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Journal of Health Policy and Management
Published by Universitas Sebelas Maret
ISSN : -     EISSN : 25490281     DOI : -
Core Subject : Health,
Medicine & Pharmacology Public Health
Journal of Health Policy and Management (JHPM) is an electronic, open-access, double-blind and peer-reviewed international multidisciplinary and integrative journal, focusing on health policy, health system, and healthcare management. It began its publication on October 21, 2015. The journal is published twice yearly. It aims to improve the design and implementation of health policies, health systems, and healthcare management, primarily in low- and middle-income countries. JHPM analyzes policy initiatives and healthcare systems and provides evidence-based research to guide policymaking and management decision-making.
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Articles 253 Documents
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Effect of Socio-Demographic Factor and Democratic Leadership on Village Midwife Performance in IUD Contraceptive Service in Jombang District, East Java Ratna Dewi Permatasari; Uki Retno Budihastuti; Didik Tamtomo
Journal of Health Policy and Management Vol. 2 No. 1 (2017)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: The threat of population explosion in Indonesia is real. Long-term contraception program is an alternative strategy for controlling population growth rate. The slowering achieve­ment of IUD contraceptive target for the last two years has become a central concern at the District Health Office Jombang, East Java. Sub-optimal quality of IUD contraceptive service, high drop-out rate, high unmet-need, and unsystematic family planning reporting and recording, are assumed to be the causes of the under-achievement. This study aimed to examine the effect of socio-demographic factor and democratic leadership on village midwife performance in IUD contraceptive service in Jombang District, East Java.Subjects and Method: This was an analytic observational study with cross-sectional design. It was conducted in 12 community health centers in Jombang District, East Java, from March to May 2017. A sample of 120 women of reproductive age was selected for this study by simple random sampling. The dependent variable was village midwife performance. The inde­pen­dent variables were knowledge, self-efficacy, compensation, democratic leadership, and work motivation. The data were collected by a pre-tested questionnaire, and were analyzed by path analysis model.Results: Midwife performance was positively affected by higher education (b=5.19; SE=0.53; p<0.001), stronger work motivation (b=0.48; SE=0.07; p<0.001), better knowledge (b=0.21; SE=0.08; p=0.006), stronger self-efficacy (b=0.18; SE=0.08; p=0.023), and democratic leadership (b=0.14; SE=0.05; p=0.008). Self-efficacy was affected by education (b=1.16; SE=0.62; p=0.063), knowledge (b=0.35; SE=0.08; p<0.001), democratic leadership (b=0.23; SE=0.04; p<0.001). Work motivation was affected by compensation (b=0.65; SE=0.16; p<0.001), democratic leadership (b=0.31; SE=0.07; p<0.001), knowledge (b=0.29; SE=0.09; p<0.001), and self-efficacy (b=0.17; SE=0.09; p=0.058).Conclusion: Midwife performance was positively affected by education, work motivation, education, self efficacy, and democratic leadership.Keywords: midwife performance, socio-demographic factor, democratic leadership, IUD contra-ceptive, family planning.Correspondence: Ratna Dewi Permatasari. Masters Program in Public Heath, Sebelas Maret University, Surakarta. Email: wahib.rifai81@gmail.com. Mobile: +6281334059159.Journal of Health Policy and Management (2017), 2(1): 16-27https://doi.org/10.26911/thejhpm.2017.02.01.02 
Motivation, Competence, Workload, and Their Association with Nurse Performance in Dr. Arif Zaenudin Hospital, Surakarta Tia Martha Pundati; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 3 No. 2 (2018)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Nurses performance remains long standing determinates of quality service rendered for patients admitted to hospitals. Improvements in quality health service can be achieved by improving nurse performance. This study aimed to analyze the relationship of competence, motivation, and workload on the nurse performance in Surakarta.Subjects and Method: This was a cross sectional study conducted at Dr. Arif Zaenudin Mental Hospital, Surakarta, Central Java, from November 24 to December 24, 2017. A sample of 200 study subjects was selected by total sampling. The dependent variable is the nurse's performance, while the independent variables are competence, motivation, workload, employment status, education and the distance between the nurse's residence and the hospital. The dependent and independent variables were measured using a questionnaire. The data analysis was done using path analysis with the STATA 13 program.Results: The performance is influenced by competence (b= 1.08; 95% CI= 0.32 to 1.74; p= 0.005), motivation (b= 0.91; 95% CI= 0.15 to 1.68; p= 0.019), workload (b= 2.65; 95% CI= 1.91 to 3.40, p<0.001), there are 2 variables that have an indirect relationship with the nurse's performance, namely education (b= 0.67; 95% CI= -1.24 to -0.11; p = 0.019) and the distance of residence (b= -0.61; 95% CI= -1.20 to -0.20; p= 0.043).Conclusion: There is a direct relationship between competence, motivation, workload and work period with nurse performance. There is an indirect relationship between education and home distance with performance.Keywords: pathway analysis, competence, motivation, workload, performanceCorrespondence:
Association Between Cigarette Package Warning Messages, Self-Efficacy, and Smoking Behavior among Students at Health Polytechnic in Surakarta, Indonesia Roy Romey Daulas Mangunsong; Bhisma Murti; Mahendra Wijaya
Journal of Health Policy and Management Vol. 1 No. 1 (2016)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Total number of smokers around the worldwide is approximately 140 million. The number of deaths caused by tobacco smoking related diseases is approximately 300,000 per year. Average age to start smoking is 17.6 years. The high number of smokers at young age indicates that public awareness of the dangers of smoking is still very low. This study aimed to determine the association between cigarette package warning messages, self-efficacy, and smoking behavior among students.Subject and Methods: This was an analytical observational study with cross sectional design, carried out in Surakarta, Indonesia. A total of 71 students at Polytechnic of health and sciences were selected by using random sampling technique. The dependent variable was smoking behavior. The independent variables were illustrated the dangers of cigarette smoking advertising and self-efficacy. The data was collected by questionnaire and analyzed by using regression logistic.Results: there is a relationship between an ad illustrated the dangers of cigarette smoking with smoking behavior (OR= 2.87; 95% CI= 0.91 to 9.03; p = 0.071). There is a relationship between the smoking behavior of yourself with the efficacy (OR = 0.23; 95% CI= 0.07 to 0.74; p = 0.013). The ads illustrated the dangers of cigarette smoking and self-efficacy was able to explain the smoking behavior of 16.2% and amounted to 83.8% explained by factors other than the research model.Conclusion: there is a connection between the ads illustrated the dangers of cigarette smoking and the smoking behavior of self-efficacy with the students.Keywords: cigarette package warning messages, self-efficacy, smoking behaviorCorrespondence: Roy Romey Daulas Mangunsong. Department of Speech and Occupational Therapy, Health Polytechnic Surakarta. Email: Surakartaroypoltekstw@gmail.comJournal of Health Policy and Management (2016), 1(1): 44-52https://doi.org/10.26911/thejhpm.2016.01.01.07 
Factors Affecting Quality of Health Service and Patient Satisfaction in Community Health Centers in North Lampung, Sumatera Mulia Yuli Widayati; Didik Tamtomo; Rita Benya Adriani
Journal of Health Policy and Management Vol. 2 No. 2 (2017)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Quality of health service and patient satisfaction are an important element in providing a health service. Assessing and evaluating a health service based on user perceptions are important for continuous improvement of health services. This study aimed to examine the factors affecting the quality of health service and patient satisfaction in community health centers in North Lampung, Sumatera, Indonesia.Subjects and Method: This was an analytic observational study with a cross-sectional design. This study was conducted in 25 community health centers in North Lampung, Sumatera, in January 2017. A total sample of 200 out-patients was selected for this study by simple random sampling and stratified random sampling for community health center. The dependent variables were quality of service and patient satisfaction. The independent variables were education, income, a frequency of visit, and accreditation status of community health center. The contextual effect was measured by accreditation status of community health center. The data were collected by questionnaire and analyzed by linear regression multilevel model.Results: Factors affecting quality of health service were income (b= -1.09, 95% CI= -5.71 to 3.52, p = 0.641), education (b = -11.48, 95% CI= -16.07 to -6.88, p< 0.001), and frequency of visits (b=6.88, 95% CI= 2.53 to 11.23, p=0.002). Intraclass correlation= 6%. Factors affecting patient satisfaction were income (b= -1.07, 95% CI= -1.58 to -0.56, p<0.001), education (b= -0.77, 95% CI= -1.31 to -0.23, p=0.005), frequency of visits (b= 0.88, 95% CI= 0.39 to 1.38, p<0.001), and quality of service (b=0.04, 95% CI= 0.02 to 0.06, p<0.001). Intraclass corelation= 13.79% indicating