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Alexander Widya Chriswanto; Pembimbing: Dumilah Ayuningtyas; Penguji: Anhari Achadi, Puput Oktamianti, Sulistyo, Deni Kurniadi Sunjaya
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Indonesia menempati peringkat 2, negara dengan angka kejadian Tuberkulosis (TB) tertinggi, namun sebagian besar kasusnya belum ditemukan. Upaya penemuan kasus TB di Tempat Praktik Mandiri Dokter (TPMD) menghadapi banyak hambatan. TPMD hanya menemukan 1% kasus dari total kasus TB pada tahun 2022, dengan rasio pencarian pengobatan masyarakat di TPMD sebesar 19%. Tujuan Penelitian : Mengetahui faktor-faktor yang berhubungan dengan capaian penemuan kasus TB di TPMD. Metode : Mix method sequential explanatory, yaitu metode kuantitatif melalui pengisian kuesioner oleh 175 responden, dilanjutkan metode kualitatif melalui wawancara mendalam 6 informan. Penelitian dilakukan di Jawa Barat, Nusa Tengga Timur, Maluku dan Sumatera Utara. Hasil : Variabel yang berhubungan dengan capaian penemuan kasus TB di TPMD adalah ketersediaan SDM Kesehatan, ketersediaan dan penggunaan sistem informasi terpadu, aksesibilitas pemeriksaan TCM, pemanfaatan alur rujukan layanan TB, keterlibatan organisasi profesi dan kelompok masyarakat. Persentase TPMD yang mencapai target penemuan kasus TB di 4 provinsi adalah sebesar 58,9%. Variabel yang paling berhubungan adalah keterlibatan kelompok masyarakat (OR = 12.008, 95% CI 4.527-31.851, p-value < 0,001). Kesimpulan : Pemerintah memiliki peluang besar untuk mengoptimalkan TPMD, namun masih menghadapi tantangan terkait pemerataan SDM dan infrastruktur, peningkatan efektivitas dan efisiensi biaya, pengembangan skema PPM, serta optimalisasi pengawasan kualitas layanan terstandar.
Indonesia is ranked as the second most Tuberculosis-affected country, but most cases remain undiagnosed. Numerous challenges still exist to identify TB cases in Private Practitioner (PPs). Only 1% of all TB cases reported by PPs in 2022, with a 19% population-based treatment rate. Objective : Determine the factors that go into a PPs successful diagnosis of TB cases. Method : Sequential explanatory mix method, 175 PPs completed questionnaires in quantitative and 6 key informants participated in in-depth interviews in qualitative. North Sumatra, Maluku, East Nusa Tenggara and West Java were the locations of the research projects. Results : Variables related to the achievement of TB case detection in PPs were the availability of human resources, availability and use of integrated information systems, accessibility of TCM examinations, utilization of TB service referral, involvement of professional organizations and community groups. The overall percentage of PPs that achieved the TB case detection was 58.9%. The variable most related to the achievement of TB case detection was the involvement of community groups (OR = 12.008, 95% CI 4.527-31.851, p-value < 0.001). Conclusion : The government has an excellent chance to maximize the role of PPs, but it has to deal with issues like equitable infrastructure and human resource, improving cost-effectiveness and efficiency and improving oversight of standardized service quality.
T-7003
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Novie Irawaty Laura Manurung; Pembimbing: Ede Surya Darmawan; Penguji: Adang Bachtiar, Wiku Bakti Bawono Adisasmito, Galuh Budhi Leksono Adhi, Retno Kusuma Dewi
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Pada tahun 2022, diperkirakan TBC anak 0-14 tahun menyentuh angka tertinggi yaitu 12% dari total kasus global atau sebesar 1,3 juta jiwa setiap tahunnya dan setengahnya merupakan anak dibawah usia 5 tahun. Indonesia berada pada peringkat kedua TBC terbanyak dimana 9,7% diantaranya adalah kasus TBC anak. Tingkat cakupan penemuan kasus TBC anak mencapai 158% namun penegakan TB pada anak yang cenderung sulit masih menjadi tantangan di lapangan, kemungkinan overdiagnosis atau underdiagnosis pada kasus anak masih cukup besar. Faktor sumber daya kesehatan dan faktor akses pelayanan kesehatan menjadi kendala dari penemuan kasus TBC anak secara aktif dan pasif. Tujuan dari penelitian ini adalah untuk mengetahui determinan faktor yang berhubungan dengan cakupan penemuan kasus tuberkulosis anak di Indonesia. Penelitian menggunakan pendekatan kuantitatif dengan desain potong lintang (cross sectional) dan dengan unit penelitian 514 kabupaten kota di Indonesia. Temuan penelitian ini mengungkapkan bahwa masih terdapat ketimpangan pada tingkat cakupan penemuan kasus TB anak, faktor ketersediaan SDM kesehatan yang terlatih, ratio ketersediaan faskes, realisasi belanja kesehatan per kapita, pelaporan dengan SITB, keterlibatan komunitas, tingkat kemiskinan, dan kewilayahan. Faktor-faktor yang berhubungan dengan cakupan penemuan kasus TBC anak adalah pelaporan fasilitas kesehatan menggunakan SITB, keterlibatan komunitas,tingkat kemiskinan, dan kewilayahan. Variabel yang paling dominan berhubungan dengan tingkat cakupan penemuan kasus TBC anak adalah keterlibatan komunitas masyarakat. Wilayah kabupaten kota yang memiliki keterlibatan komunitas masyarakat berpeluang 4,059 kali (95% CI 2,360-6,983) untuk cakupan penemuan kasus TBC anak tercapai dibandingkan dengan wilayah kabupaten kota yang tidak memiliki keterlibatan komunitas masyarakat setelah variabel lainnya dikontrol. Keterlibatan komunitas masyarakat untuk mendukung program TBC akan meningkatkan penemuan kasus TBC anak secara aktif dengan terselenggaranya kegiatan investigasi kontak dan skrining TB yang semakin kuat di masyarakat
