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RESPONS TINDAK LANJUT REKOMENDASI AUDIT MATERNAL DI KABUPATEN BREBES DAN KABUPATEN BANYUMAS Dessyana Iriani; Eugenius Phyowai Ganap; Dwi Handono Sulistyo
Journal of Health Service Management Vol 24 No 02 (2021)
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

Background: The number of cases of maternal deaths in several districts is still high and has increased as in Brebes and Banyumas districts. The Maternal Perinatal Audit Policy in the District / City as an effort to reduce the number of maternal deaths is felt to be unsuccessful. In addition, the extent to which policy makers and implementers respond to or follow up on the results of maternal audit recommendations is still a big question. Objective: To explore the responses and factors that influence the implementation of follow-up maternal audits recommendations in Brebes and Banyumas Districts. Methods: This study used a qualitative design with a case study research design. Data collection techniques through document review, in-depth interviews and focus group discussions with a total of 14 informants. Results: The immediate response to the follow-up to the maternal audit in Brebes Regency was adequate and in Banyumas District good. Planned responses in both districts were not analyzed in this study because terms of reference for activities is not reviewed. Based on the characteristics of the problems the Brebes Regency is difficult to control because there are still many problems in the field and Banyumas Regency is easy to control. Based on the Policy Characteristics of the two districts included in the good category and based on the environment the Brebes Regency has not supported and the Banyumas Regency environment supports the implementation of the follow-up to the maternal audit recommendations. Conclusion: The response of the regencies is very dependent on leadership to make decisions immediately. The immediate response to the follow-up of the maternal audit in Brebes Regency was sufficient and in Banyumas District was good. It is recommended that the District Health Offices need to make a follow-up SOP on recommendations to the implementation of monitoring and evaluation by adding a reward and punishment system and Brebes Regency should accelerate the process of adding PONEK Hospitals and pay more attention to the principles of response in MDSR.

IMPLEMENTASI PERMENKES NOMOR 43 TAHUN 2016 TENTANG STANDAR PELAYANAN MINIMAL (SPM) BIDANG KESEHATAN DI DINAS KESEHATAN KABUPATEN SUMBAWA BARAT Firdaini Armita; Laksono Trisnantoro; Dwi Handono Sulistyo
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

Background: Ministry of Health has issued Regulation the Minister of Health No. 43 of 2016 about Minimum Service Standards (SPM) Health Sector. This SPM contains 12 types of basic services which targeting 100% by the District / City Government. According to SPM report District West Sumbawa at 2017, they must more focused in three achievements indicator, among them mental disorders (ODGJ) weight (129.92%), pregnancy care (83.02%) and Tuberculosis care (TB) (28.26%). District West Sumbawa has not declared regulation about the implementation SPM in health sector become Regent Regulation because of constraints in determining indicator objectives. Objective: To describe the acceptance Health District in implemen tation Permenkes No. 43 of 2016 about SPM in West Sumbawa Regency. Methods: This research was qualitative research with descriptive research and using implementation research. Collecting data by in-depth interviews and document review. Results: The acceptance Health District West Sumbawa in implementation Permenkes No. 43 of 2016 to three SPM indicators, resulted that: (1) has accepted in affective attitude component; (2) has not accepted in burden components; (3) only TB indicator has accepted in ethicality component; (4) only TB indicator has not accepted in intervention coherence; (5) only ODGJ indicators has accepted in opportunity costs component; (6) has accepted in perceived effectiveness component; (7) has accepted in self-efficacy component. Conclusion: Factors inhibiting acceptance implementation Permenkes No. 43 of 2016 in burden component were unavailability of regional regulation regarding SPM and dominant budgeting from APBN. Then in ethicality component there was an incompatibility between ODGJ and pregnancy indicator with local government performance indicator. Lack of training in TB care became a factor inhibition in intervention coherence. Then in opportunity costs component, there was inadequate innovation of pregnancy and TB indicator. We need attention from various sectors to improve SPM policy implementation.

KINERJA TIM KENDALI MUTU KENDALI BIAYA CABANG SURAKARTA DALAM PENGENDALIAN MUTU DAN BIAYA PADA PROGRAM JAMINAN KESEHATAN NASIONAL Sholahuddin Sanjaya; Dwi Handono Sulistyo; Julita Hendrartini
Journal of Health Service Management Vol 22 No 1 (2019)
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

