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Novrita Indra Tiara Kusuma; Pembimbing: Puput Oktamianti; Penguji: Adang Bachtiar, Ede Surya Darmawan, Anna Kurniati, Leni Kuswandari
Abstrak:
Pelatihan dilakukan dalam upaya meningkatkan mutu tenaga kesehatan. Pelatihan pada dasarnya merupakan proses pembelajaran yang bertujuan untuk meningkatkan kinerja, profesionalisme, dan/atau menunjang pengembangan karir. Pelatihan bagi tenaga kesehatan dapat diselenggarakan oleh pemerintah, pemerintah daerah, dan/atau masyarakat dengan syarat pelatihan harus terakreditasi dan diselenggarakan oleh institusi penyelenggara pelatihan yang terakreditasi pemerintah pusat. Ketersediaan institusi penyelenggara pelatihan bidang kesehatan terakreditasi pemerintah pusat di Indonesia masih terbatas apabila dibandingkan dengan jumlah tenaga kesehatan yang berhak memperoleh pelatihan berkualitas, oleh karena itu penelitian ini dilakukan untuk menganalisis implementasi kebijakan akreditasi institusi penyelenggara pelatihan bidang kesehatan dengan mengamati faktor-faktor yang berkontribusi terhadap implementasi sebuah kebijakan antara lain faktor ukuran dan tujuan kebijakan, komunikasi, sumber daya, karakteristik badan pelaksana, lingkungan, disposisi pelaksana, serta kinerja kebijakan implementasi tersebut. Penelitian ini merupakan penelitian kualitatif menggunakan dua metode pengumpulan data yaitu wawancara mendalam dan telaah dokumen di Direktorat Peningkatan Mutu Tenaga Kesehatan dan institusi-institusi penyelenggara pelatihan bidang kesehatan yang telah terakreditasi. Hasil penelitian menunjukkan secara umum pencapaian indikator yang menjadi target kinerja kebijakan akreditasi institusi telah tercapai walaupun belum terlihat pemerataannya di seluruh provinsi di Indonesia. Pada beberapa faktor, seperti kejelasan dan pola penyampaian informasi masih perlu dikembangkan upaya lainnya agar informasi dapat jelas dipahami semua pelaksana dengan cara yang efektif dan efisien, khususnya bagi Direktorat Peningkatan Mutu Tenaga Kesehatan. Kemudian pada faktor lingkungan, perlu upaya pendekatan dan koordinasi yang mendalam dan meluas agar kesempatan tenaga kesehatan mengikuti pelatihan terakreditasi yang diselenggarakan institusi penyelenggara pelatihan terakreditasi semakin banyak.
Training is carried out in an effort to improve the quality of health workers. Training is basically a learning process that aims to improve performance, professionalism, and/or support career development. Training for health workers can be organized by government, regional department, or community with the condition that the training must be accredited and held by an accredited health training provider institution. The availability of institutions providing training in the health sector accredited by the central government in Indonesia is still limited when compared to the number of health workers who are entitled to receive quality training. Therefore this study was conducted to analyze the implementation of the accreditation policy for institutions providing training in the health sector by observing factors that contribute to the implementation of a policy include the size and objectives of the policy, communication, resources, characteristics of the implementing agency, environment, disposition of the implementer, as well as the performance of the implementation policy. This research is a qualitative research using two methods of data collection, in-depth interviews and document review at Direktorat Peningkatan Mutu Tenaga Kesehatan and accredited training institutions in the health sector. The results of the study show that in general the achievement of the indicators that are the performance targets for institutional accreditation policies has been achieved, although the distribution has not yet been seen in all provinces in Indonesia. On several factors, such as clarity and patterns of information delivery, other efforts need to be developed so that information can be clearly understood by all implementers in an effective and efficient manner, especially for Direktorat Peningkatan Mutu Tenaga Kesehatan. Then on environmental factors, an in-depth and widespread approach and coordination is needed so that there are more and more opportunities for health workers to take part in accredited training organized by accredited training institutions.
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Training is carried out in an effort to improve the quality of health workers. Training is basically a learning process that aims to improve performance, professionalism, and/or support career development. Training for health workers can be organized by government, regional department, or community with the condition that the training must be accredited and held by an accredited health training provider institution. The availability of institutions providing training in the health sector accredited by the central government in Indonesia is still limited when compared to the number of health workers who are entitled to receive quality training. Therefore this study was conducted to analyze the implementation of the accreditation policy for institutions providing training in the health sector by observing factors that contribute to the implementation of a policy include the size and objectives of the policy, communication, resources, characteristics of the implementing agency, environment, disposition of the implementer, as well as the performance of the implementation policy. This research is a qualitative research using two methods of data collection, in-depth interviews and document review at Direktorat Peningkatan Mutu Tenaga Kesehatan and accredited training institutions in the health sector. The results of the study show that in general the achievement of the indicators that are the performance targets for institutional accreditation policies has been achieved, although the distribution has not yet been seen in all provinces in Indonesia. On several factors, such as clarity and patterns of information delivery, other efforts need to be developed so that information can be clearly understood by all implementers in an effective and efficient manner, especially for Direktorat Peningkatan Mutu Tenaga Kesehatan. Then on environmental factors, an in-depth and widespread approach and coordination is needed so that there are more and more opportunities for health workers to take part in accredited training organized by accredited training institutions.
