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Perubahan iklim telah berkontribusi pada peningkatan frekuensi dan intensitas bencana, dengan Indonesia menempati peringkat kedua sebagai negara dengan risiko bencana tertinggi di dunia. Dampaknya mencakup gangguan kesehatan, peningkatan kasus penyakit menular, serta ketidakstabilan sistem pangan. Permenkes No. 75 Tahun 2019 diterbitkan sebagai kebijakan strategis untuk memperkuat kesiapsiagaan sektor kesehatan dalam menghadapi krisis akibat bencana. Penelitian ini bertujuan untuk menganalisis implementasi kebijakan tersebut di Dinas Kesehatan Kabupaten Bandung Barat serta mengidentifikasi faktor pendukung dan penghambatnya. Menggunakan pendekatan kualitatif dengan metode studi kasus, data dianalisis berdasarkan kerangka teori Edward III, Grindle, serta Mazmanian & Sabatier. Hasil menunjukkan bahwa implementasi tergolong cukup baik, ditandai dengan optimalisasi PSC dan pembentukan tim tanggap darurat. Namun demikian, pelaksanaannya masih menghadapi sejumlah kendala, seperti komunikasi lintas sektor dan bidang yang belum optimal, keterbatasan sumber daya, serta struktur birokrasi yang belum sepenuhnya efektif. Selain itu, rendahnya persepsi risiko dan dominasi pendekatan yang bersifat responsif turut menjadi tantangan. Temuan ini menekankan pentingnya penguatan kapasitas daerah, koordinasi lintas sektor, serta perencanaan yang adaptif dan berkelanjutan untuk mendukung sistem penanggulangan krisis kesehatan yang lebih efektif.
Climate change has contributed to the increasing frequency and intensity of disasters, placing Indonesia as the second most disaster-prone country in the world. Its impacts include public health disruptions, rising infectious disease cases, and instability in the food system. Minister of Health Regulation No. 75 of 2019 was issued as a strategic policy to strengthen the health sector's preparedness in responding to crisis situations caused by disasters. This study aims to analyze the implementation of the regulation at the West Bandung District Health Office and identify its supporting and inhibiting factors. Using a qualitative approach with a case study method, the data were analyzed based on the theoretical frameworks of Edward III, Grindle, and Mazmanian & Sabatier. The findings indicate that the implementation is progressing, as reflected in the optimization of the Public Safety Center (PSC) and the establishment of emergency response teams. However, several challenges persist, including limited cross-sectoral and interdepartmental communication, resource constraints, and an underdeveloped bureaucratic structure. Furthermore, low risk perception and a predominantly reactive approach remain major obstacles. These findings highlight the need for strengthening local institutional capacity, improving intersectoral coordination, and advancing adaptive and sustainable planning to support a more resilient health crisis management system.
The Covid-19 pandemic has exposed vulnerabilities in Indonesia’s health system and served as a wake-up call for the government to strengthen preparedness at the country’s points of entry. One key instrument for preventing and controlling the spread of potentially pandemic infectious diseases is the implementation of health quarantine. Health quarantine at points of entry is carried out by the Health Quarantine Technical Implementation Unit (UPT). However, these units face various challenges, such as weak and inconsistent cross-sectoral coordination and communication across regions, outdated regulations, limited human resources, inadequate infrastructure, and insufficient technology. This study aims to analyze policies related to institutional structure, work systems, and resources of the Health Quarantine UPT in Indonesia. A mixed-methods approach with an explanatory sequential design was used, starting with an online survey of 287 respondents, followed by in-depth interviews with 7 informants. The results show that institutional strengthening is needed, including the establishment of an Agency or Directorate General focused on health quarantine affairs—or even an independent body modeled after the CDC (Centers for Disease Control and Prevention), in which surveillance, research, and laboratory functions are integrated under one organization using a one-health approach. Although UPT work systems are relatively effective with the presence of NSPK and SOPs, many SOPs need to be updated to meet current health quarantine challenges. Additionally, a gap remains between workforce needs and available personnel, affecting the effectiveness of the UPT’s functions. Therefore, structured, measurable, and sustainable human resource planning is required to comprehensively strengthen institutional capacity.
The potential for fraud is inseperable from implementation of UHC Program in Indonesia, including in primary healthcare office in Kota Bandung. Ministry of health has released Permenkes No. 16 Year 2019 as new regulation for fraud prevention and prosecution in UHC Program. This study aims to know the readiness for Fraud Prevention System in Health Coverage Program implementation According to Permenkes No. 16 Year 2019 with case study on PHC as Primary healthcare office in Kota Bandung. This study used qualitative methods. The data analyzed were obtained from semi-structured in-depth interviews, observations, and document review. This study used combination of Van Meter and Van Horn's theory of policy analysis to analyze the variables that affect the readiness of policy implementation and Weiner's ORIC theory to analyze the internal organizational factors in the PHC that affect the readiness to implement the Fraud Prevention System. This sudy showed that the clarity of policy size and objectives, the characteristics of the implementing agency, also policy resources require more preparation to optimize the implementation of the policy because they affects communication between organizations and the disposition of the implementer. The economic, social and political environment has also not yet fully support the policy implementation. In addition, the condition of the number and capacity of human resources is a dominant factor in readiness for implementation at the PHC level. This study suggest to define fraud prevention and prosecution activities in the JKN Program as one of the deconcentration menus for Regional Governments, harmonize the regulations relating to problem solving in the JKN Program, define clear regulation for contribution fee in the JKN Program, also studies to fulfill special functional positions to support quality assurance and internal control at the PHC.
Permasalahan jenis, jumlah, kualifikasi dan distribusi tenaga kesehatan merupakan permasalahan ketenagaan yang sering dihadapi dalam pelayanan kesehatan khususnya di Daerah Tertinggal Perbatasan dan Kepulauan (DTPK). Penerapan dan pencapaian indikator kinerja Standar Pelayanan Minimal (SPM) Kesehatan sangat berkaitan dengan ketersediaan tenaga kesehatan. Penelitian ini menggunakan pendekatan kuantitatif yang bertujuan untuk mengetahui faktor penentu terhadap kelengkapan program wajib Puskesmas dan rata-rata capaian indikator kinerja SPM Kab/Kota di DTPK, variabel yang diteliti meliputi faktor tenaga kesehatan (jumlah dan jenis), kelengkapan program wajib Puskesmas dan rata-rata capaian indikator kinerja SPM Kab/Kota tahun 2011. Hasil analisis didapat bahwa faktor penentu kelengkapan program ialah ketersediaan tenaga dokter dan faktor penentu untuk rata-rata capaian indikator kinerja SPM Kab/Kota ialah kelengkapan program wajib Puskesmas.
Problems of the type, number, qualifications and distribution of health workers is a problem frequently encountered in workforce health services, especially in Disadvantaged Areas Border and Islands (DTPK). Implementation and achievement of performance indicators health minimum service standards (SPM) is very related to the availability of health personnel. This study uses a quantitative approach that aims to identify the determinants of the completeness of compulsory health center program and the average achievement of performance indicators SPM District/City in DTPK, variable factors examined included health workers (number and type), the completeness of compulsory health center and flat-average achievement of performance indicators SPM District/City in 2011. Analysis results obtained that the determining factor is the completeness of the program and the availability of doctors deciding factor for the average achievement of performance indicators SPM District/City Health Center is required to complete the program.
