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Impact of Budget Increase on Primary Health Care Performance in the Era of National Health Insurance: Case Study in Buleleng District Suranugraha, Kadek; Nopiyani, Ni Made Sri; Januraga, Pande Putu
Kesmas Vol. 13, No. 2
Publisher : UI Scholars Hub

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Abstract

Since 2014, there has been an increase in funds for primary health care (PHC) coming from the National Health Insurance program capitation funds and the Health Operational Assistance Fund. This study aimed to explore the effect of this budget increase on the health care services at PHC. The case study used a qualitative approach and interviews from 19 PHC health workers with the highest and lowest budget. Data were analyzed using thematic analysis and supported by quantitative data. The positive impact of the increasing PHC budget was felt by PHC staff due to the addition of operational equipment and incentives provided. Nevertheless, there was also a negative impact such as feeling overwhelmed due to an increase in the quantity of PHC activities and additional administrative affairs. It also triggered a negative interaction between staff due to the number of incentives received. The regulation on the use of budget empowers PHC to better arrange the schedule of activities and manage human resources. However, these regulations are considered restrictive and the administrative flow of funds is too long that hinder the optimal use of the budget.
Akses Jaminan Kesehatan Nasional pada Pekerja Seks Perempuan Nopiyani, Ni Made Sri; Indrayathi, Putu Ayu; Listyowati, Rina; Suarjana, I Ketut; Januraga, Pande Putu
Kesmas Vol. 9, No. 4
Publisher : UI Scholars Hub

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Abstract

Pekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun sebagian PSP memiliki kemauan untuk menjadi peserta JKN dan memiliki kemampuan membayar iuran JKN. Faktor penghambat akses JKN pada PSP adalah rendahnya pengetahuan mengenai prosedur pendaftaran dan portabilitas JKN, kekhawatiran keberlanjutan pembayaran iuran, persepsi buruk mengenai kualitas layanan yang akan diterima jika menggunakan JKN, ketidaklengkapan administrasi kependudukan serta kebijakan yang mengharuskan peserta bukan penerima bantuan iuran (Non-PBI) Mandiri untuk mendaftarkan seluruh anggota keluarga. Akses JKN pada PSP terhambat oleh faktor-faktor individual, layanan dan kebijakan yang perlu diatasi untuk meningkatkan cakupan JKN pada PSP. Female sex workers (FSW) is marginalized social group having a high vulnerability of health problems. Effort to expand national health insurance on FSW is still limited, so it is necessarily performed in order to support the achievement of universal health coverage. This study aimed to obtain the depiction of the insurance access among FSW in Denpasar. This study was qualitative. Data was collected through in-depth interview of 15 FSW and four pimps in Denpasar from August to October 2014. The interview result was analyzed using thematic analysis. The analysis framework used was The Health Access Livelihood Framework. The insurance ownership among FSW in Denpasar was low, even though some FSW were willing to be participants and afford to pay the premium. Factors inhibiting the insurance access were the lack of knowledge regarding registration procedures and portability, fear of premium payment sustainability, negative perceptions of quality of services that would be received if using the insurance, incomplete population administration and policy requiring independent non-premium support receiver participants to register all of their family members. The insurance access among FSW was hindered by individual, service and policy factors that need to be conquered to increase the insurance coverage among FSW.
POTENSI DAN KENDALA PROGRAM PERCEPATAN PENURUNAN STUNTING DI PROVINSI BALI Nursanyoto, Hertog; Adhi, Kadek Tresna; Kusumajaya, Anak Agung Ngurah; Mubasyiroh, Rofingatul; Sudikno, Sudikno; Nainggolan, Olwin; Sutiari, Ni Ketut; Suarjana, I Made; Januraga, Pande Putu
Penelitian Gizi dan Makanan (The Journal of Nutrition and Food Research) Vol. 46 No. 1 (2023): PGM VOL 46 NO 1 TAHUN 2023
Publisher : Persagi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/pgm.v46i1.756

