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All Journal Media Penelitian dan Pengembangan Kesehatan BULETIN PENELITIAN SISTEM KESEHATAN
Rukmini Rukmini
Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan
Decision Sciences, Operations Research & Management Environmental Science Health Professions Mechanical Engineering Public Health

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Strategi Intervensi Program dan Pemanfaatan Potensi Lokal dalam Upaya Peningkatan Cakupan ASI Eksklusif di Kabupaten Balangan Rukmini Rukmini; Eka Fatmawati; Yuli Trisnanto; Yunita Fitrianti
Media Penelitian dan Pengembangan Kesehatan Vol 30 No 3 (2020)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/mpk.v30i3.2743

Abstract

Abstract Exclusive breastfeeding is the initial stage in nutritional intake for children. Problems that occur because the pattern of breastfeeding is not in accordance with the concept of exclusive breastfeeding, such as providing complementary foods with breast milk (MP-ASI) earlier. This paper is a policy article, based on the results of qualitative research with a health ethnographic approach, to determine the factors that influence the low coverage of exclusive breastfeeding. The research was conducted in Mauya Village (ethnic Banjar) and Marajai Village (ethnic Dayak Meratus), Balangan District, South Kalimantan. The main informants are mothers who have babies 0-6 months (16 people), while the informants who support village midwives (2 people), traditional / community leaders (2 people) and health workers (2 people). Data collection by participant observation, in-depth interviews and unstructured interviews, audio-visual documentation and secondary data search in facilities and health workers. The results show that the practice of exclusive breastfeeding in Mauya Village and Marajai Village, Balangan Regency is still low influenced by several factors, namely aspects of maternal and infant health, availability of health care workers and facilities, social, economic, cultural, geographic conditions, access to information media. It can be concluded that there are 3 main factors, namely predisposing, enabling, and driving factors that are interrelated in the practice of exclusive breastfeeding. This article recommends that program intervention efforts to overcome the problem of exclusive breastfeeding,it is necessary to carry out comprehensive and integrated intervension both in improving the quality of health service programs, community empowerment and cross-sector cooperation and utilization of local cultural potentials. Abstrak Pemberian air susu ibu (ASI) eksklusif merupakan tahap awal dalam asupan gizi bagi anak. Permasalahan yang terjadi karena pola pemberian ASI yang tidak sesuai dengan konsep ASI eksklusif, seperti memberikan Makanan Pendamping Air Susu ibu (MP-ASI) lebih dini. Tulisan ini merupakan artikel kebijakan berdasarkan hasil penelitian kualitatif dengan pendekatan etnografi kesehatan, untuk mengetahui faktor-faktor yang memengaruhi rendahnya cakupan ASI eksklusif. Penelitian dilakukan di Desa Mauya (etnik Banjar) dan Desa Marajai (dominasi etnik Dayak Meratus), Kabupaten Balangan Kalimantan Selatan. Informan utama adalah ibu yang memiliki bayi 0-6 bulan (16 orang),sedangkan informan pendukung bidan kampung (2 orang), tokoh adat/tokoh masyarakat (2 orang) dan petugas kesehatan (2 orang). Pengumpulan data dengan participant observation, wawancara mendalam dan wawancara tidak terstrukur, dokumentasi audio visual, dan penelusuran data sekunder di fasilitas dan petugas kesehatan. Hasil menunjukkan praktik ASI eksklusif di Desa Mauya dan Desa Marajai Kabupaten Balangan masih rendah dipengaruhi beberapa faktor yaitu aspek kesehatan ibu dan bayi, ketersediaan petugas dan fasilitas pelayanan kesehatan, faktor sosial, ekonomi, budaya, kondisi geografis, akses media informasi. Dapat disimpulkan ada tiga faktor utama yakni faktor predisposisi, pemungkin, dan pendorong yang saling terkait dalam praktik ASI eksklusif. Artikel ini merekomendasikan upaya intervensi program untuk mengatasi permasalahan ASI eksklusif dilakukan secara menyeluruh, komprehensif dan terintegrasi baik pada peningkatan kualitas program pelayanan kesehatan, pemberdayaan masyarakat dan kerjasama lintas sektor serta pemanfaatan potensi budaya lokal.
Analisis Implementasi Kebijakan Program Pengendalian Resistensi Antimikroba (PPRA) Rukmini Rukmini; Selma Siahaan; Ida Diana Sari
Buletin Penelitian Sistem Kesehatan Vol 22 No 2 (2019): Buletin Penelitian Sistem Kesehatan
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (204.875 KB) | DOI: 10.22435/hsr.v22i2.1038