Background: Indonesia in 2014 implemented the National Health Insurance (JKN) program. The implementation of the comparison between contribution and health insurance expenditure in the Surakarta Branch Office is not optimal. The Coordinating Team in TKMKB plays an important role in JKN quality and cost control. Hence, we need to evaluate the performance with the TKMKB Surakarta Branch coordination team. Objective: To evaluate the performance of TKMKB Surakarta Branch Coordination Team in quality and cost control of JKN program and to identify performance inhibiting factors. Methods: The research was descriptive with case study design using qualitative approach focusing on developing the description and depth analysis about Coordination Team performance on national health insurance program at Surakarta Branch Office. Performance was assessed based on the implementation of the job description. Data were collected using interviews and document review. Results: The utilisation review task was not standardised yet because it was only implemented once and there was no monitoring and follow-up of utilisation review indicators, the discussion of the problem and the evaluation of the policy has not been in accordance with the standards because the recommendation issues have not been in accordance with the issues raised. The socialisation of authority, ethical guidance and professional discipline of health personnel have not been up to standard because they are not conveyed to all members of professional organisations. Factors that hamper performance were limited time, lack of data access, and facilitation. Conclusion: The performance of the Coordination Team on the task of utilisation review has not been optimal yet, the task of discussing the problem and the evaluation of the policy has not been optimal, and in the task of authority socialisation, ethics coaching and health professional discipline has not been optimal. Factors that hinder performance were limited time, lack of data access, and facilitation of TKMKB.

EVALUASI KEBIJAKAN RUMAH TUNGGU KELAHIRAN (RTK) DI KABUPATEN KONAWE PROVINSI SULAWESI TENGGARA TAHUN 2016 Sri Ayu Lestari; Laksono Trisnantoro; Dwi Handono Sulistyo
Journal of Health Service Management Vol 22 No 1 (2019)
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

Background: The high maternal mortality rate (MMR) in Indonesia prompted the government to issue a Jampersal fund policy. One of the objectives of Jampersal fund is to provide budget for operational activities of Maternity Waiting Home (MWH) Program, a government strategy to facilitate access of pregnant mother to get health service to overcome pregnant, childbirth and childbirth problems as an effort to decrease maternal MMR in Indonesia. Objective: To describe the implementation of MWH policy as an effort to facilitate pregnant women, childbirth, and postpartum to get access to health service in Konawe Regency of Southeast Sulawesi Province. Methods: The study was descriptive using qualitative design with case study approach focusing on developing in-depth description and analysis of cases also studying MWH program. Results: MWH Program in Konawe Regency has been running for one year but there was still one Puskesmas that has not run the MWH program because the location of Puskesmas is far from the citizen’s residence. MWH is not only used by pregnant women who are far from the health facility and have a high risk but also used for all pregnant women who will give birth. MWH already meets the criteria set by the Ministry of Health. The operational cost of the waiting house guarantees all the costs of pregnant and family needs during their stay. The obstacles to MWH programs were disbursement of funds, rejection of pregnant women to the waiting house and difficult road access. Conclusion: MWH Program has been effective because it has been used by all pregnant women who have risk and who will give birth are placed in the waiting house of birth. The barriers that exist during the MWH program runs were disbursement of funds, the rejection of pregnant women into waiting homes and difficult road access.

PEMANFAATAN PROGRAM JAMINAN KESEHATAN NASIONAL DI PUSKESMAS DAERAH TERPENCIL KABUPATEN SUMBA TIMUR Damaris Pura Tanya; Julita Hendrartini; Dwi Handono Sulistyo
Journal of Health Service Management Vol 22 No 2 (2019)
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

Background: National Health Insurance has been performed since The implementation aims of performing National Health Insurance to facilitate access and utilization of health care. Public Health Center (PHC) as the forefront of health care and has major role to facilitate utilization of health care for members of National health Insurance. Nowadays, utilization of National Health Insurance in PHC has not reached national target amounts 15%. Objective: To explore determinant factors on utilization of national health insurance in remote PHC, East Sumba. Methods: The study type is qualitative with case study design. Variable included access of health care, health resources, medical needs and other factors. Amounts 20 informant involved this study. The informant included patient as members of National health Insurance, provider and head of district health office. Collecting data by indepth interview. Data analysis was conducted systematically by transcript, coding and analysis. Results: The higher utilization of national health insurance when traditional market was opened (market day). Limitation on access affected patient prefer to got services in outside. Limitation of health resources such as, unavailability of medicine and always exhausted, no lighting, and unavailability of water so utilization of PHC by patient was low. Most of patient need medical care in PHC such as need injection and unavailability of medicine so patient sought care out of PHC. Cultural factors still retained by society that diseases just be cured by a shaman. The pregnant women giving birth at home was high due to unavailability of waiting home (Rumah Tunggu) and village regulation has not examined about punishment of birth at home. Conclusion: Utilization of nasional health care in PHC remote area is less than optimal. It is not supported by adequate transportation facilities, the availability of drugs, and cultural changes.

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