Abstract

Bali has the potential for good health resources. That is why Bali has been identified as the province with the lowest prevalence of stunting. However, this success should not make stakeholders think this problem is resolved. Bali still has problems which, if not addressed, will trigger a further increase in the prevalence of stunting. Considering this, it is deemed necessary to explore the perspectives of nutrition fieldworkers  and other stakeholders regarding the problem of stunting in Bali. This research aims to explore the potential and constraints to accelerating stunting reduction in Bali. This is qualitative research conducted between June and July 2022. Data was collected through in-depth interviews and focus group discussions. This study found that access to affordable health services is the main potential to support the acceleration of stunting reduction. Apart from that, there is a Balinese Traditional Village Council which always synergizes with government programs for the welfare of the community. The low quality of cadres is an obstacle to the success of the program. Many parents hesitate to take their children to posyandu because they are not satisfied with the cadre's services. Apart from that, there are other inhibiting factors, such as society's wrong understanding of stunting, teenage marriage, lack of environmental hygiene and sanitation, and inappropriate parenting patterns. This condition needs attention so that the acceleration of stunting reduction in Bali can be achieved as optimally as possible.
Harmony of Tradition and Sustainability: A Systematic Review of Management Strategies for Penglipuran Tourism Village Nyoman Teja Adiastra; Putu Indah Rahmawati; I Made Agus Jana Januraga
Jurnal Ilmu Sosial dan Humaniora Vol 15 No 1 (2026)
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/jish.v15i1.110329

Abstract

This study seeks to identify strategic themes, assess the incorporation of local values, and create a knowledge map derived from scientific literature pertaining to the administration of Penglipuran Tourism Village. This study employed a qualitative systematic review technique to assess 15 selected scientific articles published from 2015 to 2025. The study identified three primary findings: firstly, the literature reveals five strategic themes in the management of Penglipuran Tourism Village, which include the preservation of local wisdom, collaborative governance, environmental conservation, community participation, and marketing strategies grounded in legal certification. Secondly, native values such as awig-awig and Tri Hita Karana have been harmoniously incorporated into the village's regulations, social life, and economics, despite ongoing structural obstacles. The knowledge map offered an adjustable and scalable strategic framework that prioritizes cultural digitalization, community empowerment, and cross-sector collaboration for the creation of sustainable tourism villages. The research underscores the significance of multi- stakeholder engagement, digital innovation, and localized HR training as essential components for sustainability. The results are anticipated to provide a practical reference for policymakers, scholars, and managers of tourist villages in the development of culture-based and sustainable tourism models.
Invisible Families in Universal Health Coverage: Multilayered Exclusion of Underage Couples in Rural Bali, Indonesia Desak Putu Yuli Kurniati; Pande Putu Januraga; Ni Made Swasti Wulanyani; Dyah Kanya Wati; Anak Agung Sagung Sawitri; Ni Made Utami Dwipayanti; Ni Wayan Tianing; Ni Luh Putu Rita Primayuni; I Made Ady Wirawan
Journal of Public Health and Pharmacy Vol. 6 No. 3 (2026): In Progress
Publisher : Pusat Pengembangan Teknologi Informasi dan Jurnal Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/jphp.v6i3.9765

Abstract

Introduction: Despite Indonesia’s commitment to Universal Health Coverage (UHC), adolescents involved in customary marriages often remain beyond the reach of state protection. This study explores the "multilayered exclusion" experienced by these couples in accessing maternal health services in Munti Gunung, Bali. Methods: This exploratory qualitative case study involved 16 purposively selected participants, including early-married adolescent mothers (n=5), family gatekeepers (husbands/in-laws, n=5), health workers (n=5), and a community leader (n=1). Data were collected through in-depth interviews and analyzed using thematic analysis to identify barriers across the socio-ecological spectrum. Results: Inductively derived from localized empirical data, this study presents 'Administrative Invisibility' as an emergent conceptual construct describing how the lack of civil marriage certificates systematically excludes newborns from the National Health Insurance scheme. This qualitative exploration indicates that structural vulnerability is mediated by rigid household hierarchies and a mismatch in institutional capacity within resource-constrained primary care services. To secure immediate healthcare, families and local administrative actors navigate this socio-legal limbo by employing pragmatically effective yet legally high-risk informal workarounds. Conclusion: Within this single-site qualitative scope, the intersection of customary child marriage and legal identity exclusion appears to form a compounded structural node within the multi-layered matrix of healthcare exclusion for newborns. Achieving health equity requires proactive, affirmative structural reforms, specifically, piloting a 'Conditional Humanitarian Enrolment' model powered by an API-driven digital bridging framework to formally decouple an infant’s constitutional right to healthcare from parental marital status, safely integrating immediate neonatal survival with long-term socio-legal safeguards.
Understanding Indonesia’s Iron–Folic Acid supplementation policy for pregnant women using triangle and multiple-streams analyses Hesteria Friska Armynia Subratha; Ida Ayu Diah Purnama Sari; Ni Ketut Sutiari; I Wayan Gede Artawan Eka Putra; Ni Made Swasti Wulanyani; Pande Putu Januraga
Priviet Social Sciences Journal Vol. 6 No. 9 (2026): September, 2026
Publisher : Privietlab