T-6661
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Afriani Tinurbaya; Pembimbing: Adang Bachtiar; Penguji: Atik Nurwahyuni, Wahyu Sulistiadi, Anita Basuki, Yanuardo Ganda Drabenzus
Abstrak:
Tesis ini membahas gambaran implementasi kebijakan perencanaan pelatihan Tenaga Kesehatan untuk melihat kinerja dari implementasi kebijakan tersebut. Penelitian ini menggunakan pendekatan kualitatif melalui wawancara mendalam dan observasi dokumen. Analisis dilakukan dengan menggunakan modifikasi model implementasi kebijakan Edward III (1980) serta Van Meter & Van Horn (1975) untuk menganalisis berbagai faktor yang memengaruhi proses implementasi kebijakan perencanaan pelatihan Tenaga Kesehatan, yaitu dilihat dari variabel ukuran dan tujuan kebijakan, sumber daya, komunikasi antar organisasi dan kegiatan pelaksana, struktur birokrasi dan karakteristik badan pelaksana, disposisi, lingkungan sosial, ekonomi dan politik, serta kinerja implementasi kebijakan. Hasil penelitian menunjukkan bahwa kinerja implementasi kebijakan perencanaan pelatihan Tenaga Kesehatan belum optimal: belum ada indikator yang mengukur keberhasilan implementasi kebijakan, serta output kebijakan masih ada yang belum sesuai pedoman. Faktor-faktor yang mempengaruhi implementasi kebijakan perencanaan pelatihan Tenaga Kesehatan masih ditemukan ada kendala, diantaranya ukuran dan tujuan kebijakan belum jelas, sumber daya belum memadai, sosialisasi kebijakan masih terbatas, masih ada ketidakkonsistenan dalam implementasi kebijakan, penerapan SOP belum optimal, dan mekanisme pengawasan terhadap implementasi kebijakan belum jelas. Oleh sebab diperlukan evaluasi secara menyeluruh terhadap faktor-faktor tersebut untuk meningkatkan keberhasilan implementasi kebijakan perencanaan pelatihan Tenaga Kesehatan.
This study described health worker training planning policies to see the performance of the implementation policies. This study uses qualitative approach through in-depth interviews and document observation. The analysis was carried out using the policy implementation model of Edward III (1980) and Van Meter & Van Horn (1975) to analyze factors that influence the process of the implementation policies, such as size and policy objectives, resources, communication between organization and implementation of activities, bureaucratic structure and characteristics of implementing agencies, disposition, social, economic and political environment, and implementation policies. The results show that the performance of planning policy implementation for health worker training was not optimal: the training program has not been based on training needs, and there are still policy outputs that are not in accordance with the guidelines. Factors influencing the implementation of the health worker training planning policies are still found to have obstacles: the size and objectives of the policy are not yet clear, the resources are inadequate, the socialization of the policy is still limited, the inconsistencies in policy implementation, the application of SOP is not optimal, and supervision mechanisms are not yet clear. This is necessary to evaluate these factors for successful policy implementation.
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This study described health worker training planning policies to see the performance of the implementation policies. This study uses qualitative approach through in-depth interviews and document observation. The analysis was carried out using the policy implementation model of Edward III (1980) and Van Meter & Van Horn (1975) to analyze factors that influence the process of the implementation policies, such as size and policy objectives, resources, communication between organization and implementation of activities, bureaucratic structure and characteristics of implementing agencies, disposition, social, economic and political environment, and implementation policies. The results show that the performance of planning policy implementation for health worker training was not optimal: the training program has not been based on training needs, and there are still policy outputs that are not in accordance with the guidelines. Factors influencing the implementation of the health worker training planning policies are still found to have obstacles: the size and objectives of the policy are not yet clear, the resources are inadequate, the socialization of the policy is still limited, the inconsistencies in policy implementation, the application of SOP is not optimal, and supervision mechanisms are not yet clear. This is necessary to evaluate these factors for successful policy implementation.
