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Quality of Antenatal Care Services by Midwives After Training of Integrated Antenatal Care to Pregnant Women in Province of Central Sulawesi Mercy Joice Kaparang; Bagoes Widjanarko; Cahya Tri Purnami
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKKematian ibu masih cukup tinggih di propinsi Sulawesi tengah. Terdapat 122 angka kematian ibu yang terdiri dari 48 kematian ibu hamil, dan 45,83% penyebab kematian karena Hiper tensi dalam kehamilan. yang seharusnya kasus ini bisa diatasi pada saat pemeriksaan kehamilan. Kegiatan peningkatan kemampuan, sikap dan keterampilan pelaksana asuhan ibu hamil (ANC) yang bermutu disebut dengan Pelatihan ANC Terpadu. Penelitian ini bertujuan Menganalisis dimensi mutu pelayanan asuhan Antenatal care oleh bidan pasca pelatihan ANC Terpadu di Propinsi Sulawesi Tengah.. Penelitian ini dilakukan dengan metode kualitatif. Pengumpulan data dilakukan dengan observasi dan wawancara mendalam pada empat belas orang informan utama yaitu bidan yang telah mengikuti pelatihan ANC terpadu di daerah terpencil dan perbatasan serta daerah yang bermasalah kesehatan yang bertugas di Puskesmas. Informan triangulasi adalah empat belas orang ibu hamil, dan enam orang Kasi KIA DKK Kabupaten, Kota dan Propinsi Sulawesi Tengah. Analisis data dilakukan dengan metode analisis isi. Hasil penelitian menunjukkan aspek masukan: asuhan Antenatal care dilakukan oleh bidan,dengan latar belakang pendidikan D III kebidanan, Pelayanan antenatal care tidak dipunggut biaya, dan alat pemeriksaan laboratorium seperti pemeriksaan HB, test protein dan glukose belum lengkap sehingga tidak dapat mendeteksi adanya komplikasi atau penyakit yang menyertai kehamilan, yang menyebabkan mutu pelayanan bidan kepada ibu hamil belum baik. Proses pembuatan perencanaan asuhan, pemeriksaan Kehamilan dilaksanakan Setiap ada kunjungan pemeriksaan Kehamilan., sesuai tahapan standar pelayanan dan pengawasan pelaksanaan Asuhan dilakukan Sebulan sekali dan yang diawasi adalah Pencapaian PWS, Kinerja bidan, Kasus kematian, Kasus rujukan.Mutu pelayanan asuhan Antenatal care oleh bidan pasca pelatihan ANC Terpadu kepada ibu hamil di Propinsi Sulawesi Tengah sudah berjalan baik. Bidan dalam memberikan pelayanan antenatal care kepada ibu hamil menghargai, menghormati, memberikan perhatian dan mendengarkan keluhan dan juga menjaga rahasia ibu hamil. Direkomendasikan kepada Kasi KIA DKK Propinsi Sulawesi Tengah untuk lebih memperhatikan dan memenuhi kelengkapan alat pemeriksaan kehamilan, khususnya alat pemeriksaan laboratorium seperti Test Protein, Glukose dan pemeriksaan HB.Kata kunci : Mutu Pelayanan asuhan Antenatal, aspek masukan, Proses, keluaran.ABSTRACTMaternal Mortality Rate in Province of Central Sulawesi was high (122/100,000 live births).Therefore, there needed to conduct a training to improve ability, attitude, and skills of midwives in providing Antenatal Care Services (ANC). This related to quality of ANC services. An integrated training of ANC had been conducted at a province level in 2012. The aim of this study was to analyse dimensions of quality of ANC services by midwives after training of integrated ANC. This was a qualitative study. Data were collected by conducting observation and indepth interview towards 14 main informants consisted of midwives working at health centres who had followed the training of integrated ANC in remote and border areas and in an area that had health problems. Meanwhile, informants for triangulation purpose consisted of 14 pregnant women and 6 heads of Maternal and Child Health (MCH) sections at District Health Office, City Health Office, and Province Health Office of Central Sulawesi. Furthermore, data were analysed using content analysis. The results of this study showed that regarding input, ANC services were provided by Midwives graduated from D III Midwifery, ANC services were free of charge, and there was lack of laboratory equipment particularly for tests of Haemoglobin, Protein, and Glucose. Planning was made when there was any visit, ANC was conducted in accordance with a service standard. The local area monitoring of MCH coverage was implemented once a month. Midwives in providing ANC services appreciated, respected, paid attention, listened complaints, and keep secrets of pregnant women. As suggestions, Heads of MCH sections at Health Offices in Province of Central Sulawesi need to provide laboratory equipment for pregnancy test particularly for tests of protein, glucose, and haemoglobin.Keywords : Quality of Antenatal Care Services, Aspects of Input, Process, and Output

