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Yeremia Prawiro Mozart Runtu; Pembimbing: Syahrizal; Penguji: Artha Prabawa, Helda, Jhon Sugiharto, Hidayat Nuh Ghazali Djadjuli
Abstrak:
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Eliminasi Tuberkulosis (TB) di Indonesia pada tahun 2030 dapat dicapai dengan cakupan pemberian terapi pencegahan tuberkulosis (TPT) yang optimal. Namun cakupan pemberian TPT Kota Depok sebesar 8,57% dari target 50% di tahun 2023. Penilaian pelayanan TPT dilakukan untuk mengetahui tingkat kepatuhan layanan TPT berdasarkan komponen input dan proses serta mengetahui masalah utama yang menghambat layanan TPT di kota Depok. Penelitian mixed method didahului fase kuantititaif menilai tingkat kepatuhan puskesmas terhadap standar layanan TPT komponen input dan proses melalui kuesioner yang diisi mandiri oleh tim TB puskesmas. Tingkat kepatuhan dikategorikan baik (>81%), cukup (60%-80%), dan kurang (<59%). Lalu diikuti fase kualitatif dengan wawancara mendalam kepada penangungjawab program TB puskesmas. Dari 15 puskesmas, 87% (13) puskesmas tidak mencapai target nasional cakupan pemberian TPT. 60% (9) puskesmas mendapatkan skor cukup pada komponen input dan 27% (4) puskesmas mendapatkan skor cukup pada komponen proses. Tingkat kepatuhan terendah dari komponen input antara lain tidak tersedia logistik TST (85,7%), analis laboratorium dan tenaga farmasi belum dilatih program TPT (85,7%), tidak tersedianya alat TCM TB di dalam Puskesmas (73,3%), tidak tersedia logistik obat TPT untuk 1 tahun (63,7%). Tingkat kepatuhan terendah dari komponen proses adalah penemuan kasus TBC Laten tidak dilakukan dengan menggunakan rontgen dada di dalam Puskesmas (100%) dan tidak adanya kunjungan oleh Dinas Kesehatan untuk bimbinan teknis program TPT (46,7%). Persepsi tenaga kesehatan dianalisis secara tematik menunjukkan bahwa keterbatasan logistik dan tenaga kesehatan yang belum dilatih program TB dan TPT, kegiatan investigasi kontak belum dilakukan pada kasus indeks milik rumah sakit, kurangnya KIE dari tenaga kesehatan kepada keluarga pasien serta kurangnya supervisi dari dinas kesehatan menjadi hambatan layanan TPT di kota Depok. Program TB nasional perlu menetapkan standar layanan TPT. Dinas Kesehatan Kota Depok melakukan pelatihan kepada tim TB puskesmas da monitoring ketersediaan logistik TPT. Puskesmas melakukan edukasi tujuan dan manfaat TPT kepada populasi berisiko.
Elimination of Tuberculosis (TB) in Indonesia by 2030 can be achieved by providing optimal coverage of tuberculosis prevention therapy (TPT). However, the coverage of providing TPT in Depok is 8.57% of the target of 50% in 2023. The TPT service assessment was carried out to determine the level of TPT service compliance based on input and process components and to find out the main problems that hamper TPT services in Depok. This mixed method research was preceded by a quantitative phase assessing the level of compliance of puskesmas with TPT service standards for input and process components through a questionnaire filled out independently by puskesmas TB team. The Level of compliance is categorized as good (>81%), sufficient (60%-80%), and poor (<59%).This was followed by a qualitative phase with in-depth interviews with the person in charge of the puskesmas TB program. Of the 15 puskesmas, 87% (13) of puskesmas did not reach the national target for TPT coverage. 60% (9) puskesmas got a sufficient score on the input component and 27% (4) puskesmas got a sufficient score on the process component. The lowest levels of compliance from input components include unavailability of TST logistics (85.7%), laboratory analysts and pharmaceutical personnel not having been trained in the TPT programs (85.7%), unavailability of TB GenXpert in the puskesmas (73.3% ), no TPT drug logistics available for 1 year (63.7%). The lowest level of compliance with the process components was that latent TB case detection was not carried out using chest x-rays in puskesmas (100%) and there were no visits by the Depok District Health Office for supportive supervision on the TPT program (46.7%), The perception of health workers analyzed thematically shows that limited TPT logistics and health workers who have not been trained in TB and TPT programs, contact investigation activities have not been carried out in index cases belonging to hospitals, lack of IEC from health workers to the patient's family and lack of supervision from the health service are barriers to service TPT in Depok. the national TB program sets TPT services standards. The Depok District Health Office conducted training for puskesmas TB team and monitored the availability of TPT logistics. Puskesmas educates the aims and benefits of TPT to at-risk populations.
