Indonesian Journal of Health Administration
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COMPENSATION AND SOCIAL WORKING ENVIRONMENT INFLUENCING UNMET NEEDS OF FAMILY PLANNING
Get PDFBackground: The incidence of unmet needs of family planning is one of the performance indicators of Family Planning Outreach Workers. There were 30 sub-districts in Surabaya, but only two sub-districts reached the number of unmet need incidences at 7.3% as required by the government standard in 2016.Aims: The study aimed to analyze the correlation and effect of performance factors, especially salary system and social working environment towards the number of unmet need incidences in Surabaya.Method: This study employed descriptive quantitative research with a cross-sectional design. The data were obtained from questionnaires, filled out by 30 teams of Family Planning Outreach in Surabaya as respondents selected by using a total sampling method. The data were analyzed with descriptive statistical tests of cross-tabulation between salary system, workplace, and incidence of unmet need.Results: A better condition of salary system did not determine the standard number of unmet need incidences. Two districts that perceives fair social working environment have the number of unmet need incidences that follows the standard of ≤7.3%. Whereas only 10 districts have perceived a good social working system which result in the unachieved standard number of unmet need incidences at >7.3%.Conclusion: There is no significant correlation or influence between salary or compensation system with the number of unmet need incidences. However, there are not significant correlation and influence between the social working environment and the number of unmet need incidences. Therefore, improvements in the social working environment should be made to achieve the goal of family planning program.Keywords: family planning outreach workers, salary system, social working environment, unmet need
MIDWIVES' COMPLIANCE TO THE STANDARD OPERATING PROCEDURE ON THE EARLY IDENTIFICATION OF PREECLAMPSIA
Get PDFBackground: The main cause of maternal mortality in East Java was pregnancy hypertension (Preeclampsia/eclampsia). The percentages of pregnant women treated with early identification of preeclampsia care according to Standard Operating Procedure (SOP) in primary healthcare centers of Surabaya was still low (26%).Aim: This study aimed to analyze the factors that influence midwives' compliance towards the SOP implementation of early identification of preeclampsia in primary healthcare centers of Surabaya.Methods: The study was an observational analytic research with cross sectional. The samples chose midwives at 20 primary healthcare centers as the informants. The independent variables are individual factors, organizational factors, and psychological factors of the midwives. The dependent variable was midwives' compliance towards the implementation of SOP for early identification of preeclampsia.Results: The results of this study show 35% of primary healthcare centers have not implemented the SOP of early identification of Preeclampsia in pregnant women. The results also showed that the majority of primary healthcare centers in Surabaya had midwives aged 31 to 40 years (50%), graduated from a Diploma 3 education (95%), contracted status (85%) and still worked less than six years (60%).Conclusion: This research highlighted the midwives' compliance which was determined not only by individual internal factors, but also organizational behavior. Preparing early identification of preeclampsia mechanisms, facility, and equipment proposal is important to do with the implementation of supportive system, quality control team, reward as well as punishment system. Keywords: Compliance, Early identification, Midwives, Preeclampsia, SOP
THE CORRELATION BETWEEN PATIENT SATISFACTION AND PEOPLE EQUITY AMONG PARAMEDIC STAFFS IN INPATIENT ROOMS
Get PDFBackground: One of the elements controlling the quality of hospital health services is patient and employee satisfaction. The mean value of patient satisfaction with all parameters of inpatient rooms at the Islamic Hospital in Surabaya from January to August 2016 was 61.3% which is less than the standard of ≥ 90%. Whereas, people equity is a concept of human resource management that signs organizational performance.Aims: This study examined the correlation between patient satisfaction and people equity among paramedic staffs especially in inpatient rooms of the Islamic Hospital in Surabaya.Methods: This study focused on measuring people equity, patient satisfaction, and the correlation between people satisfaction and people equity. The questionnaire used in this study adopted RATER dimensions (Reliability, Assurance, Tangible, Empathy, and Responsiveness).Results: The study found that three inpatient rooms (Muzdalifah, Arofah, and Shofa) did not meet three elements of