Factors Influencing Readiness of Companies in Implementing Social Insurance Organizing Body in Mataram City Una Zaida; Sutopo Patria Jati; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKBPJS kesehatan merupakan perlindungan berupa jaminan sosial untuk melindungi masyarakat Indonesia dari masalah kesehatan. Masalah kesehatan pada masa ini membutuhkan biaya yang besar. Tenaga kerja perlu mendapat perhatian dan perlindungan dari resiko sakit atau kecelakaan kerja yang dapat menyebabkan menurunnya tingkat produktivitas. Oleh karena itu pemerintah didalam UU Jaminan Sosial Tenaga Kerja mewajibkan pengusaha untuk mendaftarkan pekerjanya untuk mengikuti program-program jaminan yang diberlakukan salah satunya program jaminan pemeliharaan kesehatan yang akan bertransformasi kedalam program BPJS. Perkembangan jumlah perusahaan yang beropersi di Kota Mataram dan telah terdaftar pada PT. Jamsostek dari tahun 1993 sampai dengan tahun 2012 sebanyak 1595 unit perusahaan. Masih ada beberapa 101 unit perusahaan yang tidak aktif. Hal ini disebabkan karena masih rendah kepesertaan pekerja formal swasta dari perusahaan menengah, kecil dan mikro di Kota Mataram. Dalam hal ini peserta belum mengetahui manfaat dari jaminan social, tidak mengetahui kepengurusan kepesertaan, iuran yang harus dibayarkan dan pelayanan kesehatan yang diterima sebagai peserta program jaminan social. Hal ini disebabkan karena kurangnya sosialisasi yang dilakukan terkait masalah kepesertaan, iuran dan pelayanan kesehatan yang diperoleh. Tujuan penelitian ini adalah untuk mengetahui factor-faktor yang mempengaruhi kesiapan perusahaan dalam pelaksanaan BPJS. Jenis penelitian survey analitik dengan pendekatan cross sectional. Instrument penelitian menggunakan kuesioner pada 113 unit perusahaan dan pimpinan perusahaan sebagai responden. Data penelitian diolah secara kuantitatif dengan uji univariat, bivariat dan multivariate dengan menggunakan uji analisis regresi linier. Hasil penelitian menunjukkan bahwa responden berpendidikan D3 (27,4%), jenis usaha menurut tingkat pendapatan perusahaan tertinggi usaha micro (64,6%), jenis usaha bila dilihat dari jumlah tenaga kerja termasuk dalam usaha kecil sebesar (90,3%). Berdasarkan pengelompokkan jawaban diperoleh hasil bahwa pengetahuan kurang baik (52,2%), karakteristik inovasi kurang baik (50,4%), saluran komunikasi baik (52,2%), system social kurang baik (54%), promosi agen pembaharuan kurang baik (50,4%) dan kesiapan perusahaan dengan tidak siap (54%). Hasil analisis hubungan menunjukkan ada hubungan antara pengetahuan (p=0,0001, r =0,898 ), karakteristik inovasi (p=0,0001, r = 0,888), saluran komunikasi (p=0,0001, r = 0,886), system social (p=0,0001, r = 0,894) dan promosi agen pembaharuan (p=0,0001, r = 0,704) dengan kesiapan perusahaan. Hasil analisis pengaruh bersama-sama berdasarkan nilai p value d” 0,05, F = 223,404 didapatkan bahwa pengetahuan, karakteristik inovasi, saluran komunikasi dan system social berpengaruh secara bersama-sama terhadap kesiapan perusahaan dalam pelaksanaan BPJS. Disarankan untuk melakukan sosialisasi pada perusahaan. Didalam lingkungan perusahaan penyampaian informasi dengan komunikasi interpersonal. Informasi yang disampaikan harus jelas dan lengkap.Kata kunci : Pengetahuan, karakteristik inovasi, saluran komunikasi, system social, promosi agen perubahan, kesiapan perusahaanABSTRACTSocial Insurance Organizing Body is to protect community and Indonesian workers from health problems. Until 2010, many companies in Mataram City had not been a member of social insurance for workers because there was a lack of socialization in terms of the importance of health insurance for companies’ sustainability. This research aimed to identify factors influencing readiness of companies in implementing Social Insurance Organizing Body.This was analytic survey with cross-sectional approach. Samples were 113 company managers. Data were collected using a questionnaire and analyzed using the methods of univariate, bivariate, and multivariate (Linear Regression test). The result of this research revealed that percentage of respondents graduated from Diploma III was 27.4%, type of business based on the highest income level of a micro business (64.6%), and type of small business based on number of employees (90.3%). In addition, mostly respondents had low knowledge (52.2%), bad characteristics of innovation (50.4%), good communication channel(52.2%), bad social system (54%), bad promotion of reforming agent (50.4%), and unready company (54%). Furthermore, variables of knowledge (p=0.0001, r=0.898), characteristics of innovation (p=0.0001, r=0.888), communication channel (p=0.0001, r=0.886), social system (p=0.0001, r=0.894), and promotion of reforming agent (p=0.0001, r=0.704) had significant correlation with readiness of companies in implementing Social Insurance Organizing Body. Multivariate analysis showed that variables of knowledge, characteristics of innovation, communication channel and social system jointly influenced readiness of companies (F test= 223.404). As a suggestion, dissemination of information needs to be conducted among companies. Additionally, providing information in companies needs to be done by using a method of interpersonal communication. Provided information must be clear and complete.Keywords : Knowledge, Characteristics of Innovation, Communication Channel, Social System, Promotion of Reforming Agent

