Tarif detemnination at Public Health Center, Lahat Regency, has not been based on the analysis result of unit cost, local paying ability and willingness so iiir. The eifective tariifhas been Rp. 300,- since the commence of regional regulation No. 25, 1987. The analysis of local paying ability and willingness toward the tariif of health services has the objective to get public health center tariH` based on the description of local paying ability and willingness at public health center of Merapi ll, Met-api distric, Lahat Regency, in the year 2001. This research applies descriptive analysis with cross sectional design. Data collecting was conducted by holding interviews based on questionnaires, which refer to National-Social Economic Survey of the year 1999 towards families at public Health Center of Mcrapi II. The result of this research is described through analysis of local percentage that is marginalized (or neglected) from health service of certain tariff From the research, it is found that there are two kinds of tariff which are based on examiner (medical examiner), those are, first, tariff of Rp. 1000 for checking up by nurse and 1 - 3 kinds of medicine, and second, tari{I` of Rp. 2000 checking up by doctor with 1 - 3 kinds of medicine. Locals who are marginalized or neglected can be supported by giving (or extending) health cards.

Rendahnya jumlah operasi katarak di Puskesmas binaan Balai Kesehatan Mata Masyarakat (BKMM) dapat dilihat dari data 5 tahun terakhir yang memperlihatkan bahwa jumlah operasi hanya sebanyak 47 operasi setahun, untuk itu perlu diteliti mengapa penderita katarak tidak memanfaatkan fasilitas operasi katarak yang telah disediakan di Puskesmas. Penelitian ini bertujuan untuk memperoleh informasi tentang: persepsi penderita terhadap penyakit dan pengobatan, persepsi penderita terhadap pelayanan kesehatan, faktor jarak tempat pelayanan kerumah, faktor biaya operasi katarak, faktor kebutuhan yang dirasakan penderita dan pemanfaatan pelayanan operasi katarak di Puskesmas. Penelitian ini dilakukan di 3 Puskesmann yaitu: Puskesmas Lubuk Alung, Sicincin dan Tarusan. Sebagai informan adalah penderita katarak yang sudah seharusnya di operasi dan penderita katarak yang sudah di operasi tetapi tidak memanfaatkan pelayanan operasi katarak yang ada di Puskesmas, penelitian ini juga melibatkan Kepala Puskesmas dan perawat Puskesmas. Penelitian ini menggunakan rancangan penelitian kualitatif dengan teknik pengumpulan data wawancara mendalam. Informan terdiri dari 11 orang penderita katarak, 2 orang diantaranya telah dioperasi di tempat lain. Hasil penelitian ini menunjukkan bahwa: 1. Hampir semua informan tidak mengetahui penyebab timbulnya katarak, tetapi semua informan tahu pengobatan katarak dan akibat jika tidak dioperasi. 2. Sebagian besar informan mengetahui bahwa di Puskesmas ada pelayanan operasi katarak dengan kualitas cukup baik. 3. Hampir semua informan mengatakan bahwa jarak ketempat pelayanan dari rumah dekat dan tidak menjadi hambatan. 4. Sebagian besar informan tidak tahu berapa biaya operasi katarak, mereka ada yang mempermasalahkan dan ada yang tidak mempermasalahkan sesuai dengan kesanggupan mereka. 5. Semua informan sangat menginginkan agar mata mereka yang buta dapat melihat kembali. 6. Sebagian besar informan keluarganya berobat ke Puskesmas dan sebagian besar mereka pemah berobat ke Puskesmas. Alasan mereka tidak memanfaatkan pelayanan operasi katarak yang tersedia di Puskesmas adalah karena takut operasi dan tidak ada biaya. Dari penelitian ini dapat disimpulkan bahwa: hambatan utama yang dihadapi informan adalah rasa takut operasi dan tidak ada biaya untuk operasi. Untuk meningkatkan pemanfaatan pelayanan operasi katarak dimasa datang, maka diperlukan penyebarluasan informasi, agar semua masyarakat mengetahui bahwa di Puskesmas ada pelayanan operasi katarak. Penyuluhan yang terus menerus tentang penyakit katarak serta memberikan informasi yang rinci tentang biaya operasi katarak. Untuk mengatasi hambatan biaya diharapkan subsidi dari pemerintah daerah bagi masyarakat yang tidak mampu.