T-7018
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Wenty Prihantinah; Pembimbing: Ratu Ayu Dewi Sartika; Penguji: Sabarinah, Wachyu Sulistiadi, Kristina R.L.Nadeak, Meilina Farikha
Abstrak:
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Latar Belakang: Tuberkulosis (TB) masih menjadi tantangan kesehatan masyarakat global, dengan Indonesia menempati peringkat kedua beban TB tertinggi di dunia. Terapi Pencegahan Tuberkulosis (TPT) adalah strategi kunci untuk menekan progresi infeksi laten menjadi TB aktif, namun cakupan TPT di Kota Bekasi masih sangat rendah, yakni hanya mencapai 14,11%. Tujuan: Penelitian ini bertujuan menganalisis mutu pelaksanaan program TPT di Puskesmas Kota Bekasi berdasarkan kerangka Donabedian (struktur, proses, dan hasil) serta mengidentifikasi adanya kesenjangan persepsi layanan (Gap 1) antara tenaga kesehatan dan pasien. Metode: Penelitian kualitatif dengan desain studi kasus, dilakukan di empat puskesmas terpilih berdasarkan capaian TPT. Data dikumpulkan melalui wawancara mendalam, observasi, dan telaah dokumen, kemudian dianalisis secara tematik. Hasil: Dari aspek struktur, program menghadapi keterbatasan sumber daya manusia (SDM), sarana diagnostik (foto thoraks), dan perbedaan kemandirian anggaran antar-puskesmas. Dalam proses, ditemukan suboptimalitas pada investigasi kontak, edukasi yang terbatas, pemantauan yang tidak berkesinambungan, serta pemanfaatan Sistem Informasi Tuberkulosis (SITB) yang belum maksimal . Analisis Gap 1 menemukan adanya kesesuaian persepsi pada layanan individual, tetapi terdapat potensi kesenjangan pada aspek non-klinis karena pasien mengharapkan edukasi yang lebih luas pada tingkat komunitas untuk mengurangi stigma. Kesimpulan: Mutu program TPT di Puskesmas Kota Bekasi sudah berjalan, tetapi masih menghadapi hambatan struktural, proses, dan potensi kesenjangan persepsi. Diperlukan penguatan kapasitas tenaga kesehatan, pemenuhan logistik dan sarana diagnostik, optimalisasi SITB, serta peningkatan edukasi berbasis komunitas untuk memperbaiki mutu program dan meningkatkan cakupan TPT di masa mendatang. Kata Kunci: Tuberkulosis, Terapi Pencegahan Tuberkulosis, Mutu Layanan, Donabedian, Puskesmas.
Background: Tuberculosis (TB) remains a global public health challenge, with Indonesia ranking second in the world for the highest TB burden. Tuberculosis Preventive Therapy (TPT) is a key strategy to suppress the progression of latent infection to active TB, but TPT coverage in Bekasi City is still very low, reaching only 14.11%. Objective: This study aims to analyze the quality of TPT program implementation in Bekasi City Puskesmas based on the Donabedian framework (structure, process, and outcome) and to identify the presence of a service perception gap (Gap 1) between health workers and patients. Method: A qualitative study with a case study design was conducted in four selected Puskesmas based on their TPT achievement. Data were collected through in-depth interviews, observation, and document review, and then analyzed thematically. Results: Regarding the structure aspect, the program faces limitations in human resources (HR), diagnostic facilities (chest X-ray), and differences in budget independence among Puskesmas. In the process, suboptimal performance was found in contact investigation, limited education, inconsistent monitoring, and underutilization of the Tuberculosis Information System (SITB). The Gap 1 analysis found a correspondence of perception in individual services, but a potential gap exists in non-clinical aspects, as patients expect broader community-level education to reduce stigma. Conclusion: The quality of the TPT program in Bekasi City Puskesmas is running, but still faces structural and process barriers, as well as a potential perception gap. Strengthening health worker capacity, fulfilling logistics and diagnostic facilities, optimizing SITB, and increasing community-based education are needed to improve program quality and increase TPT coverage in the future. Keywords: Tuberculosis, Tuberculosis Preventive Therapy, Service Quality, Donabedian, Puskesmas.
T-7463
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Siti Muhimatul Munawaroh; Pembimbing: Vetty Yulianty Permanasari; Penguji: Adang Bachtiar, Dumilah Ayuningtyas, H Imam Budi Hartono, Mutmainah Indriyati
Abstrak:
Pelayanan kesehatan orang terduga TB merupakan salah satu standar pelayanan minimal (SPM) bidang Kesehatan yang harus dipenuhi oleh pemerintah Kab/Kota. Puskesmas merupakan unit terdepan dalam pencapaian target kinerja SPM bidang Kesehatan. Capaian SPM TB di kota Depok tahun 2021 baru mencapai 36,17 % dan menjadi capaian terendah kedua dari 12 SPM bidang Kesehatan Kota Depok. Tujuan dari penelitian ini adalah untuk menganalisis secara mendalam aspek struktur, aspek proses peningkatan mutu dan kinerja dengan pendekatan PDSA (Plan-do-study-act) serta output dalam upaya peningkatan capaian pelayanan kesehatan orang terduga TB di Puskesmas Kota Depok Tahun 2022. Penelitian ini menggunakan pendekatan kualitatif dengan menggunakan desain studi kasus melalui wawancara mendalam kepada 31 informan, observasi lapangan dan telusur dokumen. Hasil penelitian, belum semua Puskesmas menetapkan Tim TB Dots, kurangnya tenaga yang terlatih,sarana-prasarana belum semua sesuai standar, bahan-obat belum memadai, penggunaan teknologi informasi belum optimal, komitmen pimpinan dan staf masih kurang. Pada faktor proses, kegiatan upaya peningkatan capaian SPM TB pada tahapan study belum semua Puskesmas melakukan monitoring dan evaluasi terhadap capaian SPM TB.Pada output; terjadi peningkatan capaian pelayanan orang terduga TB pada tahun 2022 dibandingkan tahun 2021, namun belum semua Puskesmas dapat mencapai target SPM TB yang ditetapkan. Kesimpulan: faktor struktur dan proses peningkatan mutu dan kinerja yang dilakukan berpengaruh terhadap keberhasilan dalam pencapaian SPM TB di Puskesmas
