Jurnal Kebijakan Kesehatan Indonesia : JKKI
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Pelaksanaan Pengawasan Intern oleh Dewan Pengawas dalam Rangka Menuju Optimalisasi Kinerja Studi Kasus RSUD BLUD Dr. H.M. Rabain Kabupaten Muaraenim
Get PDFBackground: Surveillance is a systematic effort to establish performance standards in planning to design a system of feedback information, to compare actual performance against the standards that have been determined, to establish whether there has been diversion, as well as to take the necessary corrective actions to ensure that all corporate or Government resources have been used as effective and efficient as possible in order to achieve the objectives of the company or the Government. Hospital is one of the integral parts that play an important role in providing health care services to the community, therefore internal supervision efforts to improve performance of the hospital is crucial. In order to do that, the Government requires Local Public Service Agency (BLUD) to have a functioning supervisory board. Objectives: To assess effectiveness of internal audit conducted by the supervisory board on the hospital performance as a Local Public Service Agency (BLUD). Methods: This research is a descriptive qualitative research design case studies. Data are obtained through in-depth interviews and observations. Results: There are a number of irregularities in the process of monitoring performance of hospitals in particular tasks, functions and duties of the supervisory board. The Board has yet to run its full duties, functions and obligations according to government’s guideline on intern supervision (APIP). Conclusion: (a) The supervisory board in BLUD hospitals dr.HM Rabain does not fully functioned in accordance to the standards of supervision and (b) the board has not been able to contribute positively in achieving good governance and clean governance. Internal auditing results have not been followed up in accordance to the standards. Results of monitoring have not shown any significant impact of improved performance to indicate whether the hospital is well-functioning or not. Latar belakang: Pengawasan adalah suatu upaya yang sistematik untuk menetapkan kinerja standar pada perencanaan untuk merancang sistem umpan balik informasi, untuk membandingkan kinerja aktual dengan standar yang telah ditentukan, untuk menetapkan apakah telah terjadi suatu penyimpangan tersebut, serta untuk mengambil tindakan perbaikan yang diperlukan untuk menjamin bahwa semua sumber daya perusahaan atau pemerintahan telah digunakan seefektif dan seefisien mungkin guna mencapai tujuan perusahaan atau pemerintahan. Rumah sakit merupakan salah satu bagian integral yang penting sebagai tempat pelayanan kesehatan bagi masyarakat, sehingga perlu pengawasan secara khusus upaya dalam meningkatkan kinerja rumah sakit tersebut. Dalam rangka itu, pemerintah menetapkan bahwa rumahsakit BLUD perlu memiliki dewan pengawas. Tujuan: Untuk mengetahui efektifitas pengawasan yang dilakukan oleh dewan pengawas terhadap kinerja rumah sakit BLUD. Metode: Penelitian ini merupakan penelitian deskriptif kualitatif dengan rancangan studi kasus. Sedangkan teknik yang digunakan dalam penelitian ini adalah quota sampling, dengan jumlah sampel 11 orang. Hasil penelitian: Pelaksanaan pengawasan intern di rumah sakit oleh dewan pengawas secara keseluruhan belum memenuhi standar yang sudah ditetapkan pemerintah yaitu standar audit APIP (Aparat Pengawasan Intern Pemerintah). Kesimpulan: Dari hasil penelitian ini: (a) dewan pengawas di RSUD BLUD dr.H.M. Rabain belum sepenuhnya melakukan pengawasan sesuai dengan standar dan (b) dewan pengawas yang ada belum dapat memberikan sumbangan positif dalam mewujudkan good governance dan clean governance. Tindak lanjut hasil pengawasan dewan pengawas di RSUD BLUD dr.H.M Rabain belum sesuai dengan standar yang berlaku. Dari hasil pengawasan belum terlihat dampak peningkatan kinerja rumah sakit secara signifikan yang menunjukkan bahwa rumah sakit dalam kondisi sehat atau tidak sehat