In 2022, it is estimated that tuberculosis (TB) in children 0–14 years old will touch 12% of the total global cases (1.3 million children), meanwhile in Indonesia 9.7% of the total case being childhood TB. The coverage rate of finding childhood TB reaches 158%; however, difficulty diagnosing tuberculosis in children is still a challenge in the field. The possibility of overdiagnosis or underdiagnosis is still quite large. Health resource factors and health service access factors are obstacles to the implementation of active and passive discovery of childhood TB. The purpose of this study is to determine the determinants of factors related to the scope of finding childhood TB in Indonesia. This study used a quantitative approach with a cross-sectional design and with research units from 514 urban districts in Indonesia. The findings of this study reveal that there are still inequalities in the level of coverage of finding childhood TB due to factors such as the availability of trained human resources, the ratio of availability of health facilities, the realisation of health spending, reporting with SITB, community involvement, poverty levels, and territoriality. Factors related to the coverage of finding childhood TB are the reporting of health facilities using SITB, community involvement, poverty rates, and territoriality. The most dominant variable related to the level of coverage for finding child TB cases is community involvement. It was possible to find 4,059 times as many cases of childhood TB (CI 95% 2,360–6,983) in districts with community involvement as in districts without community involvement, even when other factors were taken into account. Community involvement to support TB programmes will increase the discovery of active child TB cases by conducting stronger contact investigations and TB screening activities in the community.
T-6854
Depok : FKM-UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Khaula Karima; Pembimbing: Adang Bachtiar; Penguji: Puput Oktamianti, Purnawan Junadi, Nana Mulyana, Sulistyo
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Ketepatan waktu merupakan kinerja utama dari sistem surveilans. Pencegahan dan pengendalian TBC memerlukan pelaporan yang lengkap dan tepat waktu agar dapat dilakukan investigasi kontak dan pengobatan. Pada penelitian ini ketepatan waktu pelaporan digambarkan dengan interval tanggal register pasien TBC saat menjadi terduga TBC dengan tanggal input pelaporan TBC di SITB dengan batas waktu 7 hari. Berbagai penelitian menunjukkan sejumlah faktor yang berhubungan dengan ketepatan waktu pelaporan, seperti jenis fasilitas kesehatan, kepemilikan fasilitas kesehatan, karakteristik pasien, dan beberapa faktor lainnya yang digambarkan oleh Donabedian (1988) sebagai faktor input, proses, dan output. Penelitian ini adalah penelitian cross-sectional dengan pendekatan mixed method sequential design diawali analisis kuantitatif data SITB di Provinsi Jawa Barat tahun 2021 dan 2022 dengan uji chi square dan uji regresi logistik ganda, dilanjutkan dengan penelitian kualitatif. Proporsi laporan TBC tepat waktu di Jawa Barat meningkat dari 46,7% (2021) menjadi 56,7% (2022). Hasil uji chi square menunjukkan waktu register pasien TBC, jenis faskes yang melapor, kepemilikan faskes yang melapor, riwayat penyakit TBC pasien, jenis kasus TBC, volume kasus di kabupaten/kota, status kerja sama faskes dengan BPJS Kesehatan, usia, dan jenis kelamin pasien berhubungan dengan ketepatan waktu pelaporan TBC di 2021 dan 2022. Setelah dikontrol variabel lainnya, analisis multivariat menyimpulkan jenis faskes merupakan faktor yang paling berhubungan dengan ketepatan waktu pelaporan TBC di Jawa Barat. Odss tertinggi pada lapas rutan (2021=10,6 CI : 6,9-16,4; dan 2022=5,4 CI=3,8-7,6) dengan rentang confident interval yang cukup besar, dan BP4/BBKPM/BKPM (2021=3,4 CI:3,1-3,5 dan 2022=4,6 CI: 3,2-3,9) dibandingkan dengan Puskesmas. Hasil penelitian kualitatif menjelaskan keterkaitan kompetensi petugas, kebijakan, infrastruktur, persepsi manfaat, dan persepsi penggunaan sistem informasi dengan ketepatan waktu pelaporan TBC. Dengan demikian, intervensi untuk meningkatkan kualitas data TBC memperhatikan jenis fasilitas kesehatan, mendorong kebijakan yang meningkatkan keterlibatan fasilitas pelayanan kesehatan swasta, mengoptimalkan mekanisme umpan balik pelaporan TBC, serta memperkuat sistem informasi elektronik TBC yang mendukung output operasional penggunanya di faskes sangat penting.
