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EDITORIAL
No full textOver 1700 participants from over 100 countriesattended the Second Global Symposium on HealthSystem Research in Beijing from October 31 toNovember 3, 2012. The Symposium discussed stateof-the art health system research and strategies forstrengthening health systems research through keynotes,plenaries, concurrent sessions, satellites,posters, films, informal discussions and debates.One of the symposium sessions presented aconceptual framework for health system researchwhich encompasses systems at macro-, meso- andmicro- levels. Health service research was depictedat the meso- and macro- level of the systems, andmanagement research was noted as part of thehealth service research domain. Thus, health servicemanagement was viewed as a part of the overallhealth system research domain.The panelists highlighted that there are importantdifferences between research to support policymakingat macro-level and research to support managementdecision making. They first emphasizedthat the nature of the evidence required would differ,depending much on whom the evidence is supporting,e.g. goverment official, hospital manager, healthprofessional, citizens. Second, they noted that itwould also be different depending on whether we aresupporting them: (1) to select which programs, servicesand drugs to fund; or (2) to strengthen governance,financial and delivery arrangements withinsystems.They further argued that decisions about servicesand programmes are typically a single decisionmade at a single point in time by a clearly defineddecision-maker as part of routine decisionmaking. In contrast, policy making decisions aretypically consisted of a number of heterogenousdecisions, made over a long period of time, by abroad range of different decision makers, with littleor no routinization. They also highlighted that thebenefits, harms and costs of programs, services anddrugs are less context dependent, while the prosand cons of policies at macro-level is much morecontext dependent. Hence, in health policy research,local tacit knowledge, views and experiences mattermuch more.The debate described above represents an effortto clarify the boundaries of health system research,health policy research and health serviceresearch. There are however critical issues whichneeds to be examined further, particularly in the interestof health services management research.Firstly, it is rather misleading to portray health servicemanagement decision as typically technical,routine and clear cut. The health service managementdecision spectrum arguably spans from completecertainty in one end to absolute ambiguity onthe other end, and many in between. There can bepolitical dimensions to these decisions, eventhoughthey are at the organization or sub-organization level,as they often entail allocation of scarce resources.Thus, there are considerable rooms for local tacitknowledge, views and experience as well withinhealth service management research. Secondly,many management interventions are also contextspecific. A management decision to adopt clinicalpathway may lead to significantly better clinical outcomesin one hospital, but may result in minuteimprovement of clinical outcomes in anotherhospital.Thus, it is too risky to emphasize that healthservice managementdecisions are not so much influencedby context. Health service managementresearchers who fail to discuss contextual matters,may risk having their results haphazzardly generalizedor replicated. These points suggest that importantcharacteristics of health service managementresearch have not been adequately considered inthe symposium discourse above.The relative neglect of health service managementresearch in the current discourse reflects thelack of active contribution from health service managementresearchers, and perhaps also reflects thenature of a field which has not been much well developedscientifically. This calls for efforts to strengthenhealth service management research as a scientificfield. Drawing from efforts to strengthen health systemresearch as a field, we can think of several possibleways to do this. First, we need to establish acommon language by developing authoritative textbooks,journals and courses in health service managementresearch. Secondly, we need to promotecross-disciplinary learnings as heallth service managementresearch is typically multidisciplinary. Third,we need a society for health service managementresearch at national and international level. Fourth,we need more professors, authoritative scientific leaders,in health service management research.98 Jurnal Manajemen Pelayanan Kesehatan, Vol. 15, No. 3 September 2012Yodi Mahendradhata & Adi Utarini: What do we mean by health service ...JMPK, the Indonesian Journal of Health ServiceManagement, remains committed to contributetoward strengthening health service managementresearch by providing an accessible common peerreviewedplatform for state-of-the art health servicemanagement researches since more than a decadeago. We have attempted to make JMPK as accessibleas possible by providing online access to publishedcontent. We will soon expand further by providingpossibility for online submission as well.However, we are still left with the absence ofauthoritative textbooks and society of health servicemanagement research community in the country, incontrast to what we have in epidemiology or clinicalresearch for instance.In the field of epidemiology,there is the International Epidemiological Associationwhich publishes the International Journal of Epidemiologyand organizes the World Congress ofEpidemiology. At the national level, we also havethe National Epidemiology Network (JEN). The fieldof epidemiology also benefits from authoritative textbooks,such as those written by Kenneth J Rothman.For clinical research, there is the International Clinicalepidemiology network and the field benefits fromauthoritative textbooks such as those written by DavidSackett or Robert Fletcher. At the national level, theIndonesian Clinical Epidemology and EvidenceBased Medicine Network has also been established.We are looking forward to work with the healthservice management research community to moveforward with strengthening health service managementresearch as a scientific endeavour
Alternatif Strategi Pelaksanaan Peran Regulasi Pascadesentralisasi Di Daerah = Alternative Strategies To Implement Regulatory Function Post Decentralization At The Provincial And District Level
Full text linkBackground: Several reports and observations have urged the need to strengthen regulatory function in decentralization era. This is not unexpected as regulation is not only a new role for the provincial and district health office, but also regulation is not perceived as an important role. Limited literature in this field motivates the author to compose this review paper, with the objective to define regulatory function and its activities, and to discuss strategies to strengthen this function.