T-6691
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Dian Rahayu Pamungkas; Pembimbing: Rita Damayanti; Penguji: Dian Ayubi, Wachyu Sulistiadi, Ekowati Retnaningsih, Oos Fatimah Rosyati
Abstrak:
Akreditasi institusi merupakan amanah dari Undang-Undang Republik Indonesia Nomor 36 Tahun 2014 tentang Tenaga Kesehatan Pasal 31. Institusi penyelenggara pelatihan yang belum terakreditasi tetapi menyelenggarakan pelatihan kesehatan lebih banyak jumlahnya bila dibandingkan dengan institusi pelatihan yang sudah terakreditasi. Penelitian ini bertujuan untuk menganalisis kesiapan akreditasi institusi penyelenggara pelatihan bidang kesehatan dalam upaya penjaminan mutu institusi pelatihan tahun 2020. Metode yang digunakan yaitu pendekatan kuantitatif dan kualitatif (mixed method). Sampel kuantitatif adalah institusi penyelenggara pelatihan kesehatan yang belum terakreditasi sebanyak 62 institusi. Pengumpulan data menggunakan kuesioner yang dibuat menggunakan google form. Hasil menunjukkan bahwa institusi yang siap untuk diakreditasi sebanyak 34 institusi (54,8%). Unsur input yang berpengaruh terhadap kesiapan akreditasi institusi yaitu variabel SOP dan kebijakan. Pada unsur proses yang berpengaruh adalah variabel perencanaan serta pengorganisasian. Hasil analisis lebih lanjut menunjukkan bahwa pengorganisasian berhubungan signifikan terhadap kesiapan institusi untuk diakreditasi setelah dikontrol oleh variabel anggaran, SOP dan kebijakan, fasilitas dan peralatan serta perencanaan. Dari hasil analisis kualitatif faktor pendorong institusi untuk diakreditasi diantaranya adalah legalitas sebagai penyelenggara pelatihan, peningkatan mutu, persaingan antar provider. Faktor penghambat akreditasi adalah masalah kekurangan SDM, anggaran dan tidak adanya dukungan pimpinan
Institutional accreditation is a mandate of the Law of the Republic of Indonesia Number 36 of 2014 concerning Health Workers Article 31. Institutions that provide training that have not been accredited but that provide health training are more numerous than those that have been accredited. This study aims to analyze the readiness of the accreditation of training institutions in the health sector in an effort to guarantee the quality of training institutions in 2020 by using quantitative and qualitative research methods (mixed method). The quantitative sample is 62 institutions that have not been accredited health training providers. Data collection using a questionnaire created using google form. There are 34 institutions that are ready to be accredited (54.8%). From the input elements that affect the readiness of institutional accreditation, namely the SOP and policy variables. In the process element that influences the planning and organizing variables. The results of further analysis show that organizing has a significant relationship with the readiness of an institution to be accredited after being controlled by budget variables, SOP and policies, facilities and equipment and planning. From the qualitative analysis, the driving factors for an institution to be accredited include legality as a training provider, quality improvement, and competition among providers. The inhibiting factors for accreditation are the problem of lack of human resources, budget and lack of leadership support.
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Institutional accreditation is a mandate of the Law of the Republic of Indonesia Number 36 of 2014 concerning Health Workers Article 31. Institutions that provide training that have not been accredited but that provide health training are more numerous than those that have been accredited. This study aims to analyze the readiness of the accreditation of training institutions in the health sector in an effort to guarantee the quality of training institutions in 2020 by using quantitative and qualitative research methods (mixed method). The quantitative sample is 62 institutions that have not been accredited health training providers. Data collection using a questionnaire created using google form. There are 34 institutions that are ready to be accredited (54.8%). From the input elements that affect the readiness of institutional accreditation, namely the SOP and policy variables. In the process element that influences the planning and organizing variables. The results of further analysis show that organizing has a significant relationship with the readiness of an institution to be accredited after being controlled by budget variables, SOP and policies, facilities and equipment and planning. From the qualitative analysis, the driving factors for an institution to be accredited include legality as a training provider, quality improvement, and competition among providers. The inhibiting factors for accreditation are the problem of lack of human resources, budget and lack of leadership support.
