Faculty of Public Health Journal Universitas Indonesia
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Health Workforce Assessment in Jakarta for Effective HIV Policy Implementation: Challenges and Opportunities toward Epidemic Control
Get PDFAbstract Strategic efforts are needed in Indonesia to implement the recently released human immunodeficiency virus (HIV) Test and Treat policy which promotes increased treatment uptake, known to have important economic benefits. Of Indonesia’s estimated 631,635 people living with HIV (PLHIV) in 2018, only 12% are on treatment. The USAID- and PEPFAR-funded Human Resources for Health in 2030 (HRH2030) Program undertook policy analysis and assessed the available health workforce and service delivery at select sites in Jakarta to identify and anticipate Test and Treat implementation gaps. A mixed methods concurrent triangulation design was used, including policy analysis, key informant interviews, and site-level tools to capture workforce availability, skills, quality, and performance. Results indicate priorities to: define and implement HIV standards of practice for the Test and Treat policy; improve relevance and coordination of pre-service and in-service training programs; and support managers to optimize task and workforce allocation, including allocating lower-skilled workers to routine testing. Additional site-level data are needed from rural and remote sites in Indonesia, where fewer health workers are distributed. Efficiencies can help sustain HIV programs and contribute to epidemic control.Abstrak Upaya strategis dibutuhkan Indonesia untuk implementasi kebijakan Pemeriksaan dan Pengobatan (Test and Treat) HIV, seperti yang diterbitkan oleh USAID dan PEPFAR. Kebijakan ini mendorong peningkatan cakupan pengobatan yangd diyakini penting secara ekonomi. Diperkirakan pada tahun 2018 terdapat 631,635 ODHA di Indonesia dan hanya 12% yang menjalani pengobatan. Program HRH2030 yang didanai oleh USAID dan PEPFAR melakukan analisis kebijakan dan penilaian ketersediaan tenaga kesehatan dan pelayanan HIV di beberapa unit layanan di Jakarta, untuk mengidentifikasi dan mengantisipasi kesenjangan implementasi kebijakan. Kajian menggunakan metode campuran dengan melakukan analisis kebijakan, wawancara informan kunci, dan serangkaian alat asesmen tingkat unit layanan untuk menangkap informasi terkait ketersediaan, keterampilan, kualitas, dan kinerja tenaga kesehatan. Hasil kajian ini memprioritaskan adanya penetapan dan penerapan standar praktik layanan HIV yang sesuai dengan kebijakan Pemeriksaan dan Pengobatan. Peningkatan koordinasi program pendidikan pra-layanan dan pelatihan dalam jabatan dan dukungan kepada manajer unit layanan untuk mengoptimalkan alokasi tugas dan tenaga kesehatan menjadi hal yang penting. Pendekatan ini diharapkan dapat meningkatkan efisiensi layanan dan keberlanjutan program HIV. Data dan informasi tingkat unit layanan dibutuhkan, khususnya dari wilayah pedesaan dan terpencil.
Analisis Kesiapan Pembiayaan Hipertensi, Diabetes Melitus dan Gangguan Jiwa dalam Mendukung Program Indonesia Sehat dengan Pendekatan Keluarga (PIS PK) Tahun 2018-2020
Get PDFAbstrakProgram Indonesia Sehat dengan Pendekatan Keluarga (PIS PK) merupakan cara Puskesmas untuk meningkatkan jangkauan sasaran dan akses pelayanan kesehatan dengan mendatangi keluarga. Skala prioritas nasional dalam mencapai Indonesia Sehat salah satunya adalah menanggulangi penyakit tidak menular termasuk hipertensi, Diabetes Melitus dan Gangguan Jiwa yang prevalensinya semakin meningkat. Hipertensi, Diabetes Melitus dan Gangguan Jiwa merupakan salah satu indicator keluarga sehat dalam PIS PK untuk mencapai SPM. Penelitian ini menggunakan metode kualitatif dengan teknik wawancara mendalam dan telaah dokumen. Kesiapan pembiayaan Hipertensi, Diabetes Melitus dan Gangguan Jiwa dihitung dengan menggunakan metode costing SPM. Hasil penelitian menunjukkan bahwa belanja kesehatan untuk PIS PK digunakan untuk sosialisasi, edukasi dan pendataan. Mengacu pada perhitungan costing SPM, Kota Depok mampu melaksanakan SPM untuk Pelayanan Dasar Hipertensi, Diabetes Melitus dan Gangguan Jiwa karena hanya menggunakan 1,38% APBD KesehatanBelanja Langsung (Non Gaji). Akan tetapi, Kota Depok belum siap dalam