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KEBIJAKAN DAN IMPLEMENTASI BANTUAN LUAR NEGERI AUSAID DI TIMOR LESTE: EVALUASI TERHADAP PROYEK DUKUNGAN RENCANA STRATEGIK SEKTOR KESEHATAN Retna Siwi Padmawati, Manuela Pereira, Yodi Mahendradhata,
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 01 (2012)
Publisher : Jurnal Kebijakan Kesehatan Indonesia

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Background: The Ministry of Health of Timor-Leste has realizedthat they should work together with other stakeholders toachieve their vision and mission due to insufficient humanresources and budget. Therefore, the Ministry of Health hasestablished collaboration with AusAid and other developmentpartners through mechanism of coordination. However, themechanism is not yet implemented fully.Objective: To evaluate foreign aid policy in coordinating AusAiddonor and development partners to fund human resource developmentprogram (in the HSSP-SP project) through the mechanismof coordination in the Ministry of Health of Timor-Leste.Method: This was a qualitative study with a case-study design.The respondents were 16 people, consisting of 13 personsfrom the Ministry of Health and 3 persons from AusAid,World Bank and development partners.Result and Discussion: The Department of Partnership Managementhad not been optimum in managing and controlling theproject/program and activities of the donors and working partners.The approved action plan and budget were relevantwith the proposal made by the Ministry of Health but planningfor human resource development was unclear and was notbased on the work force gap faced and priority in humanresource development. The project had impact on human resourcedevelopment but the process of staff re-placementwas not in line with the principle of the right man on the rightplace. Regular consultative meeting could facilitate the approvalof action plan and budget for human resource development.However, the mechanism of coordination was less effectivebecause there was no specific instrument or mechanismto do alignment and harmonization and it only focused oncollective gain and there was too much pressure and demandto staff from both the Ministry of Health and partners. Constraintsand challenges from political aspect and human resourcecapacity had hampered the process of coordinatingAusAid and working partners.Conclusion: The implementation of foreign aid policy to coordinateAusAid and development partners to fund human resourcedevelopment (in HSSP-SP project) following the mechanismof coordination in the Ministry of Health of Timor-Lestehad run well enough but still received lack of support fromhuman resource development planning based on institutionaldevelopment.Keywords: policy evaluation, mechanism of coordination,human resource development, donor agency

Prestasi Belajar pada Remaja yang Mengalami Dismenorea Primer Fajarini, Yuniar Ika; Nurdiati, Detty Siti; Padmawati, Retna Siwi
JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Primary dysmenorrhea occurs in approximately 50% of teenage girls and cause serious disruptions in the quality of life and daily activities. Primary dysmenorrhea makes teenagers difficult to concentrate in school which will decrease their academic achievement.Objective: to investigate whether there is a correlation between Primary dysmenorrhea and academic achievement of students of SMP Islam Terpadu Pondok Pesantren Tahfidzul Qurâ€™an (SMP IT PPTQ) Ibnu Abbas Klaten.Method: This study is a case-control study through a quantitative approach and was supported with qualitative data. The research sample is 68 teenage girls of SMP IT PPTQ Ibnu Abbas Klaten who fulfilled the inclusion criteria. The cases groups are female students with low learning achievement, while the control group was female students with high learning achievement. The samples were taken using simple random sampling. Researcher used a structured questionnaire, interview and secondary data to collect the data. The data analysis was using descriptive and inferential analysis including bivariate analysis using chi-square test and multivariate analysis using logistic regression with 95% confidence intervals (CI) and a significance level of p <0.05.Result and Discussion: The bivariate and multivariate analysis showed a significant correlation between primary dysmenorrhea and learning achievement. The possibility of finding girls with primary dysmenorrhea in the group of students who received a low learning achievement is 3 times larger than the group of students who received high learning achievement. Below-average intelligence is greater in the group of low-achieving students than the group of high-achieving students. There is a correlation between the variables of intelligence, stress level and frequency of dysmenorrhea and academic achievement. The variable of absences frequency not related to learning achievement.Conclusion: There is correlation between primary dysmenorrhea and learning achievement (p=0.026). This study indicates that women and their school should pay attention to their menstrual function and dysmenorrhea phenomenon.Keywords: learning achievement, primary dysmenorrhea, teenage, menstrual disorder