T-6020
Depok : FKM-UI, 2020
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Asrina Novianti; Pembimbing: Adik Wibowo, Puput Oktamianti; Penguji: Anhari Achadi, Dwi Harti Nugraheni, Naniek Isnaini Lestari
Abstrak:
Belum adanya indikator kinerja dalam pelaksanaan kehumasan bidang kesehatan di Kabupaten Tangerang berimplikasi terhadap target luaran yang dihasilkan menjadi tidak jelas. Pedoman Umum Kehumasan Bidang Kesehatan pun belum tersosialisasikan dengan baik sehingga masih ditemui adanya kendala untuk menjalankan pedoman tersebut secara menyuluruh. Belum adanya tim kehumasan dalam bentuk jabatan fungsional turut menjadikan peran kehumasan belum dapat berjalan sesuai dengan standar aturan yang berlaku. Penelitian ini bertujuan untuk menganalisis impelementasi kebijakan kehumasan bidang kesehatan di Kabupaten Tangerang dan melihat efektifitasnya berdasarkan teori Edward III. Hasil penelitian ini diharapkan menjadi masukan untuk mengembangkan strategi kebijakan atau tindakan evaluasi yang tepat. Penelitian ini menggunakan metode kualitatif dengan teknik wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan pelaksanaan kehumasan bidang kesehatan di Kabupaten Tangerang telah berjalan. Namun, masih belum optimalnya sosialisasi Pedoman Umum Kehumasan Bidang Kesehatan menghasilkan pemahaman yang kurang mendalam mengenai prinsip kegiatan kehumasan. Selain itu pula perlu ada indikator yang jelas dalam pelaksanaan kegiatan kehumasan yang bertumpu pada prinsip kegiatan kehumasan di PMK nomor 81 tahun 2015, agar implementasi kebijakan kehumasan bidang kesehatan dapat berjalan lebih baik di Kabupaten Tangerang
The absence of performance indicators in the implementation of public relations in the health sector in Tangerang Regency has implications for the resulting outcome targets to be unclear. The General Guidelines for Public Relations in the Health Sector have not been well socialized so that there are still obstacles in carrying out these guidelines in a comprehensive manner. The absence of a public relations team in the form of a functional position has also contributed to the role of public relations that has not been able to run in accordance with the applicable rules. This study aims to analyze the implementation of public relations policy in the health sector in Tangerang Regency and see its effectiveness based on the theory of Edward III. The results of this study are expected to be input for developing appropriate policy strategies or evaluation actions. This study uses qualitative methods with in-depth interview techniques and document review. The results of the study indicate that the implementation of public relations in the health sector in Tangerang Regency has been running. However, the socialization of the General Guidelines for Public Relations in the Health Sector has not yet been optimal, resulting in a less in-depth understanding of the principles of public relations activities. Besides that, it is also necessary to have clear indicators in the implementation of public relations activities that are based on the principle of public relations activities in PMK number 81 of 2015, so that the implementation of public relations policies in the health sector can run better in Tangerang Regency.
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The absence of performance indicators in the implementation of public relations in the health sector in Tangerang Regency has implications for the resulting outcome targets to be unclear. The General Guidelines for Public Relations in the Health Sector have not been well socialized so that there are still obstacles in carrying out these guidelines in a comprehensive manner. The absence of a public relations team in the form of a functional position has also contributed to the role of public relations that has not been able to run in accordance with the applicable rules. This study aims to analyze the implementation of public relations policy in the health sector in Tangerang Regency and see its effectiveness based on the theory of Edward III. The results of this study are expected to be input for developing appropriate policy strategies or evaluation actions. This study uses qualitative methods with in-depth interview techniques and document review. The results of the study indicate that the implementation of public relations in the health sector in Tangerang Regency has been running. However, the socialization of the General Guidelines for Public Relations in the Health Sector has not yet been optimal, resulting in a less in-depth understanding of the principles of public relations activities. Besides that, it is also necessary to have clear indicators in the implementation of public relations activities that are based on the principle of public relations activities in PMK number 81 of 2015, so that the implementation of public relations policies in the health sector can run better in Tangerang Regency.
T-5494
Depok : FKM UI, 2019
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Anggi Asri Rusliana Dewi; Pembimbing: Dumilah Ayuningtyas; Penguji: Puput Oktamianti, Atet Kurniadi, Roni Razali
Abstrak:
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Hipertensi merupakan faktor risiko kardiovaskular utama yang menyebabkan kecacatan di seluruh dunia dan di antaranya tidak menyadari kondisi kesehatannya sehingga sering disebut sebagai the silent killer. Angka prevalensi hipertensi di Indonesia cukup tinggi. Berdasarkan Riskesdas (2018), Provinsi Kalimantan Selatan menunjukkan prevalensi tertinggi hipertensi, namun presentase penderita hipertensi yang mendapat pelayanan kesehatan masih rendah. Kota Banjarbaru memiliki persentase terendah yakni 11,3% dari target 100%. Pelayanan kesehatan penderita hipertensi termasuk dalam Standar Pelayanan Minimal (SPM) Bidang Kesehatan yang diatur dalam peraturan perundang-undangan dan kebijakan pemerintah. Tujuan penelitian ini untuk menganalisis implementasi kebijakan SPM bidang kesehatan penderita hipertensi di Kota Banjarbaru. Penelitian kualitatif dengan desain penelitian Rapid Assessment Procedure (RAP) dilakukan pada bulan Mei hingga Juni 2023 di Kota Banjarbaru Provinsi Kalimantan Selatan. Pengambilan data dilakukan melalui wawancara mendalam, observasi dan telaah dokumen. Hasil penelitian menunjukkan bahwa implementasi kebijakan SPM hipertensi belum optimal dapat dilihat dari laporan capaian SPM bidang kesehatan Kota Banjarbaru berada di posisi terendah di antara 12 jenis pelayanan kesehatan dasar. Kesimpulannya, beberapa kendala dalam implementasi SPM hipertensi yakni pencatatan dan pelaporan penderita hipertensi, rendahnya kesadaran masyarakat untuk melakukan pemeriksaan dan berobat di puskesmas sehingga datanya tidak tercatat, tidak ada alokasi anggaran khusus SPM hipertensi di puskesmas, dan tugas rangkap dari petugas kesehatan sehingga tidak maksimal dalam mencapai suatu program. Diperlukan upaya kerjasama lintas sektor untuk keterpaduan pencatatan dan pelaporan data pasien hipertensi, pengajuan anggaran SPM hipertensi, upaya mengajak masyarakat, dan membagi tugas secara adil bagi petugas puskesmas.