melaksanakan PIS PK dalam hal komitmen, SDM, dan anggaran. Kota Depok sudah memahami PIS PK namun pelaksanaannya tergantung pada ketersediaan pembiayaan yang berasal dari pencairan anggaran DAK Non Fisik. Hal ini disebabkan karena terdapat jeda waktu antara proses pengusulan dan realisasi pencairan anggaran sementara SDM terbatas. Diperlukan proses perencanaan yang lebih optimal serta pengalokasian SDM sesuai kebutuhan.AbstractHealthy Indonesia Program with Family Approach (PIS PK) is a way to expand Puskesmas reach and access to health services through family home visit Overcoming non-communicable diseases (NCD) is a national priority in achieving Healthy Indonesia because the prevalence of NCD continues to increase. Managing NCD specifically hypertension, Diabetes Mellitus andmental disorders are among the indicators of healthy families in achieving PIS PK. This research uses the qualitative method through in-depth interviews and related document. Analysis of readiness of financing for hypertension, Diabetes Mellitus and mental is calculated using costing method of SPM. The results indicated health spending for PIS PK activities wereutilized for socialization, education and data collection. Referring to SPM costing calculation, the City of Depok was able to implement SPM for hypertension, Diabetes Mellitus and Mental Disorder with using only 1.38% of the total APBD (non-salary). Depok City is not ready in implementing PIS PK, specifically in terms of commitment, human resources, and budget.Though already familiar with PIS PK, Depok City states due to its limited resources, PIS PK implementation depends on the availability of funding from Non-Physical DAK disbursement that tends to have a lengthy lag time between the proposal process and the realization of the disbursement. The financing of PIS PK requires a more optimal planning process and allocation of human resources as needed.
Rumah Sakit Syariah Strategi Pemasaran Vs Syiar
Get PDF ABSTRAKFenomena sadar syariah dikalangan masyarakat Indonesia, menggerakkan perekonomian diberbagai aspek kehidupan masyarakat, tak terkecuali di sektor pelayanan kesehatan. Masyarakat mulai memilih produk yang tidak saja berkualitas dari sisi medis, tetapi juga mendapatkan pelayanan yang aman secara psikososial dibingkai dengan nilai-nilai Islam. Peluang pasar sangat terbuka menangkap gejala tersebut. Rumah sakit syariah mencoba menjawab tantangan tersebut dengan mengemas nilai-nilai syariah kedalam standar pelayanannya. Studi literatur yang bersumber dari berbagai jurnal internasional terindeks scopus dan google scholar. Konsep rumah sakit syariah yang mengusung nilai-nilai spiritual sejalan dengan strategi marketing 3.0 yang memiliki kunci konsep pemasaran visi, misi dan nilai-nilai. Hal ini merupakan jawaban atas kecenderungan konsumen Muslim yang sudah memilih produk-produk syariah untuk memenuhi kebutuhan hidupnya baik primer maupun sekunder. Rumah Sakit Syariah dibentuk dalam upaya semangat mengintegrasikan nilai-nilai syariah kedalam seluruh aspek pelayanan kesehatan, administratif hingga standar pelayanan pasien yang tidak dimiliki rumah sakit nonsyariah. Hal ini sekaligus merupakan diferensiasi produk layanan rumah sakit dengan menyasar segmentasi yang jelas, walaupun layanan kesehatan pada hakikatnya bersifat universal bagi seluruh elemen masyarakat. Standar pemasaran tetap harus dilakukan yang meliputi aspek internal-eksternal dan tangible-intangible sebuah rumah sakit, termasuk yang terpenting adalah aspek mutu pelayanan rumah sakit. Sehingga Islam yang rahmatan lil alamin bisa menjadi syiar melalui rumah sakit syariah yang profesional dan terpercaya. Rumah sakit syariah yang mempunyai visi misi dan mengusung nilai-nilai, tetap harus menggunakan strategi pemasaran untuk mengenalkan produknya, sekaligus sebagai syiar ajaran islam yang menjaga kehidupan manusia. ABSTRACT The phenomenon of sharia awareness among the people of Indonesia, moves the economy in various aspects of people's lives, including the health service sector. The community begins to choose products that are not only quality from the medical side, but also get psychosocial safe services framed with Islamic values. Very open market opportunities to capture these symptoms. Sharia