considerable contextual effect of accreditation status of community health center.Conclusion: Quality of service is affected by income, education, and frequency of visits in community health center. Patient satisfaction is affected by income, education, a frequency of visits, and quality of service. Accreditation status of community health center has a considerable contextual effect on patient satisfaction.Keywords: quality of service, patient satisfaction, accreditation status, community health center, multilevel analysisCorrespondence: Mulia Yuli Widayati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A Surakarta. Email: muliayuli@yahoo.co.idJournal of Health Policy and Management (2017), 2(2): 165-175https://doi.org/10.26911/thejhpm.2017.02.02.08 
Patient Characteristics, Financing Type, Accreditation Status, and Quality of Health Services at Community Health Center, Surakarta Yeni Tri Utami; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 2 No. 1 (2017)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: An indicator of quality health service is the extent of patient expectation fulfilment. Perceived quality of health services may be influenced by various factors such as patient socio-demographic factors, financing type, and accreditation status. As statistics have shown, the number of patient visits at Surakarta Community Health Center has been decresing for the last few years. This study aimed to determine the associations between patient characteristics, financing type, accreditation status, and the quality of  health services at community health center.Subjects and Method: This was a quantitative study with cross-sectional design. It was conducted at Community Health Center, Surakarta, Central Java, from May to July 2017. A sample of 120 patients were selected for this study from 2 Community Health Centers selected at random from all 17 Community Health Centers existing in Surakarta. The independent variables were patient characteristics, financing type, and accreditation status of the Community Health Centers selected. The dependent variable was quality of health service. The data were collected using a set of questionnaire and  analyzed using multiple logistic regression.Results: Quality of service was negatively associated with patient education (OR = 0.27 ; 95% CI = 0.08 to 0.90; p = 0.033), being employed (OR = 0.15 ; 95% CI= 0.04 to 0.48; p = 0.002), higher patient income (OR = 0.28 ; 95% CI= 0.08 to 0.94; p = 0.039), being insured (OR = 3.06 ; 95% CI= 0.81 to 11.52; p = 0.099), and higher accreditation status of Community Health Care (OR = 2.96 ; 95% CI= 1.03-8.50; p = 0.044).Conclusion: Quality of service at Community Health Care is negatively associated with patient education, being employed, higher patient income, being insured, and higher accreditation status.Keywords: patient characteristic, financing type, accreditation status, quality of servicesCorrespondence: Yeni Tri Utami. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: yenie_03@yahoo.co.id. Mobile: +6285642339053.Journal of Health Policy and Management (2017), 2(1): 79-90https://doi.org/10.26911/thejhpm.2017.02.01.07 
Health System Strengthening: Adopting WHO Building Blocks- Comparison between India and Indonesia Shikha Gill
Journal of Health Policy and Management Vol. 3 No. 2 (2018)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: The objective of this review was to review and compare between Indian and Indonesian health systems. It attempted to understand the health system strengthening activities adopted by both the countries.Subjects and Method: This was a systematic review using qualitative method. The internet-based search strategy extended the traditional approach of using biblio­graphic data­bases, journals, citations to include grey literature, abstracts, web­sites, reports and documents from WHO, World Bank, Ministry of Health Indonesia, and Ministry of Health and Family Welfare India.Results: The concept of designating house­hold meeting requisite health standards as a healthy home is something which can be successfully implemented in India as social recognition plays a vital part in encouraging people to move towards healthier lifestyles. India is in the process of upgrading 150,000 Sub Centres into health and wellness centers. Compre­hensive health care will be provided in these centers, including for mother and child health and noninfectious diseases. Essential drugs and diagnostic services will be provided free of cost at these centers. Another notable feature from India is the concept of ASHA which is an acronym and stands for Accredited Social Health Activist. ASHAs are locally selected and trained women who performed the duties of health promoters and educators in communities. The ASHA is trained to work as an intermediary between the public health system and the community. Medical Insurance coverage for Primary Care and the concept of VVIP Rooms at