Timeliness of report is one of the key metrics in surveillance system. Prevention and control of Tuberculosis requires complete and timely reporting so that contact investigations and treatment can be carried out immediately. In this study, the timeliness of reporting is described by the interval between the date of registration of a TB patient when as suspected TB and the date of input registration input into TB Information system (SITB). The categorization of timely report determined by 7 days of interval, which is also referred to by the Ministry of Health in the Zero Reporting intervention. Various studies show factors related to the timeliness of reporting, i.e., type of health facility, type of provider, patient characteristics, and other factors described by Donabedian (1988) as input, process and output factors. This study using mixed method sequential design with quantitative research using SITB data continued with qualitative research. The chi square test to analyze qualitative data continued with logistic regression. The proportion of timely TB reports in West Java increased from 46.7% to 56.7%. The chi-square test shows registration time for TB patients, type of reporting health service facility, type of provider, TB patient treatment history, type of TB case, TB case volume in the districts, cooperation status with BPJS Kesehatan, patient age, and patient gender is related to the timeliness of TB reporting in 2021 and 2022. After controlling other variables, the multivariate analysis concluded that the type of health facility is the most related factor to the timeliness of TB reporting in West Java in 2021 and 2022. The highest odds were in prisons (2021=10.6 CI: 6.9-16.4; and 2022=5.4 CI=3.8-7.6) with a large confidence interval range, and BP4/BBKPM/ BKPM (2021=3.4 CI:3.1-3.5 and 2022=4.6 CI: 3.2-3.9) compared to Puskesmas. The results of qualitative research explain the relationship between officer competency, policy, infrastructure, perceived of benefits, and perceived of information systems usefulness with the timeliness of TB reporting. Thus, interventions to improve the quality of TB data by looking at the type of health facility, encouraging policies that increase the involvement of private provider, optimizing the feedback mechanism for TB reporting, and strengthening the electronic TB information system that supports the operational output of its users in health facilities are imperative.
T-6964
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Idris Ahmad; Pembimbing: Sandi Iljanto; Penguji: Purnawan Djunadi, Nunuk Agustina
Abstrak:
Tuberkulosis merupakan penyakit yang disebebakan oleh bakteri Mycobacterium tuberculosis. pada tahun 2012 mencapai prevalensi 12 juta prevalensi kasus dan 990 ribu kematian di dunia. Di Indonesia prevalensi penyakit ini sebesar 423/100.000 penduduk dan mortalitas sebesar 27/100.000 penduduk. Salah satu provinsi yang memiliki prevalensi yang lebih tinggi dari rata-rata nasional adalah Jawab Barat.Dalam sepuluh tahun terakhir pencapaian penemuan kasus baru TB BTA positif (CDR) kota Bekasi belum pernah mencapai target nasional. Selain itu, dari 31 puskesmas yang berada di wilayah Kota Bekasi hanya 3(10%) puskesmas yang mencapai target nasional. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan cakupan penemuan kasus baru TB BTA positif di puskesmas wilayah Kota Bekasi tahun 2012. Penelitian ini menggunkan metode cross sectional deengan analisis uji T dan Chi square. Penelitian ini dilakukan bulan April–Juni 2013 dengan menggunakan data sekunder baik register TB di puskesmas, dinas Kesehatan, dan laporan pendukung lainnya. Konsep yang digunakan dalam penelitian ini adalah pendekatan sistem. Hasil didapatkan bahwa dilihat dari kondisi SDM, terdapat 14 (54,8%) puskesmas dengan kondisi kurang, tingkat tanggung jawab yang dimiliki oleh penanggung jawab program TB 23 (74,2%) puskesmas tinggi, terdapat 26 (83,9%) puskesmas dengan penanggung jawab program TB dengan tingkat pengetahuan baik, dan 16 (51,6%) puskesmas memiliki proporsi pelatihan tinggi. Dari kondisi sarana dan prasarana diperoleh