The health service for people suspected of having TB is one of the minimum service standards (MSS) in the health sector that must be met by the district/city government. The Public Health Center is the leading unit in achieving the MSS performance targets in the health sector. TB MSS achievement in Depok city in 2021 only reached 36.17% and became the second lowest achievement of the 12 MSS in Depok City Health. The aim of this study was to analyze in depth aspects of the structure, aspects of the quality and performance improvement process using the PDSA (Plan-do-study-act) approach as well as outputs in an effort to increase the achievement of health services for people suspected of having TB at the Depok City Health Center in 2022. This research used a qualitative approach using a case study design through in-depth interviews with 31 informants, field observations and document searches. The results of the study, not all Public Health Centers have established TB Dots Teams, lack of trained personnel, not all facilities are up to standard, medicinal materials are not adequate, use of information technology is not optimal, leadership and staff commitment is still lacking. In terms of process factors, not all Public Health Centers have conducted monitoring and evaluation of TB MSS achievements at the study stage. On output; there has been an increase in the achievement of services for people suspected of having TB in 2022 compared to 2021, but not all Public Health Centers have reached the set TB MSS target. Conclusion: structural factors and quality and performance improvement processes carried out influence success in achieving TB MSS at the Public Health Centers
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The health service for people suspected of having TB is one of the minimum service standards (MSS) in the health sector that must be met by the district/city government. The Public Health Center is the leading unit in achieving the MSS performance targets in the health sector. TB MSS achievement in Depok city in 2021 only reached 36.17% and became the second lowest achievement of the 12 MSS in Depok City Health. The aim of this study was to analyze in depth aspects of the structure, aspects of the quality and performance improvement process using the PDSA (Plan-do-study-act) approach as well as outputs in an effort to increase the achievement of health services for people suspected of having TB at the Depok City Health Center in 2022. This research used a qualitative approach using a case study design through in-depth interviews with 31 informants, field observations and document searches. The results of the study, not all Public Health Centers have established TB Dots Teams, lack of trained personnel, not all facilities are up to standard, medicinal materials are not adequate, use of information technology is not optimal, leadership and staff commitment is still lacking. In terms of process factors, not all Public Health Centers have conducted monitoring and evaluation of TB MSS achievements at the study stage. On output; there has been an increase in the achievement of services for people suspected of having TB in 2022 compared to 2021, but not all Public Health Centers have reached the set TB MSS target. Conclusion: structural factors and quality and performance improvement processes carried out influence success in achieving TB MSS at the Public Health Centers
T-6663
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Nandya Silvalinda; Pembimbing: Agustin Kusumayati; Penguji: Dumilah Ayuningtyas, Wachyu Sulistiadi, Eti Rohati, Salma Sabira
Abstrak:
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Penelitian ini mengevaluasi implementasi Standar Pelayanan Minimal (SPM) HIV/AIDS di Puskesmas Kota Depok tahun 2025 dengan pendekatan Six Building Blocks WHO. Penelitian kualitatif deskriptif ini mengumpulkan data melalui wawancara mendalam, FGD, observasi, dan telaah dokumen di empat Puskesmas terpilih. Temuan menunjukkan capaian layanan belum merata, dipengaruhi oleh keterbatasan sumber daya, pelaporan yang belum optimal, dan lemahnya koordinasi lintas sektor. Strategi percepatan yang disusun menekankan penguatan tata kelola, kapasitas tenaga kesehatan, sistem informasi, akses obat esensial, serta peningkatan kolaborasi multisektor.
Hasil penelitian mengungkap bahwa pelaksanaan SPM HIV/AIDS masih menghadapi kesenjangan antar sasaran dan wilayah. Kelompok populasi kunci memiliki capaian tinggi karena dukungan LSM, sedangkan ibu hamil menjadi kelompok dengan capaian terendah akibat keterlambatan pelaporan dari bidan mandiri dan rumah sakit. Sistem informasi HIV/AIDS (SIHA) belum terintegrasi penuh dan masih bergantung pada kemampuan individu petugas. Ketersediaan obat antiretroviral (ARV) terbatas pada satu Puskesmas dengan sistem distribusi yang belum merata. Pembiayaan program masih bertumpu pada dana BOK dan donor, sementara regulasi seperti Perwal HIV/AIDS dan SOP PrEP belum disahkan.
Penelitian ini menegaskan perlunya penguatan kebijakan teknis sesuai Permenkes No. 6 Tahun 2024, penataan SDM dan insentif yang berkelanjutan, serta integrasi pelaporan lintas fasilitas. Peningkatan kapasitas kader, inovasi komunitas seperti CLM, dan pemanfaatan teknologi pelaporan menjadi kunci percepatan pencapaian target SPM HIV/AIDS di Kota Depok.