hospitals try to answer this challenge by packaging Islamic values into their service standards. Literature studies sourced from various scopus indexed international journals and google scholar. The concept of sharia hospitals that carry spiritual values is in line with the marketing 3.0 strategy that has the key concept of marketing vision, mission and values. This is the answer to the tendency of Muslim consumers who have chosen sharia products to fulfill their primary and secondary needs. Sharia Hospital was formed in an effort to integrate sharia values into all aspects of health services, administrative to patient service standards that are not owned by non-sharia hospitals. This is also a differentiation of hospital service products by targeting clear segmentation, although health services are essentially universal for all elements of society. Marketing standards must still be carried out which includes the internal-external and tangible-intangible aspects of a hospital, including the most important aspect is the quality of hospital services. So that Islam which is rahmatan lil alamin can become a syiar through a professional and trusted sharia hospital. Sharia hospitals that have a vision and carry values, still have to use marketing strategies to introduce their products, as well as Islamic teachings that protect human life.
Implementasi Green Hospital di RSUD R. Syamsudin, SH dengan Kriteria Kerangka Kinerja Ekselen Malcolm Baldrige
Get PDFABSTRAKKeberadaan green hospital sangat diperlukan untuk mengatasi perubahan iklim yang dapat menyebabkan gangguan kesehatan manusia dan lingkungan, karena rumah sakit merupakan salah satu penyumbang polusi. RSUD R. Syamsudin, SH menjadi anggota Global Green and Healthy Hospital serta berkomitmen untuk melaksanakan sepuluh agenda yaitu kepemimpinan, bahan kimia, limbah, energi, air, transportasi, makanan, farmasi, gedung, dan pembelian. Penelitian ini bertujuan untuk menganalisis implementasi green hospital dengan Kriteria Kerangka Kinerja Ekselen Malcolm Baldrige. Kerangka Kinerja Ekselen Malcolm Baldrige mengevaluasi berdasarkan tujuh kriteria yaitu kepemimpinan, strategi, pelanggan, pengukuran, analisis, dan manajemen pengetahuan, tenaga kerja, operasi serta hasil. Desain penelitian ini adalah kualitatif dengan mengumpulkan informasi melalui wawancara mendalam, kuesioner, dan telaah dokumen, Berdasarkan hasil penelitian, pelaksanaan green hospital RSUD R. Syamsudin, SH mendapatkan skor 620.1 dari 1000 (skor maksimal) sehingga diposisikan pada emerging industry leader. Kriteria Kepemimpinan mendapatkan poin tertinggi, sedangkan poin terendah adalah Kriteria Pelanggan. Dapat disimpulkan, RSUD R. Syamsudin, SH berada di posisi menengah dalam implementasi green hospital, artinya sudah memiliki beberapa keunggulan tetapi masih ada beberapa faktor yang dapat ditingkatkan lagi agar pelaksanaan green hospital dapat lebih optimal.Untuk itu, direkomendasikan kepada RSUD R. Syamsudin, SH agar melakukan evaluasi rutin, mempromosikan green hospital lebih gencar, melakukan optimalisasi SIM RS, serta penguatan anggaran agar pencapaian sepuluh agenda lebih optimal. ABSTRACTThe existence of green hospital is very necessary to overcome climate change which can cause disruption to human health and the environment, because hospitals are one of the contributors to pollution. RSUD R. Syamsudin, SH became a member of the Global Green and Healthy Hospital and is committed to implementing ten agendas, namely leadership, chemicals, waste, energy, water, transportation, food, pharmacy, buildings, and purchasing. Aim of this study is to analyze the implementation of green hospital with the Malcolm Baldrige Criteria Framework for Excellence Performance. Malcolm Baldrige Criteria evaluates based on seven criteria which isleadership, strategy, customer, measurement, analysis, and management of knowledge, labor, operations and results. The design of this study is qualitative by gathering information through in-depth interviews, questionnaires, and document review. Based on the results of research, the implementation of the green hospital in R. Syamsudin Hospital, SH received a score of 620.1 out of 1000 (maximum score) so that it was positioned in emerging industry leaders. The Leadership Criteria get the highest points, while the lowest points are the Customer Criteria. It can be concluded, RSUD R. Syamsudin, SH is in the average position in implementing green hospital, meaning that it already has several advantages but there are still several factors that can be improved so that the implementation of green hospital can be more optimal. For this reason, it was recommended to RSUD R. Syamsudin, SH to carry out routine evaluations, promote green hospital more aggressively, optimize hospital management information system, and strengthen the budget so that the achievement of ten agendas more optimized