Analysis on the Implementation of Delivery Assurance Programme by Village Midwives in Lumajang District Warih Respitowati; Martha Irene Kartasurya; Lucia Ratna Kartika Wulan
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKImplementasi jaminan persalinan di Kabupaten Lumajang masih belum sesuai petunjuk teknis seperti pelaksanaan KB pasca salin. Tujuan dari penelitian ini adalah menjelaskan implementasi program jaminan persalinan oleh bidan desa di Kabupaten Lumajang. Jenis penelitian ini adalah penelitian eksplanatif. Informan utama yaitu 2 orang bidan desa dari puskesmas PONED dan non PONED dengan cakupan persalinan tertinggi dan 2 orang bidan desa dengan cakupan persalinan terendah dari masing-masing puskesmas. Informan triangulasi berjumlah 8 orang yang terdiri dari 1 orang pengelola jampersal Dinas Kesehatan, 1 orang verifikator jampersal, 2 orang kepala puskesmas dan 8 orang pasien jampersal. Data didapatkan melalui indepth interview serta menggunakan metode observasi terhadap sarana dan prasarana polindes. Analisis data penelitian ini menggunakan content analysis. Hasil penelitian menunjukkan bahwa pelaksanaan program jaminan persalinan belum sesuai dengan petunjuk teknis dalam hal KB pasca salin. Namun demikian pelayanan KIA sudah sesuai standar pelayanan minimal. Dalam hal ukuran dasar dan tujuan kebijakan belum ada aturan tambahan di tingkat Kabupaten, hanya berupa himbauan. Dana masih dirasakan kurang memadai, fasilitas tidak dipenuhi dan kompetensi sumber daya manusia belum ditingkatkan. Ada dukungan bidan pelaksana terhadap program tetapi kompetensi pelaksana masih belum ditingkatkan. Sosialisasi dilaksanakan mendadak melalui perwakilan puskesmas. Kondisi ekonomi masyarakat membuat ibu bersalin lebih mudah dirujuk dengan adanya program jampersal akan tetapi semua bidan masih merasa program ini hanya sebuah kewajiban. Pelaksanaan jaminan persalinan belum dilaksanakan secara lengkap karena belum ada kebijakan pendukung, keterbatasan sumber daya, sosialisasi belum menyeluruh dan dirasakan sebagai kewajiban yang memberatkan.Kata kunci : Implementasi, Jaminan Persalinan, Bidan Desa.ABSTRACTImplementation of delivery assurance (Jampersal) program in Lumajang district was not doneaccording to the technical guideline; it was not done by way of the implementation of KB after delivery program was done. Objective of this study was to explain the implementation of delivery assurance program by village midwives in Lumajang district. This was an explanatory study. Main informants were two village midwives from PONED and non PONED primary healthcare centers (Puskesmas) with the highest delivery coverage, and two villagemidwives from each puskesmas with the lowest delivery coverage. Triangulation informants were 12 people. Those people were one Jampersal manager from district health office, one Jampersal verification person, two heads of Puskesmas, and 8 Jampersal patients. Data were collected through in-depth interview and observation to Polindes (village polyclinic) facility. Content analysis method was applied in the data analysis. Results of the study showed that activities of delivery assurance service were conducted using minimal standard service. Delivery assurance policy was a right policy to solve health cost problems. Executors of the policy were village midwives who had competency that suited with program purposes. Target and environment supported the program implementation. Basic indicator and purpose of the policy were clear and understandable for village midwives. However, funding was not maximal, and it caused many complaints from midwives. Communication and coordination were adequate; however social condition and community economy did not completely support the implementation of post-delivery KB (family planning). Funding for Jampersal was very small for both delivery assistance and consumable materials. This condition made the implementation of program was only for fulfilling the responsibility. Recommended suggestions for Lumajang district health office are to provide regulations related to post-delivery KB, to do proper planning regarding resources requirement to support serviceimplementation. Monitoring on the usage of KIA (Mother and Children) book should be done by Puskesmas to minimize technical problems such as double claim due to using double KIA book.Keywords : implementation, delivery assurance, village midwives

Information System Development for Web Based Routine Reporting of Pneumonia in Acute Respiratory Infection Control Program at Semarang District Health Office Yohanes Oktavianus Dolu; Henry Setyawan Susanto; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKKegiatan evaluasi Program Pengendalian Penyakit ISPA di Dinas Kesehatan Kabupaten Semarang seringkali berjalan kurang baik karena informasi yang berasal dari pelaporan rutin sebagai bahan utama yang diperlukan belum dapat mendukung kegiatan evaluasi. Ada beberapa permasalahan pada sistem informasi pelaporan rutin pneumonia yang saat ini berjalan yaitu petugas kesulitan melakukan perubahan maupun mengakses kembali informasi pneumonia, informasi yang dihasilkan belum lengkap dan belum jelas serta pelaporan yang tidak tepat waktu. Tujuan penelitian ini adalah mengembangkan sistem informasi pelaporan rutin pneumonia berbasis web pada Program Pengendalian Penyakit Infeksi Saluran Pernapasan Akut (P2 ISPA) di Dinas Kesehatan Kabupaten Semarang. Desain penelitian ini adalah desain pra eksperimen dengan pendekatan one group pretest-posttest, pengembangan sistem menggunakan metode FAST (Framework for the Application of System Techniques). Subjek penelitian ada dua yaitu pengguna sistem di Dinas Kesehatan dan empat puskesmas percontohan. Data dikumpulkan dengan teknik observasi, wawancara mendalam dan kuesioner tertutup, pengolahan dan analisis data menggunakan analisis isi dan uji statistik Wilcoxon. Penelitian ini menghasilkan suatu sistem informasi pelaporan rutin pneumonia baru yang berbasis web untuk mengatasi permasalahan yang terjadi pada sistem informasi yang lama. Hasil uji statistik Wilcoxon menunjukkan bahwa ada perbedaan kualitas informasi yang signifikan dilihat dari aspek kemudahan (p=0,0001), aspek kelengkapan (p=0,0001), aspek kejelasan (p=0,0001) dan aspek ketepatan waktu (p=0,0001) antara sebelum dan sesudah sistem informasi pelaporan rutin pneumonia dikembangkan. Perlu adanya komitmen dari Dinas Kesehatan Kabupaten Semarang untuk memanfaatkan sistem informasi pelaporan rutin pneumonia yang baru ini secara optimal. Selain itu, data-data yang dilaporkan dari puskesmas ke Dinas Kesehatan hendaknya benar-benar akurat dan sesuai fakta di lapangan.Kata kunci : Sistem informasi, pelaporan rutin pneumonia, Program P2 ISPAABSTRACTEvaluation activities for a program of Acute Respiratory Tract Infection Disease Control at Semarang District Health Office were not optimal because required information from a routine report could not be used to support evaluation activities. Some problems existing on current information system of pneumonia routine reporting were as follows: an officer had a difficulty to change or re-access pneumonia information, resulted information was incomplete and unclear, and submission of a report was not timely. This research aimed to develop information system of Pneumonia routine reporting based on web on the program of Acute Respiratory Tract Infection Disease Control at Semarang District Health Office.Design of this research was pre-experiment with one group pretest-posttest approach. In addition, development of the system used the methods of Framework for the Application of System Techniques (FAST). Subjects consisted of a system user at District Health Office and four pilot health centers. Data were collected using methods of observation, indepth interview, and a closed-ended questionnaire. Furthermore, data were analyzed using content analysis and Wilcoxon test. This research resulted information system of Pneumonia routine reporting based on web on the program of Acute Respiratory Tract Infection Disease Control to solve problems happened in the old system. The result of Wilcoxon test revealed that there were any quality differences of information in terms of the aspect of easiness (p=0.0001), the aspect of completeness (p=0.0001), the aspect of clarity (p=0.0001), and the aspect of timeliness (p=0.0001) before and after developing the information system.As a suggestion, Semarang District Health Office needs to have commitment to optimally operate the new system. Additionally, data reported from health centers to District Health Office must be accurate in accordance with reality in the fields.Keywords : Information System, Pneumonia Routine Reporting, A Program of Acute Respiratory Tract Infection Disease Control