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55942/pssj.v6i9.1407

Abstract

Maternal anaemia remains a persistent public health issue in Indonesia despite the existence of national Iron–Folic Acid (IFA) supplementation policies. Although IFA distribution is mandated as part of routine antenatal care, programme implementation and adherence vary widely across regions. A qualitative documentary analysis was conducted using the Health Policy Triangle (HPT) and Kingdon’s Multiple Streams Framework (MSF). Secondary sources published between 2010 and 2025 were reviewed, including national regulations, technical guidelines, maternal health reports, national survey data, programme evaluations, and peer-reviewed literature. Data were coded according to HPT domains (actors, context, content, and process) and MSF components (problem, policy, politics, and policy window). The MSF analysis shows that the high prevalence of maternal anaemia served as a clear problem signal, while established national IFA guidelines provided a viable intervention. Political prioritisation within national development plans enabled policy adoption, indicating convergence of the three streams. However, HPT findings reveal persistent implementation gaps, including supply inconsistencies, limited counselling and follow-up, fragmented coordination across governance levels, and socio-behavioural barriers affecting adherence. Although Indonesia’s IFA supplementation policy is well-aligned with global recommendations, its effectiveness remains constrained by operational and contextual challenges. Improving monitoring systems, strengthening provider capacity, enhancing community engagement, and integrating IFA into broader maternal nutrition strategies may increase programme coverage and compliance. The findings highlight that strong policy formulation must be accompanied by effective governance and context-responsive implementation to achieve meaningful maternal health improvements.
Co-Authors - Suarjawa Adiatma Siregar, Adiatma Ajeng Diantini, Ajeng Anak Agung Sagung Sawitri Andrew Paul Anton, Sri Sulistyawati Aree Jampaklay Aree Jampaklay Ariwidyastuti, Cokorda Istri Artha, Ketut Ary Diana Astuti, Maria Magdalena Zulian Puji Ayu Sugiantari Bella Riezka Aristianti Putri Benny Tjahjono Candradewi, Anak Agung Sagung Oka Nur Citra Mutiarahati, Ni Luh Cokorda Bagus Jaya Lesmana, Cokorda Bagus Jaya Cokorda Istri Ariwidyastuti Crosita, Yessi Dany Karmila Desak Nyoman Widyanthini Desak Putu Yuli Kurniati Desak Putu Yulita Kurniati Devi, Ade Dwita Nia Sita Dewa Ayu Agung Dwita Arthaningsih Dewa Nyoman Wirawan Dewa Nyoman Wirawan, Dewa Nyoman Dewi Aprelia Meriyani Dewi, Ni Made Ayu Kemala Dewi, Ni Made Umi Kartika Diaris, Ni Made Dinar Lubis Dinar Lubis Donny Hardiawan Duara, I Ketut Dusita Phuengsamran Dusita Phuengsamran Dwipayana, I Ketut Dyah Kanya Wati Dyah Pradnyaparmita Duarsa Erma Pradnyani, Putu Gde Ngurah Idraguna Pinatih Gede Bagus Parmadi Wijaya Gede Benny Setia Wirawan Gerstel, Lisanne Gusti Ayu Krisma Yuntari Gustina, Ni Luh Zallila Handayani, Miasari Harjana, Ngakan Putu Anom Hertog Nursanyoto Hesteria Friska Armynia Subratha I Desak Ketut Dewi Satiawati I Gede Diki Sudarsana