Risk Factor Analysis of Overnutrition Among Elementary School Children in Pekanbaru: An Urban-rural Perspective
Get PDFThe prevalence of childhood overnutrition is increasing in many parts of the world including Indonesia. National basic health research (RISKESDAS) 2010 showed that over-nutrition in urban children (10.4%) was greater than in rural areas (8.1%). The purpose of this study was to analyse risk factors for overnutrition on elementary students in urban and rural areas in Pekanbaru. This was an observasional analytical study with cross-sectional design. This study involved 137 urban and 113 rural students from six elementary schools in Pekanbaru recruited by quota sampling technique. This study was conducted between April-May 2018. The results showed that the proportions of overweight and obesity in urban Pekanbaru were 16.1% and 16.8% respectively, while in rural areas were 12.4% and 9.7%, respectively. Furthermore, outdoor activity and snacking habit were significant contributors of childhood overnutrition in urban area whereas frequency of main meal was associated with childhood overnutrition in rural area. In conclusion, there was no difference in the incidence of overnutrition among elementary students in urban and rural areas in Pekanbaru. This study indicated that obesity risk factors may be different between urban and rural areas in Pekanbaru
Knowledge and Practice in Household Waste Management
Get PDFDeclining environmental quality is one of population caused by household consumption behavior. Some of the highest contaminant contributions are domestic waste, waste, and company waste. Waste contamination will lead to dead fish, decreased water quality and disease transmission. Community approach can be done to solve the waste problem, especially at the household level. This study uses quantitative methods to analyze the effect of intervention and waste management training on changes in household waste management knowledge and practices. This type of research uses quasi experiment with one group of pre and post test design. The results showed that there was an increase of knowledge about waste management after being given intervention by the researcher because the p value ≤ 0,05. The results also show that there is an increasing practice on waste management after being given intervention by researchers because the p value ≤ 0.05. Based on the research results, it can be concluded that the provision of intervention is effective for improving knowledge and practice in the household waste management.Keyword: Knowledge, Practice, Waste managemen
Exclusive Breastfeeding and Decrease of Upper respiratory Infection Incidence among Infants Aged 6-12 Months in Kampar District, Riau Province
No full textUpper Respiratory Infection (URI) is a major cause of morbidity and mortality of infants and toddlers in developing countries. The high infant morbidity and mortality rates in Indonesia are associated with the low exclusive breastfeeding ability. Breast milk is a natural drink for newborns in the first month of life that is beneficial not only for the babies, but also for mothers. The aim of study was to determine exclusive breastfeeding and decrease in incidence of URI among infants aged 6-12 months. This study was conducted by using case control design. Samples were taken by using cluster random sampling. Subject of study consisted of 162 cases and 162 control with infants aged 6-12 years. Cases were 162 infants aged 6-12 months suffering from URI within one last month and taken by mothers to primary health care that was selected location of study, while control