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Untuk dapat mewujudkan Misi Indonesia Sehat 2010, ditetapkan empat misi pembangunan kesehatan dan salah satu misi tersebut adalah memelihara dan meningkatkan pelayanan kesehatan yang bermutu, merata dan terjangkau. Pelayanan kesehatan hendaknya dikerjakan sesuai dengan standar pelayanan kesehatan yang berlaku dan dilakukan secara benar dengan segera. Berbagai upaya telah dilakukan dalam rangka meningkatkan upaya pembangunan kesehatan guna mendekatkan pelayanan kesehatan kepada masyarakat dan meningkatkan pemerataan dan mutu pelayanan secara terus menerus. Sesuai dengan hal diatas, penelitian ini bertujuan untuk mengkaji alasan-alasan yang mempengaruhi tingkat kepatuhan petugas dalam menggunakan standar penatalaksanaan ISPA pada Balita di Puskesmas Dempo Kota Palembang, dimana tingkat kepatuhan petugas terhadap standar penatalaksanaan di Puskesmas tersebut masih rendah. Penelitian ini merupakan studi kasus dengan menggunakan pendekatan kualitatif. Data diperoleh melalui observasi dan wawancara mendalam dengan 5 prang informan di Puskesmas Dempo. Sebagai informan adalah petugas kesehatan yang melayani balita penderita ISPA dengan mengadakan observasi dan wawancara mendalam (in-depth interview), sedangkan kepala Puskesmas dilakukan wawancara mendalam. Untuk petugas kesehatan yang dilihat adalah pengetahuan, sikap, motivasi, pengalaman, sarana dan imbalan, untuk kepala Puskesmas yang dilihat adalah pengawasan atau supervisi. Hasil penelitian menunjukkan bahwa yang menyebabkan ketidakpatuhan petugas menggunakan daftar tilik ISPA pada balita adalah karena rendahnya pengetahuan petugas terhadap standar pengetahuan yang ada di daftar tilik, terbatasnya waktu yang ada untuk melayani balita ISPA, kurangnya penghargaan pembinaan pada petugas, kurangnya pengawasan dan kepala Puskesmas dan kurangnya j umlah petugas yang diperlukan untuk melayani penderita ISPA. Melihat dari hasil penelitian ini disarankan kepada Dines Kesehatan agar mengadakan pelatihan kembali untuk meningkatkan pengetahuan petugas, menyediakan dana khusus untuk pembinaan, meningkatkan pengawasan, menyediakan dan memperbaiki sarana, dan lebih memperhatikan pelaksanaan program ISPA. Bagi kepala Puskesmas agar meningkatkan pembinaan dan pengawasan, mengadakan diseminasi, memotivasi petugas ISPA dengan memberikan penghargaan, menyediakan ruang periksa khusus, menambah jumlah petugas ISPA, memberikan perhatian yang cukup terhadap program ISPA dan melakukan pengawasan terhadap rekam medik dan sistem pencatatan dan pelaporan ISPA. Bagi petugas kesehatan adalah agar dalam memberikan pelayanan kepada pasien tetap berpedoman pada standar yang telah ditetapkan, apabila menemukan kesulitan atau hambatan melapor ke pimpinan dan agar setiap petugas ISPA terus meningkatkan pengetahuan dan keterampilan dalam menangani pasien ISPA dengan mengikuti pelatihan-pelatihan yang diselenggarakan. Bagi peneliti lain agar meneliti variabel-variabel lain diluar variabel yang sudah diteliti dan meneliti lebih lanjut mengenai periunya daftar tilik yang ada sekarang untuk diperbaiki.