bahwa terdapat 23 (74,2%) puskesmas memiliki kondisi sarana dan prasarana yang baik. Berdasarkan alokasi dana tersebar merata 45,2% puskesmas untuk rendah ataupun tinggi. Dilihat dari angka penjaringan suspek diperoleh bahwa 16 (51,6%) puskesmas memiliki angka penjaringan suspek tinggi, dilihat menurut frekuensi kegiatan KIE TB terdapat 26 (83,9%) puskesmas dengan frekuensi KIE TB tinggi, terdapat 20 (64,5%) puskesmas dengan tingkat pemeriksaan kontak tinggi, dan terdapat 16 (51,6%) puskesmas dengan tingkat kemitraan masyrakat rendah. Hasil analisis antara proses dan output didapatkan adalah terdapat hubungan yang signifikan antara angka penjaringan suspek dengan cakupan penemuan kasus baru TB BTA positif. Didapatkan hubungan yang tidak signifikan antara KIE TB, pemeriksaan Kontak, dan juga kemitraan masyarakat. Kesimpulan dari penelitian ini adalah angka penjaringan suspek berpengaruh terhadap cakupan penemuan kasus TB BTA Positif.
Tuberculosis is a disease that caused by the Mycobacterium tuberculosis. In 2012, the prevalence of the cases reached 12 million and caused 990 thousand death cases in the world. In Indonesia, the prevalence of this disease is 423/100.000 with 27/100.000 for the mortality rate. One of the provinces which have a higher prevalence than the national average is West Java. Bekasi, as one of the city in West Java still has problem in TB control. In the last ten years, the Case Detection Rate has not reached the national target. In addition, there are only 3 (10%) health centers in Bekasi City which are achieved the national target. This reaserch is aimed to determine the factors related to the scope of tuberculosis new cases detection in Bekasi Regional Health Center Area in 2012. It then cross-sectional analysis with the T and Chi square test. The research was conducted on April-June 2013 by using secondary data from health centers, health departments, and other supporting reports. Furthermore, a system approach is used in this study. The results obtained that the human condition 14 (54.8%) in health centers with the low conditions, the level of responsibility held by the person in charge of the TB program 23 (74.2%) in health centers with a high level of responsibility, there were 26 (83.9% ) which had charge of the TB program with a good level of knowledge, and 16 (51.6%) with high training proportions. In term of infrastructure condition, it is obtained that there are 23 (74.2%) health centers in the good condition. Based on the fund allocation, it is equally spread 45.2% for good and low condition. In crawl suspect, it is obtained that 16 (51.6%) health center with high crawl suspect, seen by the frequency of Communication, Information, and Education of TB (KIE TB) activities there were 26 (83.9%) centers with a high frequency of KIE TB, then there are 20 (64.5%) health center with high examination for the person in contact, and there are 16 (51.6%) health centers with low levels of society partnerships. The result for the process and output is obtained that there is a significant correlation between the number of crawl suspected to number of coverage of the Tuberculosis (+) new case detection. Meanwhile, there is no significant correlation between KIE TB, contact examination and as well as community partnerships. The conclusion of this study is the crawl of the suspect affects number of coverage of the Tuberculosis (+) new case detection.
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Tuberculosis is a disease that caused by the Mycobacterium tuberculosis. In 2012, the prevalence of the cases reached 12 million and caused 990 thousand death cases in the world. In Indonesia, the prevalence of this disease is 423/100.000 with 27/100.000 for the mortality rate. One of the provinces which have a higher prevalence than the national average is West Java. Bekasi, as one of the city in West Java still has problem in TB control. In the last ten years, the Case Detection Rate has not reached the national target. In addition, there are only 3 (10%) health centers in Bekasi City which are achieved the national target.