The Analysis of Cataract Patients Behavior Who Didn't Utilize the Cataract Surgery Facility at Puskesmas Lubuk Alung, Sicincin and Tarusan, West Sumatera Province, 2000Low number of cataract surgery in Community Health Center (Puskesmas) cultivated by Community Eye Care Institution (BKMM) can be seen from last 5 years data which showed numbers of surgery only 47 a year, it need to take investigated the reason why cataract patients does not utilize cataract surgery service facility at the Puskesmas. This research objective is to gather information about patients perceptions to the disease and its therapy, healthcare service, distance factor, surgery cost factor, perceived need by the patients and the utilization of the cataract surgery service at the Puskesmas. This research done in 3 Community Health Center such as Lubuk Alung, Sicincin and Tarusan. The informant is a cataract patient that actually has to be operated and already operated but did not take cataract surgery service at the Puskesmas, This research also involve the Head and nurses of the Puskesmas. This research used qualitative research design with in depth interview technical to compile data. Informant consist of 11 cataract patients which 2 of them already surgery at the other health service. The result showed: 1. Almost all informants do not know why they get cataract, but all informants know how to deal with the sickness and its consequence if they ignore the sickness. 2. There are major of informant know that there is good quality of cataract surgery service at the Puskesmas. 3. Almost all informants stated no problem with the distance between house and Puskesmas. 4. There are major of informant does not know the cataract surgery cost and the take it as problem according the ability. 5. All informants really want to use their blind eyes like before again. 6. There are major of informant take the Puskesmas treatment. The reason why their does not utilize cataract surgery service at the Puskesmas because they fear with surgery and the cost does not available. The conclusion of this research is cost and fear feeling to have surgery make them avoiding to utilize the service. To increase the utilization of the cataract surgery service at the Puskesmas in the future, there is necessary to socialize information so that community knows there is cataract surgery service at the Puskesmas. Continue extension about cataract disease and detail information about the surgery cost has to be taken. And of course there are expectations of government subsidy for the poverty community.

Pelaksanaan kegiatan TRIAS UKS yang meliputi Pendidikan Kesehatan, Pelayanan Kesehatan dan Lingkungan sekolah sehat di sekolah yang dibina oleh Tim Pembina UKS secara berjenjang mulai dari TP UKS Kecamatan, TP UKS Kabupaten/Kota, TP UKS Propinsi dan TP UKS Pusat, merupakan kegiatan lintas program dan lintas sektor yang harus dikoordinasikan secara baik. Pada kenyataannya TP UKS Propinsi Sumatera Barat terdapat masalah dalam melaksanakan koordinasi TP UKS. Untuk itu penulis ingin mengetahui gambaran pelaksanaan koordinasi TP UKS Propinsi Sumatera Barat dalam pembinaan dan pengembangan program UKS tahun 2000. Penelitian ini merupakan studi kasus dengan menggunakan pendekatan kualitatif, Data diperoleh melalui penelusuran data yang terdokumentasi, observasi dan wawancara mendalam terhadap 13 informan TP UKS dan Sekretariat TP UKS Propinsi Sumatera Barat. Informan ini adalah orang-orang yang masuk namanya dalam 5K No.441.5-119-1999 tentang Tim Pembina UKS Propinsi dan memahami serta mengetahui TP UKS dan Sekretariat. Hasil penelitian ini menunjukkan bahwa pelaksanaan koordinasi TP UKS Propinsi Sumatera Barat dalam pembinaan dan pengembangan program UKS belum efektif. Mengingat koordinasi antar sektor terkait dalam wadah TP UKS Propinsi belum mencapai hasil yang efektif, maka untuk memperoleh daya guna dan hasil guna kegiatan TP UKS Propinsi yang maksimal, disarankan untuk dapat melakukan penyempurnaan SK TP UKS dan Sekretariat serta mengajak para ketua untuk selalu ikut berpartisipasi aktif dalam semua kegiatan TP UKS Propinsi, karena disadari bahwa peran ketua merupakan salah satu kunci keberhasilan koordinasi. Dalam rangka otonomi daerah, tentu diperlukan tenaga profesional dari masing-masing instansi terkait untuk duduk di TP UKS Sekretariat.

Analysis Coordination of Health School Advisory Team Province in Health School Guidance and Improvement, West Sumatera Province, 2000School Health Program activities consist of health education, health services and healthy school environment. Hierarchical advisory teams supervise implementation of these activities according to level of administration, i.e. central, province, district and subdistrict. As an integrated activity, School Health Program needs a close of both inter-programs and inter-sectors coordination. Implementation of School Health Program in West Sumatera province shows provincial advisory team's lack of coordination. The researcher intends to explore thoroughly coordination aspects of the School Health Program in West Sumatera province during the year 2000. Design of this research is a case study by using qualitative approach. Data was collected from several sources such as documented reports, observations and in-depth interviews to thirteen informants who were member of advisory team and/or secretariate of the School Health Program of West Sumatera Province. Those informants are listed in governor decree as stated in SK. No. 441.5-119-1999 with regard to Advisory Team of the School Health Program of West Sumatera Province. They know very well the program activities as well team's performance. This study reveals an ineffectiveness of implementation and development of the School Program in West Sumatera Province. Lack of inter-sectors coordination within West Sumatera Province School Health Program advisory team has been the major cause of this less optimum program effectiveness. To overcome the problem, it is recommended to revise the governor decree and to update the advisory team member. In addition, it is very important to motivate better involvement of the school head in the program. The school head play a major role in program success. Tn the day of a greater local autonomy, the School Health Program demands a lot of professionals staff of many relevant disciplines to organize Secretariate of West Sumatera Province School Health Program Advisory Team.