Analysis on the Influence of Director Leadership Style to Patient Safety Culture in Hermina Pandanaran Hospital Yuni Kartika; Sudiro Sudiro; Lucia Ratna Kartika Wulan
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKRS Hermina Pandanaran menetapkan kebijakan tentang program keselamatan pasien yang berpedoman tujuh langkah keselamatan pasien, tetapi budaya keselamatan pasien belum terlaksana dengan baik. Tujuan penelitian ini adalah menjelaskan gaya kepemimpinan transformasional direktur sesuai tujuh langkah keselamatan pasien rumah sakit dalam pelaksanaan budaya keselamatan pasien di RS Hermina Pandanaran. Jenis penelitian ini adalah kualitatif. Informan utama adalah ketua dan anggota tim Keselamatan Pasien Rumah Sakit meliputi wakil direktur medis, manajer penunjang medis, manajer keperawatan, manajer rumah tangga dan perawat PPI. Informan triangulasi pihak yang terkait dalam program keselamatan pasien rumah sakit. Pengumpulan data dilakukan melalui indepth interview dan observasi. Pengolahan data dilakukan dengan metode analsis isi (content analysis). Hasil penelitian menunjukkan bahwa gaya kepemimpinan transformasional direktur telah melibatkan staf dalam menerapkan budaya keselamatan pasien, terutama non blaming culture dan budaya belajar dari insiden, tetapi budaya pelaporan belum berjalan dengan baik. Tujuh langkah keselamatan pasien RS belum dilaksanakan seluruhnya, yaitu belum memotivasi staf dengan optimal, menjabarkan langkah-langkah penanganan insiden keselamatan pasien secara langsung di lapangan, menetapkan kebijakan tentang diklat keselamatan pasien, mengembangkan sistem pengelolaan risiko, melaksanakan pelatihan RCA di rumah sakit.Disarankan agar direktur rumah sakit lebih sering melakukan sosialisasi budaya pelaporan kepada staf dengan menekankan non blaming culture, menjabarkan langkah-langkah penanganan insiden keselamatan pasien dan melaksanakan asesmen risiko. Direktur diharapkan turun langsung ke lapangan melalui ronde keselamatan pasien dan menetapkan kebijakan tentang diklat keselamatan pasien termasuk pelatihan RCA dalam bentuk Surat Keputusan agar berjalan sesuai ketentuan dan hasilnya dapat dievaluasi.Kata kunci : Kepemimpinan, Budaya, Keselamatan Pasien, Rumah SakitABSTRACTHermina Pandanaran hospital had established a policy regarding patient safety program based on seven steps of patient safety. However, patient safety culture had not adequately performed. Objective of this study was to explain transformational leadership style of a director according to seven steps of hospital patient safety in order to implement patient safety culture in Hermina Pandanaran hospital. This was a qualitative study. Main informants were a head and team member of hospital patient safety; it included a hospital medical deputy director, a medical support manager, a nursing manager, a domestic affair manager, and PPI nurses. Triangulation informants were people who involved in the hospital patient safety program. Data management was done by applying content analysis method. Results of the study showed that transformational leadership style of a director involved staffs in the implementation of patient safety culture especially none blaming culture and learning fromincident culture. However, reporting culture was not implemented properly. Seven steps of hospital patient safety were not done completely; staffs had not been motivated optimally, steps to manage patient safety incident were not described directly in the field, policy regarding patient safety was not established, risk management system was not developed, RCA training in the hospital was not implemented. Suggestions for hospital director are to do more frequent socialization on reporting culture with stressing on non-blaming culture to staffs; to describe steps on the management of patient safety incident and conducting risk assessment. Director is expected to go directly to the field and involved in the patient safety round, and to establish a policy regarding patient safety education and training including RCA training. It could be in the form of decree in order the implementation of policy was done properly, and the results could be evaluated.Keywords : Leadership, culture, patient safety, hospital