Hypertension is a major cardiovascular risk factor that causes disability worldwide and many of them are not aware of their health condition, so it is often referred to as the silent killer. The prevalence rate of hypertension in Indonesia is quite high. Based on Riskesdas (2018), South Kalimantan Province shows the highest prevalence of hypertension, but the percentage of hypertensive patients who receive health services is still low. Banjarbaru City has the lowest percentage, namely 11.3% of the 100% target. Health services for people with hypertension are included in the Minimum Service Standards (SPM) in the Health Sector which are regulated in laws and regulations and government policies. The purpose of this study was to analyze the implementation of the SPM policy in the health sector for hypertension sufferers in Banjarbaru City. Qualitative research with the Rapid Assessment Procedure (RAP) research design was conducted from May to June 2023 in Banjarbaru City, South Kalimantan Province. Data collection was carried out through in-depth interviews, observation and document review. The results of the study showed that the implementation of the SPM policy for hypertension was not optimal, as can be seen from the achievement report on SPM in the health sector in Banjarbaru City which was in the lowest position among the 12 types of basic health services. In conclusion, several obstacles in the implementation of hypertension SPM are recording and reporting of hypertension sufferers, low public awareness to carry out examinations and treatment at the puskesmas so that the data is not recorded, there is no special budget allocation for hypertension SPM at the puskesmas, and multiple assignments from health workers so that they are not optimal in reach a program. Cross-sector collaboration efforts are needed to integrate the recording and reporting of hypertension patient data, hypertension SPM budget submission, efforts to invite the community, and distribute tasks fairly for health center staff.
T-6687
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Asyifa Widya Wardaningtyas; Pembimbing: Ede Surya Darmawan; Penguji: Adang Bachtiar, Mardiati Nadjib, Anhari Achadi, Kurnia Permitasari
Abstrak:
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Integrasi Pelayanan Kesehatan Primer (ILP) merupakan salah satu wujud transformasi pelayanan kesehatan primer yang bertujuan untuk mendekatkan akses dan pelayanan kesehatan pada setiap fase. Penelitian ini bertujuan untuk menganalisa kesiapan implementasi kebijakan ILP di wilayah dengan karakteristik perkotaan, yaitu Kota Depok, melalui Puskesmas Cinere, Puskesmas Cipayung, dan Puskesmas Abadijaya. Penelitian ini menggunakan metode kualitatif melalui wawancara mendalam, observasi, dan telaah dokumen. Informan penelitian ini berjumlah 33 orang yang mewakili berbagai instansi yang terlibat. Hasil penelitian menunjukan bahwa model pelayanan ILP yang diharapkan di Kota Depok adalah integrasi fasilitas layanan kesehatan primer untuk mendukung tiga fokus ILP. Integrasi ini didasari oleh jumlah fasilitas layanan kesehatan primer yang memadai di Kota Depok. Komitmen politik dari pemerintah pusat dan pemerintah kota telah siap mendukung implementasi ILP. Namun, ketersediaan kebijakan, pendanaan, SDM kesehatan, infrastruktur, obat dan alat kesehatan, serta teknologi digital belum optimal untuk menunjang implementasinya. Walaupun demikian, Kota Depok telah siap untuk implementasi ILP dengan sumber daya fasilitas layanan kesehatan primer yang ada dengan penguatan kerjasama antara Puskesmas dan jejaringnya. Kesiapan Kota Depok tercermin dari komitmen perubahan telah dibentuk melalui pemahaman dan respon positif terkait perubahan dan kemampuan perubahan yang memadai untuk mendukung implementasi ILP.
Integrated Primary Health Care (ILP) represents a significant initiative within this transformation, aimed at improving accessibility for communities across all life stages. This study aims to analyze the readiness for implementing ILP policies in an urban setting, specifically in Depok, through Puskesmas Cinere, Puskesmas Cipayung, and Puskesmas Abadijaya. A qualitative research approach was employed through in-depth interviews, observations, and document reviews, involving 33 informants representing relevant institutions. The findings indicate that the preferred service model in Depok is the integrated primary healthcare facilities to support the three core focuses of ILP. This model is supported by the adequate number of primary healthcare facilities in Depok. Political commitment from both central and local governments is established to support ILP implementation. However, challenges remain concerning the availability of policies, funding, healthcare personnel, infrastructure, medical supplies and equipment, and digital technology to fully support its implementation. Despite these challenges, Depok is prepared to implement ILP using its existing primary healthcare resources, strengthened by enhanced collaboration between public health centers and their networks. Depok’s readiness is reflected in its established commitment to change, demonstrated by a solid understanding and positive response to the reform, along with sufficient capacity for change to support ILP implementation.