This study evaluates the implementation of the Minimum Service Standards (SPM) for HIV/AIDS at Community Health Centers (Puskesmas) in Depok City in 2025 using the WHO Six Building Blocks approach. This descriptive qualitative study collected data through in-depth interviews, focus group discussions (FGD), observations, and document reviews at four selected Puskesmas. Findings indicate that service delivery is uneven, influenced by resource constraints, suboptimal reporting, and weak inter-sectoral coordination. The acceleration strategies developed emphasize strengthening governance, health worker capacity, information systems, access to essential medications, and enhancing multisectoral collaboration. The results show that the implementation of the HIV/AIDS SPM still faces disparities among target groups and service areas. Key populations achieved higher coverage mainly due to NGO support, while pregnant women had the lowest coverage due to delayed or incomplete reporting from private midwives and hospitals. The HIV/AIDS Information System (SIHA) has not been fully integrated and still depends on individual staff capacity. The availability of antiretroviral (ARV) drugs is limited to one health center with uneven distribution across facilities. Program financing still relies heavily on BOK and donor funds, while technical regulations such as the Mayor’s Decree on HIV/AIDS and the PrEP SOP have not yet been enacted. This study highlights the need to strengthen technical policies in accordance with Minister of Health Regulation No. 6 of 2024, ensure sustainable human resource and incentive management, and enhance cross-facility reporting integration. Strengthening community-based innovations such as CLM, capacity building for cadres, and the use of digital reporting systems are key strategies to accelerate the achievement of HIV/AIDS SPM targets in Depok City.
T-7452
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Theresa F. Napitupulu; Pembimbing: Sabarinah Prasetyo; Penguji: Dumilah Ayuningtyas, Sudijanto Kamso, Rosye Arosdiani Apip, Rulliana Agustin
Abstrak:
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Kesembuhan pasien TB merupakan outcome dari pelayanan kesehatan yang berkualitas yang dipengaruhi oleh faktor provider dan customer. Oleh sebab itu penting adanya pemenuhan kebutuhan berdasarkan perspektif faktor tersebut. Tahun 2019, dikembangkan instrumen penilaian kualitas pelayanan TB berdasarkan perspektif pasien (Quote TB Light) dengan sembilan dimensi. Penelitian ini bertujuan mengetahui hubungan kualitas pelayanan kesehatan Tuberkulosis dengan kesembuhan pasien TB. Penelitian menggunakan mix method embedded design yang dilakukan pada empat puskesmas Kota Bandung menggunakan kuesioner (google form) pada 61 pasien TB dan 11 informan (petugas kesehatan) yang dilakukan wawancara mendalam secara online. Hasil penelitian dengan menggambarkan variabel stigma masuk kategori kualitas baik tertinggi (95.1%) dan variabel keterjangkauan finansial kategori kualitas buruk (14.8%) juga terdapat kesenjangan antara perspektif customer dan provider pada variabel keterjangkauan finansial dan infrastuktur. Hasil uji fisher exact menyatakan adanya hubungan kualitas pelayanan kesehatan tuberkulosis dengan kesembuhan pasien TB (p value 0.000). Dengan hasil penelitian, disarankan adanya dukungan infrastruktur terkait ruangan DOTS, tunggu dan Laboratorium yang memadai, Serta pemantauan minum obatyang ruti pada pasien menggunakan media telepon seluler, menetapkan SOP waktu pelayanan TB dan menyediakan anggaran bantuan dana terkait kebutuhan pasien (transportasi dan gizi).
TB patient cure is an outcome of quality health services which is influenced by provider and customer factors. Therefore, it is important to fulfill the needs based on the perspective of these factors. In 2019, an instrument for assessing the quality of TB services was developed based on the patient's perspective (Quote TB Light) with nine dimensions. This study aims to determine the relationship between the quality of Tuberculosis health services and the recovery of TB patients. The study used a mix method embedded design conducted at four Bandung City Health Centers using a questionnaire (google form) on 61 TB patients and 11 informants (health workers) who conducted in-depth online interviews. The results of the study by describing the stigma variable as being in the highest good quality category (95.1%) and the financial affordability variable in the poor quality category (14.8%) there is also a gap between the customer and provider perspectives on the financial and infrastructure affordability variables. Fisher's exact test results stated that there was a relationship between the quality of tuberculosis health services and the cure of TB patients (p value 0.000). With the results of the study, it is recommended that there be infrastructure support related to DOTS rooms, waiting rooms and adequate laboratories, as well as monitoring of routine drug taking in patients using cell phones, setting SOPs for TB service times and providing budget assistance funds related to patient needs (transportation and nutrition).
T-6198
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Dina Milana Anwar; Pembimbing: Ratu Ayu Dewi Sartika; Penguji: Evi Martha, Dumilah Ayuningtyas, Rima Damayanti, Rien Pramindari
Abstrak:
Latar belakang: Laju penurunan Angka Kematian Bayi melambat sejak tahun 1991-2017. Enam puluh tiga persen kematian bayi terjadi pada periode neonatal dimana risiko kematian yang terjadi pada bayi yang tidak mendapatkan Pelayanan Kesehatan Neonatal Esensial adalah 18,56 kali lebih tinggi daripada bayi yang mendapatkan pelayanan kesehatan tersebut. Puskesmas PONED X merupakan Puskesmas PONED satu-satunya di Kecamatan X, Kota Depok, dimana terdapat kesenjangan terbesar pada indikatorindikator terkait dengan Pelayanan Kesehatan Neonatal Esensial serta memiliki kebutuhan akan layanan yang besar berdasarkan jumlah persalinan, bayi lahir hidup dan pemanfaatan puskesmas untuk melakukan persalinan. Terkait hal tersebut, penelitian ini bertujuan melakukan analisis kualitas penerapan Pelayanan Kesehatan Neonatal Esensial di Puskesmas PONED Kecamatan X. Metode: Penelitian ini merupakan studi kualitatif dengan desain studi kasus yang dilakukan di Puskesmas PONED X pada bulan April-Mei 2020. Pengumpulan data dilakukan melalui wawancara mendalam, observasi partisipatif dan telaah dokumen. Informan penelitian ini terdiri dari Kepala Puskesmas, Bidan Koordinator PONED, Bidan Koordinator KIA dan para Bidan Pelaksana PONED serta para Ibu dari neonatus yang mendapatkan pelayanan kesehatan neonatal esensial di Puskesmas Kecamatan X. Hasil: Hasil penelitian menunjukkan jumlah, jenis dan kompetensi tenaga kesehatan yang masih kurang, persiapan alat dan bahan habis pakai yang belum lengkap, serta belum sesuainya pelaksanaan dalam perawatan neonatal esensial pada saat dan setelah lahir dengan standar pelaksanaan yang ditetapkan oleh Kementerian Kesehatan RI. Meskipun hasil indikator output menunjukkan ketercapaian yang sangat baik di 4 bulan pertama tahun 2020, akan tetapi dalam pelaksanaan proses pelayanannya, belum semua standar proses dilakukan sesuai Pedoman Pelayanan Kesehatan Neonatal Esensial Kementerian Kesehatan RI. Kesimpulan dan Rekomendasi: Hasil penelitian menunjukkan bahwa kualitas penerapan Pelayanan Kesehatan Neonatal Esensial di Puskesmas PONED Kecamatan X masih kurang karena berdasarkan analisis komponen input, proses dan output, masih terdapat kekurangan baik terkait komponen input maupun proses penerapan layanan yang belum sesuai dengan standar yang ditetapkan oleh Kementerian Kesehatan RI. Penguatan pemenuhan komponen input dan penguatan manajemen serta kapasitas tenaga kesehatan dalam memahami dan melakukan proses Pelayanan Kesehatan Neonatal Esensial sesuai standar merupakan hal yang direkomendasikan.