The Importance of Community Coalition to Prevent Dengue Fever: An Ethnographic Study in Sidoluhur Village, Sleman District, Yogyakarta Special Region Muhammad Sohel Rana; Fatwa Sari Tetra Dewi; Retna Siwi Padmawati
Tropical Medicine Journal Vol 4, No 1 (2017): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Intrduction: Dengue fever is an emerging pandemic-prone viral disease in many parts of the world also in Indonesia. Java Island contributed about 71% of all cases occurring in the country. Sleman District represented nearly 30% of total infections in Yogyakarta Province. Godean sub-district contributes 89 cases in 2013 and most of them were come from Sidoluhur village. Instead of community activities Dengue cases are increasing every year. Vector control is one way to control it. This research was tried to explore how community coalition can prevent Dengue fever cases and how Dengue vector can be controlled by engaging community. Methods: This research was used ethnographic study. For collecting data in-depth interview and participatory observation was conduct. Collecting data and analysis data was done simultaneously.Results: Community in Sidoluhur village aware that Dengue fever is a serious health problem. With local knowledge, believes, customs, practice and attitudes community people are most influenced group. After getting fever people try to apply their own knowledge for prevention. Most of them do not know the reason of Dengue spread, how it breed, where it breed also how to control. Practices of Dengue prevention like Friday cleaning movement, mosquito eradication flick and child health task force are good programs but absent of continuity so Dengue cases are increasing. Cultural and medical health seeking behaviors were seen among the people. For building coalition capacity sharing information is also immobile.Conclusion: Dengue fever is still remaining a strong factor that influences public health care in Sidoluhur village. To control Dengue fever capacity building, policy implementation based on community, networking among stakeholders, blending the cultural and medical knowledge of Dengue and overall comprehensive Dengue control approaches need to be developed. Keywords: Dengue fever, community coalitions, social capital, working group.ABSTRAKPendahuluan: Demam Dengue adalah penyakit viral yang berpotensi menimbulkan pandemik di seluruh dunia termasuk Indonesia. Pulau Jawa menyumbang sekitar 70% dari seluruh kasus di Indonesia. Kabupaten Sleman menyumbang hampir 30% total infeksi di Provinsi Daerah Istimewa Yogyakarta. Kecamatan Godean menyumbang 89 kasus di tahun 2013 yang sebagian besar berasal dari desa Sidoluhur. Meskipun berbagai kegiatan pencegahan sudah dilakukan oleh masyarakat, kasus demam Dengue terus meningkat setiap tahunnya. Pengendalian vektor nyamuk merupakan salah satu kegiatan yang dilakukan untuk mencegah demam Dengue. Penelitian ini bertujuan untuk mengetahui bagaimana koalisi masyarakat di desa Sidoluhur dapat mencegah kasus demam Dengue dan bagaimana vektor Dengue dapat dikendalikan dengan melibatkan masyarakat.Metode: Penelitian ini merupakan Studi Etnografi. Pengumpulan data dilakukan dengan wawancara mendalam (in-depth interview) dan pengamatan partisipatif. Data dianalisis dan disajikan secara deskriptif.Hasil: Masyarakat desa Sidoluhur menyadari kalau Demam Dengue merupakan masalah kesehatan yang serius. Tetapi, dengan pengetahuan lokal, kepercayaan, kebiasaan, praktik dan sikap yang dimiliki, masyarakat awam meruapakan kelompok yang rentan untuk terjangkit demam Dengue. Apabila terkena serangan demam, masyarakat akan mecoba menerapkan pengetahuan yang dimiliki untuk mengobati demam dan mencegah perkembangan penyakit. Sebagian besar masyarakat tidak tahu bagaimana cara penyebaran Dengue, bagaimana dan di mana nyamuk berkembang biak dan bagaimana cara mengendalikan perkembangbiakan nyamuk tersebut. Praktik-praktik pencegahan demam Dengue seperti Gerakan Jumat Sehat, Pemberantasan Jentik Nyamuk dan satuan Tugas Kader Kesehatan Cilik merupakan program yang bagus tetapi tidak dilaksanakan secara kontinu sehingga kasus demam Dengue terus meningkat. Budaya dan kesadaran masyarakat untuk mencari pertolongan medis sudah cukup baik. Pengembangan kapasitas koalisi masyarakat perlu ditingkatkan karena kurangnya sharing informasi dalam masyarakat.Simpulan: Demam Dengue merupakan faktor kuat dalam menentukan pelayanan kesehatan masyarakat di desa Sidoluhur. Untuk mengendalikan kasus demam Dengue, pembangunan kapasitas, implementasi kebijakan berdasarkan kondisi masyarakat, kerjasama antar stakeholder, menyelaraskan budaya dan pengetahuan medis tentang Dengue dan pengendalian Dengue dengan pendekatan komprehensif perlu untuk dikembangkan.Kata kunci: demam Dengue, koalisi masyarakat, modal sosial, kelompok kerja.

