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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 8 Documents
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Search results for , issue "Vol. 3, No. 6" : 8 Documents clear
Pemenuhan Hak Konsumen di Institusi Pelayanan Kesehatan di Kota Bandung dan Kota Cimahi Juariah, Juariah
Kesmas Vol. 3, No. 6
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Kebijakan pelayanan medis secara legal formal telah memberikan perlindungan hak konsumen kesehatan. Namun, sampai kini belum terungkap upaya institusi pelayanan kesehatan untuk memenuhi dan melindungi hak konsumen kesehatan. Penelitian ini bertujuan mengeksplorasi berbagai kebijakan pemenuhan hak-hak konsumen kesehatan oleh institusi pelayanan kesehatan pemerintah dan swasta. Penelitian yang menggunakan pendekatan kualitatif dengan metode studi ini dilaksanakan pada Agustus 2008 - Januari 2009 di institusi pemerintah RSUD Cibabat-Cimahi, RSKIA Astanaanyar dan Puskesmas Garuda serta institusi swasta RS Muhammadiyah dan RB Barokah. Data dikumpulkan dengan telaah dokumen dan wawancara mendalam terhadap lima orang informan serta dianalisis dengan analisis isi. Hasil penelitian meliputi: tiga institusi pelayanan kesehatan sudah menyusun hak-hak dan kewajiban konsumen kesehatan dan melakukan sosialiasi hak dan kewajiban konsumen kesehatan; telah dikembangkan standar pelayanan, tindakan dan uraian tugas petugas serta kebijakan sistem pembayaran, penyediaan fasilitas dan tenaga; sistem pengaduan pelanggan sudah ada meski belum ada tindak lanjut; forum evaluasi pelanggan belum sinambung serta penghargaan dan sanksi untuk petugas belum jelas. This study objective is to explore policies of public and private health care institutions in order to comply consumers rights. This study applies qualitative approach with case study method. This study conducted from August 2008 to January 2009 in three public health care institutions that included Cibabat-Cimahi Hospital, Astanaanyar Mother and Child Hospital and Garuda Public Health Center and two private health care institutions that included Muhammadiyah Hospital and Barokah Birthing Center. Data was collected with indepth interview from 5 informants and policy documents study. Data was analyzed with using content analysis. Results of the study shows that: three health care institutions have already regulated rights and duties of health consumers and two institutions have not have the formal regulation yet; socialization about rights and duties of consumers have been done; health care standard and job descriptions have been regulated; policy of payment system, equipping of facility and personnel have been regulated; there is a system of consumer advocacy but the regulation of follow up has not been clear; Forum of consumer evaluation has not been continued; reward and punishment for providers have not been regulated clearly; the main constraint in the application of regulation is monitoring and evaluation; Documents to comply the rights of consumers have not been completed. There is a necessity to monitor and evaluate implementation of the regulations and also to arrange evaluation of provider performance in application of consumer rights.
Budaya Organisasi, Kepuasan Kerja dan Komitmen Dokter Spesialis di RSUD Kota Bekasi Sumartini, Ni Made
Kesmas Vol. 3, No. 6
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Komitmen dokter pada rumah sakit mempengaruhi tingkat kehadiran, produktivitas dan mutu pelayanan di rumah sakit. Waktu dan tenaga yang tidak penuh diberikan dokter spesialis pada rumah sakit berpengaruh terhadap produktivitas yang kurang optimal. Tujuan penelitian ini menilai hubungan budaya organisasi, kepuasan kerja dengan komitmen dokter spesialis. Penelitian ini dilakukan pada 35 responden dokter spesialis dengan menggunakan pengukuran organinizational culture survey Denison, a job satisfaction survey Spector dan organizational commitment Allen & Meyer dengan skala yang dimodifikasi. Metoda analisis kuantitatif yang digunakan adalah univariat, bivariat dan multivariat. Sumber kepuasan dokter spesialis dengan komitmen yang tinggi adalah rekan kerja dan pekerjaan. Sumber ketidakpuasan adalah imbalan, promosi, supervisi dan kondisi kerja. Kepuasan kerja berhubungan dengan komitmen, tetapi budaya organisasi berupa praktek manajemen tidak berhubungan, karena belum terfokus pada keterlibatan, konsistensi, adaptabilitas dan penghayatan misi dokter spesialis. Dokter spesialis berhubungan dengan praktek manajemen yang terfokus pada konsistensi dan kepuasan imbalan. Komitmen normatif berhubungan dengan praktek manajemen yang