Catatan Akhir Tahun Sektor Kesehatan
Get PDFHarapan Indonesia untuk mencapai jaminan kesehatan semesta pada tahun 2019 memerlukan upaya untuk membangun lebih lanjut berdasarkan kemajuan sektor kesehatan Indonesia saat ini dan membuat perbaikan di tiga dimensi utama yang umum digunakan dalam system jaminan kesehatan semesta, yaitu cakupan populasi, cakupan pelayan- an, dan cakupan biaya. Tujuannya untuk memasti- kan bahwa seluruh masyarakat Indonesia dapat menggunakan pelayanan promotif, preventif, kuratif, rehabilitatif, dan layanan kesehatan paliatif yang mereka butuhkan, dan bahwa layanan ini memenuhi kualitas tertentu yang efektif, dan juga memastikan bahwa penggunaan layanan ini tidak mengakibatkan pengguna mengalami kesulitan keuangan. Penye- diaan layanan dan kesiapan sisi penawaran adalah elemen sistem kesehatan mendasar dan penting untuk pada akhirnya meningkatkan luaran kesehatan dan mendukung pengembangan sumber daya manu- sia, hal-hal yang merupakan pendorong utama untuk pertumbuhan ekonomi.Cakupan asuransi kesehatan di Indonesia telah meningkat secara signifikan dalam beberapa tahun terakhir, yaitu dari 27% pada tahun 2004, menjadi 65% pada tahun 2012. Di sisi pena- waran, jumlah rumah sakit naik hampir dua kalilipat, yaitu dari 1,246 pada tahun 2004, menjadi sekitar 2,228 pada tahun 2013, dan lebih dari setengahnya adalah swasta. Jumlahpuskesmas juga meningkat dari 7.550 pada tahun 2004, menjadi 9.654 pada ta- hun 2013, dan sebagai hasilnya ketersediaan tempat tidur rawat inap per kapita meningkat dari 7,0 menja- di 12,6 per 10.000 penduduk. Tingkat pemanfaat- an rawat jalan dan rawat inap telah terus meningkat, terutama di kelompok 40% terbawah dari populasi, dan hal ini semakin terjadi di fasilitas swasta. Ke- siapan pelayanan umum di fasilitas kesehatan telah menunjukkan peningkatan. Sekarang lebih dari 90% dari puskesmas telah memiliki listrik, kamar konsul- tasi pasien dengan privasi wicara dan privasi visual, timbangan untuk orang dewasa, stetoskop, alat te- kanan darah, alat suntik sekali pakai/auto-disable, solusi rehidrasi oral, dan parasetamol. Ketersediaan layanan khusus juga telah meningkat, karena hampir semua puskesmas, 65% dari klinik swasta, dan sekitar 60% dari posyandu menyediakan layanan antenatal. Sekitar 74% dari puskesmas menyedia- kan layanan KB, 86% menyediakan layanan imuni- sasi, 66% menyediakan layanan preventif dan kuratif untuk anak, 76% menyediakan layanan diabetes, 73% menyediakan layanan penyakit pernapasan kro- nis, dan sekitar 81% menyediakan layanan kardio- vaskular.Namun, seperti kita ketahui, Indonesia tidak “on- track” untuk beberapa indikator MDG. Selain itu, Indo- nesia terus memperlihatkanbesarnya kesenjangan geografis dan kesenjangan luaran kesehatan yang terkait dengan kesenjangan pendapatan. Misalnya, data provinsi menunjukkan kisaran kesenjangan dua sampai tiga kali lipat dalam angka kematian bayi. Beberapa peningkatan yang telah dialami Indonesia ternyata masih berada di bawah standar. Misalnya, rasio kepadatan tempat tidur yang saat ini 12,6 per 10.000 penduduk masih jauh di bawah rekomendasi dan standar WHO yaitu 25 per 10.000. Maldistribusi juga merupakan masalah, ditunjukkan oleh adanya perbedaan rasio kepadatan tempat tidur antar provinsi hingga empat kali lipat. Meskipun di Indonesia jarak rata-rata ke fasilitas kesehatan hanya 5 km, namun di provinsi-provinsi seperti Papua Barat, Papua, dan Maluku jarak rata-ratanyaternyata jauh lebih tinggi, yaitu lebih dari 30 km. Sementara itu, lebih dari 18% penduduk Indonesia membutuhkanwaktu lebih dari satu jam untuk mencapai rumah sakit umum (meng- gunakan sarana transportasi apa pun). Walau pun akses ke puskesmas lebih mudah karena hanya 2,4% dari populasi yang membutuhkan waktu lebih dari satu jam untuk mencapai puskesmas, tetapi pro- porsi dari populasi secara nasional yang menghadapi tantangan waktu tempuh ini jauh lebih tinggi di Papua (27,9%), Nusa Tenggara Timur (10,9%), dan Kaliman- tan Barat (10,9% ). Tingkat pemanfaatan masih tetap sangat rendah