KEBIJAKAN DAN IMPLEMENTASI BANTUAN LUAR NEGERI AUSAID DI TIMOR LESTE: EVALUASI TERHADAP PROYEK DUKUNGAN RENCANA STRATEGIK SEKTOR KESEHATAN Manuela Pereira, Yodi Mahendradhata, Retna Siwi Padmawati
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 1 (2012)
Publisher : Center for Health Policy and Management

Background: The Ministry of Health of Timor-Leste has realizedthat they should work together with other stakeholders toachieve their vision and mission due to insufficient humanresources and budget. Therefore, the Ministry of Health hasestablished collaboration with AusAid and other developmentpartners through mechanism of coordination. However, themechanism is not yet implemented fully.Objective: To evaluate foreign aid policy in coordinating AusAiddonor and development partners to fund human resource developmentprogram (in the HSSP-SP project) through the mechanismof coordination in the Ministry of Health of Timor-Leste.Method: This was a qualitative study with a case-study design.The respondents were 16 people, consisting of 13 personsfrom the Ministry of Health and 3 persons from AusAid,World Bank and development partners.Result and Discussion: The Department of Partnership Managementhad not been optimum in managing and controlling theproject/program and activities of the donors and working partners.The approved action plan and budget were relevantwith the proposal made by the Ministry of Health but planningfor human resource development was unclear and was notbased on the work force gap faced and priority in humanresource development. The project had impact on human resourcedevelopment but the process of staff re-placementwas not in line with the principle of the right man on the rightplace. Regular consultative meeting could facilitate the approvalof action plan and budget for human resource development.However, the mechanism of coordination was less effectivebecause there was no specific instrument or mechanismto do alignment and harmonization and it only focused oncollective gain and there was too much pressure and demandto staff from both the Ministry of Health and partners. Constraintsand challenges from political aspect and human resourcecapacity had hampered the process of coordinatingAusAid and working partners.Conclusion: The implementation of foreign aid policy to coordinateAusAid and development partners to fund human resourcedevelopment (in HSSP-SP project) following the mechanismof coordination in the Ministry of Health of Timor-Lestehad run well enough but still received lack of support fromhuman resource development planning based on institutionaldevelopment.Keywords: policy evaluation, mechanism of coordination,human resource development, donor agency

Benarkah Rumahsakit Pemerintah Menggunakan Manajemen Keluhan Pasien untuk Melindungi Pembayar Pajak? Studi Reformasi Birokrasi di Rumahsakit Bantul DIY Siti Suryati; Mubasysyir Hasanbasri; Retna Siwi Padmawati
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 2 (2012)
Publisher : Center for Health Policy and Management

Rumah sakit pada umumnya bergerak kearah sistem manajemen berdasarkan konsep usaha yang mengarah pada mekanisme pasar dan prinsip efisiensi. Kepedulian terhadap para pelanggan ditunjukkan dengan adanya mekanisme untuk mengenali apa yang dipersyaratkan oleh pelanggan dan ditujukkan dalam perilaku pemberi layanan yang mencerminkan tata nilai yang berlaku dalam organisasi. Indikator pelayanan (BOR) di RSUD Panembahan Senopati Bantul 89,28%, hal ini menunjukkan bahwa pemanfaatan tempat tidur sudah melebihi standar yang ada. Kondisi demikian ini apabila tidak disertai dengan pelayanan yang bermutu baik dari sisi sarana dan prasarana termasuk pengelolaan manajemennya, bukan tidak mungkin akan mengalami hal-hal yang tidak diinginkan.Tujuan penelitian ini adalah untuk mengetahui strategi penanganan keluhan pelanggan dan bagaimana keluhan pelanggan dikelola dalam rangka pelaksanaan sistem manajemen mutu di RSUD Panembahan Senopati BantulPenelitian studi kasus dengan subyek penelitian pelanggan rawat jalan dan rawat inap dipilih secara purposive sampling dan wawancara terhadap manajemen meliputi direktur, kepala bagian pengembangan, humas, serta melakukan observasi. Analisa data dilakukan secara deskriptif dan kualitatif.Pemerintah Kabupaten dan direksi telah mengimplementasikan Total Quality Management, walaupun belum dilaksanakan secara optimal. Prosedur tetap dan tim khusus yang menangani keluhan belum semuanya ada. Berbagai macam fasilitas untuk menyampaikan keluhan telah tersedia antara lain melalui kotak saran, SMS center, telephone, web, email, dialog melalui radio maupun televisi, dan media cetak. Pelanggan eksternal lebih menyukai penyampaian langsung apabila ada keluhan, namun kenyataannya pelanggan eksternal lebih banyak menyampaikan keluhan melalui SMS center. Cara penanganan keluhan yang sudah ditetapkan oleh direktur belum dilaksanakan secara totalitas terutama dalam hal tindak lanjut.Agar pengelolaan keluhan pelanggan dapat dilaksanakan secara optimal maka perlu ada tim khusus atau unit yang menangani keluhan dilengkapi dengan prosedur tetap dan pelaksanaan prosedur tetap tersebut di semua lini.

