Indonesian Journal of Health Administration
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IMPLEMENTATION OF PRIMARY HEALTH CARE SYSTEM IN COUNTRIES
Full text linkBackground: Primary Health Care (PHC) systems are essential for delivering comprehensive and accessible health services globally, focusing on individuals’ and communities’ fundamental health and well-being.
Aims: To assess PHC systems to ensure universal access, regardless of socio-economic status or location, by providing comprehensive services such as illness prevention, treatment, rehabilitation, support, and health promotion.
Methods: This study utilised the PICO framework, with methods and results of this systematic review based on PRISMA guidelines. Articles were identified through an initial generic search in PubMed, ScienceDirect, and Scopus databases.
Results: After the assessment, a total of 18 articles were selected. The following priorities for PHC policy implementation emerged: enhancing collaboration between public and private sectors, improving information sharing through technology and health literacy, establishing quality evaluation systems, and promoting community-based training programs. Identified challenges include workforce shortages, particularly in rural areas, and inadequate coordination between primary and secondary care. Addressing these challenges and focusing on these priorities can lead to better health outcomes and more effective PHC systems.
Conclusion: The Alma-Ata Declaration of 1978 was a transformative milestone in global health. It advocated for "Health for All" through Primary Health Care (PHC). Despite initial challenges, the principles of Alma-Ata have significantly influenced PHC systems worldwide.
Keywords: Country-specific health primary care, health care systems, primary healthcar
HEALTH ADVERTISING ON INSTAGRAM: IS IT EFFECTIVE WHILE FOLLOWING ETHICAL GUIDELINES?
Full text linkBackground: Given the popularity of digital marketing in business today, every hospital can start utilizing it by establishing a social media account. Instagram is a social media platform that focuses on photographs. The AISAS (Attention, Interest, Search, Action, and Share) model can be used to assess the efficacy of marketing communications. Regardless, there are issues regarding legal and ethical issues. Therefore, a question emerges: How can health advertisements be effective while following ethical guidelines?
Aims: The purpose of this research is to analyze the content of healthcare advertisements on Instagram
Methods: This study uses the quantitative descriptive content analysis method. The samples are Instagram advertisements for health services. Search them using the hashtags (#) #dokterjogja, #klinikjogja, #klinikyogyakarta, and #rumahsakitjogja. Using convenience sampling, the researcher randomly scrolls and stops on Instagram. The data were assessed by two coders using a checklist to ensure objectivity. The checklist contains three indicators, in this case, the AIA (Attention, Interest, Action) indicator, and the other indicators were obtained from the Regulation of the Minister of Health of the Republic of Indonesia (PERMENKES) number 1787 of 2010
Results: The highest score of the AIA (Attention, Interest, Action) indicator is 12, and there are a total of 34 advertisements (coder 1), and 84 advertisements (coder 2) violate The Regulation of the Minister of Health (PERMENKES) No.1787/2010
Conclusion: This study finds that effective advertising is almost certain to violate the regulation. An educational health information advertisement that introduces the services provided is a good way to promote healthcare providers while remaining ethical.
Keywords: advertising, AISAS, ethics, health, social medi
ANALYSIS OF PUBLIC SAFETY CENTER 119 AMBULANCE SERVICES USING LEAN SIX SIGMA
Full text linkBackground: DKI Jakarta reports about 5,000 annual deaths from heart disease, disasters, accidents, and other causes. Ambulance demand has risen, especially for COVID-19 cases that require quick medical attention. In 2022, the average emergency response time was 21-30 minutes. Therefore, efforts are needed to improve the response time of PSC 119 ambulances to minimize impacts.
Aims: This study uses the Lean Six Sigma methodology to analyze the factors contributing to prolonged response times in emergency ambulance services.
Methods: This study used a mixed-method approach based on the DMAI (define, measure, analyze, and improve). The data were collected through observations, document reviews, and in-depth interviews.
Results: The results showed that the average duration of ambulance services was 4 hours and 30 minutes. The identified inefficiencies include software issues with the Nusantara app, staff fatigue, and license renewals, difficult access for ambulance and URC units, delays from call center staff awaiting family decisions, closely located posts leading to fewer cases per post, community-initiated patient movements, challenges in finding suitable referral hospitals for special cases, and slow response times from referral hospitals.