fokus pada penghayatan misi dan kepuasan profesi. Physician’s commitment has significant relationship with their level of attendances, and their productivity in term of services quality, which will leverage the total quality of hospital . Objectives of this research are: examining the relationship of organization culture toward physician’s commitment; and the relationship of job satisfaction toward the physician’s commitment; the relationship of both organization culture and job satisfaction toward physician’s commitment. Method: Respondent for this research are 35. Scale of organizational culture survey Denison, scale of job satisfaction survey Spector, and scale of organizational commitment Allen & Meyer are the measurement tools. The analysis quantitative is performed in univariate, bivariate and multivariate. Results : The physician has been highly committed to RSUD Bekasi. Physician’s’s satisfaction is influent by their type of job and the relationship within their professional colleagues. Their dissatisfaction can be influent by the lack of benefit and promotion opportunities, and the non-conducive work environment conditions.The job satisfaction level has significant relationship to organization commitment. Separately, organization commitment does not have significant relate to organization culture. Organization culture, base on physician opinion, has not yet focus on empowerment; has not consistent in development of work instruction and implementation; has not adaptive with the change of organization environment; and has a lack of organization’s mission understanding. Physician’s continuans commitment has a relationship to management practices that focus on consistency and benefit . Physician’s normative commitment has a relation- ship to management practices that focus on organization mission, and their job satisfaction as a physician.
Pengetahuan, Sikap dan Persepsi Petugas Gawat Darurat Terhadap Kesalahan Medik Nasution, Refi Fitri Hamdani
Kesmas Vol. 3, No. 6
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Kesalahan medik serius paling sering terjadi di intensive care unit, ruang operasi, dan unit gawat darurat. Tujuan penelitian ini mendapat informasi tentang pengetahuan, sikap, dan persepsi tenaga kesehatan terhadap kesalahan medik. Penelitian dilakukan terhadap manajer, kepala seksi, kepala ruangan, ketua kelompok perawat, dokter dan perawat pelaksana. Metode yang digunakan adalah metode kualitatif meliputi wawancara mendalam, observasi, dan telaah dokumen. Metode analisis yang digunakan adalah analisis konten yg membandingkan hasil penelitian dengan teori. Ditemukan bahwa pengetahuan, sikap, dan persepsi tenaga kesehatan cukup baik, tetapi belum diikuti tindakan, sarana prasarana dan pengawasan yang memadai. Sistem rujukan pasien yang kurang baik menyulitkan keluarga pasien. Kesalahan medik dipengaruhi oleh kasus sulit, pasien banyak dan tindakan tergesa-gesa. Sumber kesalahan medik adalah manusia, komunikasi, pasien. Keterampilan SDM dan kondisi fasilitas telah memadai. Namun, ruangan yang belum memadai dinilai sebagai sumber kesalahan medis. Selain itu, sikap antispasi atasan terhadap kesalahan medik kurang memadai. Untuk memperkecil kesalahan medik yang dilakukan upaya-upaya pelatihan, refreshing keilmuan, kolaborasi sesama tim, perbaikan komunikasi, dan mengikuti SOP. Medical error is known to occur mostly in the intensive care unit, operation room, and emergency unit. The objective of this study is to obtain information on knowledge, attitude, and perception of health workers on medical error. Study was conducted to manager, head of section, head of room, head of nursing team, doctors, and nurse. Qualitative method was employed including in-depth interview, observation, and document review. Analysis was conducted using content analysis that compare study results with theory. The study found that knowledge, attitude, and perception are relatively good, but has not been followed by appropriate action and not supported by sufficient facilities and monitoring system. Not very good referral system was an obstacle for patient’s family. Medical error was infleunced to happen by the presence of difficult cases, big number of patients, and in hurry action. The source of medical error was human factor, communication, and patient. Insufficiency or less equipped room was also perceived as source of medical error. Moreover, the attitude of ma- nagement regarding medical error was not really appropriate. To minimize medical error, it is necessary to conduct trainings, refreshing course, collaboration between teams, communication improvement, and SOP compliance.