Implementasi Kebijakan JKN oleh Pemberi Pelayanan Kesehatan di Kabupaten Kepulauan Anambas Irawati Sagala; Laksono Trisnantoro; Retna Siwi Padmawati
Jurnal Kebijakan Kesehatan Indonesia Vol 5, No 3 (2016)
Publisher : Center for Health Policy and Management

ABSTRACTBackground: On January 1st, 2014, the implementation of NHI started in Indonesia as well as in the district of Anambas Islands accordance with the mandate of Law No. 24 in 2014. NHI policy is a top-down policy that must be implemented. On the process of implementation, the health service providers in the RSL, as the main reference in Anambas Islands, have some problems due to the characteristics’ differences of regional and limitations the District of Anambas Islands as the border areas, islands and separated-areas (DTPK). In the context of health, rural and remote areas is often associated with a state of limited public transport, poor road infrastructure, long distances to health service facilities and difficulties in recruiting and retaining health personnel. As a result there is a significant impact on the provision of adequate health care. The availability of resources is inadequate in every health facility in Anambas Islands is also an obstacle for the implementation of NHI any existing health facilities in the District of Anambas Islands must qualify credensialing set by BPJS Health.The Objective: To analyze the implementation of NHI policy by the health service providers in the District of Anambas Islands.Method: This research is using the descriptive research with qualitative methods using a single case study, design to analyze the implementation of the NHI policy established by the health service providers in Anambas Islands, which is focused on resources, bureaucratic structure and disposition.Result: Implementation of policy NHI by health care providers both in health centers and hospitals are still many have constraints such as limited power specialist, especially in hospitals, general practitioners definitive still lacking in some health facilities, the limited infrastructure in health centers and hospitals that cause will not want the patient should be referred. This adds to the burden of transportation costs to society as ocean freight rates are quite expensive though some things can be addressed as a problem of information and improvement of bureaucratic structures, but it can not prevent the public to be referred.Conclusion: The implementation of NHI policy does not match held in Anambas Islands as the border areas, islands and separated-areas area because of the benefits received by the community of NHI be limited due to so many constraints faced by health care providers. Keywords : Implementation of policy, the National Health Insurance, health service providers.ABSTRAKLatar belakang : Dengan diberlakukannya UU Nomor 24 Tahun 2014 maka pada tanggal 01 Januari 2014 Jaminan Kesehatan Nasional dimulai di Indonesia, demikian juga halnya di Kabupaten Kepulauan Anambas. Kabupaten Kepulauan Anambas merupakan kabupaten yang dikategorikan sebagai daerah DTPK. Dalam konteks kesehatan, daerah pedesaan dan terpencil sering dikaitkan dengan keadaan transportasi umum yang terbatas, infrastruktur jalan yang buruk, jarak yang jauh ke fasilitas pelayanan kesehatan dan kesulitan dalam merekrut dan mempertahankan tenaga kesehatan. Akibatnya ada dampak yang signifikan untuk penyediaan pelayanan kesehatan yang memadai. Ketersediaan sumber daya yang tidak memadai pada setiap fasilitas kesehatan di Kabupaten Kepulauan Anambas juga menjadi kendala karena dalam pelaksanaan JKN setiap fasilitas kesehatan yang ada di Kabupaten Kepulauan Anambas harus memenuhi syarat kredensialing yang telah ditetapkan oleh BPJS Kesehatan.Tujuan: Menganalisis implementasi kebijakan JKN oleh pemberi pelayanan kesehatan di Kabupaten Kepulauan Anambas.Metode: Penelitian ini merupakan jenis penelitian deskriptif dengan metode kualitatif menggunakan rancangan studi kasus tunggal terjalin untuk menganalisis implementasi kebijakan JKN oleh pemberi pelayanan kesehatan di Kabupaten Kepulauan Anambas, yang difokuskan pada sumber daya, struktur birokrasi dan disposisi.Hasil: Implementasi kebijakan JKN oleh pemberi pelayanan kesehatan baik di puskesmas maupun rumah sakit masih banyak mengalami kendala seperti terbatasnya tenaga spesialistik khususnya yang ada di rumah sakit, dokter umum yang definitif masih kurang di beberapa fasilitas kesehatan, keterbatasan prasarana di puskesmas dan rumah sakit yang menyebabkan mau tidak mau pasien harus dirujuk. Hal ini menambah beban biaya transportasi bagi masyarakat karena tarif angkutan laut yang cukup mahal walaupun beberapa hal dapat dibenahi seperti masalah informasi dan perbaikan struktur birokrasi namun hal tersebut tidak dapat mencegah masyarakat untuk dirujuk.Kesimpulan: Implementasi kebijakan JKN tidak cocok dilaksanakan di Kabupaten Kepulauan Anambas sebagai daerah DTPK karena manfaat yang diterima masyarakat dari JKN menjadi terbatas disebabkan begitu banyak kendala yang dihadapi oleh pemberi pelayanan kesehatan. Kata Kunci : Implementasi kebijakan, Jaminan Kesehatan Nasional, pemberi pelayanan kesehatan