Abstract

Antimicrobial resistance has become a problem in Indonesia. The Ministry of Health has established a policy ofAntimicrobial Resistance (AMR) Control Program in hospitals to resolve the issue. A qualitative case study was conducted at Dr. RSUP Wahidin Sudirohusodo hospital, Makassar in 2018 to analyze the implementation of AMR control program. The data were collected through in-depth interviews and analyzed descriptively. The study showed that policy AMR control program has not be carefully implemented. The function of AMR control program team is to make policies and guidelines for antibiotic use, to make surveillance of germ patterns and antibiotic sensitivity, clinical audits of antibiotic use, to conduct studies/research and to make evaluation that is reported to the Hospital Director. However, this AMR control program has not been optimally implemented due to many challenges such as lack of budget, lack of commitment and internal coordination between the AMR control program team members. Implementation of AMR control program in this hosptal management is not optimal. The Program dissemination and AMR team activities were not evenly distributed. High workload, inadequate infrastructure and antibiotic resistance issues of the referred patients. As a conclusion AMRcontrol program policy in RSUP. Wahidin Sudirohusodo, Makassar, has not been properly disseminated and implemented. Coordination, dissemination and discussion forums on PPRA policies internally and externally with cross-sectoral hospitals are needed to improve antimicrobial resistance control commitment.
Inovasi Program Pelayanan Kesehatan Tradisional pada Lansia di Puskesmas Made Kota Surabaya Rukmini Rukmini; Oktarina Oktarina
Buletin Penelitian Sistem Kesehatan Vol 23 No 2 (2020): Buletin Penelitian Sistem Kesehatan
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsr.v23i2.3101

Abstract

Traditional health services (Yankestrad) are part of the health care subsystem in the National Health System, aiming to change the curative treatment paradigm to be promotive and preventive. The study was conducted in 2019, collecting data through in-depth interviews with the Head of Puskesmas and FGD with related cross sectors. The implementation of traditional health services at the Surabaya Made Health Center had been in line with central and regional policies and regulations. The types of complementary traditional health services provided are acupuncture, acupressure, baby massage, and herbal medicine. Most cases of traditional health services for the elderly are relaxation, for non-communicable diseases, stroke, diabetes mellitus, hypertension, and obesity. Yankestrad’s innovation in building with the integration of internal referrals from other polyclinics such as general poly, wound care poly, dental poly, and nutrition poly to yankestrad poly. Innovation outside the building in the form of fostering independent Toga care and acupressure integration with the independent care group (Asman) Acupressure Toga and Elderly Posyandu. Conclusion Yankestrad at the Puskesmas is very potential as an alternative health service for the elderly. This study recommends improving coordination across programs and sectors so that traditional health services can work well and support other programs’ achievement, especially non-communicable diseases and the elderly program. Abstrak Pelayanan kesehatan tradisional (Yankestrad) merupakan bagian subsistem upaya kesehatan dalam Sistem Kesehatan Nasional, bertujuan untuk merubah paradigma pengobatan kuratif menjadi promotif dan preventif. Tulisan ini bertujuan mengkaji inovasi program pelayanan kesehatan tradisional pada lansia di Puskesmas Made Kota Surabaya. Studi dilakukan tahun 2019, pengumpulan data melalui wawancara mendalam kepada Kepala Puskesmas dan FGD dengan lintas sektor terkait. Pelaksanaan pelayanan kesehatan tradisional di Puskesmas Made Kota Surabaya telah sesuai dengan kebijakan dan regulasi pusat dan daerah. Jenis pelayanan kesehatan tradisional komplementer yang diselenggarakan adalah akupunktur, akupressure, pijat bayi dan herbal medik. Kasus terbanyak pelayanan kesehatan tradisional untuk lansia adalah relaksasi, untuk penyakit tidak menular stroke,diabetes mellitus,hipertensi,dan obesitas. Inovasi Yankestrad dalam gedung dengan integrasi rujukan internal dari poliklinik lainnya seperti Poli umum, Poli rawat luka, Poli Gigi dan Poli Gizi ke Poli Yankestrad. Inovasi luar gedung berupa pembinaan asuhan mandiri Toga dan akupressure integrasi dengan kelompok asuhan mandiri (Asman) Toga akupressure dan Posyandu lansia. Kesimpulan Yankestrad di Puskesmas sangat berpotensi sebagai salah satu alternatif pelayanan kesehatan pada lansia. Disarankan untuk meningkatkan koordinasi lintas program dan lintas sektor agar pelayanan kesehatan tradisional dapat berjalan baik dan dapat mendukung pencapaian program lain, terutama program penyakit tidak menular dan lansia.
Gambaran Pemanfaatan Pelayanan Kesehatan Tradisional pada Penduduk Lanjut Usia di Indonesia Rukmini Rukmini; Lusi Kristiani
Buletin Penelitian Sistem Kesehatan Vol 24 No 1 (2021): Buletin Penelitian Sistem Kesehatan
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsr.v24i1.3843