menurut standar global dan masih ada kesenjangan besar antar provinsi. Tingkat pe- manfaatan rawat inap di Indonesia yaitu 1,9% adalah kurang dari seperlima dari patokan yang diusulkan WHO,yaitu 10 kepulangan pasien (discharges) per 100 penduduk, dan ada perbedaan antar provinsi hingga lima kali lipat dalam hal ini. Kesiapan layanan umum puskesmas masih lemah di banyak dimensi dan ada variasi yang luasantar provinsi, dengan skor yang lebih rendah terutama di beberapa provinsi-pro- vinsi bagian timur Indonesia seperti Papua, Maluku, Papua Barat, Sulawesi Barat, dan Maluku Utara. Akses puskesmas ke komunikasi rujukan penting dan sistem transportasi sangat lemah. Banyak tan- tangan terkait dengan ketersediaan layanan khusus dan kesiapan layanan khusus di puskesmas untuk beberapa kategori pelayanan kesehatan, misalnya sehubungan dengan pelayanan keluarga berencana, pelayanan antenatal, pelayanan kebidanan dasar, imunisasi rutin, malaria, TBC, diabetes, bedah dasar, transfusi darah, dan bedah komprehensif.Hal-hal di atas menjadi tantangan saat ini dan ke depan, khususnya karena bahkan di era pembia- yaan jaminan kesehatan semesta pun beberapa fakta mendasar tidak berubah. Pada tahun 2012, angka belanja kesehatan publik di semua tingkat pemerintahan hanya sekitar 1,2% dari PDB. Ini ada- lah rasio angka kesehatan belanja terhadap PDB kelima terendah dunia. Alokasi untuk kesehatan biasanya kurang dari 5% dari anggaran pemerintah pusat dalam beberapa tahun terakhir, jauh lebih rendah dibandingkan alokasi pendidikan dan hanya hampir sepertiga dari alokasi subsidi BBM. Dari perspektif tata kelola dan manajemen keuangan publik, desentralisasi kesehatan diikuti oleh arus pembiayaan kesehatan menjadi jauh lebih kompleks dan sulit untuk dikelola, ditandai dengan adanya berbagai saluran pembiayaan pemerintah vertikal, masing-masing dengan aturan dan prosedur yang berbeda. Pengawasan pemerintah terhadap sektor swasta tetap terbatas meskipun jumlah penyedia swasta terus meningkat, dan hanya sedikit yang diketahui mengenai jumlah dan distribusi layanan swasta, serta cakupan dan kualitas layanan mereka Edisi kali ini menyuguhkan beberapa potret dari beberapa tantangan di sektor kesehatan yang masih tersisa untuk dibenahi. Beberapa artikel menyoroti mengenai tantangan di sisi penawan, misalnya me- ngenai ketersediaan tenaga spesialis di rumah sakit, dan bagaimana dampak ketidaksiapan fasilitas kesehatan terhadap pembiayaan kesehatan di bawah system jaminan kesehatan semesta. Selain itu, ada pula potensi fraud yang perlu diwaspadai dalam hal pembiayaan jaminan kesehatan semesta. Beberapa artikel lain menyoroti bahwa proses membuat dan menjalankan kebijakan untuk menjalankan program kesehatan tidak selalu mudah dan belum optimal. Artikel lain membahas bagaimana unit pelayanan kesehatan swasta pun memiliki potensi peran yang besar dalam system jaminan kesehatan semesta dan perlu mendapat dukungan pemerintah.Tahun 2014 dimulai dengan diluncurkannya sys- tem Jaminan Kesehatan Nasional yang menerbitkan harapan baru. Mari kita tutup tahun 2014 dengan harapan pula bahwa di tahun-tahun selanjutnya In- donesia di bawah pemerintahan yang baru terus membangun keberhasilan sektor kesehatan dan berhasil mengatasi satu persatu tantangan yang masih tersisa. Selamat membaca. Shita DewiPusat Kebijakan dan Manajemen Kesehata
MANAJEMEN PERUBAHAN DI LEMBAGA PEMERINTAH: STUDI KASUS IMPLEMENTASI KEBIJAKAN PELAKSANAAN PPK-BLUD DI RUMAH SAKIT JIWA PROVINSI NTB