S-7886
Depok : FKM-UI, 2013
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Rona Firmana Putri; Pembimbing: Jaslis Ilyas; Penguji: Amal Chalik Sjaaf, Purnawan Junadi, Nurrahmiati, Andi Alfian Zainuddin
Abstrak:
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Indonesia masih mengalami kesulitan terkait akses masyarakat terhadap layanan kesehatan serta kurangnya tenaga kesehatan, terutama di wilayah perdesaan dan terpencil. Berdasarkan data Sistem Informasi Sumber Daya Manusia Kesehatan (SISDMK), terdapat kekurangan tenaga kesehatan, khususnya dokter, yang ditandai dengan masih banyaknya jumlah Puskesmas tanpa dokter. Provinsi Maluku adalah salah satu Provinsi yang memiliki persentase Puskesmas tanpa dokter tertinggi yaitu 17,6% dan Puskesmas tersebut mayoritas terletak di wilayah perdesaan dan terpencil yang ditetapkan oleh pemerintah. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan motivasi dokter untuk bekerja di daerah perdesaan dan terpencil di Provinsi Maluku. Desain penelitian ini adalah cross-sectional menggunakan kuesioner online yang disebarkan kepada 344 dokter yang bekerja di Provinsi Maluku. Hasil penelitian menunjukkan bahwa dari 192 (56%) dokter yang mengisi kuesioner, faktor pengalaman di perdesaan dan terpencil (p=0,032), peluang karir (p=0,000), peluang pengembangan pendidikan dan profesional (p=0,010) dan kondisi kehidupan (p=0,016) merupakan faktor-faktor yang berhubungan dengan motivasi dokter untuk bekerja di daerah perdesaan dan terpencil di Provinsi Maluku. Sementara faktor yang paling dominan berhubungan adalah peluang karir (AOR=4,32 95% CI 1,43-11,76 95% CI) dan pengalaman di perdesaan dan terpencil 1-5 tahun (AOR=4,30 95% CI 1,24-14,70 95% CI). Penelitian ini menunjukkan bahwa dalam membuat kebijakan untuk mengatasi kekurangan dokter di daerah perdesaan dan terpencil khususnya di Provinsi Maluku, pemerintah harus memberikan perhatian khusus terhadap peluang pengembangan pendidikan dan profesional, kondisi kehidupan, dan terutama kebijakan terkait peluang kemajuan karir dokter serta kebijakan yang menunjang dokter agar memiliki pengalaman praktik di perdesaan dan terpencil.
Indonesia is still experiencing difficulties related to community access to health services and the need for more health workers, especially in rural and remote areas. Based on data from the Health Human Resources Information System (SISDMK), there is a shortage of health workers, especially doctors, as indicated by the large number of Public Health Centers that are without doctors. Maluku Province is one of the provinces with the highest percentage of Public Health Centers without doctors, at 17.6%, and most of these are located in rural and remote areas designated by the government. This study aims to determine the factors that associated with doctors' motivation to work in rural and remote areas in Maluku Province. The design of this study was cross-sectional, using an online questionnaire distributed to 344 doctors working in Maluku Province. The results showed that of 192 (56%) partisipants who filled out the questionnaire, the factors of experience in rural and remote areas (p=0.032), career opportunities (p=0.000), educational and professional development opportunities (p=0.010), and living conditions (p=0.016) were factors associated with doctors' motivation to work in rural and remote areas in Maluku Province. While the most dominant factors associated are career opportunities (AOR = 4.32 95% CI 1.43-11.76 95% CI) and experience in rural and remote areas 1-5 years (AOR=4,30 95% CI 1,24-14,70 95% CI). This study suggests that in making policies to overcome the shortage of doctors in rural and remote areas, especially in Maluku Province, the government should consider the following factors such as educational and professional development opportunities, living conditions, and primarily policies related to opportunities for career advancement of doctors and policies that support doctors to have practice experience in rural and remote areas.
T-7039
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Hilda Anandya Sugianto; Pembimbing: Budi Hidayat; Penguji: Pujiyanto, Tiur Febrina Pohan
S-8879
Depok : FKM UI, 2015
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Putri Sarah Dita; Pembimbing: Prastuti C. Soewondo; Penguji: Wahyu Sulistiadi, Murdiati Nadjib, Nopi Hendriani, Lemi Kurniawan
Abstrak:
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Target ambisius Pemerintah Indonesia, seperti tercermin dalam peta jalan Sistem Jaminan Sosial Nasional, untuk mencakup kepesertaan Jaminan Kesehatan Nasional (JKN) bagi semua penduduk Indonesia di tahun 2019. Salah satu kendala perbaikan indikator kesehatan adalah terbatasnya akses pada pelayanan kesehatan. Kepesertaan Bidan Praktek Swasta (BPS) pada program JKN di Kota Salatiga masih kurang, dimana hanya 7 BPS (22%) yang telah berjejaring dengan BPJS Kesehatan dari 32 BPS yang ada di kota tersebut. Penelitian ini bertujuan untuk mendapatkan faktor yang berhubungan dengan keputusan BPS menjadi jejaring BPJS Kesehatan pada program JKN di Kota Salatiga. Desain penelitian kualitatif ini menggunakan informan pada BPS yang sudah menjadi jejaring dan belum menjadi jejaring. Penelitian dilakukan pada bulan Februari sampai dengan Oktober 2017. Hasil penelitian menunjukkan bahwa keputusan BPS menjadi jejaring dipengaruhi oleh aspek pengalaman dimana sebagian besar adalah pensiunan bidan di Puskesmas. Sementara BPS bukan jejaring mayoritas masih aktif bekerja di Puskesmas dan tidak mempunyai sisa waktu untuk praktek swasta. Besarnya imbalan yang didapat perlu disesuaikan serta penyederhanaan alur klaim paling tidak seperti pada era Jaminan Persalinan. BPS belum menjadi jejaring tidak merasa dirugikan bila kunjungan pasien menurun mengingat telah ada tambahan dana jasa pelayanan dari JKN di instansinya bekerja. Perlu ditinjau kembali mekanisme kerjasama antara BPS dan BPJS Kesehatan serta upaya sosialisasi dengan tujuan persuasif yang mengajak BPS menjadi jejaring dalam program JKN.