differential pricing is some­thing which can be tried in Indian context while, the latest  Government funded medical insurance for Secondary and Tertiary care and Strategic purchase from Private sector is something Indonesia can emulate. For tackling the rural health care problems : schemes like National Rural Health Mission (NRHM) and mandatory service in rural areas by doctors if they want government job can be looked at by Indonesian Health care professionals. The concept of Posyandu (Maternity Hut) and the registered midwife clinics is a unique concept which can be tried in Indian Context.Conclusion: The Indian and Indonesian health care systems have been compared and contrasted.Keywords: health care system, India, IndonesiaCorrespondence: Shikha Gill. International Institute of Health Management Research, New Delhi, India.Email: shikhaparttapgill@gmail.comJournal of Health Policy and Management (2018), 3(2): 101-107https://doi.org/10.26911/thejhpm.2018.03.02.06
Evaluation on the Implementation of Regional Mapping Referal System in the National Health Insurance Primary Care Services in Boyolali, Central Java Linda Widyaningrum; Didik Tamtomo; Arief Suryono
Journal of Health Policy and Management Vol. 1 No. 2 (2016)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan finance preventive, promo­tive, curative, rehabilitative services. The referal system is needed to enhance services and to assure patient safety. The purpose of this study is to evaluate the implementation of regional mapping referal system of the national health insurance, at the primary care level.Subjects and Method: This was a qualitative study with fenomenology approach. This study was conducted at Wonosegoro I and Karanggede Community Health Centers, type C Boyolali Pandanarang district hospital, type D Boyolali Simo hospital, and Boyolali District Health Office. Data were collected by in-depth interview, direct observation, and document review.Results: Regional mapping referal system in Boyolali district was implemented under the head of the District Health Office regulation no 440/4214/15 /2014. The number of personal in charge of referal system in Wonosegoro I and Karanggede Community Health Centers, which provided inpatient care was lacking. The infrastructure and equipment were insufficient to address common diseases that consist of 155 diagnoses. The information and communication system has not connected to the referal system facilities. Telephone was used to check about the hospital bed of availability. Therefore, patient information could not be sent to the hospital beforehand.Conclusion: The current infrastructure and equipment at Community Health Centers in Boyolali, Central Java are insufficient to support the regional mapping referal system.Keywords: mapping, referal system, BPJS Kesehatan, primary care.Correspondence: Linda Widyaningrum. School of Medical Records, APIKES Citra Medika, Surakarta, Central Java. Email: linda.ningrum@ymail.comJournal of Health Policy and Management 1(2): 95-101https://doi.org/10.26911/thejhpm.2016.01.02.04
Factors Affecting the Quality of Microscopic Tuberculosis Examination in Madiun, East Java: A Multilevel Analysis Sri Hartini; Endang Sutisna Sulaeman; Bhisma Murti
Journal of Health Policy and Management Vol. 3 No. 1 (2018)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Tuberculosis (TB) remains major cause of morbidity and mortality due to any one of infectious agent worldwide. In low income countries, Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment. Refresher training for laboratory professionals involved in Acid Fast Bacilli (AFB) microscopy at peripheral health facilities is important. This study aimed to assess factors affecting the quality of microscopic tuberculosis examination in Madiun, East Java, using a multilevel analysis model.Subjects and Method: A cross-sectional study conducted at 23 puskesmas (community health centers) in Madiun, East Java, from March to April 2018. A sample of 230 preparations was selected by simple random sampling. The dependent variable was quality of microscopic TB examination. The independent variables were tenure, refresher training, and accreditation status of puskesmas. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Quality of microscopic TB examination was positively associated with tenure ?3 years (b= 2.77; 95% CI= 0.81 to 4.73; p= 0.006) and accredited community health center (b= 3.06; 95% CI= 0.81 to 4.62; p<0.001). The association between refresher training and quality of microscopic TB examination was not statistically significant (b= -0.51; 95% CI= -2.33 to 1.32; p= 0.580). Puskesmas had a contextual effect on quality of microscopic TB examination with ICC= 22.01%.Conclusion: Quality of microscopic TB examination is positively associated with tenure and accredited puskesmas. Refresher training for laboratory technicians was not effective in improving the quality of microscopic TB examination Puskesmas has a considerable contextual effect on quality of microscopic TB examination.Keywords: microscopic TB examination, quality, tenure, community health center, accreditation, multilevel analysisCorrespondence:
Effectiveness of Counseling onthe Willingness to Use Intra-Uterine Device Contraceptive After Placenta Detachmentamong the Health Insurance Participants in Panembahan Hospital, Bantul Ristiana Eka Ariningtyas; Hermanu Joebagio; Eti Poncorini P
Journal of Health Policy and Management Vol. 1 No. 1 (2016)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Counseling on family planning and contraceptive use after deliverymay increase awareness of women to use contraceptives. Any use of contraceptives there are side effects, including in the use of contraceptives used in the uterus post placenta, side effects and failure was a factor that caused the acceptors are having dropped out of the methods used. This study aimed to determine the effectiveness of counseling on willingness to use intra-uterine device contraceptive after delivery.Subject and Methods: This was a qualitative study with case studies carried out in Bantul Yogyakarta. A total of 3 midwives and 3 contraceptive use in the uterus post placenta acceptor Panembahan Senopati hospital. The dependent variable was health insurance participant. The independent was contraceptive used in the uterus post placenta. The data collected by interview, observation, document. The informant was 3midwifery and 3 acceptor of post placenta.Results: Socialization and counseling is done always accompanied and informed consent when the pregnancy inspection. Midwives play a role in counseling process by involving the husband as support for potential acceptors. Such side effects are still within the limits of reasonable expulse. Contraceptives used in the uterus post placentainstallation carried out by a competent midwife by SPO. Midwives provide education and counseling reset when the client still complained of side effects.Conclusion: Socialization and counseling potential acceptors are effective to increase willingness to use intra-uterine device contraceptive among the health insurance participants.Keywords: counseling, intra-uterine device contraceptiveCorrespondence: Ristiana Eka Ariningtyas. STIKes Jenderal Ahmad Yani, Yogyakarta. Email: tyasarin1988@gmail.com. Mobile: 08985069979.Journal of Health Policy and Management (2016), 1(1): 8-12https://doi.org/10.26911/thejhpm.2016.01.01.02
The Role of Community Health Workers in Maternal and Child Health Surveillance to Optimize Maternal and Child Health in Pasuruan District, East Java Ninil Dwi Pangestu; Hermanu Joebagio; Setyo Sri Rahardjo
Journal of Health Policy and Management Vol. 2 No. 2 (2017)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Abstract

Background: Maternal mortality ratio, infant mortality rate, and underfive mortality rate are still high in Indonesia. Pasuruan is one of the districts in East Java with the highest infant mortality rate. One of the public health interventions that has been undertaken to address this issue is maternal and child health surveillance program with community health workers being the leading implementers. This study aimed to describe the role of community health workers in maternal and child health surveillance to optimize maternal and child health care services in Pasuruan District, East Java.Subjects and Method: This was a qualitative study using case study approach. It was conducted in Pasuruan, East Java. Key informants were selected by criterion sampling. The data were collected by in-depth interview, focus group discussion, observation, and document review. Data validity was checked by triangulation.Results: Community based maternal and child health surveillance program has been implemented for 4 years. However, only some of all community health workes have been trained in this program. The tasks of these community health workers included advocacy and monitoring of maternal and child health in the areas of posyandu. The implementation of these surveillance program had some obstacles, including low insentive of community health worker, inactive community health worker, lack of awareness among community members on maternal and child health issues, and medical factors of pregnant mothers that caused mortality.Conclusion: Community health workers help improve the quality of maternal and child health care by surveillance program, although their performances have yet to be enhanced.Keyword: maternal mortality rate, infant mortality rate, community health workersCorrespondence: Ninil Dwi Pangestu. Masters Program in Public Health, Sebelas Maret University,  Jl. Ir. Sutami No. 36A Surakarta 57126, Jawa Tengah. E-mail: pangestu.ninil@gmail.com. Mobile +62856553737.Journal of Health Policy and Management (2017), 2(2): 128-136https://doi.org/10.26911/thejhpm.2017.02.02.04

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