Factors Affecting Commitment Midwives Implementation in 7T Minimum Care Standards Antenatal Care in Konawe District Yustiari Yustiari; Sudiro Sudiro; Chriswardani Suryawati
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKCakupan pelayanan K1 dan K4 di Kabupaten Konawe pada tahun 2012 masih rendah yaitu 60,2% dan 54,2%. Hasil studi pendahuluan menunjukan komitmen bidan desa dalam penerapan standar asuhan minimal 7T masih rendah. Tujuan penelitian adalah mengetahui faktor-faktor yang mempengaruhi komitmen bidan desa dalam penerapan standar asuhan minimal 7T pada pelayanan antenatal care di Kabupaten Konawe. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Variabel bebas adalah kondisi kerja, harapan, ketersediaan pekerjaan, kompensasi, personal value, kewajiban moral. Variabel terikat adalah komitmen bidan desa. Pengumpulan data dengan metode angket. Jumlah sampel 80 bidan desa secara teknik purposive sampling di 12 Puskesmas. Analisis bivariat dengan uji chi square dan analisis multivariat dengan uji regresi logistik. Hasil penelitian menunjukkan bahwa komitmen baik 51,2%, kondisi kerja baik 62,5%, harapan kurang 52,5%, ketersediaan pekerjaan baik 52,5 %, kompensasi baik 67,5%, personal value baik 53,8% serta kewajiban moral baik 61,5%. Ada hubungan antara komitmen bidan dengan harapan (p=0,045), ada hubungan antara komitmen bidan dengan ketersediaan pekerjaan (p=0,003), ada hubungan antara komitmen bidan dengan kompensasi (p=0,000), ada hubungan antara komitmen bidan dengan personal value (p=0,002) dan ada hubungan antara komitmen bidan dengan kewajiban moral (p=0,005). Hasil multivariat menunjukkan bahwa kompensasi (p=0,001;OR=7,9) dan harapan (p=0,037;OR=2,9), secara bersama-sama memiliki pengaruh terhadap komitmen bidan desa dalam penerapan standar asuhan minimal 7T pada pelayanan ANC. Perlu adanya dukungan dan penyediaan fasilitas pelayanan antenatal seperti alat pemeriksaan laboratorium sederhana untuk meningkatkan pelayanan berkualitas secara keseluruhan khususnya memberikan pelayanan antenatal, konseling, deteksi dini masalah, penyakit dan penyulit/komplikasi kehamilan.Kata kunci : Komitmen Bidan Desa, Penerapan Asuhan Pelayanan Minimal 7T, Pelayanan ANCABSTRACTCoverage of K1 and K4 services in District of Konawe in 2012 was still low, namely 60.2% and 54.2% respectively. A preliminary study revealed that commitment of village midwives inimplementing 7T minimum care standards in Antenatal Care (ANC) services was still low. This research aimed to identify factors influencing the commitment of village midwives in implementing the 7T minimum care standards in ANC services in District of Konawe. This was observational analytic research with cross-sectional approach. Independent variables consisted of work condition, expectation, availability of jobs, compensation, personal value, and moral obligation. On the other hand, commitment of village midwives was as a dependent variable. Data collection used a questionnaire. Number of samples were 80 village midwives selected using a purposive sampling technique from 12 selected health centers in District of Konawe. Furthermore, data were analyzed using methods of bivariate (Chi Square test) and multivariate analyses (Logistic Regression test). The result of this research showed that most respondents had good commitment (51.2%), good work condition (62.5%), lack of expectation (52.5%), good availability of jobs (52.5%), good compensation (67.5%), good personal value (53.8%), and good moral obligation (61.5%). The result of bivariate analysis revealed that variables of expectation (p=0.045), availability of jobs (p=0.003), compensation (p=0.000), personal value (p=0.002), and moral obligation (p=0.005) had significant association with the commitment of village midwives. In contrast, the factor of work condition was not significant. Furthermore, variables of compensation (p=0.000; OR=7.9) and expectation (p=0.037; OR=2.9) jointly influenced the commitment of village midwives. As suggestions, there needs support and facilities of ANC services such as providing simple laboratory equipment, providing compensation based on the standard, and increasing expectation of midwives to improve the their commitments in implementing 7T minimum care standards.Keywords : Commitment of Village Midwives, Implementation of 7T Standards, Antenatal Care