Get PDFBackground: NTB Mental Hospital as the only major referralcenter for mental health services in NTB was required to servethe community, to develop and be self-sufficient, while at thesame time must be able to compete in providing quality andaffordable services to the community. In order to fulfill thesedemands, since January 29, 2011 NTB Mental Hospital hasreceived full endorsement as a Mental Hospital with FinancialManagement Patterns of Local Public Service Agency (PPKBLUD).Therefore, indepth review of the implementation ofPPK-BLUD policy in NTB Provincial Mental Hospital (RSJP) isrequired.Objectives: To explore the transformation process andimplementation of PPK-BLUD policy in RSJP.Methods: The design of this study is a qualitative researchcase study to describe the dynamics of the change processand implementation of PPK-BLUD policy in RSJP.Results and Discussion: The phase of transformationprocess was not running as expected. The implementation ofPPK-BLUD policy is not optimal because some flexibility as ahospital privileges with BLUD financial pattern have not beenimplemented yet. The f inance manager was hesitant toimplement the flexible financial management and still followingthe local government financial management mechanisms. Forexternal stakeholders, the implementation of PPK-BLUD policyimplementation in RSJP did not harm local fiscal policy becausethe revenue of RSJP was still counted as revenue for localgovernment, as opposed to independent PPK-BLUD. A surveywas conducted, consisting of community satisfaction towardsthe services in RSJP, data of revenue and budgettingmanagement and distribution of fee services to employees inRSJP. The survey result described that the implementation ofPPK-BLUD policy in RSJP gives positive impacts on financial,services and benefits performances to RSJP. The positiveimpacts were an increase in the number of income, increasedof service indicators measurement and increased incentive toall employees.Conclusion: Management changes in the transformationprocess were not running optimal so that the PPK-BLUD policyin RSJP is not fully implemented, although there were someperceived positive results.Keywords: Local Public Service Agency, policy, changemanagement
Implementasi Kebijakan Subsidi Pelayanan Kesehatan Dasar Terhadap Kualitas Pelayanan Puskesmas di Kota Singkawang
Get PDFBackground: Health sector is inseparable from thedecentralized system of local autonomy. Health sector is aresponsibility of the local government, even though it isfrequently included in the political policies of a leader. Thedirection of healthcare service development, particularly atthe level of Health Center, has been maintained in the Mayor'sDecree of Singkawang No. 82/2009 on the subsidiary ofhealthcare in Kota Singkawang.Objective: To find out the quality of healthcare at the HealthCenters in relation to the primary healthcare subsidy based onthe perception of society, control/supervision of Local HealthOffice, management, service time, service capacity/type, andattitude of the health center staffs.Method: A descriptive research with case study design wasconducted in three Health Centers: Singkawang Tengah, SingkawangTimur, and Singkawang Utara Health Centers. Subjectsof the research were 15 health staffs and 111 patients.The data were collected using questionnaire, observation, andinterviews.Results: The research found a score of 3.3 for the healthcarein Singkawang Tengah, Singkawang Timur, and SingkawangUtara Health Centers. It means that the Health Center providedrelatively high quality healthcare. From the Reliability dimension,a score of 2.92 was found for Point 2 quick examinationservice with reference to the standard procedure and a scoreof 2.97 for Point 5, the timeliness of healthcare. From the Responsivenessdimension, a score of 2.77 was found for Point 3– the patients did not wait long to get the healthcare service –and a score of 2.94 for Point 4 – the working hour of the HealthCenter. Qualitative analysis showed that the Local Health Officecontrolled/supervised the Health Centers by means of utilization/visit reports and management. It was found that servicetime was frequently ignored and that service type/capacity atthe Health Centers was constrained by the availability of reagentsand medication. The health staffs tended to ignore servicequality and time and there was an indication of deviation inthe utilization/visit reports sent by the Health Centers.Conclusion: The Local Health Office did not have adequatetools to control/supervise the Health Centers, as evident fromthe aspect of management, service time, service type/capacity,and health staff attitude. Procurement of healthcare supplieswas hampered by bidding process and the health staffs needcontinuous training and development.Keywords: Health Office, Health Centers, Public Perception,and Healthcare qualit