X BEONC Primary Health Center (PHC), the only BEONC PHC in sub-district X, Depok City, where there is the largest gap in the proxy indicators of Neonatal Essential Health Services (6,94%) and has a large need for services based on the number of service targets (5765 live birth) and the use of health centers for delivery (1105 deliveries). This research is a qualitative case study that aims to analyze the quality implementation of Essential Neonatal Health Services at the X BEONC PHC in sub-district X, conducted in April-May 2020. Data collection was carried out through in-depth interviews, participatory observation and documents review. The results showed that in the elements of health workers, references, equipment and consumables were still lacking, as well as inadequate implementation of essential neonatal care at and after birth to the standards set by the Indonesian Ministry of Health. It was concluded that the quality of implementation of Neonatal Essential Health Services at the BEONC PHC sub-district X was still lacking, because there were still shortcomings in terms the input components and the service implementation process that were not in accordance with the standards set by the Indonesian Ministry of Health. Meeting the input components and strengthening management and the capacity of health workers in understanding and carrying out the process of Neonatal Essential Health Services according to standards is highly recommended.
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X BEONC Primary Health Center (PHC), the only BEONC PHC in sub-district X, Depok City, where there is the largest gap in the proxy indicators of Neonatal Essential Health Services (6,94%) and has a large need for services based on the number of service targets (5765 live birth) and the use of health centers for delivery (1105 deliveries). This research is a qualitative case study that aims to analyze the quality implementation of Essential Neonatal Health Services at the X BEONC PHC in sub-district X, conducted in April-May 2020. Data collection was carried out through in-depth interviews, participatory observation and documents review. The results showed that in the elements of health workers, references, equipment and consumables were still lacking, as well as inadequate implementation of essential neonatal care at and after birth to the standards set by the Indonesian Ministry of Health. It was concluded that the quality of implementation of Neonatal Essential Health Services at the BEONC PHC sub-district X was still lacking, because there were still shortcomings in terms the input components and the service implementation process that were not in accordance with the standards set by the Indonesian Ministry of Health. Meeting the input components and strengthening management and the capacity of health workers in understanding and carrying out the process of Neonatal Essential Health Services according to standards is highly recommended.
T-5874
Depok : FKM-UI, 2020
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Naila Falichatul Muannisa; Pembimbing: Wachyu Sulistiadi; Penguji: Dumilah Ayuningtyas, Evi Martha, Andri Mursita, Eti Rohati
Abstrak:
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Penelitian ini membahas capaian Standar Pelayanan Minimal (SPM) layanan usia produktif sebelum dan sesudah penerapan kebijakan Integrasi Layanan Primer (ILP) di Kota Depok. Tujuan penelitian adalah menganalisis kontribusi komponen pendekatan Primary Health Care (pelayanan terintegrasi, pemberdayaan masyarakat, kolaborasi lintas sektor) serta komponen penggerak (kerangka kebijakan, sumber daya manusia, pendanaan, tata kelola, dan pemantauan–evaluasi) terhadap capaian SPM. Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus pada enam Puskesmas, didukung analisis deskriptif capaian SPM tahun 2023–2025. Hasil penelitian menunjukkan bahwa implementasi ILP mendorong perubahan struktur layanan, peran kader yang lebih aktif, serta perluasan jejaring lintas sektor. Namun, capaian SPM menunjukkan variasi antar Puskesmas: beberapa wilayah mengalami peningkatan stabil, sementara lainnya menghadapi fluktuasi atau stagnasi. Faktor internal berupa kesiapan tata kelola, SDM, dan adaptasi digital, serta faktor eksternal berupa dukungan lintas sektor dan regulasi, terbukti sangat menentukan keberhasilan ILP. Dengan demikian, keberhasilan transformasi ILP memerlukan penguatan kebijakan operasional, pemerataan kapasitas SDM, serta kolaborasi multipihak agar peningkatan mutu layanan usia produktif dapat berkelanjutan.