Analysis on the Implementation of Clinical Performance Management Development in the Obstetric Inpatient Ward of Belu District General Hospital East Nusa Tenggara Yusfina Modesta Rua; Apoina Kartini; Septo Pawelas Arso
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKPMKK adalah upaya pengembangan kemampuan manajerial dan kinerja Bidan dalam memberikan pelayanan asuhan kebidanan di institusi pelayanan kesehatan yang bermutu. Beradasarkan surat keputusan Kep. Menkes RI. No 836/MENKES/SK/VI/2005 tentang Pengembangan Manajemen Kinerja Klinik (PMKK) maka program tersebut selanjutnya di jalankan oleh RSUD Atambua pada tahun 2006 namun kenyataannya program tersebut sulit dilaksanakan dengan hasil evaluasi yang menunjukkan bahwa program PMKK belum berjalan dengan baik. Penelitian ini menggunakan rancangan observasional dengan pendekatan kualitatif. Informan utama yaitu 7 orang bidan yang bertugas di ruang rawat inap kebidanan RSUD Atambua. Sedangkan informan triangulasi adalah kepala ruang rawat Inap kebidanan, kepala seksi pelayanan, kepala bidang pelayanan dan pasien. Struktur birokrasi secara khusus terkait PMKK misalnya SK petugas tidak ada, sehingga kejelasan bentuk dan tanggung jawabnya sulit diketahui dan dipahami oleh petugas PMKK. Telah tersedia SOP, uraian tugas, dan indikator kinerja namun pelaksanaannya hanya berdasarkan rutinitas. Tidak ada DRK maupun monitoring dan evaluasi yang disusun sesuai dengan standar PMKK, akan tetapi pelaksanaan diskusi, monitoring dan evaluasi selalu dilakukan secara bersamaan dan terjadwal. umumnya komunikasi antara petugas dengan pimpinan kurang baik khususnya PMKK dilihat dari tidak adanya sosialisasi program PMKK kepada bidan selaku pelaksana sehingga ada beberapa bidan yang tidak mengetahui program PMKK. Tidak ada tim khusus yang dibentuk secara resmi untuk pelaksanaan program PMKK, sarana dan prasarana dalam program PMKK belum tersedia sesuai dengan yang dibutuhkan. RSUD Atambua Perlu membentuk tim PMKK, untuk meningkatkan pemahaman bidan terhadap program PMKK perlu dilakukan sosialisasi kebijakan dengan meningkatkan intensitas forum interaktif antara DKK dengan RS serta pelatihan tahunan khusus program PMKK, Demi kesinambungan program, sebaiknya diskusi refleksi kasus, monitoring dan evaluasi program lebih ditingkatkan dan terjadwal dengan baik dan evaluasi dilakukan dengan menggunakan daftar tilik.Kata kunci : Program PMKK, Implementasi Kebijakan, Rawat Inap KebidananABSTRACTDevelopment of clinical performance management (PMKK) was an effort to develop managerial ability and performance of midwives in implementing obstetric care service in the qualified health service institution. Based on the Indonesian Health Minister Decree no. 836/MENKES/SK/VI/ 2005 regarding PMKK, accordingly, that program would be implemented by Atambua District General Hospital (RSUD) in 2006 but in the reality that program was difficult to be implemented.The result of an evaluation showed that PMKK program had not run well. This study used applied observational design and qualitative approach. The main informants were 7 midwives working at the obstetric inpatient wards of RSUD Atambua. Triangulation informants were the head of the obstetric inpatient wards, head of the service unit, head of the service department and patients. Bureaucracy structure was specifically related to PMKK such as no workers decree, consequently clarity of their task form and responsibilities were difficult to know and understood. Standard operating procedure, job description and performance indicator had been provided however the implementation was based only on the rutinity. No DRK or monitoring and evaluation that were designed according to PMKK standard, but the implementation of discussion, monitoring and evaluation were done together and scheduled. In general, there was poor communication between workers and their leaders specifically on PMKK. It could be seen that there was no PMKK program socialization to midwives and as a results several midwives have no knowledge on PMKK program. No special team formed formally to implement PMKK program. Facilities for PMKK program had not been provided according to the need.Atambua district general hospital needs to assemble PMKK team. To improve midwives understanding on PMKK program, the hospital needs to do socialization of the policies by increasing the intensity of interactive forum between District Health Office and Hospital and also conducting special training on PMKK program annually. For program continuity, it is better to increase the frequency of case reflection discussion, program monitoring and evaluation. It has to be scheduled properly and using check list when conducting evaluation.Keywords : PMKK program, policy implementation, obstetric inpatient

