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Journal : Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)

KAPASITAS SUSTAINABILITY PROGRAM HIV/AIDS DI KABUPATEN SINTANG Hermanto; Yodi Mahendrahata; Yanri Wijayanti Subronto
Journal of Health Service Management Vol 23 No 02 (2020)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (141.354 KB) | DOI: 10.22146/jmpk.v23i02.4179

Abstract

Background: HIV/AIDS sufferers in Sintang Districts recorded the number of new cases from 29 people in 2012 to 63 people in 2017. Funding for the HIV/AIDS program from the Global Fund is uncertain, while funding from the Sintang Regency APBD tends to decrease. These data indicated that the dependence on funding for the HIV/AIDS program from donors, namely the Global Fund, is large enough that a study on the sustainability of the HIV/AIDS program is required if funding support from donors ceases. This can be a consideration for local governments and managers of the HIV/AIDS program to maintain the sustainability of the HIV/AIDS program to achieve the benefits and objectives to be achieved in the HIV/AIDS prevention program. Objective: To describe capacity sustainability (funding stability, or ganizational capacity, program evaluation, program adaptation and communication) of HIV/AIDS programs in Sintang District. Methods: This research used a qualitative approach with descriptive research type. Subjects of this study were 21 people. This research used purposive sampling and snowballing sampling for People living with HIV/Aids (PLWHA), with data analysis used is content analysis. Results: The sustainability of HIV/AIDS programs has not been supported by varied funding sources and the ability to obtain funding through the private sector (CSR). Priority setting of the proposed funding program is not evenly distributed, especially on cross-sectoral OPD and lack of NGO independence in terms of funding. Increased availability of health personnel and improvement of facilities at puskesmas to be able to perform HIV / AIDS testing. Standard evaluation report formats are still not getting attention, not yet supported by the local monitoring and evaluation team as well as some OPD across sectors have not benefited from the evaluation. weak aspects of prevention of HIV/AIDS transmission and cross sectoral involvement in monitoring. lack of availability of counselors and weak cross-sectoral involvement in communicating programs. Conclusion: The capacity of funding stability, organizational capacity, program evaluation, program adaptation and communication still require improvement and improvement with priority setting policy and funding through the private sector, support for the role of stakeholders related to the HIV/AIDS program.
Implementasi Kebijakan Tatalaksana HIV di Puskesmas Kabupaten Sleman Seruni Angreni Susila; Yanri Wijayanti Subronto; Tiara Marthias
Journal of Health Service Management Vol 25 No 03 (2022)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (361.665 KB) | DOI: 10.22146/jmpk.v25i03.5121

Abstract

Background: HIV AIDS is still a global and national challenge. The government is trying to control it by expanding access to HIV treatment at the Puskesmas, including 4 Puskesmas in Sleman Regency. However, efforts to expand access to treatment have not yet reached the target of 95% of people living with HIV who are receiving ART and 95% of people living with HIV who are viral loadsuppressed. WHO in 2017 recommended the immediate initiation of diagnosed HIV-positive people regardless of CD4 cell count and followed by changes in the national HIV management policy through a fast-track strategy in 2018 to provideimmediate initiation of ARVs, provision of Tuberculosis Preventive Therapy, and viral load monitoring. The rapid change in HIV management strategies raises the question of whether the Puskesmas in Sleman Regency can carry out HIVmanagement according to the latest policy recommendations in achieving the target of 90% of people living with HIV who are suppressed by viral load. Objectives: Measuring the suitability of the implementation of HIV management at the Puskesmas based on regulations and finding the supporting factors and obstacles in the implementation of HIV management at the Puskesmas.Methods: This is mixed-method research with a sequential explanatory approach. The location of research was carried out in four health centres in Sleman Regency, which had organized the HIV Treatment Support Care Service Program. Data was collected in May-June 2022. Quantitative data was secondary data on cases of people with HIV who accessed PDP services registered at the Puskesmas from 2019 until July 2021. Qualitative data were taken from 9 informants, selected by the purposive sampling method, through in-depth interviews. The quantitative sampling method uses a non-probability sampling method. Results: There is a discrepancy in the suitability of treatment at the Puskesmas with management standards according to regulations, as well as the low number of people living with HIV who are monitored for viral load suppression. The inhibiting factor for implementing HIV management in Puskesmas is the attitude of health workers to delay treatment related to perceptions of HIV prevention policies that have not been well socialized. Not all service providers are trained,lack of viral load testing facilities in hospitals, inefficient HIV management records systems, and stigma are obstacles to implementing HIV management. The supporting factors for the implementation of PDP HIV are the attitude of the willingness of health workers to provide treatment related to the perception of peer support and the presence of trained officers in counseling and logisticalsupport for adequate drugs. Conclusion: Not all people living with HIV treated at the Puskesmas have received treatment according to regulations until viral load suppression is monitored. For this reason, it is necessary to increase the capacity of HIV counselingand management for all health workers involved in providing PDP services, adding viral load testing facilities at regional hospitals, and providing HIV stigma prevention programs for people living with HIV, families, communities and health services.
STUDI KASUS TERAPI ARV PADA PASIEN LOST TO FOLLOW-UP DI JAKARTA PUSAT TAHUN 2021 Awani Luksita; Yodi Mahendradhata; Yanri Wijayanti Subronto
Journal of Health Service Management Vol 25 No 02 (2022)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (617.248 KB) | DOI: 10.22146/jmpk.v25i02.5515

Abstract

Background: There are 9,338 patients undergoing ARV therapy in Central Jakarta and based on data from April to June 2021, 3,651people are missing due to follow-up. Lost To Follow-Up (LTFU) is when the patient does not revisit after three months or more after thelast visit. Objective: Knowing the factors influencing ARV therapy in LTFU patients in Central Jakarta.Methods: This research is a case study research with a total of 12 informants consisting of LTFU patients, NGOs, doctors, and nursesfrom the priority health office in Central Jakarta. Data collection techniques using in-depth interviews and document review. Data analysis using framework analysis technique. Results: This study shows that the experience of LTFU patients wheninitially diagnosed with HIV experienced a pause in ARV therapy because they could not accept themselves as being HIV positive, andsome patients still did not understand ARV therapy treatment. ARV therapy decision-making is based on the motivation to be healthy andwant to see the child’s growth and development into adulthood. Patients feel that undergoing ARV therapy adds to activities that makethem unable to adjust their medication schedule, hampering work time because they must go to drug collection services. Some alsooften forget to bring medicine and feel the need to hide to take medicine when outside the house. The inhibiting factors for LTFU patientsare the effects of drugs; the COVID-19 pandemic condition; feeling healthy; tired of undergoing therapy; being far from health services,the number of costs incurred to go to services; not receiving complete information; and loss of support from the closest people.Conclusion: The government needs to improve strategies for LTFU patients to return to ARV therapy by optimizing the multi-month dispensing (MMD) program; inviting and providing education for family members or relatives of LTFU patients to take ARV therapy treatment by becoming a Drug Swallowing Supervisor (PMO); and it is important to support the design of HIV treatment telemedicine during the COVID-19 pandemic.