Subject and methods: This policy paper reviews regulatory concepts in the context of decen¬tralization in health. Empirical papers and on-going projects related to development of this regulatory function is presented to illustrate the concept.
Results: Regulatory function differs from provision of services in terms of its objective, unit of analysis, consequence and requirement. The objective of regulation is to ensure quality of service provided by health care facilities. The unit of analysis is, therefore, not only government facilities but also those that are privately owned.The scope of regulation covers modern, comple¬mentary and alternative medicine. Consequently, this function should be implemented in a credible and objective way, either through licensing, certification and accreditation. Two strate¬gies were presented to develop this regulatory function, i.e. strengthening the capacity of pro¬vincial-district health offices or building alliance with an independent body.
Conclusions: This paper has presented the definition and breadth of regulatory function in terms of its scope and activities. Taking into consideration the design, information, capacity, authority and context, an appropriate strategy should be explored and determined by the pro¬vincial or district health offices. Future development of the strategy should then be based on a multiyears planning.
Keywords: decentralization, regulatory function, healthcare service delivery, development strateg
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Tak Kenal Maka Tak Sayang : Penelitian Kualitatif Dalam Pelayanan Kesehatan
No full text15,5 x 23 cm; xx + 334 hl
Mengapa Wanita Tidak Memilih Bersalin Di Rumah Sakit?
Full text linkABSTRACT
Pre-natal interventions have been widely implemented as the main strategy to reduce maternal mortality and morbidity. This strategy, however, is not sufficient to attack the problem due to inparticular, inappropriate referral system and untimely intervention. Recognition of these problems combined with a relatively high proportion of unknown cause of maternal death has led to different priorities in Safe Motherhood Initiative, among those are to improve access to emergency obstetric care. This consequently means to remove any obstacles in the utilization of such services. This study aims to identify service factors which perceived by the user to influence household decision making in the utilisation of district hospital delivery facilities. A qualitative study using an indepth interview was performed in Klaten district hospital to collect information regarding reasons for choosing a particular facility to give birth. interviews of 23 women who had experienced at least two deliveries revealed 2 categories of barriers. Service delivery, namely regulations for visitors, negative staff attitude, and care for the newborn, was expressed as a substantial barrier for women to give birth at the hospital. Surprisingly, distance and cost appeared not to be the main obstacle. These findings imply that service factors may have a significant influence in the decision to use a hospital maternity service on the subsequent pregnancy. The relatively less importance of distance and cost in relation to utilisation may suggest further hypothesis, that is if cultural factors are to be incorporated into the provision of a modern maternity service, women may be more capable to overcome problems associated with distance and cost.
Key words: utilisation, hospital maternity service, user perspectiv
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Penanganan diare di pusat pelayanan kesehatan masyarakar
Full text linkKeywords: penyakit diare, tingkat kematian, layanan masyarakat, pengobatan-penangana
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