was mothers who took their infants aged 6-12 months who did not suffer from URI within one last month to the selected primary health care. Data analysis included univariate, bivariate, stratification, and multivariate analysis with logistic regression. Results of study found that infants who were not exclusively breastfed were 1.69 times (95% CI: 1.02-2.80) more at risk of increasing URI incidence compared to infants who were breastfed exclusively after controlled by smoker in house and immunization variables. Health promotion of 6-month exclusive breastfeeding, provision of immunization, and anti-smoking program need to be implemented continuously to decrease the rates of morbidity and mortality due to URI disease
Determinan Sosial Ekonomi Kepemilikan Jaminan Kecelakaan Kerja pada Tenaga Kerja Informal di Indonesia: Analisis Data SUSENAS 2017
Get PDFAbstrakJumlah tenaga kerja informal lebih banyak dibandingkan dengan tenaga kerja formal di Indonesia. Cakupan kepemilikan jaminan kecelakaan kerja masih sangat rendah sedangkan angka kecelakaan kerja masih cenderung tinggi. Penelitian ini bertujuan untuk mengetahui determinan sosial ekonomi kepemilikan jaminan kecelakaan kerja pada tenaga kerja informal di Indonesia. Penelitian ini menggunakan desain studi cross sectional dengan analisis bivariat dengan metode maximum likelihood dengan model logit. Data yang digunakan adalah Data Susenas (Survei Sosial Ekonomi Nasional) tahun 2017 diolah menggunakan stata dengan uji regresi logistic/logit serta dianalisis dengan pendekatan model ekonometri. Variabel yang diamati yaitu, umur, jenis kelamin, status pernikahan, keluhan kesehatan, pendidikan, wilayah dan sosial ekonomi/pendapatan tenaga kerja informal. Hasil penelitian menunjukkan adanya hubungan antara wilayah (p =0,0005), umur (p=0,0005), jenis kelamin (p=0,0005), status pernikahan (p=0,001), pendidikan (p=0,0005), dan sosial ekonomi/pendapatan (p=0,0005) tenaga kerja informal terhadap kepemilikan jaminan kecelakaan kerja di Indonesia. Dengan model ekonometri diketahui faktor yang paling berpengaruh terhadap kepemilikan jaminan kecelakaan kerja pada tenaga kerja sektor informal yaitu karakteristik tenaga kerja informal terdiri dari pendidikan (OR 1,94), Umur (OR 1,09), wilayah (OR 1,71) dan pendapatan (OR 1,79). AbstractThe number of informal workers is higher than the formal workforce in Indonesia. The coverage of working accident protection is still very low while the work accident rate still tends to be high. This study aims to determine the socio-economic determinants of employ-ment accident insurance ownership in informal workers in Indonesia. This study used a cross sectional study design with bivariate analysis using the estimation method of maximum likelihood. The Susenas Data (National Socio-Economic Survey) in 2017 is ana-lyzed using logistic/logit regression. The variables observed were age, sex, marital status, health, education, regional complaints, and socio-economic/informal labor income. The results of the study indicated a relationship between region (p=0,0005), age (p=0,0005), sex (p=0,0005), marital status (p=0,001), education (p=0,0005), and socio-economic/income (p=0,0005) in informal labor on em-ployement accident insurance ownership in Indonesia. The econometric model show that the factors that most influence the owner-ship of work accident insurance in the informal sector workforce are informal labor characteristics consisting of education (OR 1.94), Age (OR 1.09), region (OR 1.71), and income (OR 1.79)
AN ANALYSIS ON THE IMPLEMENTATION OF THE INTEGRATED GUIDANCE POST (POSBINDU) ACTIVITIES FOR NON-COMMUNICABLE DISEASES AT BOGOR CITY IN 2018