Analysis of Promotional Mix Effect (Marketing Communication Mix) on Patient Loyalty in Obstetric and Gynaecology Outpatient Unit in RSIA Kurnia Cilegon Eka Yunila Fatmasari; Sudiro Sudiro; Septo Pawelas Arso
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 3 (2015): Desember 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKPenurunan kunjungan rawat inap terutama ruang rawat inap kebidanan di RSIA Kurnia Cilegon, penurunan jumlah pasien lama dan penurunan jumlah persalinan memperkuat indikasi loyalitas pasien di Poliklinik Obstetri dan Ginekologi menurun. Adanya persaingan rumah sakit swasta menempatkan bauran komunikasi pemasaran penting dalam meningkatkan kunjungan dan membangun hubungan jangka panjang dengan pasien. Penelitian ini bertujuan untuk mengetahui nilai promotional mix (bauran komunikasi pemasaran) dikaitkan dengan loyalitas pasien. Jenis penelitian observasional dengan pendekatan cross sectional. Variabel yang diteliti meliputi komunikasi personal, periklanan, publisitas dan hubungan masyarakat, materi pembelajaran, rancangan korporat dan kepuasan pasien. Data penelitian diolah secara kuantitatif dengan metode univariat, bivariat dan multivariat dengan uji analisis regresi logistik dilengkapi dengan analisis secara kualitatif (content analysis). Hasil penelitian menemukan bahwa persepsi kurang baik pada komunikasi personal sebesar 62%, persepsi kurang baik pada periklanan sebesar 55%, persepsi kurang baik pada publisitas dan hubungan masyarakat sebesar 63%, persepsi kurang baik pada materi pembelajaran sebesar 54%, persepsi kurang baik pada rancangan korporat sebesar 53% dan persepsi kurang baik pada kepuasan pasien sebesar 72%. Hasil analisis pengaruh bersama-sama menunjukkan bahwa komunikasi personal, periklanan, publisitas dan hubungan masyarakat, materi pembelajaran, rancangan korporat dan kepuasan pasien berpengaruh terhadap loyalitas pasien. Hasil tersebut dapat dibuat persamaan regresi yaitu Y= 0,871 + 2,145 variabel komunikasi personal + 1,879 variabel periklanan + 1,044 variabel publisitas dan hubungan masyarakat + 1,758 variabel materi pembelajaran + 1,233 variabel rancangan korporat + 1,445 variabel kepuasan pasien. Komunikasi personal memiliki pengaruh yang paling kuat sedangkan publisitas dan hubungan masyarakat memiliki pengaruh yang paling lemah terhadap loyalitas pasien. Disarankan manajemen RSIA Kurnia Cilegon untuk meningkatkan komunikasi personal bidan dan informasi sms gateway.Kata kunci : Promotional Mix, Loyalitas Pelanggan, Perilaku Konsumen. ABSTRACTThe decrease of inward visit specifically in the obstetrics inward room of Kurnia maternal andchild hospital (RSIA) Cilegon, the decrease of the number of old patients, and the decrease of the number of deliveries strengthen the indication of decreasing patient’s loyalty in the obstetrics and gynecology policlinic. Competition among private hospitals placed a promotional mix an important matter to increase patient visit, and to build long term relationship with patients. Objective of this study was to identify promotional mix value in relation with patients’ loyalty. This was an observational study with cross sectional approach. Study variables were personal communication, advertising, publicity and public relation, teaching materials, corporation design, and patient satisfaction. Data were analyzed quantitatively using univariate and bivariate methods; and multivariate analysis was conducted by applying logistic regression test. Qualitative analysis was implemented, and content analysis was applied. Results of the study showed that perception on personal communication was not good (62%), perception on the advertising was not good (55%), perception on publicity and public relation were not good (63%); perception on teaching materials was not good (54%), perception on corporate design was not good (53%), and perception on patient satisfaction was not good (72%). Result of multivariate analysis showed that personal communication, advertising, publicity and public relation, teaching materials, corporate design, and patient satisfaction influenced the patient loyalty. The regression formula was Y= 0.871 + 2.145 communication personal + 1.879 advertising + 1.044 publicity and public relation + 1.758 teaching materials + 1.233 corporate design + 1.445 patient satisfaction. Personal communication had the strongest influence, publicity and public relation had the weakest influence to patient loyalty. It is suggested to the management of RSIA Kurnia Cilegon to improve midwives personal communication and sms information gateway.Keywords : promotional mix, customer loyalty, consumer behavior

Relationship between Management Functions of P2 ISPA Program and Target Achievement of Coverage Rate of Pneumonia on Children under Five Years Old at Health Centres in Semarang City Sri Isroyati; Sri Suwitri; Sutopo Patria Djati
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 3 (2015): Desember 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKAngka cakupan pneumonia balita di puskesmas kota Semarang tahun 2012 sebesar 25% dan tahun 2013 sebesar 26%,kondisi ini masih dibawah target yang ditetapkan oleh DKK Kota Semarang yaitu 37 % pada tahun 2013. Hal ini menunjukkan rendahnya angka cakupan pneumonia balita yang diduga belum optimalnya fungsi manajemen program P2 ISPA. Tujuan penelitian adalah menganalisis fungsi manajemen program P2 ISPA kaitannya dengan angka cakupan pneumonia balita di puskesmas kota Semarang. Penelitian ini merupakan penelitian observasional dengan pendekatan cross sectional. Cara pengumpulan data melalui wawancara menggunakan kuesioner terstruktur dan observasi dokumen menggunakan checklist observasi terhadap fungsi manajemen program P2 ISPA. Jumlah sampel 36penanggung jawab program di 37Puskesmas Kota Semarang karena 1 penanggung jawab tidak memenuhi kriteria sampel. Analisis bivariat dengan uji chi square. Hasil penelitian menunjukkan dari puskesmas yang mencapai target cakupan proporsi penanggung jawab program yang memiliki perencanaan baik 87,5%, pengorganisasian baik 87,5%, penggerakan baik 75,0% dan pengawasan baik 87,5%. Dari puskesmas yang tidak mencapai target cakupan proporsi penanggung jawab program yang memiliki perencanaan baik 39,3%, pengorganisasian baik 42,9%, penggerakkan baik 28,6% dan pengawasan baik 46,4%. Puskesmas yang telah mencapai target cakupan sebanyak 22,2%. Analisis bivariat menunjukkan ada hubungan antara fungsi perencanaan (p value = 0,045) dan penggerakkan (p value = 0,049) dengan ketercapaian target angka cakupan pneumonia balita. Disarankan agar penanggung jawab program mengikutsertakan kader dalam deteksi dini, memotivasi petugas pelaksana teknis agar patuh dalam pendekatan MTBS, sosialisasi dalam tatalaksana standar, membuat laporan 3 bulanan dan 6 bulanan untuk upaya pemantauan rutin.Kata kunci : Fungsi Manajemen P2 ISPA, Cakupan Pneumonia BalitaABSTRACTCoverage rate of pneumonia on children under five years old at health centres in Semarang in 2012 was 25% and in 2013 was 26%. This results were lower than a target released by Semarang City Health Office (CHO) in 2013, namely 37%. This problem might be due to not optimal in conducting management functions of P2 ISPA program. The aim of this study was to analyse management functions relating to coverage rate of pneumonia on children under five years old at health centres in Semarang City. This was an observational study using cross-sectional approach. Data were collected using structured questionnaires and document observation using a checklist of management functions of P2 ISPA program. Number of respondents were 36 officers in charge of the program at 37 health centres in Semarang City. One officer had not met sample criteria. Data were analysed using Chi-Square test. The results of this research showed that among health centres that achieved the target, most ofofficers in charge of the program had good planning (87.5%), good organising (87.5%), goodactuating (75.0%), and good monitoring (87.5%. In contrast, among health centres that did not reach the target, some of officers in charge of the program had good planning (39.3%), good organising (42.9%), good actuating (28.6%), and good monitoring (46.4%). Proportion of health centres that had achieved the target was (22.2%). Bivariate analysis indicated that functions of planning (p value = 0.045) and actuating (p value = 0.049) had significant relationship with the target achievement of coverage rate of pneumonia on children under five years old. As suggestions, officers in charge of the program need to involve cadres in conducting early detection, motivate implementing technical officers in order to use MTBS approach, socialise in implementing a standard, make quarterly report and semester report as a routine monitoring.Keywords : management functions of P2 ISPA; coverage of pneumonia on children under five years old

