Pandemi COVID-19 mengganggu berbagai aspek sistem dan pelayanan kesehatan, termasuk pelayanan penyakit tidak menular (PTM). Dampak gangguan pelayanan dan penanggulangan PTM dikhawatirkan dapat mengakibatkan efek katastropik jangka panjang setelah pandemi COVID-19, dan PTM perlu menjadi masalah kesehatan prioritas dalam kebijakan kesehatan pasca-pandemi COVID-19. Penelitian ini menggunakan metode kualitatif dan pendekatan teori social determinants of health, teori pengembangan kebijakan berbasis bukti, model pengembangan kebijakan sosial berbasis kebijakan sains, dan determinan dampak kebijakan terhadap luaran kesehatan. Penelitian ini melakukan penilaian dari kebijakan penanggulangan PTM dan pelayanan PTM sebelum, ketika terdampak COVID-19, dan setelah pandemi COVID-19. Temuan dari penelitian menunjukkan bahwa kebijakan penanggulangan PTM di Indonesia sudah mencerminkan strategi global, dengan advokasi dan kemitraan, promosi kesehatan dan penurunan faktor risiko, penguatan sistem pelayanan kesehatan, penguatan surveilans, monitoring-evaluasi, dan riset, dan menunjukkan capaian yang baik sebelum pandemi COVID-19. Ketika terdampak pandemi COVID-19, aspek pelayanan PTM yang terganggu adalah pembatasan sosial, SDM, pemberhentian layanan, ketidaksiapan infrastruktur dan fasilitas, hambatan pelaksanaan program dan tidak tercapainya target layanan maupun program. Dari dampak yang terjadi, dilakukan adaptasi dalam penanggulangan PTM saat COVID-19, antara lain dengan integrasi layanan, dan menunjukkan hasil yang baik dengan ketercapaian sasaran. Masalah yang ditemukan dalam upaya penanggulangan dan pelayanan PTM sebelum dan saat pandemi antara lain dibutuhkannya peningkatan sistem rujukan, pencatatan dan pelaporan, serta pengendalian faktor risiko PTM. Dampak dari COVID-19 juga membentuk kebijakan transformasi kesehatan Indonesia, dengan enam pilar, di antaranya berupa transformasi layanan kesehatan primer, transformasi layanan rujukan, transformasi sistem ketahanan kesehatan, transformasi pembiayaan kesehatan, transformasi SDM kesehatan, dan transformasi teknologi kesehatan. Diharapkan kebijakan penanggulangan dan pelayanan PTM pasca pandemi COVID-19 menjadi salah satu masalah kesehatan prioritas yang mengikuti transformasi kesehatan.
The COVID-19 pandemic has disrupted various aspects of the healthcare system and services, including the management of noncommunicable diseases (NCDs). The potential long-term catastrophic effects of the disruption in NCD services and management post-COVID-19 pandemic are a cause for concern. NCDs need to be prioritized as a health issue in post-COVID-19 health policies. This research employs a qualitative method and utilizes the social determinants of health theory, evidence-based policy development theory, social policy-based policy development model, and determinants of policy impact on health outcomes. The study assesses NCD prevention policies and NCD services before, during the COVID-19 impact, and after the pandemic. Findings indicate that NCD prevention policies in Indonesia already reflect global strategies, including advocacy and partnerships, health promotion, and the reduction of risk factors, strengthening healthcare systems, surveillance enhancement, monitoring and evaluation, and research, showing good achievements before the COVID-19 pandemic. When affected by the COVID-19 pandemic, disrupted aspects of NCD services include social restrictions, human resources, service discontinuation, infrastructure and facility unpreparedness, program implementation barriers, and unmet service and program targets. Adaptations in NCD management during COVID-19, such as service integration, have shown positive results in achieving targets. Challenges identified in NCD prevention and services before and during the pandemic include the need for referral system improvement, recording and reporting, and the control of NCD risk factors. The impact of COVID-19 has also shaped Indonesian health transformation policies with six pillars, including the transformation of primary health services, referral services, health resilience systems, health financing, healthcare workforce, and health technology. It is hoped that NCD prevention and services policies after COVID-19 pandemic become one of the priority health issues following health transformation.
Fatira Ratri Audita-Tesis-FKM-Full Text-2024.pdf ::