Get PDFAbstract. One of the endeavors that the government has done to prevent and control non-communicable diseases (NCD) by increasing community participation in the early detection of NCDs is the NCD Integrated Guidance Post (Posbindu). However, in 2017, only 12.96% of the residents in Bogor City accessed it. This meant that the 30% target was not reached. The in this study, we researched the implementation of the NCD Posbindu at Bogor City. Data was gathered through in-depth interviews, Focus Group Discussion (FGD), documentary research, and observations. Eleven informants was interviewed and 24 informants was involved in the FGD. Two NCD Posbindus was observed at Mekarwangi and Cipaku Public Health Centers (PHC). We discovered that the standards and policies have supported the program, but not all the informants were aware of the targets of the program; there were also problems in the number and abilities of the human resources involved, ineffective communication between the cadres, in the coordination between the cadres, and lack of support from local public figures. The program had adequate funding from the regional budget, the Operational Health Aid Funds, and donations from the community. Although more funds are necessary for the promotion and prevention part of the program. We recommend that new cadres are recruited and trained, and that a reward system is used to provide motivation for the cadres.Abstrak. Salah satu upaya pemerintah untuk mencegah dan mengendalikan penyakit tidak menular melalui peningkatan peran serta masyarakat dalam deteksi dini faktor risiko penyakit tidak menular adalah melalui Pos Pembinaan Terpadu (Posbindu) Penyakit Tidak Menular (PTM). Namun, pada tahun 2017 cakupan kunjungan masyarakat ke Posbindu PTM di Kota Bogor hanya sebesar 12,96%. Ini berarti target yang ditetapkan (30%) belum tercapai. Penelitian ini bertujuan untuk mengetahui bagaimana implementasi kegiatan Posbindu PTM di Kota Bogor. Metode yang digunakan adalah wawancara mendalam, Focus Group Discussion (FGD), telaah dokumen dan observasi. Informan penelitian terdiri dari 11 informan wawancara mendalam dan 24 informan FGD. Observasi dilakukan di 2 Posbindu PTM di Puskesmas Mekarwangi dan Puskesmas Cipaku. Peneliti menemukan bahwa standar dan kebijakan yang ada telah mendukung program, tetapi belum semua informan mengetahui siapa target program, selain itu juga terdapat permasalahan dalam jumlah dan kemampuan kader, komunikasi yang tidak efektif antar kader, koordinasi antar kader, dan kurangnya dukungan dari tokoh masyarakat local. Pendanaan program tidak mengalami masalah, karena dana program berasal dari APBD, dana Bantuan Operasional Kesehatan, dan sumbangan masyarakat. Walaupun masih membutuhkan pendanaan lebih lanjut untuk promosi dan pencegahan. Peneliti merekomendasikan dilaksanakannya pembaharuan informasi dan pelatihan yang berkala untuk para kader, perekrutan kader baru, pemberian reward atau pemilihan kader teladan dan Posbindu PTM terbaik, peningkatan kerja sama lintas sektor lembaga pendidikan, pemerintah dan swasta
Epidemiologi Deskriptif Kematian Ibu di Kabupaten Serang Tahun 2017
Get PDFAngka Kematian Ibu (AKI) merupakan indikator kesejahteraan masyarakat suatu negara. Sasaran RPJMN 2015-2019 di Indonesia AKI ditargetkan menjadi 306 pada tahun 2019. AKI di Kabupaten Serang tahun 2017 adalah 195/100.000 KH, atau 58 kasus dengan jumlah kelahiran hidup sebanyak 29.787 jiwa. Dari 58 kasus kematian ibu, 14 orang persalinan ditolong dukun (24,14%). Tujuan penelitian ini adalah eksplorasi deskriptif epidemiologi kematian ibu di Kabupaten Serang tahun 2017. Penelitian ini menggunakan studi case series pada 58 kasus kematian ibu hasil dari AMP (Audit Maternal Perinatal). Lokasi penelitian di 24 puskesmas wilayah Dinas Kesehatan Kabupaten Serang. Kematian ibu di Kabupaten Serang tahun 2017 berdasarkan tiga penyebab kematian ibu tertinggi adalah Perdarahan (37,9%), Eklampsi (27,6%) dan Penyakit Jantung (22%). Kematian ibu yang ditolong oleh tenaga kesehatan 44 orang (75,9%) dan ditolong oleh dukun 14 orang (24,1%). Jumlah paritas terbanyak pada anak <5 (96,6%). Periode maternal terbanyak kematian ibu di masa nifas (53,4%). Tempat meninggal ibu terbanyak di RS (63,8%) dan perjalanan (24,1%). Kematian ibu berdasarkan 3T meliputi 34,5% terlambat memutuskan, 53,4% terlambat rujukan dan 12,1% terlambat penanganan. Transportasi menggunakan umum (88%). Kematian ibu di Kabupaten Serang tahun 2017 banyak disebabkan oleh perdarahan dan keterlambatan dalam rujukan serta faktor resiko terbesar transportasi, penolong persalinan, dan tempat meninggal. Penulis berharap penelitian ini dapat bermanfaat dan menjadi bahan rujukan untuk penelitian selanjutnya. sehingga dapat digunakan untuk pembuatan kebijakan dan intervensi yang efektif dan efisien dalam menurunkan AKI di Kabupaten Serang