Penelitian ini bertujuan untuk menganalisis implementasi Peraturan Menteri Kesehatan Nomor 23 Tahun 2022 tentang penanggulangan HIV/AIDS di Rumah Sakit Kanker Dharmais. Penelitian ini menggunakan pendekatan kualitatif dengan metode studi kasus. Data dikumpulkan melalui wawancara mendalam dengan tenaga medis, manajemen rumah sakit, serta pasien HIV, dan didukung oleh analisis dokumen kebijakan terkait. Hasil penelitian menunjukkan bahwa meskipun kebijakan telah diterapkan, terdapat beberapa kendala, termasuk pemanfaatan kapasitas rumah sakit yang tidak optimal, kekurangan tenaga medis terlatih, ketidakjelasan dalam pembiayaan layanan HIV oleh BPJS, dan stigma yang memengaruhi aksesibilitas layanan. Selain itu, koordinasi antar fasilitas kesehatan dalam penanganan pasien HIV masih memerlukan perbaikan. Penelitian ini menyimpulkan bahwa diperlukan pemisahan layanan HIV dari spesialisasi kanker, peningkatan kapasitas sumber daya, penghapusan stigma melalui pelatihan tenaga medis, revisi kebijakan pembiayaan, serta penguatan sistem logistik distribusi obat ARV. Rekomendasi ini bertujuan untuk meningkatkan efektivitas layanan HIV/AIDS di Indonesia.

This study aims to analyze the implementation of Indonesia's Ministry of Health Regulation No. 23 of 2022 on HIV/AIDS management at Dharmais Cancer Hospital. A qualitative approach was employed using a case study method. Data were collected through in-depth interviews with medical staff, hospital management, and HIV patients, supported by the analysis of relevant policy documents. The findings indicate that despite the policy's implementation, several challenges persist, including suboptimal utilization of hospital capacity, a shortage of trained medical personnel, unclear BPJS financing for HIV services, and stigma that affects service accessibility. Additionally, coordination among healthcare facilities in managing HIV patients requires improvement. The study concludes that separating HIV services from cancer specialization, enhancing resource capacity, reducing stigma through medical staff training, revising financing policies, and strengthening the ARV drug distribution system is essential. These recommendations aim to improve the effectiveness of HIV/AIDS services in Indonesia.

Implementasi Peraturan Menteri Kesehatan Nomor 58 Tahun 2016 tentang Sponsorship bagi Tenaga Kesehatan menunjukkan fenomena kesenjangan data yang signifikan secara nasional (4,9%), dimana keaktifan pelaporan pihak industri (pemberi) tidak diimbangi oleh pihak tenaga medis dan tenaga kesehatan (penerima). Penelitian ini bertujuan untuk menganalisis penghambat dan pendorong perilaku kepatuhan implementasi regulasi pelaporan sponsorship di Rumah Sakit Vertikal Kementerian Kesehatan wilayah Jabodetabek, serta merumuskan rekomendasi kebijakan. Menggunakan pendekatan kualitatif dengan desain studi kasus komparatif, penelitian ini membedah akar disfungsi secara sistemik melalui integrasi Teori Implementasi Kebijakan Publik (Mazmanian & Sabatier) dan model perilaku COM-B (Michie). Data dikumpulkan melalui wawancara mendalam terhadap 13 informan (makro, meso, dan mikro) serta triangulasi telaah dokumen. Hasil penelitian menunjukkan kepatuhan di level makro terhambat oleh disharmonisasi aturan standar biaya dan ketiadaan integrasi sistem pelaporan antar-lembaga. Di level meso, kepatuhan tersendat oleh birokrasi perizinan internal yang kaku dan salah tafsir kebijakan. Kondisi tersebut membebani kapabilitas dan menurunkan motivasi di level mikro akibat tingginya kelelahan klinis, persepsi kompleksitas administratif, dan ketiadaan umpan balik. Akumulasi kelemahan tata kelola ini berimplikasi pada kepatuhan semu (pseudo-compliance) pada kelompok sasaran berupa taktik bypass perizinan dan lobi penunjukan nama secara informal. Sebaliknya, perilaku kepatuhan dapat didorong melalui keteladanan pimpinan puncak, strategi pengawasan proaktif, serta kuatnya infrastruktur kepatuhan dari vendor multinasional. Berdasarkan kerangka Behaviour Change Wheel (BCW), peningkatan kepatuhan kelompok sasaran menuntut intervensi pada tahapan formulasi kebijakan (policy formulation) melalui fasilitasi sistem dari otoritas, yang disusun dalam wujud kaskade kebijakan (policy cascading matrix). Intervensi tersebut mencakup pengaturan mandatori ekosistem pelaporan digital terpadu, legitimasi formasi staf administrasi kepatuhan (enablement), penerapan transparansi publik terbatas (Public Disclosure), serta penegakan pakta integritas vendor.