Qualitative Analysis of Personnel Compliance In Using ARI Check List in Infants: Case Study in Dempo Community Health Center, Palembang, South Sumatera Year 2001In order to realize the vision of Healthy Indonesia 2010, four health development missions have been set and one of such mission is to maintain and improve high quality, well-distributed and affordable health service. The health service must be done according to the prevailing health standard and shall be done correctly and immediately. Various efforts have been done in an attempt to improve health developments in order to give health service to the people and improve its distribution and quality continuously. According to the above matters, this research in intended to study the reasons that affect the level of personnel compliance in using the ARI administration standard in infants in Community Health Center in Dempo, Palembang, where the level of compliance of the personnel towards administration standard in such Community Health Center is still low. This research is a case study by using qualitative approach. The data is obtained through observation and in-depth interview with 5 informants in Dempo Community Health Center. The informants are health personnel that serve the infants ARI patients by performing observation and in-depth interview, while the Head of Community Health Center perform in-depth interview. The health personnel observed are knowledge, attitude, motivation, experience, facilities and rewards, while for the Head of Community Health Center the characteristics observed are supervision or control. Results of study shows that the cause of incompliance of personnel in using the ARl Check List in infants is the low level of such personnel knowledge toward the knowledge in such check list, the limitation of the available time to serve the ARI infants, the lack of incentive for guidance in such personnel, the lack of supervision from Head of Community Health Center and the lack of personnel needed to serve the ARI patients. Having observed this research it is suggested that the Health Office to perform retraining to increase knowledge of such personnel, provide special fund for development, increase supervision, provide and improve facilities, and pay more attention to the ART program implementation. For the Head of Community Health Center, they must improve development and supervision, dissemination, motivating the ARI personnel by giving rewards, provide special check room, increase the number of ARI personnel, provide sufficient attention to ARI program and perform supervision towards medical records and recording and reporting system of ARi. For the health personnel, in providing service to the patients they must stick to the standard that has been set, in case they have difficulties or obstacles they must report supervisor and each ARI personnel must continue to increase their knowledge and skill in handling ARI patients by following training. For other researchers, the variables other than that have been to studied can examined and further research regarding the need to improve the existing checklist.
Puskesmas Pembantu merupakan sarana pelayanan kesehatan terdepan di Indonesia dengan jumlah 21115 unit. Puskesmas Pembantu tersebut turut menentukan berhasil tidaknya pembangunan kesehatan di Indonesia. Dewasa ini peranan yang belum optimal dan kinerja petugas yang masih rendah berimbas terhadap rendahnya kesehatan masyarakat dan pencapaian target atau cakupan beberapa program kesehatan. Dalam hal ini, perlu diadakan suatu penelitian yang bertujuan untuk mendapatkan gambaran kinerja petugas Puskesmas Pembantu dalam pelayanan kesehatan dan faktorfaktor yang berhubungan dengan kinerja Puskesmas Pembantu dalam pelayanan kesehatan di Kabupaten Bungo-Tebo.Penelitian ini menggunakan cross sectional design melalui studi observasional untuk melihat faktor status perkawinan, motivasi, tempat tinggal, lama kerja, supervisi dan pelatihan dalam hubungannya dengan kinerja Puskesmas Pembantu Didalam penelitian ini tidak dilakukan, sampling karena seluruh populasi dijadikan responden yaitu . semua petugas Puskesmas Pembantu di Kabupaten Bungo-Tebo yang berjumlah 102 prang.Hasil penelitian menunjukan bahwa faktor supervisi, motivasi dan pelatihan berhubungan dengan kinerja Puskesmas Pembantu. Sementara faktor status perkawinan, tempat tinggal dan lama kerja tidak berhubungan dengan kinerja petugas Puskesmas Pembantu. Dari ketiga faktor yang berhubungan dengan kinerja petugas Puskesmas Pembantu tenyata faktor supervisi paling dominan berhubungan dengan kinerja petugas. Puskesmas Pembantu, dimana petugas Pustu yang cukup mendapatkan supervisi berpeluang mempunyai kinerja baik 2,6 kali dibanding yang kurang mendapat supervisi OR=2,6 (95% CI: 1,063-6,349).Hasil penelitian ini menunjukkan bahwa tingkat kinerja petugas Puskesmas Pembantu di Kabupaten Bungo-Tebo masih rendah yang disertai dengan tidak tercapainya target cakupan pelayanan kesehatan yang telah ditetapkan. Oleh sebab itu, Puskesmas kecamatan mesti melakukan supervisi secara sistematis, terjadwal dengan memperhatikan kualitas dan kuantitas supervisi dan meningkatkan cakupan pelayanan kesehatan di mass mendatang.
