Dalam upaya pemenuhan tenaga kesehatan di Fasilitas Pelayanan Kesehatan (Fasyankes) Daerah Terpencil Perbatasan, dan Kepulauan (DTPK) dan Daerah Bermasalah Kesehatan (DBK), Kementerian Kesehatan RI mengeluarkan kebijakan Peraturan Kementerian Kesehatan nomor 27 tahun 2021 tentang Program Afirmasi Pendidikan Tinggi Tenaga Kesehatan (Padinakes). Kebijakan ini telah ditetapkan dan dilaksanakan di Poltekkes Kemenkes Jakarta III sejak tahun 2021 berdasarkan Surat Keputusan (SK) Kepala Badan Pengembangan dan Pemberdayaan SDM Kesehatan nomor HK.02.02/I/10434/2021, namun dalam pelaksanaan kebijakan terkendala dalam pendayagunaan lulusan dan penghentian rekrutmen peserta pada tahun 2022 di Poltekkes Kemenkes Jakarta III. Tujuan penelitian ini adalah menganalisis implementasi kebijakan pendidikan dan pendayagunaan tenaga kesehatan, menganalisis faktor-fakor pendorong dan penghambat dalam implementasi kebijakan Padinakes di Poltekkes Kemenkes Jakarta III. Penelitian ini adalah penelitian kualitatif dengan desain Rapid Assessment Procedure (RAP). Teknik pengumpulan data dengan dengan wawancara mendalam, Focus Group Discussion (FGD) dan telaah dokumen. Hasil dari penelitian ini menunjukkan implementasi kebijakan belum berjalan dengan baik terutama pada implementasi pendayagunaan lulusan padinakes Poltekkes Kemenkes Jakarta III ke Fasyankes DTPK dan DBK. Faktor-faktor yang menghambat dalam implementasi kebijakan adalah capaian indikator program padinakes belum sesuai tujuan kebijakan, sosialisasi dengan Pemerintah Daerah belum berjalan baik, semua pembiayaan menggunakan APBN, struktur organisasi Pemerintah Daerah bukan bertanggung jawab kepada Kementerian Kesehatan, sikap Pemerintah Daerah yang belum patuh dalam pendayagunaan program padinakes, Pemerintah Daerah belum terlibat dalam perencanaan kouta, rekrutmen, monitoring dan evaluasi, dan pendayagunaan peserta, belum ada sanksi tegas untuk Pemerintah daerah yang tidak mendayagunakan lulusan padinakes. Oleh karena itu, Kementerian Kesehatan diharapkan dapat melakukan revisi kebijakan; penyesuaian indikator program dengan tujuan kebijakan; advokasi ke Kemendagri dan Kemenkeu untuk sanksi ke Pemerintah Daerah; pendampingan ke Pemerintah Daerah dalam proses replikasi program nusantara sehat; membuat tracer study khusus; penyempurnaan e-Padinakes; peningkatan kapasitas dan menetapkan SK tim pengelola; menetapkan SK pendayagunaan peserta program studi lain yang tidak ada di kebijakan (Fisioterapi); rutin monitoring dan evaluasi Poltekkes Kemenkes Jakarta III dan Fasyankes DTPK dan DBK
In an effort to fulfill health workers in Health Service Facilities (Fasyankes) in Remote Areas, Borders and Islands (DTPK) and Health Problem Areas (DBK), the Indonesian Ministry of Health issued a policy Ministry of Health Regulation number 27 of 2021 concerning the Health Worker Higher Education Affirmation Program (Padinakes). This policy has been determined and implemented at the Poltekkes Kemenkes Jakarta III since 2021 based on the Decree (SK) of the Head of the Health Human Resources Development and Empowerment Agency number HK.02.02/I/10434/2021, but the implementation of the policy is constrained in the utilization of graduates and the termination of recruitment of participants in 2022 at the Poltekkes Kemenkes Jakarta III. The purpose of this study is to analyze the implementation of the policy on education and utilization of health workers, analyze the driving and inhibiting factors in the implementation of the Padinakes policy at the Poltekkes Kemenkes Jakarta III. This research is a qualitative research with Rapid Assessment Procedure (RAP) design. Data collection techniques were in-depth interviews, Focus Group Discussions (FGDs) and document review. The results of this study indicate that policy implementation has not gone well, especially in the implementation of the utilization of graduates of the Jakarta III Health Polytechnic to DTPK and DBK health facilities. Factors that hinder the implementation of the policy are the achievement of Padinakes program indicators that are not in accordance with policy objectives, socialization with local governments has not gone well, all financing uses the state budget, the organizational structure of the local government is not responsible to the Ministry of Health, the attitude of local governments that have not complied with the utilization of the Padinakes program, local governments have not been involved in planning quota, recruitment, monitoring and evaluation, and utilization of participants, there are no strict sanctions for local governments that do not utilize Padinakes graduates. Therefore, the Ministry of Health is expected to revise the policy; adjust program indicators with policy objectives; advocate to the Ministry of Home Affairs and the Ministry of Finance for sanctions to local governments; assist local governments in the process of replicating the healthy archipelago program; create a special tracer study; improve e-Padinakes; increase capacity and determine the management team decree; determine the decree on the utilization of participants in other study programs that are not in the policy (Physiotherapy); routine monitoring and evaluation of the Poltekkes Kemenkes Jakarta III and DTPK and DBK health facilities.
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