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All Journal BULETIN PENELITIAN SISTEM KESEHATAN
Selma Siahaan
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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Dinamika Jender terhadap Akses Pelayanan Kesehatan Maternal Sembilan Etnis di Indonesia Isfandari Siti; Selma Siahaan; Grace Wanggae; Ratna Widyasari; Aan Kurniawan; Ni Ketut Aryastami; Niniek Lely Pratiwi
Buletin Penelitian Sistem Kesehatan Vol 22 No 1 (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 (249.916 KB) | DOI: 10.22435/hsr.v22i1.652

Abstract

This is a review of maternal mortality risk due to preference of non skilled health worker delivery assistance among 9 ethnics applying gender analysis. Data obtained from 9 ethnograpic studies reports conducted by Pusat Humaniora. Estimation of maternal mortality rate (MMR) in Indonesia is between 305 (Supas) – 359 (Susenas) per 100.000 live birth. There is no single cause of maternal death. The greatest contributors 75% are due to direct cause namely bleeding, infection, hypertension, delivery complication and unsafe abortion. Government intervention prioritizes to prevent direct cause of maternal death through health service delivery improvement. Among them are midwives in village, PONEK, PONED. However MMR is still high. Social factors as Indirect causes such as poverty, distance, information, inadequate service and culture have not yet considered as important. In fact contribution of social factors cannot be neglected. This review explores gender dynamics of preferences on non skilled health worker delivery assistance from 9 ethnic in Sumatra, Jawa and NTT. The results showed each ethinc had different gender dynamics. Among which are gender relation in each culture. Some ethnic shows gender equity, while others believe woman have full responsibility of her pregnancy and delivery without assistance from others. Powerlessness of woman is indicated by preference of traditional birth attendant for delivery due to culture and comfort. Even the pregnant women herself did not aware that delivery is a life risk. However the studies showed there is no sharp inequity with strong preference to boy over girl. Accessibility, education, comfort perceived culture, and economy are important for delivery assisted by health providers.
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.
Co-Authors Aan Kurniawan Grace Wanggae Ida Diana Sari Isfandari Siti Ni Ketut Aryastami Niniek Lely Pratiwi Ratna Widyasari Rukmini Rukmini