipulated in thedecesion of Minister for Empowering State apporatus NumberNo. 25/2004 on General Guide for Society Satisfaction Indexat Service Unit of Goverment Institution.Result and Conclusion: The result of measuring SSI atAchmad Mochtar Hospital showed; (1) in general, service givento society has been good, except for aspects; officers disciplinein serving, the speed of service, the certanty of service costand service schedule, (2) from service side, service at inhospitalstay is better that service at out-hospital stay andemergency service, (3) the difference in service occuredaccording to service unit and three best service based on SSIwere in the unit of modwifery, sex/skin and THT. Based on thisfinding, goverment and hospital can improve health service.Keywords: society satisfaction index, helath service, publicservice
PENILAIAN KUALITAS PELAYANAN PUSAT KESEHATAN MASYARAKAT DI WILAYAH SUMATERA UTARA, INDONESIA Santosa, Heru
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Background: Public Health Center (“Puskesmas”/PusatKesehatan Masyarakat) is a leading health service facility inthe development of community health in Indonesia and plays avital role to realize the vision of Healthy Indonesia 2010. Theobjectives to evaluate the health service quality of Puskesmas;The quality of Puskesmas services was evaluated usingSerqual method while the data was collected using quantitativeand qualitative methods.Method and Result: The quantitative analysis indicated thatthe mean score for quality was 3.79. In addition, the healthservice quality of Puskesmas, on all dimensions, generallyshows the scores above 3. This means that the health servicequality of Puskesmas is at a relatively good level. Stratified bythe mean scores, the dimensions of responsiveness andreliability have similar mean scores of 3.85; the dimension ofempathy has a mean score of 3.81; and the dimension ofassurance has a mean score of 3.79.Conclusion: The dimension of tangible has the lowest meanscore of 3.64. The factors affecting the improvement of healthservice quality in Puskesmas are the input factors, processfactors, and environmental factors for achieving the vision ofHealthy Indonesia 2010 through the implementation of the NorthSumatera Province Health Project-II.Keywords: public health center, Puskesmas
CEMA-COMMUNITY TO IMPROVE KNOWLEDGE AND SKILLS IN EVALUATING MEDICINE ADVERTISEMENTS Wiedyaningsih, Chairun
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 01 (2011)
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Backgrounds: Since objective information on medicineadvertisements are often scarce, medicine advertisementsmay affect community’s perception and health. The CriticalEvaluation Medicine Advertisement by the community (CEMAcommunity)was a strategy that may empower community inevaluating medicine advertisements. It was developed basedon the previous study targeted to medical students withmodifications on the content and the inclusion of local regulationon medicine promotion.Objectives: To evaluate effectiveness of the CEMAcommunitymethod in improving knowledge and skills ofparticipants.Methods: The study utilized pre and post in time series withcontrol group design. The CEMA-community intervention methodconsisted of two sessions; the first was a brief lecture andthe second was small group discussions using printed andaudiovisual medicine advertisements in problem-orientedapproach. Activity materials and methods were developed andprovided to the activity. Data on knowledge was obtained byquestionnaires. Data on skills was assessed by the number ofinappropriate claims they could identify the advertisements.Effectiveness of approach was shown by the significance ofincreasing level of knowledge and skills after intervention.Results: Participants’ knowledge and skills in the CEMAcommunitygroup improved significantly (Wilcoxon test, p< 0.05).Score of knowledge in the CEMA-community group before-,right-, and 2, 4 weeks-after intervention (means: 13.9±2.52;18.0±2.72; 19.0±3.10; 18.3±3.74, respectively) improvedsignificantly (Mann-Whitney, p<0.05) as compared to controlgroup (means: 14.1± 2.84; 14.8±2.94; 14.8±2.85; 15.6±2.45,respectively). At the same time points, scores of skills in theCEMA-community group (means: 7.8±6.05; 16.5±10.01;32.6±12.89; 32.2±13.06, respectively) also improvedsignificantly (Mann-Whitney, p<0.05) as compared to controlgroup (5.5±6.60; 4.7±4.91; 8.7±10.07; 9.5±10.15, respectively).Conclusion: CEMA-community was effective in increasingknowledge and skills to critically evaluate medicineadvertisements.Keywords: community empowerment, medicineadvertisements, knowledge, skills, CEMA-community, problemorientedapproach

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