DETERMINAN KINERJA PELAYANAN KESEHATAN IBU DAN ANAK DI RUMAH SAKIT PEMERINTAH INDONESIA (ANALISIS DATA RIFASKES 2011)
Get PDFBackground: The hospital has quite an important role inreducing IMR and MMR because hospitals as providers ofplenary personal health services including maternal and childhealth (MCH). However, until now the IMR and MMR Indonesiais still high compared to other ASEAN countries. The maincauses of maternal mortality are obstetric complications ordisease as a complication that arises during pregnancy, childbirthand postpartum. This factor was experienced by approximately20% of all pregnant women, while complication cases thatwere treated well are less than 10%.Objective: The research aims to identify the effect of hospitalcharacteristics, management of MCH services, humanresources for MCH, MCH services, and MCH equipment on theperformance of MCH services in government hospitals inIndonesia.Methods:Research is using secondary data of Health FacilitiesResearch 2011 (RIFASKES) with a cross sectional study.Population and sample is the entire Indonesian governmenthospitals (685 hospitals). The research variables wereidentified from the available variables in the questionnaireRIFASKES. Performance measurement of the compositevariable proportion of maternal deaths due to hemorhage d”1%, d” 10% pre-eclampsia, sepsis d” 0.2%, d” 20% secariasection, the proportion of stillborn d” 4%, and the proportion ofLBW handling 100% based SPM hospital. Multivariate logisticregression was used to obtain a model determinants ofperformance MCH services.Results: The majority (66.3%) government hospitals inIndonesian has less than optimal performance. As thedeterminant is unaccredited status (OR = 2.99: 1.43 to 6.28),the hospital is not a vehicle of education (OR = 1.78; 1.11 to2.85), team PONEK is incomplete (OR = 1.89; 1.27 to 2.82),there is no PONEK-trained doctor in the ER (OR = 1.89; 1.27 to2.82), there is no team ready to perform the operation or taskthough on call (OR = 2.16; 1.32 to 3.53). The most dominantfactor is the unaccredited status.Conclusions: Suboptimal performances of MCH at Indonesiangovernment hospitals are influenced by the low hospital servicecharacteristics and incomplete of human resources. TheMinistry of Health needs to support improvement in all types ofservices to complete an accredited hospitals (16 types ofservices), not just 5 or 12 services. They also need to makethe government hospital as a vehicle of education, increasethe quantity and quality of human resources are trained inPONEK-skill, ensure availability of PONEK-trained doctor inemergency, provide the team that are ready to perform theoperation or task though on call, and increase organizationalcommitment to overall performance improvement.Keywords: Performance, Maternal and Child Health Services,Government Hospita
HUBUNGAN ANTARA REALISASI DANA BANTUAN OPERASIONAL KESEHATAN DENGAN INDIKATOR GIZI KIA DI KABUPATEN/KOTA PROVINSI JAWA TENGAH TAHUN 2012
Get PDFBackground: Health Operational Fund (HOF) is a grant fromcentral government through the Ministry of Health. The goal isto help local governments for implementing health servicesbased on Minimum Service Standards (MSS) in the field ofhealth to accelerate the achievement of the MillenniumDevelopment Goals (MDGs). Health development policies in2010-2014 are directed to enable availability of fundamemntalhelalth access that cheap and affordable especially for thelower-middle gorups. This is indicated by increasing lifeexpectancy, infant mortality and maternal mortality. One of thehealth priority programs is Nutrition Program and the Maternaland Child Health (MCH).Methods: This research is quantitative research. Analysismethod uses a simple regression. Research data are secondarydata in 2012 of 35 districts/cities in