Indonesian Journal of Health Administration
Not a member yet
304 research outputs found
Sort by
RECORDING GLOBAL VOICES: SYSTEMATIC LITERATURE REVIEW IN PATIENT SAFETY CULTURE SURVEYS
Full text linkBackground: Measurement of patient safety culture is often conducted using various questionnaire methods and multiple respondents. Patient safety culture cannot be ignored; therefore, understanding these results is crucial for further study.
Aim: To investigate the results of measuring patient safety culture in hospitals across various countries.
Method: This study is a systematic literature review of articles published between 2013 and 2023. The selection process followed the PRISMA, which included identification, screening, eligibility, and inclusion. Selected articles were evaluated for quality, and the data were then analyzed thematically to identify instruments, approaches, and challenges in measuring patient safety culture.
Results: The systematic review identified 45 relevant studies. The HSOPSC instrument was the most widely used, followed by the SAQ and the PSFHI, with varying local adaptations. The analysis revealed challenges with instrument reliability, differences in cultural contexts, and resource limitations. These findings promoted standardization and local adaptation in measuring patient safety culture.
Conclusion: After 24 years of global recognition of patient safety, this study confirms that measuring patient safety culture is a strategic pillar in hospital quality improvement. This finding has academic and practical values, supporting cultural improvement strategies and evidence-based patient safety policies.
Keywords: Doctor, Hospital Community, Hospital, Nurse, Patient Safety Cultur
APPLYING AN IMPLEMENTATION RESEARCH LENS TO INDONESIA’S FREE NUTRITIOUS MEAL PROGRAM
Full text linkThe Makan Bergizi Gratis (MBG, or free nutritious meal) program was designed by the Indonesian government to enhance community nutrition, particularly for students. Ensuring the effective implementation of programs is essential to achieving various objectives. In general, implementation research serves as a method to identify implementation determinants, formulate strategies, and assess outcomes within the specific context of the MBG program. Therefore, this research aims to investigate the potential use of implementation research methodology for improving the MBG program. Research in the area may rely on the application of frameworks, theories, and models within implementation science. The methodology covered three areas: 1) delineation of the implementation process; 2) identification of factors affecting implementation, and 3) assessment of implementation outcomes. The research can concentrate on the phases of formulating implementation strategies and converting research into practice during the identification of the implementation process. Further opportunities for inquiry include investigating the factors influencing implementation, the effectiveness-implementation hybrid design, outcomes of implementation, economic evaluation, and the phases of scaling up the strategies within the MBG program. The active role of end-users can help ensure that the results are relevant and applicable in practice, thereby increasing the possibility of adoption.
Keywords: Free nutritious meals, implementation science, perspectives, school-based progra
ASSESSING THE DISTRIBUTION OF SELF-PAYING INNOVATIVE ONCOLOGY MEDICINES AMONG CANCER PATIENTS
Full text linkBackground: Innovative oncology medicines offer advanced cancer treatment but often come with high costs, limiting access through public healthcare funding.
Aims: This study examines the distribution of self-paying innovative cancer drugs among patients in Malaysian public hospitals.
Methods: Using oncology pharmacy records from 2017 to 2020, 157 patient samples were collected, constrained by COVID-19 restrictions.
Results: The average patient age was 57 years (SD= 11.47), with a predominance of females (73.9%) and Chinese ethnicity (48%). Breast cancer was the most common diagnosis (47%), followed by lung (17%) and colon cancer (10%). Frequently prescribed drugs included Trastuzumab, Palbociclib, Osimertinib, Cetuximab, and Bevacizumab, most of which are listed in the Ministry of Health’s Formulary of Listed Anticancer Drugs (FLAD). Patients paid an average annual cost of MYR 16,233.90 (SD= 20,424.67) for FLAD medicines and MYR 11,239.75 (SD= 122,793.50) for non-FLAD medicines.
Conclusion: The study highlights that out-of-pocket payments are the primary funding source for these treatments, posing significant financial burdens and potential long-term economic strain on cancer patients in Malaysia.
Keywords: FLAD, Funding Mechanism, Innovative Oncology Medicin
STRENGTHENING MATERNAL AND CHILD HEALTH SYSTEM TOWARDS INDONESIA EMAS 2045
Full text linkThis editorial article highlights the important role of strengthening the maternal and child health system for the overall increase of the nation’s productivity, as well as the achievement of Indonesia Emas 2045. The discussion emphasized accessibility of maternal health services in community health services like Posyandu through readiness of health cadres, especially after the government implemented Integrated Primary Health Services or Integrasi Layanan Primer (ILP). Moreover, the implementation of exclusive breastfeeding was found to be significantly associated with stunting, making it a pivotal program to decrease stunting prevalence and increase infants’ health quality. Although some challenges like geographic barriers, limitation of knowledge and education, as well as low household income existed, investing in the maternal and child health system would solve the problem of the high mortality rate among mothers and infants. As Indonesia Emas 2045 was set as national development goals, the article stands up for better quality of maternal and child health in Indonesia through collaboration across sectors with an inclusive decision-making process.