T-7196
Depok : FKM UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Nurul Safitri; Pembimbing: Dumilah Ayuningtyas; Penguji: Pujiyanto, Vetty Yulianty Permanasari, Ismiyati, Anisa
Abstrak:
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Alat kesehatan di Indonesia masih dipenuhi oleh lebih dari 70% alat kesehatan impor. Selain itu, transaksi alat kesehatan dalam negeri dalam e-katalog pada tahun 2019-2020 yang masih rendah (12%) menandakan masih besarnya ketergantungan terhadap alat kesehatan impor. Upaya Kementerian Kesehatan Republik Indonesia untuk mengatasi hal tersebut adalah dengan menerbitkan Peraturan Menteri Kesehatan Nomor 20 Tahun 2017 yang mewajibkan penerapan Cara Pembuatan Alat Kesehatan yang Baik (CPAKB), paling lambat 4 tahun sejak peraturan tersebut diterbitkan. Hingga tahun 2022, jumlah sarana produksi alat kesehatan yang memiliki sertifikat CPAKB hanya 30,52%. Tujuan penelitian ini adalah untuk menganalisis implementasi kebijakan Cara Pembuatan Alat Kesehatan yang Baik tahun 2022. Penelitian dilakukan secara kualitatif dengan menggunakan teknik wawancara mendalam terhadap informan dari pemerintah, asosiasi, dan industri alat kesehatan di Indonesia, serta telaah dokumen. Penelitian menggunakan model implementasi kebijakan Grindle dan Van Meter Van Horn yang dimodifikasi dalam kerangka segitiga kebijakan Walt-Gilson. Hasil penelitian adalah ukuran dan tujuan kebijakan, kepentingan yang dipengaruhi, dan manfaat kebijakan sudah jelas, namun terkendala dari sumber daya keuangan yang masih terbatas. Lingkungan ekonomi, sosial, dan politik berpengaruh terhadap pelaksanaan kebijakan. Karakterisitik lembaga pelaksana mendukung implementasi kebijakan, namun strategi para pelaksana masih belum dilaksanakan secara optimal. Disposisi pelaksana masih kurang dan komunikasi kebijakan perlu ditingkatkan. Dari sisi aktor/pelaksana kebijakan, masih terdapat keterbatasan jumlah sumber daya manusia untuk menerapkan kebijakan. Kesimpulan dari penelitian ini adalah secara umum kebijakan sudah terlaksana dengan baik, namun masih terdapat beberapa kendala pada pelaksanaannya. Penelitian ini merekomendasikan perlunya penguatan kebijakan-kebijakan yang mendorong penerapan CPAKB dan dukungan dari para pelaksana kebijakan, terutama terkait penguatan kebijakan izin edar alat kesehatan dalam negeri dimana CPAKB dijadikan persyaratan wajib dalam pengajuan izin edar.
Medical devices in Indonesia are still fulfilled by more than 70% of imported medical devices. In addition, domestic medical device transactions in e-catalogs in 2019-2020 were still low (12%) indicating that there was still a large dependence on imported medical devices. The effort of the Ministry of Health of the Republic of Indonesia to overcome this is by issuing Minister of Health Regulation Number 20 of 2017 which requires the application of Good Medical Device Manufacturing Practices (CPAKB), no later than 4 years after the regulation was issued. Until 2022, the number of medical device production facilities that have CPAKB certificates is only 30.52%. This study aimed to analyze the implementation of the Good Medical Device Manufacturing Practice policy in 2022. The research was conducted qualitatively using in-depth interviews with informants from the government, associations, and the medical device industry in Indonesia, as well as document reviews. This research uses the policy implementation model of Grindle and Van Meter Van Horn which is modified within the framework of the Walt-Gilson policy triangle. The results of the research are that the standard and objectives of the policy, the interests affected, and the benefits of the policy are clear, but are constrained by limited financial resources. The economic, social, and political environment influences policy implementation. The characteristics of implementing agencies support policy implementation, but the strategies of implementing agencies have not been implemented optimally. The disposition of implementers is still lacking and policy communication needs to be improved. In terms of actors/policy implementers, there is still a limited number of human resources to implement policies. This study concludes that in general the policy has been implemented well, but there are still obstacles in its implementation. This study recommends the need to strengthen policies that encourage the implementation of CPAKB and support from policy implementers, especially related to strengthening the policy for registration of distribution permits for domestic medical devices where CPAKB must be a mandatory requirement in the application.
T-6649
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Puji Lestari; Pembimbing: Puput Oktamianti; Penguji: Prastuti Soewondo, Anhari Achhadi, Agus Salim
Abstrak:
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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.