Conclusion: The recommended improvements include using a kaizen board, conducting expert training, promoting the Integrated Referral System or Sistem Informasi Rujukan Terintegrasi (SISRUTE), and revising standard operating procedures.
Keywords: ambulance services, Public Safety Center 119, Lean Six Sigm
INPATIENT CARE UTILIZATION AFTER JKN: A STUDY CASE IN EAST NUSA TENGGARA
Full text linkBackground: Healthcare utilization is a predictor of health status among the population. The issues of its accessibility and equity have been raised, particularly after the government launched JKN (Jaminan Kesehatan Nasional)
Aim: This study aims to analyze the determinants of inpatient care utilization in East Nusa Tenggara.
Method: We used SUSENAS 2019 dataset and carried out descriptive and econometrics analysis to covariates including age, gender, educational level, type of health insurance, employment status, and type of residence.
Result: We found that all covariates analyzed were statistically significant in affecting the probability of inpatient care utilization (p-value<0.005). Different patterns of sociodemographic factors among people in East Nusa Tenggara will affect their rate of inpatient care utilization.
Conclusion: Inpatient care utilization rate is crucial to measure health accessibility and prevent any aggravated morbidity due to delayed treatment. Strategies to increase inpatient care utilization are needed to provide accessible treatment for all and increasing population health status.
Keywords: East Nusa Tenggara, health utilization, hospitalization, inpatient car
ANALYSIS OF THE MARKET STRUCTURE OF HOSPITAL INDUSTRY IN INDONESIA
Full text linkBackground: Over the past decade, private investments in health care including hospital have grown significantly, more than doubling. As the number of hospitals in Indonesia increases, a competitive business environment develops. Identifying hospital market structure can help various stakeholders to optimize the hospital's performance.
Aims: This study analyzed the market structure and concentration of the hospital industry in Indonesia.
Methods: This study used hospital characteristics data from Ministry of Health of Indonesia that retrieved in October 2020. Market concentration is determined by the number of industry players operating in a market, the distribution of services, and the types of services offered. The hospital market concentration was identified by measuring the Concentration Ratio (CR) and the Herfindahl–Hirschman index (HHI).
Results: The results showed that the market share of hospitals in Indonesia was still dominated by government hospitals, which represent 51.4% of the market share. The concentration ratio of four companies (CR4) remains <40, indicating that competition remains relatively open among private hospitals at the national level.
Conclusion: Several cities have established hospital markets that are characterized by robust competition, whereas in other cities, the hospital industry remains oligopolistic or monopolistic. It is important to note, however, that this does not imply that the market structure is ineffective on account of competition; rather, it is the result of a scarcity of hospitals in a number of Indonesian cities.
Keywords: Concentration ratio, Economic competition, Herfindahl–Hirschman Index, Hospital marke
PROVISION OF LACTATION CLINIC IN COMPANIES IN SEMARANG CITY: A REVIEW OF POLICY IMPLEMENTATION
Full text linkBackground: As of 2022, Semarang City has 4,083 companies. However, according to the Labor Office of Semarang City, only 109 out of 529 companies provide lactation clinics. In addition, based on previous research in Pedurungan, Semarang City, most of the women (83,3%) who work do not practice exclusive breastfeeding (EBF), one reason being the lack of lactation clinics in companies.
Aims: This study examines the implementation of lactation clinic policies in companies in Semarang City.
Methods: This study used a qualitative method with a descriptive approach. The research variables included effectiveness, consistency, relevance, organizational structure, resources, sociocultural environment, economic environment, organizational culture, geographic environment, knowledge and skills, communication, and political support. Informants were selected based on purposive criteria, involving eight key informants and 18 supporting informants from eight companies in Semarang City.
Results: Lactation clinic policies were ineffective because companies were unaware of their contents and perceived them as recommendations only. On the contrary, working mothers who breastfed recognized the benefits of the policies and considered them relevant. Three out of eight companies provided lactation clinics. The people in charge had yet to be appointed due to the different capacities of the companies. Due to a lack of support from the sociocultural environment, working mothers needed more awareness of the importance of breastfeeding. However, the companies' economic and geographic environments and organizational culture were relatively favorable. Meanwhile, adequate dissemination could have helped communication. In addition, most companies do not provide lactation clinics or recommend formula milk.