Keywords: Child health, health system, infant health, maternal health
ASSESSING POSYANDU CADRES’ READINESS IN IMPLEMENTING INTEGRATED PRIMARY HEALTH SERVICES IN YOGYAKARTA, INDONESIA
Full text linkBackground: The readiness of Posyandu (a community-based health service) cadres’ to implement the Integrated Primary Health Services (Integrasi Layanan Primer/ILP) is vital to advancing preventive and promotive care.
Aims: This study aims to evaluate the cadres’ readiness, identify challenges, and propose effective strategies for sustainable implementation.
Methods: A mixed-method design from April to June 2024. 113 cadres from Kulon Progo, Sleman, and Yogyakarta City participated in a cross-sectional study. Cadres' readiness was evaluated based on the posyandu cadres’ basic skills training curriculum. Ten informants were interviewed to explore the opportunities, needs, and limitations of the ILP implementation. Descriptive statistics were used for data analysis.
Results: Most cadres (63.7%) were aged 41–50 years, 60.2% had completed senior high school, and 72.6% were housewives. The cadres demonstrated high readiness for ILP implementation, with the main needs in the form of improving logistics, funding, training, and community participation. In addition, there was a need to improve the literacy and skills of cadres in providing health services across the life stages, such as immunization, growth and development monitoring, and infant and child feeding.
Conclusion: Posyandu cadres are ready to implement the ILP; however, strengthening cadres’ capacity and fostering community collaboration are key strategies for ensuring the sustainability of the program and achieving health transformation.
Keywords: cadres, health transformation, integrated primary service, posyand
DETERMINANTS OF WORK MOTIVATION AMONG DOCTORS AT COMMUNITY HEALTH CENTERS IN INDONESIA
Full text linkIntroduction: Effective work motivation among healthcare professionals significantly enhances health service performance and plays a pivotal role in improving service quality.
Aims: This study aims to analyze the determinants influencing work motivation among doctors at community health centers in Indonesia.
Methods: This study employed a quantitative approach with a cross-sectional design, utilizing secondary data from the 2017 Indonesian Workforce Research in the Health Sector. The study sample comprised 9,988 respondents. Logistic regression was employed for data analysis.
Results: In 2017, 55.1% of doctors at community health centers in Indonesia reported high work motivation. Significant correlations were identified between work motivation and various factors: individual characteristics (age, education, marital status, position), intrinsic factors (training and continuing education), extrinsic factors (salary/wages, work area), financial incentives (performance allowances, capitation fund incentives), and non-financial incentives (official vehicles) (p < 0.05). Among these, the type of position was identified as the most dominant factor influencing work motivation (p < 0.05; prevalence ratio (PR) = 1.805 CI 95% [1.608-2.028]).
Conclusion: Work motivation among doctors at community health centers in Indonesia is significantly influenced by individual characteristics, intrinsic and extrinsic factors, as well as financial and non-financial incentives, with the type of position being the most dominant factor. To enhance motivation and improve healthcare services, policymakers should strengthen career development, expand training opportunities, improve financial and non-financial incentives, and implement targeted retention strategies, especially in underserved areas.
Keywords: Community health center, doctor, Indonesia, work motivatio
THE HIDDEN ECONOMIC BURDEN OF LEPTOSPIROSIS: HEALTHCARE COSTS AND PATIENT IMPACT
Full text linkBackground: Leptospirosis is a public health issue caused by the Leptospira bacterium, leading to significant economic impacts. The cost of illness due to Leptospirosis encompasses hidden costs that significantly affect individuals and society
Aims: This study aimed to assess the hidden economic burden (direct and indirect costs) experienced by patients and their families due to healthcare treatment of leptospirosis.
Methods: This descriptive cross-sectional study was conducted in Banyumas Regency from February to June 2024. Data were collected from patients who completed leptospirosis treatment in 2023. The variables of cost were categorized into direct treatment cost, treatment cost, and indirect cost, which were analyzed descriptively.
Results: Most leptospirosis patients were male, aged 26 – 45 years old, and the majority worked as farmers. Our study reveals that uninsured patients incurred higher out-of-pocket expenses during leptospirosis’ treatment. The productivity loss was estimated at USD 44.75, with significant hidden costs being transportation (USD 31.90), caregiver support (USD 86.38), and hospital treatment (USD 231.40).