The implementation of the Minister of Health Regulation Number 58 of 2016 concerning Sponsorship for Healthcare Professionals reveals a significant national data discrepancy (4.9%), where active reporting by the industry (providers) is not balanced by healthcare professionals (recipients). This study aims to analyze the barriers and facilitators to compliance behavior with the implementation of sponsorship reporting regulations in Vertical Hospitals of the Ministry of Health in the Greater Jakarta (Jabodetabek) area, and to formulate policy recommendations. Using a qualitative approach with a comparative case study design, this research systemically dissects the root of dysfunction through the integration of the Public Policy Implementation Theory (Mazmanian & Sabatier) and the COM-B behavioral model (Michie). Data were collected through in-depth interviews with 13 informants (macro, meso, and micro) as well as triangulation of document reviews. The results indicate that compliance at the macro level is hindered by the disharmonization of cost standard regulations and the lack of integration in inter-institutional reporting systems. At the meso level, compliance is obstructed by rigid internal licensing bureaucracy and policy misinterpretation. These conditions burden the capability and decrease the motivation at the micro level due to high clinical burnout, perceived administrative complexity, and the absence of feedback. The accumulation of these governance weaknesses leads to pseudo-compliance among target groups in the form of bureaucratic bypass tactics and informal name-appointment lobbying. Conversely, compliance behavior can be facilitated by top leadership role-modeling, proactive supervisory strategies, and the robust compliance infrastructure of multinational vendors. Based on the Behaviour Change Wheel (BCW) framework, enhancing target group compliance demands interventions at the policy formulation stage through system facilitation from authorities, structured in a policy cascading matrix. These interventions include the mandatory regulation of an integrated digital reporting ecosystem, the legitimacy of compliance administrative staff formation (enablement), the application of a limited Public Disclosure policy, and the enforcement of vendor integrity pacts.