Central Java Province.Results: The realization of Health Operational Fund (HOF) issignificant ( Sig.0,000 < ±=1%) on neonatus first visit/KN1, therealization of Health Operational Fund (HOF) is significant (Sig.0,000 < ±=1%) on assistance by skilled health personnel/Pn, and the realization of Health Operational Fund (HOF) issignificant ( Sig.0,000 < ±=1%) on children weighing or D/S.Coefficient of determination (r ²) is 0.629 for the effect of HOFon KN1, 0.636 for the effect of HOF on Pn, and 0.690 for HOFon D/S. The result of classical assumptions shows that residualvariables are normally distributed, despite heteroscedasticityand despite autoccorelation.Conclusion: HOF has positive effect and significant on KN1,HOF has positive effect and significant on Pn, and HOF haspositive effect and significant on D/SKey Words: HOF, MCH Nutrition, Simple Regression, CentralJav
STUDI EFEKTIVITAS PENERAPAN KEBIJAKAN PERDA KOTA TENTANG KAWASAN TANPA ROKOK (KTR) DALAM UPAYA MENURUNKAN PEROKOK AKTIF DI SUMATERA BARAT TAHUN 2013
Get PDFBackground: Area free from tobacco (AFT) policy is the onlyeffective and inexpensive way to protect the public from thedangers of second hand smoke. In West Sumatra there arethree cities that have local regulation on this, namely Padang,Panjang Padang, and Payakumbuh, but in reality the policy hasnot been able to reduce the active smokers. This study aims todetermine the effectiveness of AFT policy in reducing smokersactive beside its effectiveness to protect the public from thedangers of second hand smoker in West Sumatera.Methods: The study was conducted with the method, a mixof quantitative and qualitative research with explanatory design.Data collection was conducted in the city of Padang, PadangPanjang and Payakumbuh. Quantitative data from 100 personswere collected using a questionnaire, while the qualitativedata was collected through in-depth interviews. Informants ineach city are representatives of Department of Health,professional organizations, community leaders, smokers andfocus group discussions. Some secondary data are obtainedthrough documents review related to the implementation ofAFT. The quantitative data is analysed using univariate analysis,and the qualitative data is analysed using content analysis.Results: Based on the quantitative data it can be seen that inthree cities in West Sumatera the smoker rate are 59%. InPadang Panjang, the regulation has been proceeded succesfulydue to the commitment of the Mayor and the legislative parlementin implementing the policies that there should not be any tobaccoadvertising as well as sanctions for smokers, especially foremployees who smoke at the office or at school, according tothe law no. 8/2009; suf ficient funds are available forsocialization and supervision AFT, a total of Rp75.000.000,00collected from tobbacco fundation and Rp24.000.000,00 fromthe budget. In Payakumbuh there is also the commitment of theMayor and the support of the Health Department according tothe Regulation of Area Free tobbacco no 15/2011. Establishmentof Supervisory Team for AFT with funds allocated forsocialization and supervision, a total amount ofRp341.278.129,00. Padang has not yet applying the AFT policyin government offices and schools, only in private sector suchas bank. Tobacco advertising still exists and there is no sanctionfor smokers despite the existing Regulation No. AFF 14/2011with accompanying funds provided Rp85.000.000,00.The study shows that the majority (60%) public opinion supportthe implementation of AFT. Some (51%) of the public say thatAFT is effective enough to reduce active smoker, over half ofrespondents thought AFT should apply to a particular location.According to 59% of respondents, smoking in public placesshould be given sanction. In Padang Panjang there is amonitoring service via SMS and phone to report breach of theregulation so that the Mayor may impose sanctions. InPayakumbuh a similar system exist through reports and spotchecks. Violaters of the regulation are given sanction by themayor. In Padang