people equity (Alignment, Capabilities, and Engagement). Patient satisfaction with the inpatient rooms was good, except for the tangible dimension especially room cleanliness which is still relatively low. People equity among the paramedic staff has strong relevance and is directly proportional to patient satisfaction with the inpatient rooms of the Islamic Hospital in Surabaya.Conclusion: Internalizing an organizational culture that considers patient satisfaction and patient equity among paramedic staffs is essential to harmonize the goals, vision, and mission between the hospital and its staffs. This study recommends that there should be a more serious evaluation of the cleanliness of all service units at the Islamic Hospital in Surabaya.Keywords: Patient satisfaction, People equity, Human Resource Management, Service performance
INSPECTING PRIMARY HEALTHCARE CENTERS IN REMOTE AREAS: FACILITIES, ACTIVITIES, AND FINANCES
Get PDFBackground: Progress towards health-for-all must be supported by quality health facilities that are available to everyone. However, health care facilities in remote and underdeveloped areas, borderland, and outlying islands or Daerah Terpencil, Tertinggal, Perbatasan dan Kepulauan (DTPK) are facing some constraints to have access to health coverage.Aim: This study aimed to provide a comprehensive picture of the readiness of primary healthcare centers or puskesmas as the main provider of primary health services located in remote areas.Methods: Observations were taken from 18 primary healthcare centers in locations that had been identified by the government as remote and underdeveloped areas, borderland, and outlying islands in 3 provinces: Bengkulu, Nusa Tenggara Timur (East Nusa Tenggara), and South Sulawesi.Results: The findings reveal that many facilities in primary healthcare centers are still insufficient. In particular, roads to primary healthcare centers are in poor physical conditions, operational hours are too short, and doctors and lab technicians are unavailable. The good news is that primary healthcare centers have managed to run many indoor and outdoor activities, such as health education classes and detection of priority diseases in the community. Regarding primary healthcare centers' finances, they largely depend on public funding to support their increasing expenses to provide health services, pay worker salaries, and run indoor and outdoor activities.Conclusions: Overall, some constraints faced by the primary healthcare centers in DTPK include difficult access to facilities and temporary health personnel. All of this information provides valuable inputs to policymakers in building a health infrastructure and human resources for health in DTPK. Keywords: Remote area, Human resources for health, Primary healthcare center
RESOURCES REQUIRED IN CLINICAL PATHWAY FOR TYPHOID FEVER TREATMENT AT KALIWATES GENERAL HOSPITAL IN 2017
Get PDFBackground: A clinical pathway is a concept of an integrated service which describes the stages of healthcare services from the admission until the return of patients based on the medical service standards and evidence-based nursing care with measurable results. Kaliwates General Hospital is an accredited hospital with a clinical pathway. Typhoid case was the highest disease in 2017 at Kaliwates General Hospital.Aims: This study aims to describe the resources at Kaliwates General Hospital in the implementation of clinical pathways, especially typhoid fever treatment.Method: This study was a descriptive and qualitative study. Nine respondents were selected using purposive sampling, including one internist and the quality team at Kaliwates General Hospital. The variables studied include human resource factors, budget factors, method factors, and time factors.Results: The results suggested that the human resources at Kaliwates General Hospital had high commitment, motivation, and moderate knowledge in the implementation of clinical pathways. All equipment and documents were considered adequate. The communication among the implementers was good, but compliance and training for staffs were considered less prominent. The task division of each staff was fairly distributed even though the pharmacy unit perceived that the division was quite unfair.Conclusion: The implementation of the clinical pathway for typhoid fever treatment at Kaliwates General Hospital runs quite well. The hospital must identify and plan staff training regularly, prepare the job description appropriately, and perform performance appraisal based on the job description that has been developed.Keywords: clinical pathway, typhoid fever, resource
THE EFFECT OF PREGNANT MOTHER'S BEHAVIOR IN THE PRE-PURCHASE STAGE TOWARDS THE SELECTION OF BIRTHPLACE