T-7297
Depok : FKM UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Renta Yulfa Zaini; Pembimbing: Wachyu Sulistiadi; Penguji: Ascobat Gani, Dumilah Ayuningtyas, Upik Rukmini, Anita Dianawati
Abstrak:
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Untuk mewujudkan seluruh program prioritas yang menjadi tanggung jawabnya, Puskesmas melakukan kolaborasi dengan jejaring Fasilitas Kesehatan Tingkat Pertama lain di wilayah kerjanya melalui integrasi pelayanan kesehatan. Kementerian Kesehatan telah menerbitkan Pedoman Penyelenggaraan Integrasi Pelayanan Kesehatan di Puskesmas dengan FKTP lain dalam pelaksanaan Program Prioritas. Penelitian ini bertujuan untuk menganalisis implementasi kebijakan Integrasi Pelayanan Kesehatan di Puskesmas dengan FKTP Lain di Kabupaten Kendal Jawa Tengah. Penelitian merupakan analisis kebijakan, menggunakan pendekatan kualitatif dengan disain penelitian menggunakan model implementasi kebijakan Edward III yang dikombinasikan dengan kerangka kerja dari WHO dan segitiga analisis kebijakan dari Walt & Gilson untuk memetakan variabel-variabelnya. Pengambilan data dilakukan melalui wawancara mendalam dan telaah dokumen yang dilaksanakan pada bulan April – Mei 2024. Hasil penelitian menunjukkan bahwa kebijakan sudah mulai berjalan akan tetapi belum semua kebijakan terlaksana. Sikap pelaksana sudah baik tetapi belum didukung pemahaman kebijakan yang utuh. Dukungan sumber daya belum optimal dalam hal anggaran dan pemanfaatan teknologi digital untuk pelaporan. Komunikasi belum efektif dalam kejelasan kebijakan. Struktur birokrasi di tingkat FKTP masih kurang, pemahaman pedoman kurang sehingga peran dan pembagian wewenang di FKTP belum berjalan dengan baik. Monitoring dan evaluasi belum berjalan optimal, serta keterlibatan swasta perlu didorong dalam integrasi pelayanan kesehatan. Oleh karena itu, upaya-upaya peningkatan efektivitas implementasi memerlukan penguatan kebijakan, peningkatan komunikasi, penatalaksanaan sumber daya, serta monitoring dan evaluasi
To implement all priority programs for which they are responsible, Puskesmas collaborates with other First Level Health Facility networks in their working areas through health service integration. The Ministry of Health has issued Guidelines for the Implementation of Health Service Integration at Puskesmas with other primary health care facilities in the implementation of Priority Programs. This study aims to analyze the implementation of the Health Service Integration policy at Puskesmas with other FKTPs in Kendal District, Central Java. The research is a policy analysis using a qualitative approach with a research design using the Edward III policy implementation model combined with the WHO framework and the policy analysis triangle from Walt & Gilson to map the variables. Data collection was carried out through in-depth interviews and document reviews conducted in April - May 2024. The results showed that the policy has started to run but not all policies have been implemented. The attitude of the implementers is good but has not been supported by a complete understanding of the policy. Resource support has not been optimal in terms of budget and utilization of digital technology in reporting. Communication has not been effective in policy clarity. Bureaucratic structure at the FKTP level is still lacking, and understanding of the guidelines is lacking so the role and division of authority at FKTP has not gone well. Monitoring and evaluation have not run optimally, and the involvement of the private sector needs to be encouraged in the integration of health services. Therefore, efforts to improve implementation effectiveness require strengthening policies, improving communication, managing resources, as well as monitoring and evaluation.