Perundungan terhadap peserta didik Program Pendidikan Dokter Spesialis (PPDS) merupakan permasalahan sistemik dalam pendidikan kedokteran di Indonesia yang berdampak pada kesehatan mental peserta didik, kualitas pendidikan klinis, keselamatan pasien, dan mutu pelayanan kesehatan. Sebagai respons terhadap berbagai kasus yang terjadi, Kementerian Kesehatan menerbitkan Instruksi Menteri Kesehatan Nomor 589 Tahun 2025 tentang Pencegahan dan Penanganan Perundungan terhadap Peserta Didik pada Rumah Sakit Pendidikan di Lingkungan Kementerian Kesehatan. Penelitian ini bertujuan menganalisis implementasi kebijakan tersebut pada Rumah Sakit Pendidikan di lingkungan Kementerian Kesehatan. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Data diperoleh melalui wawancara mendalam terhadap pembuat kebijakan, pimpinan Rumah Sakit Pendidikan, pengelola Program Pendidikan Dokter Spesialis, dan peserta didik PPDS, serta didukung telaah dokumen kebijakan. Analisis dilakukan menggunakan model implementasi kebijakan Van Meter dan Van Horn yang meliputi standar dan sasaran kebijakan, sumber daya, komunikasi dan aktivitas penegakan, karakteristik agen pelaksana, kondisi ekonomi, sosial, dan politik, serta disposisi pelaksana. Hasil penelitian menunjukkan bahwa implementasi Instruksi Menteri Kesehatan Nomor 589 Tahun 2025 telah berjalan melalui pembentukan Tim Pencegahan dan Penanganan Perundungan, penyusunan regulasi internal, serta mekanisme pelaporan dan penanganan kasus, namun implementasinya belum optimal. Standar kebijakan dinilai telah memberikan definisi dan mekanisme yang jelas, tetapi masih menyisakan area abu-abu dalam membedakan pembinaan klinis dengan perundungan. Sasaran kebijakan dipahami tidak hanya untuk melindungi peserta didik, tetapi juga mendukung keselamatan pasien, meskipun target zero bullying dinilai belum realistis. Implementasi juga dipengaruhi oleh keterbatasan sumber daya, belum optimalnya komunikasi dan koordinasi lintas institusi, kompleksitas hubungan antar pelaksana, budaya hierarkis, hidden curriculum, fear of retaliation, serta budaya pendidikan kedokteran. Penelitian ini menyimpulkan bahwa implementasi Instruksi Menteri Kesehatan Nomor 589 Tahun 2025 telah memperkuat sistem pencegahan dan penanganan perundungan di Rumah Sakit Pendidikan, namun belum sepenuhnya efektif dalam mengatasi faktor-faktor struktural yang melatarbelakangi perundungan. Penguatan implementasi memerlukan harmonisasi kebijakan lintas sektor, penguatan kelembagaan dan sistem pelaporan, penyusunan pedoman operasional yang lebih spesifik, peningkatan kapasitas pelaksana, penguatan perlindungan peserta didik, serta pengembangan mekanisme deteksi dini dan integrasi indikator budaya anti-perundungan ke dalam sistem monitoring dan akreditasi Rumah Sakit Pendidikan.

Bullying among residents in Specialist Medical Education Programs (Program Pendidikan Dokter Spesialis/PPDS) has become a systemic issue in medical education in Indonesia, adversely affecting residents' mental health, the quality of clinical education, patient safety, and healthcare service quality. In response to a series of reported cases, the Ministry of Health issued Minister of Health Instruction Number 589 of 2025 concerning the Prevention and Management of Bullying against Medical Trainees in Teaching Hospitals under the Ministry of Health. This study aimed to analyze the implementation of this policy in teaching hospitals under the Ministry of Health. This study employed a qualitative approach with a case study design. Data were collected through in-depth interviews with policymakers, teaching hospital leaders, residency program administrators, and medical residents, complemented by a review of relevant policy documents. Data were analyzed using the Van Meter and Van Horn model for policy implementation, which comprises policy standards and objectives, resources, communication and enforcement activities, characteristics of implementing agencies, economic, social, and political conditions, and implementers' disposition. The findings indicate that the implementation of the Minister of Health Instruction Number 589 of 2025 has progressed through the establishment of Bullying Prevention and Management Teams, the development of institutional regulations, and the implementation of reporting and case management mechanisms. However, implementation has not yet been fully optimal. Although policy standards provide clear definitions and procedures, ambiguities remain in distinguishing legitimate clinical supervision from bullying. Policy objectives are widely understood as extending beyond the protection of residents to include patient safety, although achieving zero bullying is considered unrealistic in the short term. Policy implementation is further constrained by limited resources, suboptimal communication and inter-institutional coordination, complex relationships among implementing actors, hierarchical culture, the hidden curriculum, fear of retaliation, and resistance to cultural change within medical education. This study concludes that the implementation of Ministry of Health instruction No. 589 of 2025 has strengthened the system for preventing and managing bullying in teaching hospitals. However, its implementation has not yet been fully effective in addressing the structural factors underlying bullying. Strengthening policy implementation requires cross-sectoral policy harmonization, institutional strengthening, and improvements to the reporting system; the development of more specific operational guidelines; capacity building for implementers; enhanced protection for medical residents; as well as the development of early detection mechanisms and the integration of anti-bullying culture indicators into the monitoring and accreditation systems of teaching hospitals.