Ambitious target of the Indonesian government, as stated in the roadmap of National Social Security System, aims to provide universal coverage to all Indonesians by 2019. One of the main obstacles to improve health development is the limited access to health services. Private midwives participants in the JKN program in Salatiga is still insufficient, only 7 out of the 32 private midwives (22%) have been included in the BPJS Health network. This study aims to understand the issues in private midwives participancy in JKN program in Salatiga. Qualitative approach is used with case study using informan of private midewives networked, as well as private midwives that are not yet networked with BPJS Kesehatan. The study was conducted from February to October 2017. The research indicated that decisions of Private Midwives successfully networked with BPJS Health is heavily influenced by years of experience, where the majority of private midwives networked is are retired. Meanwhile, the non-network private midwives are still actively working in primary health care, and not time left for private practice. Another aspect is that the amount of rewards earned is deemed insufficient and the flow of claims is more complicated when compared with Jampersal. Private midwives not in the network have yet to feel the loss with the decrease in patient visits since their offices already receive additional funding services from JKN. A review of the mechanism of cooperation between private midwives and BPJS Health is necessary, as well as socialization of benefits to the private midwives not yet included.
T-5353
Depok : FKM UI, 2018
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Eka Purnamasari; Pembimbing: Hafizurrachman; Penguji: Mieke Savitri, Dumilah Ayunigtyas, Agustine Zaini, Rita Endang
Abstrak:
Kepatuhan petugas PBF yang berperan dan bertanggung jawab dalam pengelolaan cold chain di PBF dipengaruhi oleh beberapa faktor diantaranya adalah sikap. Sikap diperoleh melalui pengalaman dan interaksi yang terus menerus dengan lingkungannya, objek sosial atau peristiwa sosial. Tujuan penelitian adalah Diketahuinya faktor-faktor yang berhubungan dengan sikap petugas PBF terhadap pengelolaan cold chain di empat PBF tahun 2010. Penelitian cross sectional melibatkan 188 petugas PBF, cara ukur dilakukan dengan pengisian sendiri terhadap kuesioner yang tersedia. Variabel dilihat berdasarkan teori yang dikembangkan dari Mar'at (1984), Sarwono (2009) dan Notoatmodjo (2010) yang menyatakan bahwa sikap berkaitan dengan pengetahuan. Pengetahuan dipengaruhi oleh pengalaman dan fasilitas. CFA digunakan untuk menguji validitas dan reliabilitas indikator, model fit (GFI=0.72, PGFI=0.64, RMSEA=0.073, AIC=5305,83, CAIC=5479.52). Hasil penelitian didapatkan faktor yang berperan tidak langsung terhadap sikap adalah fasilitas (0.75). Faktor fasilitas berhubungan dengan pengetahuan dalam mempengaruhi sikap. Faktor yang mempengaruhi sikap adalah faktor pengetahuan (0.61). Tidak ditemukan bukti faktor pengalaman berpengaruh terhadap pengetahuan. Kesimpulan adalah tidak semua faktor saling berhubungan mempengaruhi sikap. Disarankan Pemerintah dalam hal ini Badan POM melakukan revisi terhadap materi yang terkait pengelolaan cold chain dan vaksin dalam pedoman CDOB dan dibuat standardisasi materi pelatihan teknis prosedur pengelolaan cold chain. PBF diharapkan meningkatkan kualitas kegiatan pelatihan baik dari segi materi maupun metode pelatihan.
