Penerbitan Surat Izin Praktik (SIP) bagi dokter spesialis merupakan aspek krusial dalam menjamin legalitas dan mutu pelayanan kesehatan. Terbitnya Undang-Undang Nomor 17 Tahun 2023 tentang Kesehatan membawa perubahan signifikan terhadap kebijakan perizinan, salah satunya adalah penghapusan kewajiban memperoleh rekomendasi dari organisasi profesi. Penelitian ini bertujuan untuk menganalisis kesesuaian penerapan kebijakan pembuatan SIP dokter spesialis di DKI Jakarta dengan peraturan terbaru tersebut. Penelitian menggunakan pendekatan kualitatif dengan desain studi deskriptif komparatif melalui wawancara mendalam terhadap informan dari DPR RI, Dinas Kesehatan, DPMPTSP, rumah sakit, dan dokter spesialis di DKI Jakarta. Hasil penelitian menunjukkan bahwa masih terdapat ketidaksesuaian antara norma, standar, prosedur, dan kriteria (NSPK) dengan pelaksanaan di lapangan, terutama dalam aspek komunikasi kebijakan, keterbatasan pemahaman dari sumber daya manusia dan teknologi informasi. Selain itu, masih terjadi kebingungan terkait perubahan regulasi dan lemahnya sosialisasi kepada tenaga medis. Dari sisi output, implementasi kebijakan belum sepenuhnya efektif dalam memastikan percepatan dan efisiensi layanan perizinan, meskipun proses digitalisasi telah mulai diterapkan. Kesimpulannya, penerapan kebijakan pembuatan SIP dokter spesialis di DKI Jakarta pasca terbitnya UU No. 17 Tahun 2023 masih belum sepenuhnya sesuai dengan harapan regulasi dan membutuhkan perbaikan dari aspek struktur birokrasi, dukungan teknologi, dan peningkatan koordinasi lintas sektor.

The issuance of a Practice License (SIP) for medical specialists is a crucial aspect in ensuring the legality and quality of healthcare services. The enactment of Law Number 17 of 2023 on Health has brought significant changes to licensing policies, one of which is the elimination of the requirement to obtain recommendations from professional organizations. This study aims to analyze the conformity of the implementation of SIP issuance policy for medical specialists in DKI Jakarta with the new regulation. The study uses a qualitative approach with a comparative descriptive study design through in-depth interviews with informants from the House of Representatives (DPR RI), the Health Office, One-Stop Integrated Service (DPMPTSP), hospitals, and medical specialists in Jakarta. The results show that discrepancies still exist between the norms, standards, procedures, and criteria (NSPK) and their implementation in the field, particularly in aspects of policy communication, limited understanding among human resources, and inadequate information technology systems. Furthermore, confusion persists regarding regulatory changes and weak socialization efforts toward medical personnel. From the output perspective, policy implementation has not yet been fully effective in ensuring the acceleration and efficiency of licensing services, even though digitalization processes have begun to be adopted. In conclusion, the implementation of the SIP issuance policy for medical specialists in DKI Jakarta following the enactment of Law No. 17 of 2023 has not yet fully aligned with regulatory expectations and requires improvements in bureaucratic structure, technological support, and enhanced inter-sectoral coordination.