This study examines the achievement of Minimum Service Standards (MSS) for productive-age health services before and after the implementation of the Integrated Primary Care (ILP) policy in Depok City. The research aims to analyze the contribution of selected Primary Health Care components—integrated services, community empowerment, and cross-sector collaboration—as well as enabling factors including policy frameworks, human resources, financing, governance, and monitoring–evaluation. A qualitative approach with an intrinsic case study design was employed across six Puskesmas, supported by descriptive analysis of MSS data from 2023–2025. The findings indicate that ILP implementation encouraged service restructuring, more active roles of health cadres, and the expansion of cross-sectoral partnerships. Nevertheless, MSS achievements varied: some areas recorded stable improvements, while others faced fluctuations or stagnation. Internal factors such as governance readiness, human resource capacity, and digital adaptation, along with external factors such as cross-sectoral support and regulatory alignment, were critical to ILP success. Therefore, the sustainability of ILP transformation requires strengthened operational policies, equitable human resource capacity building, and multi-stakeholder collaboration to ensure continuous improvement of productive-age health services.
T-7439
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Ria Sonata; Pembimbing: Yayuk Hartriyanti; Penguji: Adang Bachtiar
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Dalam upaya penurunan Angka Kematian Ibu (AKI) di Indonesia, Departemen Kesehatan RI mencanangkan Gerakan Nasional Kehamilan yang Aman (Making Pregnancy Safer - MPS) dengan salah satu strategi yang dilaksanakan adalah meningkatkan kualitas dan cakupan pelayanan kesehatan. Berdasarkan SKRT tahun 1995 ditemukan 22,1% wanita hamil selama kehamilannya tidak pernah melakukan pemeriksaan antenatal. Kota Depok yang sedang mengalami perkembangan mempunyai gambaran yang tidak jauh berbeda. Walaupun angka cakupan pemeriksaan antenatal tinggi, namun dari segi kualitas masih belum memuaskan (Profil Kesehatan Kota Depok Tahun 2001). Tujuan penelitian ini adalah untuk mengetahui gambaran tingkat kepuasan dan pengetahuan ibu hamil terhadap mutu pelayanan antenatal di Puskesmas Kota Depok. Penelitian ini menggunakan rancangan cross sectional, dengan jumlah sampel ibu hamil sebanyak 97 orang dan 15 orang bidan responden pelaksana antenatal dari sepuluh puskesmas di wilayah Depok. Skor kepuasan dan pengetahuan ibu hamil sebesar 91,65 dan 70,27. Skor mutu pelayanan antenatal sebesar 54,16. Berdasarkan hasil analisis statistik diperoleh hubungan yang bermakna antara variabel pendidikan, pekerjaan, dan penolong persalinan dengan pengetahuan (p< 0,02). Tidak ada hubungan antara karakteristik ibu hamil dengan kepuasan. Dari lima dimensi kepuasan maka skor rata-rata kepuasan yang paling rendah berturut-turut adalah dimensi tangible (89,89), responsiveness (91,06), dan reliability (91.27). Berdasarkan analisis terhadap diagram kartesius, terdapat dua unsur yang perlu diprioritaskan untuk diperhatikan yaitu: kelengkapan alat-alat yang digunakan dan kebersihan serta kenyamanan ruang periksa. Disarankan agar puskesmas (1) meningkatkan kebersihan, kerapian dan kenyamanan ruang periksa dan ruang tunggu pasien. (2) memperbaiki dan meningkatkan pelayanan melalui ketepatan jadwal dan kecepatan dalam memberikan pelayanan. (3) membentuk gugus kendali mutu yang akan memantau pelaksanaan mutu pelayanan di puskesmas, (4) melakukan pelatihan SPK antenatal bagi seluruh bidan di puskesmas dan pembinaan secara berkala agar kepatuhan terhadap SOP dapat ditingkatkan, (5) melakukan pengukuran kepuasan dengan metode SERVQUAL. Daftar bacaan. 46 (1980-2002)
Some Factors Related to Satisfaction and Knowledge of Pregnant Women towards Antenatal Care in Ten Health Centres in Depok in 2002In reducing the Maternal Mortality Rate in Indonesia, the Ministry of Health have launched national movement for Making Pregnancy Safer (MPS). One of the MPS' strategy is to increase the health service quality and coverage. The Household Survey (SKRT) in 1995 found 22.1 % of pregnant women never had antenatal care visit. Depok as one of developing city in West Java, have the same picture. Although the antenatal care coverages are high, the qualities are not satisfying (Profit Kesehatan Kota Depok, 2001) The objective of this study is to get the information about satisfaction and knowledge level of pregnant women towards antenatal care in ten Health Centres in Depok. The sample of this cross sectional study were 97 pregnant women and 15 midwives from the sampled Health Centers. The score of satisfaction and knowledge are 91.65 and 70.27. The score of antenatal care quality are 54.16. Based on statistical analysis, there are correlation between education, job, and delivery assistance with knowledge (p< 0.02). There are no relation between the characteristics of pregnant women with satisfaction. The lowest score of five dimensions are tangible (89,89), responsiveness (91,06), and reliability (91,27) respectively. Cartesius diagram shows two aspects that should put in priorities: the instruments are completed and the examination room are clean and comfortable. It is suggested that the health centers (I) increase their quality care especially in providing the clean, comfortable examination room and waiting room, (2) enhance the services through the punctuality schedule and prompt treatment, (3) establish the quality assurance team to monitor the quality improvement in the health centers, (4) implement the SPK training for all health centers midwives, assisting and monitoring them regularly in order to ensure the increasing of compliance in standard operating procedure, (5) measure patient's satisfaction using SERVQUAL method. References: 46 (1980-2002)