Evaluasi Manfaat Program Jaminan Kesehatan Daerah bagi Masyarakat Kota Yogyakarta Rohadanti Rohadanti; Sigit Riyarto; Retna Siwi Padmawati
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 2 (2012)
Publisher : Center for Health Policy and Management

Background: The Program of Community Health Insurance Scheme (Jamkesda) in Yogyakarta Municipality is organized by the Technical Unit Regional Health Insurance Provider (UPT PJKD) with funds from the municipal budget. The rules about membership, benefits and amount of Jamkesda are appointed in the Mayor Regulation. There has been no comprehensive research about benefits and the perceived difficulty when using Jamkesda. Therefore, this research aims to determine this issue. Methods: This was an observational study using quantitative and qualitative methods. The quantitative respondents (n= 154) were selected accidentally when the patients were being treated at two hospitals in Yogyakarta and were based on the recapitulation of the claims in the previous month. The qualitative respondents (n = 10) were selected by purposive sampling for patients with chronic illnesses and with very high claims. Data collection was taken by questionnaire and guide- line for in-depth interviews to Jamkesda participants who had been treated in the two hospitals. Results: The respondents perceived that Jamkesda was beneficial despite objecting to 51.30% of the cost sharing. Therefore, in in-depth interviews five respondents expressed that they had to borrow money to pay for it. A total of 61.04% respondents used a letter of recommendation from Department of Social, Labor and Transmigration (those with no health insurance). Difficulty in handling the identity of membership was only experienced by 16.23%, while 78.57% had no prob- lem in it. Those who found difficulty were looking for a solution to the government administrator as RT/RW, parliaments, NGOs and neighbors. Around 78.57% of respondents did not under- stand about the Jamkesda service limit; they only knew infor- mation relating to their current interests. A total of 89.61% respondents knew that Jamkesda was an aid. All respon- dents in in-depth interview and around 73.38% respondents paid the cost sharing more than 10% of total claims. From the total household expenditure, almost all (99.35 %) were cata- strophic as the health spent more than 40% of their household expenditure whereas 73.38% earned below the minimum wage income. Conclusion: High cost sharing can result in large catastrophic expenses. Therefore, there is a need for reassessing the Jamkesda benefit package in order that the financial protec- tion of household can be achieved.Latar Belakang: Program Jaminan Kesehatan Daerah (Jam- kesda) Kota Yogyakarta diselenggarakan oleh Unit Pelaksana Teknis Penyelenggara Jaminan Kesehatan Daerah (UPT PJKD) dengan sumber dana berasal dari APBD Kota Yogyakarta. Aturan tentang kepesertaan, benefit dan besarannya terdapat dalam Peraturan Walikota. Belum ada penelitian yang kompre- hensif tentang manfaat dan kesulitan yang dirasakan masya- rakat dalam menggunakan Jamkesda Kota Yogyakarta maka penelitian ini bertujuan untuk mengetahui hal tersebut. Metode: Penelitian ini adalah penelitian observasional dengan metode kuantitatif dan kualitatif. Responden kuantitatif (n=154) dipilih secara accidental ketika pasien sedang berobat di dua rumah sakit di Yogyakarta dan didasarkan pada rekapitulasi klaim pada bulan sebelumnya. Responden kualitatif (n=10) dipilih dengan purposive sampling yaitu pasien dengan penyakit kro- nis dan yang mempunyai klaim sangat tinggi. Pengumpulan data menggunakan kuesioner dan pedoman wawancara men- dalam kepada peserta Jamkesda yang sedang atau telah dira- wat di dua RS tersebut. Hasil: Responden merasakan manfaat Jamkesda walaupun 51,30% merasa keberatan dengan besar cost sharing, se- hingga sebagian responden pada wawancara mendalam me- nyatakan mengutang untuk membayarnya. Sebanyak 61,04% responden menggunakan surat rekomendasi Dinas Sosial Tena- ga Kerja dan Transmigrasi untuk berobat karena tidak memiliki jaminan kesehatan. Kesulitan dalam pengurusan identitas kepe- sertaan hanya dialami oleh 16,23%, sedangkan 78,57% merasa mudah dalam pemanfaatannya. Masyarakat yang merasa kesu- litan pada wawancara mendalam, mencari solusi kepada pe- ngurus RT/RW, anggota DPRD, LSM dan tetangga. Sekitar 78,57% responden tidak memahami batasan pelayanan Jam- kesda dan hanya mengetahui informasi yang berhubungan dengan kepentingan mereka saat itu. Sebanyak 89,61% res- ponden mengetahui bahwa Jamkesda hanya bersifat bantuan. Semua responden pada wawancara mendalam serta 73,38% responden membayar cost sharing lebih dari 10% total klaim dari pengeluaran rumah tangga, hampir semua (99,35% res- ponden) mengalami pengeluaran katastrofik yakni pengeluaran biaya kesehatan lebih dari 40% pengeluaran rumah tangga setelah dikurangi pengeluaran kebutuhan pokok padahal 73,38% masyarakat berpenghasilan di bawah UMR. Kesimpulan: Cost sharing yang besar dapat berakibat pe- ngeluaran katastrofik sehingga perlu dikaji kembali benefit pack- age Jamkesda agar perlindungan terhadap keuangan rumah tangga dapat dicapai.