The Impact of Succession on Working Situation at Jayapura Health Office in Papua Province Youke A. Supit; Chriswardani Suryawati; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 3 (2015): Desember 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKOtonomi daerah memberikan kewenangan penuh pada Bupati/Walikota mengatur semua potensi yang ada di daerah, termasuk Sumber Daya Manusia. Dalam periode 2010-2012, Dinas Kesehatan Kota Jayapura telah mengalami 6 kali pergantian Kepala Dinas. Pergantian tersebut berdampak pada situasi kerja staf/karyawan Dinas Kesehatan Kota Jayapura.Tujuan penelitian adalah menjelaskan dampak pergantian pemimpin Dinas Kesehatan terhadap situasi kerja. Penelitian dilakukan dengan metode kualitatif. Informan utama meliputi pejabat eselon 3 (3orang) dan eselon 4 (3orang) serta staf administrative (2orang). Informan triangulasi yaitu Kepala Puskesmas (2orang), Kepala Gudang Farmasi (1orang), Koordinator LSM (2orang) dan Ketua Bappeda (1orang). Pengumpulan data dilakukan dengan wawancara mendalam. Analisis data dilakukan dengan content analysis. Hasil penelitian menunjukkan bahwa staf/karyawan mempersepsikan pergantian pimpinan merupakan kewenangan Walikota berdasarkan pertimbangan tertentu termasuk pertimbangan politis. Pergantian pemimpin merupakan hal wajar karena bersifat tour of duty. Dampak yang ditimbulkan yaitu miskomunikasi berupa terganggunya komunikasi, koordinasi, perubahan kebijakan dan pengawasan. Koordinasi terganggu karena adanya keputusan yang seringkali berbeda, mekanisme pengawasan berubah, hubungan interpersonal cenderung bersikap saling curiga dan persaingan mengakibatkan motivasi kerja menurun yang terjadi di lingkungan Dinas Kesehatan Namun demikian terdapat juga dampak positif yang ditemui berupa penyegaran suasana yang baru oleh karena Kepala Dinas yang baru. Disimpulkan bahwa proses pergantian pemimpin lebih berdampak negatif terhadap situasi kerja berupa perubahan kebijakan, gangguan komunikasi, koordinasi serta penurunan motivasi kerja.Kata kunci : Pergantian Pemimpin, Otonomi Daerah, Kepemimpinan, Situasi KerjaABSTRACTDistrict autonomy status gave full authority for district/ city leader to manage all district/citypotencies including human resource. In the period of 2010-2012, Jayapura city health office had six times of leader change. This change had impact to the work situation of Jayapura city health office workers. Objective of this study was to explain the impact of leader change in the health office toward work situation. This study was done using qualitative method. Main informants were 3 people from the third echelon, 4 people from the fourth echelon, and 2 administrative staffs. Triangulation informants were 2 heads of primary healthcare centers (puskesmas), one head of pharmacy storage, 2 coordinators of non-government organization (LSM), and one Bappeda leader. Data collection was done through in-depth interview. Content analysis was applied in the data analysis. Results of the study showed that workers considered the leader change as a district leader’s authority that was based on certain considerations including political issue. Leader change was an ordinary event because it was a tour of duty. Impact of leader change was miscommunication such as communication disturbance, coordination, policy change, and supervision. Coordination disturbance occurred due to the existence of different decisions, change in the mechanism of supervision, non-conducive interpersonal relationship, and unhealthy competitive work atmosphere. Those situations caused reduction in the work motivation. However, a positive impact was found such as giving a fresh work atmosphere. In conclusion, leader change process gave more negative impacts to the work situation such as change in policies, communication disturbance, communication disturbance, and work motivation reduction.Keywords : leader change, district autonomy, leadership, work situation

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Prodi Magister Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat UNDIP, Jalan Professor Soedarto, Tembalang, Kota Semarang, Jawa Tengah 50275, Indonesia

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Editorial Address Prodi Magister Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat UNDIP, Jalan Professor Soedarto, Tembalang, Kota Semarang, Jawa Tengah 50275, Indonesia

Location Kota semarang, Jawa tengah INDONESIA

Abstract

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Contact Name
-

Contact Email
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Prodi Magister Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat UNDIP, Jalan Professor Soedarto, Tembalang, Kota Semarang, Jawa Tengah 50275, Indonesia

Location
Kota semarang,

Jawa tengah

INDONESIA