Implementasi Program Asuransi Kesehatan Masyarakat Miskin di Nusa Tenggara Timur Lestari, Tri Rini Puji
Kesmas Vol. 3, No. 6
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Kesehatan merupakan hak asasi manusia, sehingga upaya pelayanan pengobatan untuk penduduk miskin tidak boleh dipandang sebagai sesuatu yang konsumsi, tetapi sebagai investasi untuk mencapai masyarakat yang sejahtera. Penelitian ini bertujuan mendapatkan informasi tentang akses penduduk miskin pada pelayanan rumah sakit melalui program Askeskin di Nusa Tenggara Timur (NTT). Penelitian menggunakan pendekatan kualitatif dengan informan kunci adalah pejabat di RSU Prof. DR. W.Z. Johannes NTT dan PT Askes cabang Kupang. Hasil penelitian memperlihatkan bahwa jumlah kartu yang diterbitkan tidak sesuai dengan realita jumlah maskin dan ada oknum tidak maskin yang menggunakan fasilitas Askeskin. Juga ditemukan beberapa obat yang tercantum dalam formularium Askeskin tidak tersedia pada saat dibutuhkan. Sehingga pasien miskin terpaksa diberi obat sejenis dari luar formularium dengan konsekuensi harga yang lebih mahal dan harus ditanggung oleh pihak rumah sakit karena tidak dapat diklaim. Selain itu, ketiadaan dukungan dana dari pemerintah daerah, mengakibatkan segala pembiayaan di luar pertanggungan Askeskin harus dibebankan pada rumah sakit penyelenggara pelayanan kesehatan. Public health improvement, especially for underprivilege, needs more attention. Health issues should not be considered as a matter of mere consumption. Health should be viewed as an investment in order to achieve welfare as one of many faces of human rights. This research was aim at gathering information on the improvement of health access at the hospital designated for under-privilege through Askeskin by PT Askes in East Nusa Tenggara (NTT). The research used qualitative approach with key informants of official at Prof. DR. W.Z. Johannes General Hospital of NTT and PT Askes Kupang branch. The research shows that the total number of distributed cards was not a reflection of the actual number of poor people and there were individuals that not fall into poor category using Askeskin facilities. There were also finding on drugs other than formularium, which brought it to an increase in price and the hospital has to be responsible for the additional cost for they could not claim it. Moreover, there were no financial support from local government, causing a delay on the payment other than Askeskin and the health service provider, e.i. hospital held responsible to it.
Situasi Malaria di Kabupaten Lebak Hayat, Fauzul; Kurniatillah, Nia
Kesmas Vol. 3, No. 6
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Pada periode 2002-2006, di Kabupaten Lebak, API tergolong Middle Case Incidence (MCI), dengan nilai rata-rata (2.87%) dan berada pada kisaran 2.04-4.51%. Dari 35 wilayah kerja puskesmas terdapat enam wilayah endemis yang meliputi puskesmas Malimping, Binuangeun, Bayah, Cihara, Panggarangan dan Cilograng. Ada wilayah kerja puskesmas yang dilaporkan dengan klasifikasi MCI. Penderita positif malaria cenderung meningkat secara fluktuatif dengan puncak yang tidak jelas, kasus positif malaria tertingi ditemukan pada bulan Februari, Maret, Mei, Juli dan Desember. Tingkat infeksi malaria yang tinggi pada kelompok populasi ditentukan berdasarkan proporsi sediaan darah positif malaria dari sediaan darah yang diperiksa dengan angka SPR 006 rata-rata 12.64%, dengan kisaran 8.68%-15.87%. Proporsi Annual Blood Examination Rate (ABER) digunakan untuk menentukan cakupan penduduk dilakukan pengambilan dan pemeriksaan sediaan darah. Pada tahun 2004-2006, ABER di Kabupaten Lebak rata-rata (26.03%) tersebar pada kisaran 14.35%-43.49%. Pada tahun 2006, kasus malaria (159 kasus) terdiri dari species P. Palcifarum (34) dan P.Vivax (124). Proporsi P.vivax yang tinggi mengindikasikan transmisi lokal malaria di kabupaten lebak yang rendah dan atau strategi pengobatan yang masih efektif terutama untuk P. palcifarum. Pengobatan