Measure of Compliances for Therapeutic Product Distributors personnel who in charge in cold chain operation is depends on some factors such as personnel attitude. Attitude has been gained from experiences, continuing interaction with circumstances, social object as well as social accomplishment. Objective of this research is to identify factors that have correlation with Therapeutic Product Distributors personnel attitude in term of cold chain management in area of four Therapeutic Product Distributors during 2010. This cross sectional research involved about 188 Therapeutic Product Distributors personnel using method of self assessment survey. Variables have been achieved based on theory that developed by Mar'at (1984), Sarwono (2009) and Notoatmodjo (2010) that said attitude has relationship with knowledge. Meanwhile knowledge is dependent on experience and facility. CFA has been used to examine both validity and reliability of indicator, model fit (GFI=0.72, PGFI=0.64, RMSEA=0.073, AIC=5305,83, CAIC=5479.52). Result of this research attain that facility factor (0.75) has indirect association with attitude factor. Facility factor has correlation to knowledge factor. Meanwhile, knowledge (0.61) has been association with attitude. Additionally, there is no evidence that experience rely on knowledge. In conclusion, its not overall factor has relationship with attitude. It is recommended to Government particularly Badan POM to revise guideline of cold chain management in the document of Good Distribution Practices and provide standard module of cold chain management training as well. Furthermore, Therapeutic Product Distributors have been expected to improve training activity both in module and method.
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Measure of Compliances for Therapeutic Product Distributors personnel who in charge in cold chain operation is depends on some factors such as personnel attitude. Attitude has been gained from experiences, continuing interaction with circumstances, social object as well as social accomplishment.
T-3158
Depok : FKM-UI, 2010
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Lulus Prihandari; Pembimbing: Dumilah Ayuningtyas; Penguji: Mardiati Nadjib, Vetty Yulianty Permanasari, Anwar Fachry, Fajar Ariyanti
Abstrak:
Peningkatan kesehatan ibu dan anak merupakan isu global. Memperluas akses imunisasi adalah hal yang sangat penting dalam mencapai Sustainable Development Goals (SDGs). Berdasarkan data Riskesdas 2018 target pencapaian imunisasi dasar lengkap di Provinsi Jawa Timur menurun dari tahun 2013 sebesar 74,5% menjadi sebesar 69,16% di tahun 2018 sedangkan imunisasi tidak lengkap naik menjadi 26,27% dari sebelumnya pada tahun 2013 hanya 21,8%. Tujuan penelitian ini untuk mengetahui faktor yang berhubungan dengan pemanfaatan imunisasi dasar di Provinsi Jawa Timur. Metode penelitian yang digunakan kuantitatif dengan desain cross sectional menggunakan data sekunder Riskesdas 2018 dengan unit analisis bayi usia 12-23 bulan dengan responden ibu sebanyak 1.245 responden. Hasil penelitian ini menunjukkan bahwa responden yang memanfaatkan imunisasi dasar 64,2% dan yang kurang memanfaatkan 35,8%. Responden dikatakan memanfaatkan apabila imunisasi yang didapatkan lengkap dan masuk kategori kurang memanfaatkan apabila imunisasi yang diterima tidak lengkap dan tidak mendapat imunisasi sama sekali. Pada analisis bivariat didapatkan kepemilikan buku KIA, akses fasilitas kesehatan dan tempat persalinan memiliki hubungan yang signifikan terhadap pemanfaatan pelayanan kesehatan imunisasi dasar di Jawa Timur. Hal ini dikarenakan ketiga faktor tersebut memiliki responden cukup banyak pada status imunisasi lengkap dan dikatakan berhasil memanfaatkan pelayanan kesehatan imunisasi dasar di Jawa Timur. Saran kepada Dinkes Provinsi Jawa Timur khususnya para tenaga kesehatan harus memaksimalkan pemberian informasi tentang kegunaan dan manfaat mengenai imunisasi di buku KIA agar tersampaikan dengan baik, memberi informasi kepada ibu hamil untuk memilih tempat persalinan yang sudah memenuhi standar akreditasi agar pelayanan ibu dan bayi yang diterima dapat maksimal serta meningkatkan kemudahan akses pelayanan kesehatan yang lengkap dan berkualitas agar dapat diakses oleh semua kalangan masyarakat.