city, sanctions have not been given. Thelocal government regulation in banning advertising andpromotion of cigarettes is implemented in two cities, the city ofPadang Panjang and Payakumbuh. Some factors that affectthe implementation of AFT are dependent on the commitmentand the role of District mayor, as well as the need for communityempowerment..Conclusion: It is concluded that the AFT policy without thecommitment and support of all parties to the implementation ofAFT difficult. AFT can be effective to protect the second handsmokers and it has potential to reduce active smokers.Keywords: Effective, AFT Policy, Reducing active smokers
ANALISIS KEBIJAKAN PEMERINTAH DAERAH DALAM PENGEMBANGAN ‘JAMINAN SOSIAL KESEHATAN SUMATERA SELATAN SEMESTA’ MENYAMBUT UNIVERSAL HEALTH COVERAGE
Get PDFBackground: The ‘Jamsoskes Sumsel Semesta’ is a localprogram that offered free medical treatment for health servicesfor the people of South Sumatra who do not have healthinsurance. Meanwhile, starting in 2014, the national Governmentwill implement the Universal Health Coverage as mandated bythe Social Security Law. As insurance have a principle ofindemnity where there should not be a duplicate social security,there should be no society that is assured by the two programswith the aim of speculating to make a profit. This study aims toexplore the implementation of the expansion plan of ‘JamsoskesSumsel Semesta’ to pave the way to Universal Health Coveragein 2014 in South Sumatera.Methods: This study was a qualitative policy research withexploratory design. The focus are policy content, context,actors, and policy processes. Data were collected by in-depthinterviews and observation. Sources of information obtainedfrom five informants from the institution of Provincial HealthOffice, Planning and Regional Development Agency of SouthSumatra, and Provincial Government who selected bypurposive technique based on considerations of participationin Jamsoskes. The analysis used is the analysis of policy.Results and Discussion: Based on the results of study it isfound that the South Sumatra provincial government willcontinue to provide the Jamsoskes program in 2014 as it is,managed by the Health Office. Some of the considerations arefor efficiency and flexibility and that it does not include all thepeople. Also, in the Presidential Decree No. 12 of 2013, thenational government still provides opportunities for local schemeto grow until 2019. Some development is done in Jamsoskesincluding improving the quality and quantity of health careproviders. Preparations are coordinated with Social SecurityAgency about number of contribution beneficiaries. One ofthe challenges is that the community rather go to the hospitaldirectly so it can interfere with the referral system.Conclusion: There has not been a lot of development effortundertaken by local government onJamsoskes in preparationfor the 2014 to welcome Universal Health Coverage. The SouthSumatra provincial government should develop further theservices under Jamsoskes as adjustments in welcoming theimplementation of the second phase of the National HealthInsurance.Keywords: Policy, Health Insurance, Jamsoskes, Efficienc
PELAKSANAAN KEBIJAKAN OBAT GENERIK DI APOTEK KABUPATEN PELALAWAN PROVINSI RIAU
Get PDFBackground: Medicine is an integral part of community healthservice. Therefore it must be available in sufficient quantity,types and adeqaute quality, properly distributed and accessiblefor community when its needed. In order to meet thecommunity’s need for medicine and to guarantee medicineaccessibility, the government released generic medicine policy.Although the price of the generic medicine has already beenset up and fixed by government, there are variety of the pricestill can be found on implementation of the generic medicinesold in the pharmacy store or in the market, and can causeprice uncertainty for community in finding medicine they need.That is why a research needs to be conduct towardimplementation of the generic medicine price policy on thedistribution channel