Abstract

One of the health efforts that have the opportunity to improve the health status of the elderly is traditional health services (Yankestrad). This paper aims to describe the use of Yankestrad among the elderly in Indonesia. The data source in this analysis is Riskesdas 2018, a research conducted by the Ministry of Health with the elderly (≥60 years) as the analysis unit. Data were analyzed descriptively. The results showed that the use of Yankestrad in the elderly was 37.0% and self-medication with traditional medicine was 17.3%. Young elderly people mostly use Yankestrad (37.9%), while self-medication with traditional medicine are dominated by elderly women (18.3%) in rural areas (19.5%). The use of Toga in the elderly in Indonesia (31.9%), mostly women (33.3%) in rural areas (36.3%). The most common types of Yankestrad used by the elderly were manual skills, potions, and homemade potions. Male elderly (55.5%) in urban areas (56.5%) used more prepared ingredients, while female elderly (43.6%) in rural areas (46.5%) preferred homemade ingredients. Older people with low expenditure levels tend to take advantage of prepared ingredients or homemade ingredients, while high expenditures tend to take advantage of manual skills. Traditional healers (98.2%) are the type of yakestrad used mostly by the elderly. In conclusion, Yankestrad in Indonesia is mostly used by the elderly, therefore it has the potential to be developed as an alternative model of health services for the elderly. Given the high interest of the elderly with Yankestrad and the use of traditional healers, it is necessary to provide Yankestrad facilities, especially in Puskesmas with traditional health workers who are able to provide safe and quality health services to the elderly. Abstrak Salah satu upaya kesehatan yang berpeluang meningkatkan status kesehatan lansia adalah pelayanan kesehatan tradisional (Yankestrad). Tulisan ini bertujuan untuk mengetahui gambaran pemanfaatan Yankestrad pada penduduk lansia di Indonesia. Sumber data dalam analisis ini adalah Riskesdas 2018. Riset yang dilakukan oleh Kementerian Kesehatan dengan unit analisis lansia (≥60 tahun). Analisis data secara deskriptif. Hasil menunjukkan, pemanfaatan Yankestrad pada lansia 37,0% dan upaya sendiri dengan obat tradisional 17,3%. Lansia muda terbanyak memanfaatkan Yankestrad (37,9%), sedangkan upaya sendiri dengan obat tradisonal didominasi lansia perempuan (18,3%) di perdesaan (19,5%). Pemanfaatan Toga pada lansia di Indonesia (31,9%), terbanyak perempuan (33,3%) di perdesaan (36,3%). Jenis Yankestrad terbanyak dimanfaatkan lansia adalah keterampilan manual, ramuan jadi dan ramuan buatan sendiri. Lansia laki-laki (55,5%) di perkotaan (56,5%) lebih banyak memanfaatkan ramuan jadi, sedangkan lansia perempuan (43,6%) di perdesaan (46,5%) lebih menyukai ramuan buatan sendiri. Lansia dengan tingkat pengeluaran rendah cenderung memanfaatkan ramuan jadi atau ramuan buatan sendiri, sedangkan pengeluaran tinggi cenderung memanfaatkan ketrampilan manual. Penyehat tradisional (98,2%) adalah jenis tenaga terbanyak dimanfaatkan lansia. Kesimpulan, Yankestrad di Indonesia lebih banyak dimanfaatkan oleh lansia, oleh karena itu berpotensi untuk dikembangkan sebagai alternatif model pelayanan kesehatan bagi lansia. Rekomendasi, mengingat tingginya minat para lansia dengan Yankestrad dan pemanfaatan penyehat tradisional, maka diperlukan penyediaan fasilitas Yankestrad khususnya di Puskesmas dengan tenaga kesehatan tradisional yang mampu memberikan pelayanan kesehatan yang aman dan berkualitas bagi para lansia.
Co-Authors Eka Fatmawati Ida Diana Sari Lusi Kristiani Oktarina Oktarina Selma Siahaan Yuli Trisnanto Yunita Fitrianti