Improving maternal and child health is a global issue. Expanding access to immunization is very important in achieving the Sustainable Development Goals (SDGs). Based on the 2018 Riskesdas data, the target of achieving complete basic immunization in East Java Province decreased from 2013 of 74.5% to 69.16% in 2018 while incomplete immunization increased to 26.27% from the previous year 2013 only 21.8 %. The purpose of this study was to determine the factors associated with the use of basic immunization in East Java Province. The research method used is quantitative with cross sectional design using secondary data from Riskesdas 2018 with the unit of analysis for babies aged 12-23 months with mother respondents as many as 1,245 respondents. The results of this study indicate that respondents who use basic immunization are 64.2% and those who are less use are 35.8%. Respondents are said to be using it if the immunization is complete and it is in the under-utilized category if the immunization received is incomplete and does not get immunized at all. In the bivariate analysis, it was found that ownership of the MCH booklet, access to health facilities and place of delivery had a significant relationship with the utilization of basic immunization health services in East Java. This is because these three factors have quite a lot of respondents on complete immunization status and are said to have succeeded in utilizing basic immunization health services in East Java. Suggestions to the East Java Provincial Health Office, especially health workers, should maximize the provision of information about the use and benefits of immunization in the MCH book so that it is conveyed properly, providing information to pregnant women to choose a place of delivery that meets accreditation standards so that the services of mothers and babies received maximally and increase the ease of access to comprehensive and quality health services so that they can be accessed by all people
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Improving maternal and child health is a global issue. Expanding access to immunization is very important in achieving the Sustainable Development Goals (SDGs). Based on the 2018 Riskesdas data, the target of achieving complete basic immunization in East Java Province decreased from 2013 of 74.5% to 69.16% in 2018 while incomplete immunization increased to 26.27% from the previous year 2013 only 21.8 %. The purpose of this study was to determine the factors associated with the use of basic immunization in East Java Province. The research method used is quantitative with cross sectional design using secondary data from Riskesdas 2018 with the unit of analysis for babies aged 12-23 months with mother respondents as many as 1,245 respondents. The results of this study indicate that respondents who use basic immunization are 64.2% and those who are less use are 35.8%. Respondents are said to be using it if the immunization is complete and it is in the under-utilized category if the immunization received is incomplete and does not get immunized at all. In the bivariate analysis, it was found that ownership of the MCH booklet, access to health facilities and place of delivery had a significant relationship with the utilization of basic immunization health services in East Java. This is because these three factors have quite a lot of respondents on complete immunization status and are said to have succeeded in utilizing basic immunization health services in East Java. Suggestions to the East Java Provincial Health Office, especially health workers, should maximize the provision of information about the use and benefits of immunization in the MCH book so that it is conveyed properly, providing information to pregnant women to choose a place of delivery that meets accreditation standards so that the services of mothers and babies received maximally and increase the ease of access to comprehensive and quality health services so that they can be accessed by all people
T-6076
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Nurrahmiati; Pembimbing: Sandi Iljanto; Penguji: Amal C. Sjaaf, Anwar Hassan, Idawaty Abdurachman
Abstrak:
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Periode persalinan merupakan periode yang berkontribusi besar terhadap angka kematian ibu di Indonesia, kematian saat bersalin dan 1 minggu pertama diperkirakan 60% dari seluruh kematian ibu. Pertolongan persalinan oleh tenaga kesehatan terlatih menjadi sangat penting dalam upaya penurunan kematian ibu. Propinsi Banten yang merupakan wilayah pada penelitian ini membutuhkan upaya yang lebih besar untuk mencapai cakupan persalinan oleh tenaga kesehatan mengingat cakupan persalinan oleh tenaga kesehatan yang dicapai hanya sebesar 68,9% menurut data susenas 2009. Penelitian ini dilakukan untuk mengetahui faktor-faktor yang berhubungan dengan cakuipan persalinan oleh tenaga kesehatan di provinsi Banten tahun 2010, dengan menggunakan pendekatan kuantitatif dan metode cross sectional. Penelitian menunjukkan bahwa jarak tempuh dan pelayanan persalinan di puskesmas merupakan faktor yang berhubungan secara signifikan dalam meningkatkan cakupan persalinan oleh tenaga kesehatan. Nilai R square sebesar 0.217 artinya 8 (delapan) variabel bebas yang diteliti dapat menjelaskan variabel cakupan persalinan 21.7% , sedangkan sisanya dijelaskan oleh variabel lain yang tidak termasuk dalam penelitian ini.
Delivery period is the period that contribute greatly to maternal mortality in Indonesia, death during childbirth and a first week of an estimated 60% of all maternal deaths. Aid deliveries by trained health personnel to be very important in an effort to decrease maternal mortality. Banten Province which is a region in this study requires a larger effort to achieve coverage of deliveries by health personnel in accordance with the target of Minimum Services Standard in 2015 ie by 90%, considering the scope of delivery by health personnel who achieved 68.9% (Susenas, 2009). This study used cross sectional method. Study shows that the mileage and service delivery in health centers is a factor that has a significant association in improving the coverage of deliveries by health personnel. R square value of 0.217 means 8 (eight) independent variables under study may explain the variable scope of delivery for 21.7%, while the rest is explained by other variables not included in this study.
T-3498
Depok : FKM UI, 2012
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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