Evaluasi Program Terpadu Pengendalian Malaria, Pelayanan Ibu Hamil dan Imunisasi di Kabupaten Hulu Sungai Selatan dan Kota Banjarbaru Provinsi Kalimantan Selatan Hanifah Rogayah; Yodi Mahendradhata; Retna Siwi Padmawati
Jurnal Kebijakan Kesehatan Indonesia Vol 4, No 1 (2015)
Publisher : Center for Health Policy and Management

Background: To reduce child and maternal mortality, as well as mortality and morbidity of malaria, an integrated malaria control program along with antenatal care and immunization has been implemented through malaria screening and provision of LLIN to pregnant women and the provision of LLIN to children under five who received full immunization. Objective: The objective of this study is to evaluate integrated malaria control program in Hulu Sungai Selatan District and Banjarbaru City, South of Kalimantan Province by exploring input, process and output of the program. Method: The study uses evaluation formative approach using qualitative method with exploratory qualitative design. Data is collected through in-depth interviews, focus group discussion, checklist of observation and documents related to the integrated program. Data analysis was performed with the reduction and presentation of the data, visualization, conclusions, and verification that describe the input, process and output variabels relevant to integrated malaria control program. Result: The dominant challenges in the input are commodity, funds, as well as the organization of integrated programs. Implementation of the integrated program is not optimal in the form of policies, capacity building, QA, supervision, and recording and reporting. The integrated program did not achieve the intended output in terms of LLIN coverage for children under f ive as well as pregnant women ANC coverage (Trimester I and IV). Conclusion: The implementation of integrated malaria control program in general was relatively weak in terms of input, process and output. Adequate inputs and processes to strengthen the implementation of the integrated program are necessary, so it can be one of the exit strategies for malaria control in pregnant women and children under five. Latar Belakang: Dalam upaya menurunkan angka kematian ibu dan anak serta angka kesakitan dan kematian akibat malaria, telah dilaksanakan program terpadu pengendalian malaria, pelayanan ibu hamil dan imunisasi melalui skrining malaria dan pemberian kelambu berinsektisida pada ibu hamil serta pemberian kelambu pada balita yang mendapat imunisasi lengkap.Tujuan: Penelitian ini bertujuan untuk mengevaluasi program terpadu di Kabupaten Hulu Sungai Selatan dan Kota Banjarbaru Provinsi Kalimantan Selatan dengan mengeksplorasi input, proses dan output program. Metode: Penelitian ini merupakan penelitian evaluasi formatif, dengan metode kualitatif dan desain penelitian kualitatif eksploratif. Pengumpulan data dengan wawancara mendalam, diskusi kelompok terarah serta observasi dan checklist dokumentasi. Hasil: Tantangan yang paling besar dan dominan pada input adalah komoditi, dana, serta organisasi program terpadu. Belum optimalnya pelaksanaan proses program terpadu berupa kebijakan, capacity building, QA , supervisi, serta pencatatan dan pelaporan. Tidak tercapainya output program terpadu yaitu cakupan kelambu pada balita dan cakupan kunjungan ANC ibu hamil (K1 atau K4). Kesimpulan: Program terpadu pengendalian malaria, pelayanan kesehatan ibu hamil dan imunisasi belum optimal pada komponen input, proses dan output. Adekuatnya input dan proses dapat memperkuat pelaksanaan program terpadu, sehingga dapat menjadi salah satu exit strategi pengendalian malaria pada ibu hamil dan balita.