especially at the pharmacy store.onPelalawan District in Riau Province.Method: This research is non experimental/observationalresearch with qualitative and quantitative method using crosssectional design, data analyzed descriptively.Result: Research result indicates that access to genericmedicine at pharmacy store for available medicine are 99,3%,for un available medicine are 0,7% and for replaced medicineare 0,5%. Average availability of the medicine at the pharmacystore are 4-7,3 months. Highest availability rate for medicine isHidrocortison cream 2,5% for 7,3 months and the lowest isPirazinamid tablet 500 mg for 4 months. Pharmacy store thathave an expired medicine are PR (0,7%) and KH (2%). Everypharmacy store have no damaged medicine, 0% percentage.Almost all pharmacy store experiencing out of supply formedicine between 4 to 90 days. Price of the medicine soldaveragely increasing from its pharmacy store Highest RetailPrice (HRP). But there are several medicine that sold under theHRP The highest price medicine that are sold higher than itsHRP is Clorfeniramin Maleat (CTM) tablet by 515,4% increaseand Dexametason tablet is the lowest price sold under HRP by65,2%. Even so they are Alopurinol, Digoksin, and Ranitidin.From in depth interviews with patients, can be learn that theyhave a purchase ability for generic medicine.Conclusion: Implementation of generic drug price on Pelalawandistrict is good. It can be seen from generic medicine accessby community that are high after the release of regulation fromHealth Department of Republic Indonesia, the level of availabilityof generic medicine on pharmacy store at Pelalawan Districtare low but there are no expired or damaged medicine. Theprice of generic medicine at Pelalawan District are variable butthe community still can afford to buy them.Keyword: Generic medicine, availability and affordability
ANALISIS UNTUK PENERAPAN KEBIJAKAN: ANALISIS STAKEHOLDER DALAM KEBIJAKAN PROGRAM KESEHATAN IBU DAN ANAK DI KABUPATEN KEPAHIANG
Get PDFBackground: Maternal, neonatal and child health (MNCH)program is a national priority programs in health development.In 2006 the Ministry of Health to provides the largest budgetallocation to the KIA programs. This policy was taken in orderto accelerate the decline in maternal mortality and infant throughthe implementation of the making pregnancy safer strategy(MPS) with focus on some activities that are considered to becost effective. MNCH sustainability of the program dependson political commitment and support from stakeholders in theregion. Therefore, stakeholder analysis is important for theimplementation of policy to support the MNCH program.Objectives:Assessing the political commitment of the localgovernment to MNCH program in Kepahiang Regency.Methods: This research is a descriptive, qualitative designwith a case study. Unit of analysis is a research MNCH programstakeholder. How do the data with the brainstorming, depthinterviews, reports and documents, and direct observation.Results: Political commitment of the local government tomaternal, neonatal and child health program is still low, this isevidenced by the lack of budget allocation maternal, neonataland child health program. Essentially all stakeholders agreeand support the program. The involvement of local stakeholdersin the process of planning and budgeting programs is still lacking.Coordination among health agencies with key stakeholders inthe planning and budgeting also are not running well, so oftenthere are differencesin understanding the program. Besidesthe quality planning activities are still considered low, and thereis still weak advocacy capacity of health district office.Conclusion: The small budget allocation for the programshows the commitment to maternal, neonatal and child healthprogram of the local government is still low. This problem wasmore due to the quality of the program planning (design) that isnot well-developed. Also the role and involvement ofstakeholders in the planning process is still lacking.Keywords: Stakeholder, MNCH polic