Conclusion: The current policies have not adequately supported the provision of lactation clinics in companies in Semarang City. To address this issue, lactation clinics should be classified according to the companies' capacities. It is also necessary to develop a leading sector that is transparent and responsible for supervising the provision of lactation clinics.
Keywords: exclusive breastfeeding in workplace, lactation clinic, policy implementatio
WHAT IS THE ROLE OF JOURNALISM IN THE POLITICAL ADVOCACY OF HEALTH POLICY IN INDONESIA?
Full text linkIn this short commentary article, the complex association between journalism, health policy, and political campaigning in Indonesia is explained, in need of more scholarly expansion. Within those limitations, the paper does alert to the necessary function journalism serves intrinsic to the public discourse that drives health policy recommendations, as well as noting how this has been perverted by misinformation and dwindling faith in the media. The article examines how journalism (including digital and social media) has shaped health policy advocacy and public opinion and highlights the role of the media in health communication campaigns and policy reform. Through scrutiny of its role in health policy advocacy, with a broader look at how journalism roles have shifted over time. In this article, the author demonstrated that journalism is a bridge between health policy experts and the public, enabling a more informed democratic engagement with health policy. These conclusions highlight the need to build a nexus between democratic journalism and health policy advocacy for public health priorities in Indonesia.
Keywords: health policy, journalism, political campaig
BARRIER OF REFERRAL–BACK IN SECONDARY HEALTH FACILITIES: PROVIDER AND PATIENT PERSPECTIVES
Full text linkBackground: The referral-back program (RBP) is a program for chronic outpatient patients at hospitals to return to access services at first-level health facilities (Primary Healthcare Centers/ PHC) once their condition has been declared stable by the doctor. However, data indicate that many hospitals and clinics in Denpasar City have not met the RBP target.
Aims: This study aimed to explore the implementation of RBP and the challenges faced by providers and patients.
Methods: Conducted in March 2023, this study used a qualitative approach with in-depth interviews. The sample was determined purposively, consisting of 13 informants. The data were analyzed using the thematic method.
Results: From the provider's perspective, issues included low commitment of medical staff, lack of coordination between the hospital and PHC, limited supply of RBP drugs at the PHC, absence of Standard Operating Procedures (SOPs), and ignorance of notifications regarding potential RBP patients. Moreover, from the patient's perspective, challenges included low patient knowledge about RBP, proximity of the patient's house to the hospital so that patients tend to visit the hospital, difficulty in obtaining RBP drugs at PHC, and ineffective procedures.
Conclusion: To overcome these obstacles, coordination, and improvement of RBP are needed through the preparation of SOPs and determination of RBP patient criteria.
Keywords: barrier, implementation, referral-back progra
HUMAN RIGHTS-BASED LEGAL PROTECTION FOR HEALTH WORKERS IN CONFLICT ZONES
Full text linkBackground: One of the human rights issues in the health sector is legal protection in conflict areas. The obstacles faced were the limited number of security personnel on guard and the long distance between the security post's location and the conflict's location.
Aims: This study aims to determine how legal protection for health workers in conflict areas is.
Methods: The method of this study is a literature review. The nature of this study is descriptive. The data collection method used is the literature study method, namely by collecting secondary data related to the issues raised.
Results: The results of this study show that the central and regional governments have not been maximal in protecting health workers in conflict areas.
Conclusion: Based on the results and discussion of this study, the recommendations are to make a grand design for health, security, and occupational safety for health workers, specifically in conflict areas, and to make standard operating procedures for handling cases of attacks on health workers in conflict areas.
Keywords: Human Rights, Legal Protection. Health Workers
SEVERAL PILLARS OF HEALTH TRANSFORMATION IN INDONESIA: FROM RESILIENCE PHARMACEUTICAL SUPPLY, HEALTH INSURANCE, PRIMARY HEATH CARE, TO DIGITAL HEALTH
Full text linkIndonesian Government is currently focusing on several efforts to accelerate the achievement of health goals through the implementation of health transformation initiatives. In November 2022, the Indonesian Minister of Heath announced six pillars for health transformation, which are: (1) transformation of primary service; (2) transformation of referral service; (3) health resilience system transformation; (4) transformation of health financing system; (5) health human resources transformation; (6) transformation of health technology