Peran Stakeholder Kunci dalam Kebijakan Penanggulangan dan Pencegahan HIV/AIDS Studi Kasus di Kabupaten Sorong Provinsi Papua Barat Mitsel Mitsel; Yodi Mahendradhata; Retna Siwi Padmawati
Jurnal Kebijakan Kesehatan Indonesia Vol 4, No 2 (2015)
Publisher : Center for Health Policy and Management

Background.: The problem of HIV in Indonesia today has become a major problem not only in health but also has led to problems of social, culture, economic and politic. Cases of HIV in Sorong District in 2007 reached 16 cases, but on 1 July 2014 at increased to 1.029 cases. Data from Sorong KPAD showed a huge increase in the periode of 7 years. Increase in the number of cases should be a considered serious concern by the local goverment in make commitments and allocating budgets particularly in reduction and prevention of HIV in Sorong. Objective: To determine the role of key stakeholders in the policy of reduction and prevention of HIV in District of Sorong, West Papua. Method: This is a qualitative research with case study de- sign. Case study approach is used for the purpose of techni- cal research, in principle is to answer “why there is no spe- cific policy of the local goverment in the response to HIV pre- vention and how the role of the key stakeholders in the reduc- tion and HIV prevention policy in health district of Sorong.This research is carried out in District Sorong, West Papua. The subjects of this study were BAPPEDA, DPRD,Sub-Dinas PP&PL, Health Office of Distrist Sorong and KPAD as the key stakeholders in policy making at the local level. Result : The result showed that the advocacy of the key stakeholders in prevention and reduction of HIV/AIDS by KPAD and Health Department has not gone well, which there are no reports to the key stakeholders as an policy makers, resulting in weak support for the allocation of funds in prevention and reduction of HIV /AIDS in Sorong District, West Papua. Until now there is no local regulation on HIV/AIDS. Conclusion. Advocacy of the key stakeholder in this regard KPAD and Health district of Sorong should be more active as a key policymakers to both the executive (BAPPEDA) and legis- lative (DPRD) so that the response to HIV/AIDS in Distrist Sorong can run optimally. Latar Belakang : Permasalahan HIV/AIDS pada saat ini telah menjadi masalah besar di Indonesia. Peningkatan Kasus HIV/ AIDS di Kabupaten Sorong mencapai 16 kasus tahun 2007 namun meningkat menjadi 1.029 per Juli tahun 2014. Data dari KPAD Kabupaten Sorong ini menunjukkan peningkatan yang sangat besar dalam periode 7 tahun terakhir. Peningkatan jumlah kasus ini merupakan masalah yang seharusnya menjadi perhatian serius oleh Pemda Kabupaten Sorong dalam membuat komitmen dan mengalokasikan anggaran dari APBD secara khusus dalam Kebijkan Penanggulangan dan Pencegahan HIV/ AIDS. Tujuan Penelitian : Untuk mengetahui peran Stakeholder Kunci dalam kebijakan penanggulangan dan pencegahan HIV/AIDS di Kabupaten Sorong Provinsi Papua Barat. Metode Penelitian : Jenis penelitian adalah penelitian kulaitatif dengan rancangan studi kasus. Pendekatan studi kasus digunakan karena tujuan penelitian ini pada prinsipnya adalah untuk menjawab mengapa (why) belum ada kebijakan secara khusus dalam kebijakan Pemerintah Kabupaten Sorong dalam upaya Penanggulangan dan Pencegahan HIV/AIDS dan bagaimana (how) Peran advokasi Stakeholder Kunci dalam Kebijakan Penanggulangan dan Pencegahan HIV/AIDS di Kabupaten Sorong. Penelitian dilakukan di Kabupaten Sorong Provinsi Papua Barat, subyek penelitian ini adalah BAPPEDA, DPRD, Subdin P2&PL Dinas Kesehatan, dan KPAD sebagai Stakeholder Kunci dalam membuat kebijakan di tingkat daerah Kabupaten Sorong. Hasil . Hasil penelitian menunjukkan bahwa advokasi dari stakeholder kunci dalam penanggulangan dan pencegahan HIV/AIDS oleh KPAD dan Dinas Kesahatan belum berjalan dengan baik, belum ada laporan ke stakeholder kunci pembuat kebijakan, membuat lemahnya dukungan alokasi dana dalam upaya pencegahan dan penangulangan HIV/AIDS di Kabupaten Sorong. Sampai saat ini belum ada Perda HIV/AIDS. Kesimpulan dan saran. Advokasi dari stakeholder kunci yaitu KPAD dan Dinas Kesahatan harus lebih giat dilakukan terhadap stakeholder kunci yang membuat kebijakan baik kepada eksekutif (BAPPEDA) maupun legislatif (DPRD) agar upaya penanggulangn dan pencegahan HIV/AIDS di kabuapen Sorong bisa berjalan dengan maksimal,