T-1703
Depok : FKM-UI, 2003
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Mutmainah Indriyati; Pembimbing: Syahrizal Syarif; Penguji: Dumilah Ayuningtyas, Dian Ayubi, Enny Ekasari, Yani Haryani Sachmar
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Latar Belakang: Puskesmas yang sudah terakreditasi berarti sudah menerapkan konsep Total Quality Management (TQM) dimana fokusnya adalah memberikan kepuasan kepada pelanggan internal dan eksternal. Manfaat terhadap pelanggan internal dilakukan melalui survey kepuasan kerja, sedangkan terhadap pelanggan eksternal dapat dilihat melalui hasil survey Indeks Kepuasan Masyarakat (IKM). Hasil IKM 2019 pada Puskesmas di kota Depok didapatkan unsur pelayanan yang berhubungan dengan responsiveness memperoleh penilaian yang kurang baik dari masyarakat, dan beberapa Puskesmas yang terakreditasi belum mencapai target sesuai rencana strategis Dinas Kesehatan kota Depok. Tujuan: Penelitian ini dilakukan untuk mendapatkan gambaran kepuasan kerja pegawai dan responsiveness pelayanan kesehatan serta hubungannya satu sama lain pada Puskesmas yang terakreditasi di kota Depok. Metode: Penelitian dilakukan terhadap 30 Puskesmas terakreditasi di kota Depok dengan desain deskriptif analitik dengan pengambilan data secara cross sectional. Analisis deskriptif dilakukan untuk mengetahui tingkat kepuasan kerja pegawai dan responsiveness pelayanan kesehatan Puskesmas. Sedangkan analisis statistik dilakukan untuk melihat ada tidaknya hubungan antara kepuasan kerja dan responsiveness. Hasil: Rata-rata tingkat kepuasan kerja Puskesmas adalah 2,71 (Puas) dari skala 4. Dimensi kepuasan dengan kategori tidak puas adalah upah, promosi, dan manfaat tambahan. Rata-rata tingkat responsiveness Puskesmas adalah 2,95 (baik) dari skala 4, namun terdapat responsiveness yang tidak baik pada aspek prompt attention dan keramahan petugas pada beberapa Puskesmas. Kepuasan kerja pegawai mempunyai hubungan yang kuat dan bermakna dengan responsiveness dengan koefisien korelasi r=0,760 dan p=0,0005 (p<0,05), sehingga semakin tinggi skor kepuasan kerja pegawai maka semakin tinggi skor responsiveness. Kesimpulan: Ketidakpuasan pegawai terdapat pada dimensi upah, promosi, dan manfaat tambahan. Terdapat responsiveness yang tidak baik di beberapa Puskesmas pada aspek prompt attention dan keramahan petugas. Terdapat hubungan antara kepuasan kerja pegawai dengan responsiveness.
Background: An accredited Community Health Center (Puskesmas) means that it has implemented the concept of Total Quality Management (TQM) where the focus is on providing satisfaction to internal and external customers. Benefits for internal customers are done through job satisfaction surveys, while external customers can be seen through the results of the Community Satisfaction Index (IKM) survey. The results of the 2019 IKM at the Puskesmas in Depok obtained elements of service related to responsiveness received poor evaluation from the community, and several accredited Puskesmas have not reached the target according to the strategic plan of the Depok city Health Service. Objective: This study was conducted to obtain an overview of employee job satisfaction and responsiveness of health services and their relationship with one another at an accredited Puskesmas in the city of Depok. Method: The study was conducted on 30 accredited Puskesmas in Depok with analytic descriptive design with cross sectional data collection. Descriptive analysis was conducted to determine the level of employee job satisfaction and responsiveness of health services at the Puskesmas. While the statistical analysis is done to see whether there is a relationship between job satisfaction and responsiveness. Results: The average level of job satisfaction at the Puskesmas was 2.71 (Satisfied) from a scale of 4. The dimensions of satisfaction with the dissatisfied categories were pay, promotions, and additional benefits. The average level of responsiveness at the Puskesmas was 2.95 (good) from a scale of 4, but there were poor responsiveness in the aspects of prompt attention and dignity at several Puskesmas. Employee job satisfaction has a strong and meaningful relationship with responsiveness with the correlation coefficient r = 0.760 and p = 0.0005 (p <0.05), so the higher the employee job satisfaction score, the higher the responsiveness score. Conclusion: Employee dissatisfaction lies in the dimensions of pay, promotions, and additional benefits. There is a bad responsiveness in some Puskesmas on the aspects of prompt attention and dignity. There is a relationship between employee job satisfaction and responsiveness. Key words: Relationship, Job Satisfaction, Responsiveness, Community Health Centre
T-5871
Depok : FKM-UI, 2020
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Rora Asyulia; Pembimbing: Sutanto Priyo Hastono; Penguji: Wahyu Sulistiadi, Robiana Modjo, Mutmainah Indriyati, Eti Rohati
Abstrak:
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Penelitian kuantitatif dengan desain potong lintang (Cross Sectional) akan meneliti capaian program pelayanan kesehatan pada orang berisiko terkena HIV dengan pendekatan Malcolm Baldrige di Puskesmas Kota Depok. Tujuan dari penelitian ini adalah mengetahui capaian Program pelayanan kesehatan pada orang berisiko terkena HIV dengan pendekatan Malcolm Baldrige. Populasi penelitian ini adalah seluruh Puskesmas di Kota Depok yang berjumlah 38 Puskesmas. Instrumen penelitian menggunakan kuisioner dan wawancara yang dibuat berdasarkan rujukan baku dari kriteria Malcolm Baldrige yang sudah diterjemahkan ke dalam Bahasa Indonesia oleh peneliti terdahulu dan disesuaikan dengan tujuan penelitian. Variabel Independen ada 6 yaitu Kepemimpinan, perencanaan strategis, focus pada pelanggan, pengukuran analisis dan manajemen pengetahuan, focus pada sumber daya manusia dan manajemen proses