Sub health centre (SHC) is front health service unit in Indonesia numbering as many as 21115 units. This SHC contributes the failure or success of Indonesian health development program. So far, its fair role and its officer working attitude influence on the poor health community and health target achievement or coverage. In this respect, there should be a research in order to obtain description on working attitude of SHC in performing its health service and some factors related to SHC working attitude in order to give health service in Bungo-Tebo District.This research uses cross sectional design through observational study in order to analyz the factor of marriage status, motivation, residence, job duration, supervision and training in relation with SHC working attitude. The research uses total samples in form of whole SHC in Bungo-Tebo District as many as 102 units.Research result shows that the factors of supervision, motivation and training are related with SHC working attitude. On the other hand, The factors of marriage, residence and job duration are not related with SHC working attitude. From three variables related to SHC working attitude, the most related variable is supervision with OR=2,6 (95% CI: 1,063-6,349).The research result shows that health officers' working attitude of SHC in Bungo-Tebo District is stiII low accompanied with the failure of establish health target Therefore, SHC should make supervision systematically and regularly considering supervision quality and quantity in order to improve future health target.
Background and Objective: Public Health Service of Pagar Alam Town at autonomous era of area this time require a strategic plan of expected Human Resource Health in harmony with Vision Mission Public Health Service in range of time 2006 - 2010. This matter is base and also the target of this research. Methods: To be able to compile strategic plan of Human Resource Health in Pagar Alam Town, conducted by research of operational with Analysis Qualitative and Quantitative. Compilation of strategy through some phases. First phase (Input Stage) compose environmental analysis of external and internal Human Resource Health of Public Health Service of Pagar Alam Town pass/through Consensus Decision Making Group (CDMG). At phase both (Matching Stage), CDMG do analyze Internally - External Matrix and SWOT Matrix. At third phase (Decision Stage) analyze conducted by using QSPM to determine best strategy. Results: Result Research, at election of strategy alternative by pursuant to IE Matrix, known by position of Human Resource Public Health Service of Pagar Alam Town reside in cell of V with the meaning residing in on course Hold and Maintenance where suggested to strategy consist of Market Penetration and Product Development. As according to agreement at meeting of CDMG that factor of external becoming opportunity namely the existence of improvement of level education people of Pagar Alam Town, applying of it area autonomy and peripheral of his law, existence of development of information network, existence of commitment / support of Government of town in the effort development of Human Resource health. External factor becoming threat is : low PAD of Pagar Alam Town, supply of Human Resource too a few every year, disease of infection still high, medium education of health there is no. While internal environmental factor which become strength is motivation and devotion of SDMK the high enough, existence of improvement of SDMK following second education and training, low of reduction of SDMK and amenity of permit continue education. For the factor of weakness namely interest of SDMK still lower, there is no Protap/SOP, there is no separate budget post for the development of SDMK, budget still limited. Chosen strategy of Market Penetration priority is to improve professionalism of SDMK existing, giving wide of opportunity to improve to education, developing information network function, braiding cooperation with medium education of existing health profession. For the strategy of priority development product of is optimal of Existing SDMK, preparing SDM being based on health of environment, improving advocate to party taker of policy, proposing the existence of separate budget post for the development of SDMK, making Protap/SOP. Conclusions: In the effort realizing required by long-range target of commitment the highness, can look after cooperation and braid communications which do well by sector which play a part in intake of policy. While suggestion able to be given is to be Renstra development of this Human Resource Health can be socialized to all staff at meeting of routine or special. Then operational strategy follow-up can which have been made by researcher. To be earning in line with Vision Mission Public Health Service of Pagar Alam Town hence required by monitoring to execution of activity. Keywords: Strategic Plan, Human Resource Health, Public Health Service, Market Penetration, Product Development.