malaria masih merupakan pilihan strategi yang tepat pengendalian malaria di Kabupaten lebak. Penemuan kasus secara dini dan pengobatan secara cepat dapat dilakukan dengan peran serta masyarakat dengan metode yang telah dikembangkan dan akan diimplementasikan di Kabupaten Lebak. During 2002-2006 , API in Distric of Lebak 2004-2006 was categorized in Middle Case Incidence ( MCI) which mean (2.87%) in interval of 2.04-4.51%. From 35 work regions of Public Health Center (puskesmas) in Distrik of Lebak, there are 6 regions of endemic reagent which include Malimping, Binuangeun, Bayah, Cihara, Panggarangan and of Cilograng. The endemic malaria of work regions of Puskesmas in 2002-2006, have reported the existence classified of MCI region. Positive malaria patients in 2001-2006 was fluctuative trend to increase with the higest in Februari, Maret,May, July and December. Level of malaria infection is indicated by the proportion of positive slide bloods malaria with number of SPR in Distric of Lebak in 2004-2006 (12.64%) with interval of 8.68%-15.87%. Percentage of ABER to determine the level of taken resident coverage and checked [by] his blood slide, where number of Annual Blood Examination Rate ( ABER) in Lebak District in the year 2004-2006 mean equal to 26.03% spread over from 14.35%-43.49%. From malaria case in the year 2006 equal to 159 malaria case consist of 34 species P. Palcifarum and 124 P.Vivax. Height Proportion of P.Vivax give indication that transmission of local malaria in Lebak District was low and or medication strategy still effective especially for the P. palcifarum of. effective medication for malaria still is correct strategy choice for the operation of malaria in Lebak District. Quick identification and medication can be done through community-based approach that has been developed and implemented in Lebak District.
Perilaku Hidup Bersih Sehat dengan Pendekatan Partisipatif Krianto, Tri
Kesmas Vol. 3, No. 6
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Murid sekolah dasar adalah sasaran strategis upaya promosi kesehatan, karena mereka berjumlah besar serta berada pada tahap awal perkembangan kepribadian. Mereka seharusnya berperilaku sehat, tetapi di Cisalak memperlihatkan keadaan yang sebaliknya. Studi intervensi yang dilakukan terhadap anak-anak sekolah dasar menunjukkan bahwa observasi sebelum intervensi memperlihatkan bahwa tingkat pengetahuan dan praktik mereka adalah rendah. Namun, pada akhir studi, skor pengetahuan dan praktek mereka terlihat lebih tinggi daripada sebelumnya. Uji non parametric seperti Wilcoxon sampel berpasangan dan korelasi Spearman digunakan dalam analisis. Studi ini menyimpulkan : a) intervensi promosi kesehatan yang dilakukan pada anak sekolah dasar terbukti dapat meningkatkan perilaku murid pada kisaran 30% - 240 %. b) pengetahuan anak sekolah berkorelasi kuat dengan praktek. Oleh sebab itu, disarankan agar pemerintah menyelenggarakan upaya promosi kesehatan PHBS secara berkesinambungan melalui sekolah-sekolah dasar. Elementary school children is a strategic target of health promotion, because of their proportion in the population and considering that they are in the early stage of personality development. They ought to have a healthy behaviour, however evidence in Cisalak showed the contrary. An intervention study conducted to elementary school children showed that before the intervention, both knowledge and practice were poor. But, in the end of the intervention the knowledge and practice score was considerably higher than before. Non parametric test such as Wilcoxon paired sample test and Spearman correlation were used to analyze the data. Conclusion of the study were: a) health promotion intervention has been proven to improve pupil’s behavior around 30 – 240 %, b) the knowledge among school children has strong correlation with their practice. For those reason we suggest the government to conduct sustainable promotion of clean and healthy behavior through elementary schools.