T-6972
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Hendro Nurcahyo; Pembimbing: Adang Bachtiar; Penguji: Dumilah Ayuningtyas, Puput Oktamianti, Nurrahmiati, Rosita
Abstrak:
Kondisi saat ini presentase Puskesmas dengan jenis tenaga kesehatan sesuai standar baru mecapai 23% dan target di tahun 2024 adalah 83% maka Indonesia memiliki tugas untuk memenuhi 60% kekuranganya. Selain indikator di atas RPJMN 2020-2024 juga menargetkan 100% puskesmas di Indonesia sudah memiliki dokter akan tetapi sesuai data Kementerian Kesehatan RI per tahun 2018 masih terdapat 15% puskesmas di Indonesia belum memiliki dokter. Dalam menanggapi permasalahan mengenai pemenuhan tenaga kesehatan dapat dilakukan penugasan khusus secara individu ataupun tim dalam mendukung Program Nusantara Sehat. Penugasan khusus tenaga kesehatan dalam mendukung program Nusantara Sehat merupakan kebijakan yang potensial untuk menyelesaikan permasalahan pemerataan pelayanan kesehatan di Indonesia.Penelitian ini bertujuan mengetahui implementasi Kebijakan Penugasan Khusus Tenaga Kesehatan dalam Peraturan Menteri Kesehatan Republik Indonesia Nomor 33 Tahun 2018. Dalam Penelitian ini menggunakan metode kualitatif dengan data primer yang diperoleh melalui wawancara mendalam dan data sekunder melalui telaah dokumen. Penelitian menggunakan teori analisis kebijakan Van Meter dan Van Horn dengan variabel ukuran dan tujuan, sumber daya, karakteristik badan pelaksana, komunikasi antar organisasi, disposisi pelaksana, serta lingkungan ekonomi, sosial, dan politik yang mempengaruhi implementasi kebijakan. Hasil penelitian didapatkan bahwa tujuan kebijakan ini masih ada yang belum terukur. Sumber daya terkendala kurangnya pemahaman akan pemanfatan dana BOK Pusekesmas yang terdapat tim Nusantara Sehat. Komunikasi antar organisasi pelaksana baik. Karakteristik pelaksana terkendala dengan keterbatasan SDM. Sikap pelaksana mendukung. Kondisi ekonomi dan politik baik dapat dikondisikan dengan adanya komunikasi yang baik. Kesimpulan didapatkan bahwa implementasi berjalan dengan baik walapun dengan kendala kendala yang ditemukan. Rekomendasi penelitian ini yaitu keberhasilan implementasi akan dicapai bila dilakukan evaluasi dan monitori dan perbaikan dari kekurangan. Kebijakan Permenkes ini dikondisikan akan mengalami revisi kembali sehingga perlu adanya perbaikan yang akan mempermudah dan memperjelas bagaimana pelaksanaan kebijakan ini
The current condition of the percentage of Puskesmas with types of health workers according to new standards has reached 23% and the target in 2024 is 83%, so Indonesia has a duty to meet 60% of its shortcomings. In addition to the indicators above, the 2020-2024 RPJMN also targets that 100% of puskesmas in Indonesia already have doctors, but according to data from the Indonesian Ministry of Health as of 2018 there are still 15% of puskesmas in Indonesia that do not have doctors. In responding to problems regarding the fulfillment of health workers, special assignments can be carried out individually or in teams to support the Healthy Nusantara Program. The special assignment of health workers in supporting the Nusantara Sehat program is a potential policy to solve the problem of equal distribution of health services in Indonesia. This study aims to determine the implementation of the Health Workforce Special Assignment Policy in the Regulation of the Minister of Health of the Republic of Indonesia Number 33 of 2018. In this study using qualitative methods with primary data obtained through in-depth interviews and secondary data through document review. The study used Van Meter and Van Horn's theory of policy analysis with variables of size and objectives, resources, characteristics of the implementing agency, communication between organizations, implementing dispositions, and the economic, social and political environment that influence policy implementation.The results showed that the objectives of this policy are still not measurable. Resources are constrained by a lack of understanding of the use of BOK Pusekesmas funds available by the Nusantara Sehat team. Good communication between implementing organizations. The characteristics of the implementer are constrained by limited human resources. The attitude of the executor is supportive. Good economic and political conditions can be conditioned by good communication. The conclusion was that the implementation went well even with the obstacles that were found. The recommendation of this research is that the successful implementation will be achieved if evaluation and monitoring and correction of deficiencies are carried out. This Permenkes policy is conditioned to undergo revision again so that improvements are needed that will simplify and clarify how this policy is implemented
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The current condition of the percentage of Puskesmas with types of health workers according to new standards has reached 23% and the target in 2024 is 83%, so Indonesia has a duty to meet 60% of its shortcomings. In addition to the indicators above, the 2020-2024 RPJMN also targets that 100% of puskesmas in Indonesia already have doctors, but according to data from the Indonesian Ministry of Health as of 2018 there are still 15% of puskesmas in Indonesia that do not have doctors. In responding to problems regarding the fulfillment of health workers, special assignments can be carried out individually or in teams to support the Healthy Nusantara Program. The special assignment of health workers in supporting the Nusantara Sehat program is a potential policy to solve the problem of equal distribution of health services in Indonesia. This study aims to determine the implementation of the Health Workforce Special Assignment Policy in the Regulation of the Minister of Health of the Republic of Indonesia Number 33 of 2018. In this study using qualitative methods with primary data obtained through in-depth interviews and secondary data through document review. The study used Van Meter and Van Horn's theory of policy analysis with variables of size and objectives, resources, characteristics of the implementing agency, communication between organizations, implementing dispositions, and the economic, social and political environment that influence policy implementation.The results showed that the objectives of this policy are still not measurable. Resources are constrained by a lack of understanding of the use of BOK Pusekesmas funds available by the Nusantara Sehat team. Good communication between implementing organizations. The characteristics of the implementer are constrained by limited human resources. The attitude of the executor is supportive. Good economic and political conditions can be conditioned by good communication. The conclusion was that the implementation went well even with the obstacles that were found. The recommendation of this research is that the successful implementation will be achieved if evaluation and monitoring and correction of deficiencies are carried out. This Permenkes policy is conditioned to undergo revision again so that improvements are needed that will simplify and clarify how this policy is implemented
T-6276
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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