Conclusion: The significant burden of Leptospirosis in Indonesia highlights the economic impact on individuals and the challenges within the healthcare system. This study calls for enhanced public health strategies focused on prevention, early diagnosis, and improved healthcare access to address the leptospirosis burden effectively.
Keywords: Cost of illness, economic burden, financial impact, leptospirosis, productivity los
EVALUATING THE EFFECTIVENESS OF SOCIAL PROTECTION IN REDUCING STUNTING IN INDONESIA
Full text linkBackground: Social protection programs constitute sensitive interventions addressing the underlying causes of stunting. However, empirical evidence regarding the extent to which social protections contribute to reducing stunting remains inconclusive.
Aims: This study examines the correlation between social protection programs and the incidence of stunting in Indonesia, utilizing data from the 2022 Survey of the Nutritional Status of Indonesian (SSGI) with a sample size of 323,887 children aged 3 to 60 months.
Methods: The study employed binary logistic regression, with childhood stunting incidence as the dependent variable. This method enables the estimation of the probability of stunting based on variations in program exposure. The key programs of interest are Program Keluarga Harapan (PKH), Bantuan Langsung Tunai (BLT), Bantuan Pangan Non-Tunai (BPNT), and Wilayah Prioritas Stunting (DPS), incorporating other control variables related to child, household, and household infrastructure characteristics.
Results: BLT is positively associated with stunting, while PKH, BPNT, and DPS show no significant effects. Conversely, access to clean water, sanitation, and clean cooking energy reduces stunting, underscoring the role of health-related infrastructure and the limited contribution of social protection programs to child nutrition.
Conclusion: In a policy perspective, the findings underscore the need for greater harmonization between social assistance programs and broader improvements in health, nutrition, environmental conditions, targeted education, health behaviour towards improved nutritional intake, and healthy practices. A novel contribution of this study is offering one of the largest nationally representative analyses linking multiple social protection programs (PKH, BPNT, BLT, and DPS) to stunting outcomes using SSGI 2022 data at the individual level.
Keywords: Stunting, Family Hope Program (PKH), Direct Cash Transfer (BLT), Non-Cash Food Assistance (BPNT), Stunting Priority Areas (DPS)
SPATIAL ANALYSIS FOR MICROPLANNING TO ADDRESS IMMUNIZATION INEQUALITIES IN INDONESIA
Full text linkBackground: To achieve high and equitable immunization coverage, it is important to understand the access and utilization barriers, as well as the influencing determinants among population groups.
Aims: This study aims to identify high-risk regencies and explore the application of spatial analysis to support microplanning in immunization programs.
Methods: This study employed an implementation research design conducted in Aceh Province, Indonesia. Secondary datasets on immunization coverage, health human resources, facilities, and socio-economic parameters were analyzed. Focus group discussions (FGDs) and training sessions were conducted with health workers.
Results: The average coverage of universal child immunization (UCI) across villages was 24.18%, while complete basic immunization (CBI) reached 55.85%. In general, regencies with low UCI and CBI often had limited human resources, inadequate health facilities, and a high proportion of high-risk populations. This study identified hot spots and cold spots in the study area. Additionally, participants reported that mapping using the application was easier and beneficial for supporting the preparation of immunization micro-planning.
Conclusion: Spatial analysis can help address inequalities in immunization services and support resources during immunization. Qualitative approaches provided a deeper understanding of undocumented information. The use of mapping applications facilitated more effective microplanning in immunization programs.
Keywords: Child mortality, health risk, immunization, microplanning, vaccine
RETENTION OF REMOTE PUBLIC HEALTH CENTER DOCTOR IN NORTH KONAWE DISTRICT
Full text linkBackground: Remote public health centers (PHCs) have the highest proportion of PHCs without doctors, with Southeast Sulawesi Province ranking fifth in this regard. PHCs serve as the main gateway to health services in rural and remote areas. Despite its high fiscal capacity and provision of support for medical education and incentives, North Konawe District has not succeeded in retaining doctors in its public health centers.
Aims: This study aims to analyze factors that influence the retention of doctors in remote PHCs in the North Konawe District.
Methods: This qualitative study employed a case study design, involving in-depth interviews with 14 informants and a review of six documents.
Results: Factors affecting doctor retention in the North Konawe District include individual factors, work factors, living environment factors, and health system factors.
Conclusion: Doctors in remote PHCs in North Konawe District are Ministry of Health placement doctors working on temporary contracts. Strategies to improve the retention of doctors in remote PHCs include improving living conditions in remote areas, supporting job opportunities for doctors' spouses, recruiting doctors early in their careers, implementing government disincentive policies, building PHCs with official housing, requiring mandatory service for recipients of medical education scholarships, and developing doctor attendance information systems.
Keywords: Doctor, PHC, remote area, retention