Kebijakan Pembakaran Limbah Medis Padat dengan Insenerator di RSUD Dr. H. Moch. Ansari Saleh Banjarmasin Rusdiana HM; Hari Kusnanto; Retna Siwi Padmawati
Jurnal Kebijakan Kesehatan Indonesia Vol 3, No 1 (2014)
Publisher : Center for Health Policy and Management

Background: Hospital activities produce waste that can be the medium of transmission of diseases and environmental pollution. The waste should be destroyed. RSUD Dr. H. Moch. Saleh Ansari Banjarmasin have solid medical waste destruction policy use incinerator. Many things qualify for solid medical waste management is good and does not cause adverse effects to workers, patients, the public and environment. Objective: To determine how the use of an incinerator, waste management procedures, the efforts made to minimize the risk arising from operational incinerator at RSUD Dr. H. Moch. Saleh Ansari Banjarmasin. Methods: This study is a qualitative using case study design. Result: RSUD Dr. H. Moch. Saleh Ansari Banjarmasin established the policy implementation as refers to the government regulations. Although the separation of medical and non-medical wastes has been done, but building an incinerator close to several building. This can cause negative effects, especially for staff working close to incinerator building. Ash disposal using open dumping system. Separation of medical and non medical waste has been done. Transportation using special trolley. Transporting and burning activities are recorded and reported. Utilization of solid medical waste is carried out by former utilization infusion bottles. Officer of the incinerator only one person, sometimes not fuel available, the capacity of the incinerator and sometimes less damage. Disturbance of operational incinerator fumes and odors, especially in the mental ward. Conclusion: Some things should be included in the planning of the hospital incinerator repositioning away from the room, routine monitoring and inspection of the quality of incinerator ash and gas, manufacturing waste incinerator ash landfills are safe and supervision is supported by the decisive and obvious regulations. Latar Belakang: Kegiatan rumah sakit menghasilkan berbagai limbah yang dapat menjadi media penularan penyakit dan sumber pencemaran lingkungan. Limbah tersebut harus dimusnahkan, salah satu caranya adalah dengan insenerator. RSUD. Dr. H. Moch. Ansari Saleh Banjarmasin menetapkan kebijakan pemusnahan limbah medis padat melalui pembakaran dengan insenerator. Banyak hal dipersyaratakan untuk pengelolaan limbah medis padat yang baik sehingga tidak menimbulkan dampak buruk bagi petugas, pasien, masyarakat dan lingkungan. Tujuan: Mengetahui bagaimana pemanfaatan insenerator, prosedur pengelolaan limbah, dampak serta upaya yang dilakukan untuk memperkecil resiko yang ditimbulkan dari operasional insenerator di RSUD. Dr. H. Moch. Ansari Saleh Banjarmasin. Metode: Merupakan penelitian kualitatif dengan rancangan studi kasus. Hasil: RSUD Dr. H. Moch. Saleh Ansari Banjarmasin menetapkan kebijakan pelaksanaan pengelolaan limbah yang mengacu kepa- da peraturan pemerintah. Walaupun pemisahan limbah medis dan non medis telah dilakukan, tetapi bangunan insenerator berdekatan dengan beberapa ruangan. Hal ini dapat menimbul- kan dampak buruk terutama bagi petugas yang bekerja dekat dengan bangunan insenerator apalagi pembuangan abu hasil pembakaran menggunakan sistem open dumping. Pengang- kutan menggunakan troli khusus, kegiatan pengangkutan dan pembakaran dicatat dan dilaporkan. Pemanfaatan limbah medis padat yang dilakukan adalah dengan memanfaatkan bekas botol infus. Kendala dalam pengelolaan limbah adalah jumlah operator insenerator hanya satu orang, bahan bakar kadang tidak tersedia serta kondisi insenerator yang mempunyai kapa- sitas pembakaran kurang dan kadang mengalami kerusakan. Gangguan yang ditimbulkan dari operasional insenerator berupa asap dan bau terutama di ruang perawatan jiwa Kesimpulan : Beberapa hal sebaiknya dimasukkan dalam perencanaan rumah sakit yaitu penempatkan insenerator yang jauh dari ruangan, pemantauan dan pemeriksaan rutin kualitas abu dan gas buangan insenerator, pembuatan tempat pembuangan abu yang aman serta pengawasan yang di dukung dengan peraturan pengelolaan limbah medis padat yang tegas dan jelas.

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