Get PDFBackground: A preliminary study at Mother and Child Hospital of Nyai Ageng Pinatih, Gresik, showed a gap between the number of pregnant women conducting antenatal examinations and the number of deliveries at the hospital in 2011. The number of pregnant women visits for antenatal care was relatively high. It is known that the average number of pregnant mothers giving birth at Mother and Child Hospital of Nyai Ageng Pinatih in 2011 was only 53.85%. Aims: This study aimed to analyse the effect of maternal behaviour on the pre-purchasing stage during pregnancy in choosing a birth location.Methods: This research was an analytical study with a cross sectional design. The population of this study was 235 mothers who completed the antenatal care at Mother and Child Hospital of Nyai Ageng Pinatih and were predicted to give birth around March to May 2012. The sample size was 75 people determined by using a cluster sampling method. Each independent variable was tested by identifying the influence on the choice of birth location by using univariate logistic regression with α value of <0.05. Results: The results of this study indicated that maternal behaviour in the pre-purchasing stage of delivery services consists of 3 stages (identification of needs, information seeking, and evaluation of alternatives) that influence the choice of birth place by pregnant mothers. It showed that the pre- purchasing stage has an impact on the choice of delivery place.Conclusions: The mother's behavior at the pre-purchasing stage during pregnancy influences the choice of delivery place inside and outside Mother and Child Hospital of Nyai Ageng Pinatih. Providing information about maternity care and delivery services can promote services provided at the hospital. The hospital should provide brochures about available services, post posters about health service options available, and promote delivery services conducted by obstetricians or midwives as an alternative delivery service. Keywords: Mother's behaviour, Pre-purchasing stage, Selection of delivery location
URBAN-RURAL DISPARITY: THE UTILIZATION OF PRIMARY HEALTHCARE CENTERS AMONG ELDERLY IN EAST JAVA, INDONESIA
Get PDFBackground: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output.Aim: This study analyzed the urban-rural disparity in the utilization of primary healthcare center by the elderly.Method: This study used in the 2013 Basic Health Research raw data. The 2013 Basic Health Research was designed as a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province participated. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in primary healthcare centers than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424).Conclusion: There was a disparity between urban and rural areas in the utilization of outpatient primary healthcare centers in East Java by the elderly. Policymakers in East Java are recommended to improve facilities and infrastructure of the primary healthcare centers in rural areas by paying attention to the results of this study.Keywords: elderly, urban-rural disparities, primary healthcare center, healthcare utilization, inpatient-outpatient.
REDESIGNING THE ROLES OF TUBERCULOSIS TREATMENT SUPPORTER IN INDONESIA
Get PDFBackground: Indonesia is the third-highest rank country for tuberculosis. Many studies already compared the effectiveness of the Directly Observed Treatment-Short (DOTS) course with self-administered therapy (SAT) in tuberculosis treatment and pointed out that DOTS did not improve the succession rate (SR) significantly. The participation of a tuberculosis treatment supporter that has an important rule in the DOTS strategy to improve the patients' adherence in taking treatment should be reviewed.Aims: The study aims to analyze the determination of environmental factors in the effectiveness of tuberculosis treatment which can lead to the program improvement issue.Method: This research was a cross-sectional study conducted by involving 55 of 121 tuberculosis patients. The sampling frame was tuberculosis patients who were reported under the first and third quarters in Primary Healthcare Center of Tanah Kalikedinding as it had failed to reach the succession rate during 2012-2015.Results: These findings indicated that the social environment of tuberculosis patients significantly contributed to their adherence to taking medicine. It showed that tuberculosis treatment supporters had an essential role in maintaining the patients' adherence. Tuberculosis treatment supporters who lived in one roof with the patient tended to get 2.265 times risk to be contagious. This study also pointed out that the physical environment had the highest determination in the success rate of treatment.Conclusion: Modifying the physical environment of tuberculosis patients can be the greater alternative program to fight tuberculosis rather than the tuberculosis treatment supporters. Tuberculosis treatment supporters must be provided with universal protection due to their high-risk position to be contagious.Keywords: treatment adherence, DOTS, patient environment, treatment effectiveness