Filariasis limfatik masih menjadi tantangan kesehatan masyarakat di Indonesia, khususnya di wilayah endemis seperti Kecamatan Membalong, Kabupaten Belitung, yang telah memperoleh sertifikat eliminasi namun, angka mikrofilaria rate di beberapa wilayahnya tetap berada di atas ambang batas nasional. Penelitian ini bertujuan untuk menganalisis implementasi Pemberian Obat Pencegahan Massal (POPM) filariasis tahun 2023 di Kecamatan Membalong dengan menggunakan pendekatan kualitatif dan desain studi kasus. Data dikumpulkan melalui wawancara mendalam, dan telaah dokumen terhadap pelaksana program di dua Puskesmas serta Dinas Kesehatan. Analisis menggunakan model Donabedian diperkuat dengan pendekatan Indeks Kualitas Kebijakan (IKK) dari LAN, dan model Van Meter dan Van Horn untuk mengevaluasi aspek structure, process, serta output dan outcome berupa dampak. Hasil penelitian pada aspek structure menunjukkan bahwa kebijakan POPM filariasis di Kecamatan Membalong tergolong efektif sebagai dasar pelaksanaan program dan telah memenuhi indikator kualitas kebijakan menurut pendekatan IKK. Strategi pelaksanaan dinilai adaptif, ditunjukkan melalui penyesuaian waktu, pelaksanaan, sweeping serta pelibatan lintas sektor. Namun, terdapat kendala keterbatasan jumlah sumber daya manusia dan pencatatan logistik yang masih manual sehingga menimbulkan potensi risiko. Sarana prasarana dinilai memadai, dan dana kegiatan juga mencukupi kebutuhan, meskipun terdapat perbedaan dalam sistem penganggaran antar Puskesmas. Pada aspek process, Komunikasi dan koordinasi antar pemangku kepentingan sudah berjalan, namun perlu ditingkatkan sebab penting dalam dimensi process IKK yang turut menentukan kualitas implementasi kebijakan pelaksanaan POPM. Pendataan sasaran telah dilakukan secara detail, namun akurasinya masih dipengaruhi oleh mobilitas penduduk. Sosialisasi telah dilaksanakan, namun belum sepenuhnya menjangkau seluruh lapisan masyarakat. Pemberian obat telah mengikuti petunjuk teknis, namun belum seluruh sasaran hadir dan mengonsumsi obat di pos pelayanan. Sweeping efektif meningkatkan cakupan, namun keterbatasan SDM dan waktu membuat pelaksanaannya belum optimal. Fleksibilitas sweeping menjadi indikator penting dalam proses IKK untuk menilai efektivitas kebijakan. Kejadian ikutan pasca POPM umumnya bersifat ringan dan telah tertangani, tetapi pelaporan dan pemantauan masih bersifat pasif. Monitoring dan evaluasi POPM sudah terstruktur, namun masih terkendala kepatuhan, pelaporan manual, dan kurangnya integrasi. Hal ini menunjukkan perlunya penguatan indikator IKK, terutama dalam aspek efektivitas, efisiensi, dan umpan balik pelaksanaan kebijakan. Dari aspek Output, Cakupan obat di Kecamatan Membalong tinggi, namun prevalensi mikrofilaria masih >1% di beberapa wilayah. Dalam IKK, keberhasilan dinilai dari konsumsi obat yang valid serta dampaknya, bukan hanya capaian angka. Jumlah obat yang digunakan telah sesuai dengan sasaran, tetapi ditemukan selisih antara obat yang didistribusikan dengan yang benar-benar dikonsumsi oleh masyarakat. Hasil survei darah jari menunjukkan angka MF rate di wilayah Puskesmas Simpang Rusa masih di atas 1%. Pada aspek Outcome menunjukkan bahwa POPM filariasis menurunkan kasus namun eliminasi belum tercapai di seluruh kecamatan. Kesimpulan penelitian ini menegaskan bahwa Implementasi POPM filariasis di Kecamatan Membalong didukung kebijakan yang kuat dan strategi adaptif, namun masih terkendala kekurangan SDM, pencatatan logistik manual, dan pemantauan minum obat yang belum optimal. Cakupan pemberian obat tinggi, tetapi eliminasi belum tercapai karena masih ada wilayah dengan MF rate di atas ambang batas. Temuan ini menegaskan perlunya penguatan SDM, sistem pencatatan, dan kolaborasi lintas sektor.  Dalam IKK, hal ini menunjukkan efektivitas kebijakan masih perlu evaluasi dan penyesuaian strategi agar eliminasi filariasis dapat dicapai secara berkelanjutan.

Lymphatic filariasis remains a public health challenge in Indonesia, especially in endemic areas such as Membalong Subdistrict, Belitung Regency, which has received elimination certification; however, the microfilaria rate in several regions still exceeds the national threshold. This study aims to analyze the implementation of the Mass Drug Administration (MDA) program for filariasis prevention in Membalong Subdistrict in 2023 using a qualitative approach and case study design. Data were collected through in-depth interviews and document reviews involving program implementers at two primary health centers (Puskesmas) and the District Health Office. The analysis applied the Donabedian model, reinforced with the Policy Quality Index (IKK) from LAN, and Van Meter and Van Horn’s implementation model to evaluate aspects of structure, process, as well as output and outcome in terms of program impact. The findings on the structural aspect indicate that the filariasis MDA policy in Membalong is effective as the program’s foundation and fulfills policy quality indicators according to the IKK approach. The implementation strategy is considered adaptive, shown by schedule adjustments, door-to-door sweeping, and cross-sectoral involvement. However, challenges remain, such as limited human resources and manual logistic recording, which pose potential risks. Facilities and infrastructure are generally adequate, and funding meets the needs, although there are differences in budgeting systems between health centers. In terms of process, communication and coordination among stakeholders are established, but need strengthening, as these are essential in the IKK process dimension, which also determines the quality of policy implementation. Target population data collection has been conducted in detail, though its accuracy is still affected by population mobility. Socialization activities have been carried out, but have not fully reached all community groups. Medicine distribution has followed technical guidelines, but not all targets have attended and consumed the drugs at service posts. Sweeping has effectively increased coverage, but human resource and time constraints have hindered optimal implementation. The flexibility of sweeping is an important indicator in the IKK process dimension for assessing policy effectiveness. Adverse events after MDA were mostly mild and well managed, but reporting and monitoring remain passive. Monitoring and evaluation are structured but still hampered by compliance issues, manual reporting, and lack of integration. This highlights the need to strengthen IKK indicators, especially in effectiveness, efficiency, and feedback in policy implementation. In terms of output, drug coverage in Membalong is high, but microfilaria prevalence remains above 1% in some areas. According to the IKK, success is measured not just by coverage numbers, but by valid drug consumption and real impact. The number of drugs used matches the target, but discrepancies remain between drugs distributed and those actually consumed. Blood survey results show that the MF rate in the Simpang Rusa health center area is still above 1%. The outcome aspect indicates that the MDA program has reduced cases but elimination has not yet been achieved throughout the subdistrict. The study concludes that MDA implementation in Membalong is supported by strong policy and adaptive strategies, but still faces barriers such as limited human resources, manual logistics recording, and suboptimal drug consumption monitoring. Coverage is high, but elimination has not been achieved, as some areas still have MF rates above the threshold. These findings underscore the need to strengthen human resources, data recording systems, and cross-sector collaboration. According to the IKK, this suggests that policy effectiveness still requires evaluation and strategic adjustment to achieve sustainable filariasis elimination.