sedangkan variabel dependen adalah capaian Standar pelayanan minimal pada pelayanan kesehatan orang berisiko terkena HIV. Analisis data menggunakan analisis data univariat melihat frekwensi distribusi hasil capaian, analisis data bivariat melihat hubungan antara 6 (enam) kriteria Malcolm Baldrige dengan hasil capaian Standar pelayanan minimal Program Pelayanan Kesehatan pada orang berisiko terkena HIV di Puskesmas Kota Depok dan analisis multivariat untuk mencari factor paling dominan mempengaruhi capaian standar pelayanan minimal HIV. Hasil penelitian Univariat mayoritas masuk kategori kurang kepemimpinan (53,07%), perencanaan strategis (46,21%) focus pada pelanggan (43,84%), pengukuran, analisis dan manajemen pengetahuan (44,21%), sumber daya manusia (47,85%) dan manajemen proses (47,49%) sedangkan hasil capaian Standar pelayanan minimal pada orang berisiko terkena HIV (69,86%) masuk kategori cukup. Pada analisis bivariat semua variabel independent memiliki hubungan yang kuat dan positif terhadap variabel dependen. Pada analisis multivariat ada korelasi yang kuat antara capaian SPM HIV (Y) dengan variabel kepemimpinan dan focus pada pelanggan (R=0,749) dan memiliki R Square 0,561 dimana variabel yang paling dominan adalah Focus pada Pelanggan (48,5%)
Quantitative research with a cross-sectional design (Cross Sectional) will examine the achievements of health service programs for people at risk of getting HIV using the Malcolm Baldrige approach at the Depok City Health Center. The purpose of this study was to determine the performance of the health service program for people at risk of getting HIV using the Malcolm Baldrige approach. The population of this study were all Community Health Centers in Depok City, totaling 38 Health Centers. The research instrument used questionnaires and interviews which were made based on standard references from Malcolm Baldrige's criteria which had been translated into Indonesian by previous researchers and adapted to the research objectives. There are 6 independent variables, namely leadership, strategic planning, focus on customers, measurement analysis and knowledge management, focus on workforce and process management, while the dependent variable is achievement of minimum service standards in health services for people at risk of getting HIV. Data analysis used univariate data analysis to look at the frequency distribution of performance results, bivariate data analysis looked at the relationship between 6 (six) Malcolm Baldrige criteria and the achievement results of the minimum service standard for the Health Service Program for people at risk of getting HIV at the Depok City Health Center and multivariate analysis to find the most common factor Dominantly affect the achievement of minimum HIV service standards. The majority of Univariate research results fall into the category of lacking leadership (53.07%), strategic planning (46.21%) focus on customers (43.84%), measurement, analysis and knowledge management (44.21%), workforce (47.85%) and process management (47.49%) while the results of the minimum service standards for people at risk of getting HIV (69.86%) are in the sufficient category. In the bivariate analysis all independent variables have a strong and positive relationship to the dependent variable. In the multivariate analysis there is a strong correlation between HIV MSS achievement and leadership and customer focus variables (R=0,749) and R square =0,561 where the most dominant variable is Customer Focus (48.5%).
Quantitative research with a cross-sectional design (Cross Sectional) will examine the achievements of health service programs for people at risk of getting HIV using the Malcolm Baldrige approach at the Depok City Health Center. The purpose of this study was to determine the performance of the health service program for people at risk of getting HIV using the Malcolm Baldrige approach. The population of this study were all Community Health Centers in Depok City, totaling 38 Health Centers. The research instrument used questionnaires and interviews which were made based on standard references from Malcolm Baldrige's criteria which had been translated into Indonesian by previous researchers and adapted to the research objectives. There are 6 independent variables, namely leadership, strategic planning, focus on customers, measurement analysis and knowledge management, focus on workforce and process management, while the dependent variable is achievement of minimum service standards in health services for people at risk of getting HIV. Data analysis used univariate data analysis to look at the frequency distribution of performance results, bivariate data analysis looked at the relationship between 6 (six) Malcolm Baldrige criteria and the achievement results of the minimum service standard for the Health Service Program for people at risk of getting HIV at the Depok City Health Center and multivariate analysis to find the most common factor Dominantly affect the achievement of minimum HIV service standards. The majority of Univariate research results fall into the category of lacking leadership (53.07%), strategic planning (46.21%) focus on customers (43.84%), measurement, analysis and knowledge management (44.21%), workforce (47.85%) and process management (47.49%) while the results of the minimum service standards for people at risk of getting HIV (69.86%) are in the sufficient category. In the bivariate analysis all independent variables have a strong and positive relationship to the dependent variable. In the multivariate analysis there is a strong correlation between HIV MSS achievement and leadership and customer focus variables (R=0,749) and R square =0,561 where the most dominant variable is Customer Focus (48.5%).
T-6599
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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