I Gusti Agung Komang Diafari Djuni Hartawan I Gusti Ayu Agung Putri Krismayanthi I Gusti Ngurah Edi Putra I Gusti Ngurah Edi Putra I Gusti Ngurah Edi Putra I Ketut Duara I Ketut Dwipayana I Ketut Surya Negara I Made Ady Wirawan I Made Ady Wirawan I Made Edy Listartha I Made Suarjana I Nyoman Dharma Wiasa I Nyoman Mangku Karmaya I Wayan Gede Artawan Eka Putra I Wayan Gede Artawan Eka Putra I Wayan Gede Artawan Eka Putra, I Wayan Gede Artawan Eka Ida Ayu Agung Dewi Sawitri Ida Ayu Diah Purnama Sari Ida Ayu Putri Widhiastuti Indraswari, Ni Luh Astri Indrayani, Putu May Jampaklay, Aree Juwita, Mery Nurma K. Budiartha Kadek Suranugraha Kadek Tresna Adhi Kardiwinata,, Made Pasek Karmila, Dany Ketut Ary Diana Artha Ketut Suarjana Komang Ayu Kartika Sari Kowara, Mellysa Krismayanthi, I Gusti Ayu Agung Putri Kurniati, Desak Putu Y Kusumajaya, Anak Agung Ngurah Laszlo Robert Koloszvari Laurensius Patrick Lisanne Gerstel Luh Putu Sinthya Ulandari Luh Seri Ani Made Ayu Devi Pita Loka Made Pasek Kardiwinata Manuaba, I.B.G. Fajar Maria Magdalena Zulian Puji Astuti Maria Salestina Sekunda Maria Salestina Sekunda Mas Manik Astawastini, I Dewa Ayu Meriyani, Dewi Aprelia Monika Sri Yuliarti Muchamad Zaenal Arifin, Muchamad Zaenal Murniati, Ni Nengah Narendra Suputra, I Dewa Gede Agung Ngakan Made Ari Mahardika Ni Kadek Ari Arniti Ni Kadek Esilia Septigar Pranati Ni Ketut Sri Lestari Ni Ketut Sutiari Ni Ketut Sutiari Ni Komang Yudi Sri Astari Ni Luh Putu Rita Primayuni Ni Luh Putu Suariyani Ni Made Ayu Kemala Dewi Ni Made Dian Kurniasari Ni Made Diaris Ni Made Mas Dwi Purwaningrat Ni Made Parwati Ni Made Sri Nopiyani Ni Made Sri Nopiyani Ni Made Suasti Wulanyani Ni Made Swasti Wulanyani Ni Made Utami Dwipayanti Ni Nengah Murniati Ni Nyoman Sri Budayanti Ni Putu Purlimaningsih Ni Putu Widarini Ni Wayan Arya Utami, Ni Wayan Arya Ni Wayan Septarini Ni Wayan Tianing Ni Wayan Trisnadewi, Ni Wayan Nirmala, Putu Nitya Nyoman Teja Adiastra Octaviana, Betty Olwin Nainggolan P. Muliawan P. Muliawan Panithee Thammawijaya Panithee Thammawijaya Pemayun, Cokorda Istri Mita Phuengsamran, Dusita Pradnyani RS, I Gusti Ayu Indah Pradnyawati, Luh Gede Pradnyawati, Luh Gede Prawinegara, Rozar Purlimaningsih, Ni Putu Putra, I Gusti Ngurah Edi Putu Aryani Putu Ayu Indrayathi Putu Emy Suryanti Putu Indah Rahmawati Putu Nitya Nirmala Rai Riska Resty Wasita Rina Listyowati Rina Listyowati Rina Listyowati, Rina Rofingatul Mubasyiroh rosida, Anik Rudi Wisaksana S.Pd. M Kes I Ketut Sudiana . Sagitariani, Sayu Kade Alit Santosa, Karina Samaria Sari, Komang Ayu Kartika Sawitri, Anak Agung Sagung Sawitri, Ida Ayu Agung Dewi Sayu Kade Alit Sagitariani Scholte, Willem F Suandana, Iwan Abdi Sudewi, Ni Made Ayu Sri Ratna Sudikno Sudikno Sugiantari, Ayu Sulaiman, Nurjannah Suranugraha, Kadek Surya Negara, Surya Suryanti, Putu Emy Susila, I Made Dwie Pradnya Swapatni, Ni Made Adi Thammawijaya, Panithee The Angela Prisilia Taroreh Ulandari, Luh Putu S Utami, Kadek Cahya Valerie, Ivy Cerelia Wati, Putu Ayu Wayan Citra Wulan Sucipta Putri Wibawa, I Komang Gede Sentanu Widhiastuti, Ida Ayu Putri Widowati, I Gusti Ayu Rai - Willem F Scholte Wirawan, Ady Yudi Ardiana Yudi Ardiana, Yudi Yuntari, Gusti Ayu Krisma