Pengaruh Penyuluhan Demam Berdarah Terhadap Perilaku Ibu Rumah Tangga Resmiati, Resmiati; Cita, Yatnita Parama; Susila, Arif
Kesmas Vol. 3, No. 6
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Pada periode tahun 1989-1995, insiden demam berdarah di Indonesia berada pada kisaran 6-15 per 100.000 penduduk. Pada tahun 1998, dengan angka insidens demam berdarah meningkat tajam menjadi 35,19 per 100.000 penduduk dengan angka kematian (CFR) 2 %. Penelitian ini bertujuan mengetahui pengaruh penyuluhan terhadap perilaku. Penelitian ini dilaksanakan di RW 12, Pondok Kelapa, Kecamatan Duren Sawit, Jakarta Timur, terhadap 227 respondent. Penelitian ini menggunakan rancangan penelitian kuasi eksperimen pra-pasca tes dalam satu kelompok (One group pra test and post test design). Pengetahuan dan sikap diukur dengan lembar kuesioner serta tindakan diukur dengan lembar observasi yang sebelumnya telah dilakukan uji coba. Pengukuran dilakukan sebelum dan setelah penyuluhan terhadap 227 responden. Ditemukan penyuluhan tentang DBD berpengaruh secara bermakna terhadap pengetahuan,sikap dan tindakan penduduk (nilai p=0,000). Setelah penyuluhan, nilai rata-rata pengetahuan meningkat dari (14,4; 30%) menjadi (18,9; 88,1%), nilai sikap meningkat dari (64,6 70,9%) menjadi (69,6; 96,9%), tindakan dari (5,1; 7,5%) menjadi (6,0 ;17,6%). In the period of 1989-1995, the incidence of dengue hemorrhagic fever in Indonesia was within the interval of 6 -15 per 100.000 population. In 1998, the incidence increased sharply (35,19 per 100.000 population) with case fatality rate of 2%. The purpose of this research is to evaluate the effect of health counseling on the behaviour of housewives. This research was conducted in 227 respondents in RW 12 of Pondok Kelapa in Duren Sawit district, East Jakarta, to measure respondents’ knowledge and practice before and after health counseling. This research used one group quasy experiment design (pre-and-post- test design). The measuring tool is a list of questions and observation check list that had been tested before. The health counseling on dengue fever significantly influences the knowledge and practice of the housewives. This result showed increase of knowledge and practice before and after the counseling. The average knowledge (14.42; 30%) increased to 18.91;88.1%. The attitude score increased from 64.42;70.9% to 69.58; 96.9%. The practice score increased from 5.11;7.5% to 5.98;17.6%.
Praktek Ibu dalam Perawatan Neonatus di Kabupaten Garut, Jawa Barat Haryanto, Aji; Hadi, Ella Nurlaella
Kesmas Vol. 3, No. 6
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Angka kematian bayi (AKB) di Kabupaten Garut pada tahun 2005 (54,8 per 1000 kelahiran hidup) merupakan yang tertinggi di provinsi Jawa Barat, akibat kematian neonatus dalam tiga tahun terakhir terus meningkat. Studi yang bertujuan mengetahui determinan praktek ibu dalam perawatan neonatus, dilakukan dengan analisis lanjut data Survei Dasar Kesehatan Neonatus Esensial di Kabupaten Garut tahun 2007. Analisis dilakukan dengan menggunakan metoda regresi logistik ganda. Hasil studi menunjukkan, dari 577 ibu bayi 1-11 bulan yang menjadi sampel penelitian, sekitar 51,5% ibu melakukan praktek perawatan neonatus kurang baik. Faktor yang paling dominan berhubungan dengan praktek perawatan neonatus adalah pengetahuan ibu setelah dikontrol oleh dukungan keluarga, pendidikan ibu, pekerjaan ibu dan penyuluhan oleh tenaga kesehatan. Ibu yang berpengetahuan baik melakukan praktek perawatan neonatus baik 2,2 kali lebih besar daripada ibu yang dengan pengetahuan kurang baik. Disarankan agar Bidan di Desa (BdD) mengubah cara pemberian informasi kepada ibu dan keluarganya dengan metode diskusi dan menggunakan gambar serta buku Kesehatan Ibu dan Anak (KIA), sehingga ibu lebih mudah memahami dan menerapkan kepada bayinya. Infant Mortality Rate (IMR) in 2005 at Garut District (54.8/1000 live births), is the highest in West Java Province, due to ever increasing neonatus mortality rates in the last three year. The purpose of this study was to investigate the determinant of mother’s practice in neonatus care at Garut District, conducted by advance analysis of Baseline Survey of Essential Neonatus Health Services at Garut District data in 2007. The data was analyzed using chi square test and multiple logistic regression. The result of this study showed that out of 577 baby mothers who had 1-11 months as the sample of this research, 51.5% had unfavorable practice in neonatus care. The most dominant factor related to practice in neonatus care was knowledge of mother after adjusting by family support, mother’s education, mother’s occupation and counseling by health provider. Mothers who have good knowledge in neonatus care practice had chance 2.2 times higher compared to mothers who had unfavorable knowledge to implement good practice. Based on the result of this study, it is suggested that the Village Midwives should change the way in giving of information to mothers and her families by using more discussion method and utilizing picture, and also utilizing Maternal and Child Health book, so that it would be easier for the mothers to understand and to apply good practices to their babies.

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