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Kebijakan terkait kemandirian sediaan alat kesehatan telah diterbitkan sejak tahun 2016. Namun, jumlah izin edar dan jumlah transaksi pengadaan alat kesehatan dalam pengadaan e katalog masih didominasi oleh alat kesehatan impor. Hal ini menunjukkan bahwa belum terjadi kemandirian dalam produksi alat kesehatan dalam negeri. Penelitian ini bertujuan untuk mengevaluasi implementasi kebijakan pengembangan industri alat kesehatan dalam negeri. Penelitian ini menggunakan pendekatan kualitatif dengan melakukan wawancara mendalam pada aktor kebijakan yang terlibat, asosiasi perusahaan alat kesehatan, dan pengguna alat kesehatan dan telaah dokumen. Penelitian ini melihat bagaimana kebijakan tersebut diimplementasikan dari aspek kebijakan, sumber daya, komunikasi, kesetaraan akses, potensi pasar, dan kualitas produk. Secara umum, kebijakan pengembangan industri alat kesehatan dalam negeri sudah berjalan, namun dalam implementasinya masih terdapat banyak tantangan untuk dapat mencapai optimal. Lemahnya sistem tata kelola dalam pengembangan industri alat kesehatan menyebabkan implementasi kebijakan tidak optimal.
Policies related to self-reliance in medical device provision have been issued since 2016. However, the number of marketing authorizations and procurement transactions for medical devices in the e-catalog remain dominated by imported medical devices. This indicates a lack of self-sufficiency in domestic medical device production. This study aims to evaluate the implementation of policies for developing the domestic medical device industry. This research employs a qualitative approach, utilizing in-depth interviews with involved policy actors, medical device company associations, and medical device users, alongside document analysis. The study wants to see how the policy implemented from the aspects of policy, resources, equitable access, market potential, and product quality. These aspects are then evaluated to determine whether the policy implementation aligns with the existing policy content. Generally, the policy for domestic medical device industry development is underway, however, its implementation still faces numerous challenges to achieve optimal results. Weak governance in the medical device industry's development leads to suboptimal policy implementation.
The needs of medical devices in Indonesia currently 90% are met by imported medical devices. Therefore the government issued Minister of Health Regulation No. 17 of 2017 concerning Action Plans for the Development of the Pharmaceutical Industry and Medical Devices, one of which is through the policy of accelerating the licensing of medical devices. So this study aims to determine the implementation of accelerated medical device licensing policies to support the development of the domestic medical device industry. This study uses qualitative methods and is analyzed with Van Meter and Van Horn policy theory with variable size and objectives, resources, characteristics of implementing agencies, communication between organizations, disposition of implementers, as well as economic, social, and political environments that influence policy implementation. The results of the study are that the size and objectives of the policy are clear but are still constrained by the availability of human resources and the limited characteristics of the implementing agency, as well as the disposition of implementers that are still less than the intensity of the implementation of the policy. Communication between organizations related to policy is quite optimal, and the economic and social environment is quite supportive, but the political environment is not enough to support policy. This study recommends making accompanying policies such as the obligation to use domestic medical devices at government health service facilities to expand the domestic production of medical devices.
This study described health worker training planning policies to see the performance of the implementation policies. This study uses qualitative approach through in-depth interviews and document observation. The analysis was carried out using the policy implementation model of Edward III (1980) and Van Meter & Van Horn (1975) to analyze factors that influence the process of the implementation policies, such as size and policy objectives, resources, communication between organization and implementation of activities, bureaucratic structure and characteristics of implementing agencies, disposition, social, economic and political environment, and implementation policies. The results show that the performance of planning policy implementation for health worker training was not optimal: the training program has not been based on training needs, and there are still policy outputs that are not in accordance with the guidelines. Factors influencing the implementation of the health worker training planning policies are still found to have obstacles: the size and objectives of the policy are not yet clear, the resources are inadequate, the socialization of the policy is still limited, the inconsistencies in policy implementation, the application of SOP is not optimal, and supervision mechanisms are not yet clear. This is necessary to evaluate these factors for successful policy implementation.
The current condition of the percentage of Puskesmas with types of health workers according to new standards has reached 23% and the target in 2024 is 83%, so Indonesia has a duty to meet 60% of its shortcomings. In addition to the indicators above, the 2020-2024 RPJMN also targets that 100% of puskesmas in Indonesia already have doctors, but according to data from the Indonesian Ministry of Health as of 2018 there are still 15% of puskesmas in Indonesia that do not have doctors. In responding to problems regarding the fulfillment of health workers, special assignments can be carried out individually or in teams to support the Healthy Nusantara Program. The special assignment of health workers in supporting the Nusantara Sehat program is a potential policy to solve the problem of equal distribution of health services in Indonesia. This study aims to determine the implementation of the Health Workforce Special Assignment Policy in the Regulation of the Minister of Health of the Republic of Indonesia Number 33 of 2018. In this study using qualitative methods with primary data obtained through in-depth interviews and secondary data through document review. The study used Van Meter and Van Horn's theory of policy analysis with variables of size and objectives, resources, characteristics of the implementing agency, communication between organizations, implementing dispositions, and the economic, social and political environment that influence policy implementation.The results showed that the objectives of this policy are still not measurable. Resources are constrained by a lack of understanding of the use of BOK Pusekesmas funds available by the Nusantara Sehat team. Good communication between implementing organizations. The characteristics of the implementer are constrained by limited human resources. The attitude of the executor is supportive. Good economic and political conditions can be conditioned by good communication. The conclusion was that the implementation went well even with the obstacles that were found. The recommendation of this research is that the successful implementation will be achieved if evaluation and monitoring and correction of deficiencies are carried out. This Permenkes policy is conditioned to undergo revision again so that improvements are needed that will simplify and clarify how this policy is implemented
ABSTRAK
Tesis ini membahas implementasi kebijakan larangan merokok pada kantor Kementerian Kesehatan. Pemerintah telah menerbitkan beberapa peraturan perundang-undangan terkait pengendalian dampak rokok, salah satunya Undangundang Nomor 36 Tahun 2009 tentang Kesehatan. Hingga kini implementasi kebijakan-kebijakan tersebut belum memperlihatkan hasil yang signifikan. Prevalensi perokok dari tahun ke tahun terus bertambah. Dilingkungan kantor Kementerian Kesehatan sendiri kebijakan larangan merokok belum dilaksanakan secara optimal. Desain penelitian ini adalah kualitatif eksplanatoris. Hasil penelitian menunjukkan bahwa titik lemah pelaksanaan kebijakan larangan merokok di lingkungan Kementerian Kesehatan adalah kurangnya penegakkan hukum. Sangat disarankan kepada pihak berwenang untuk segera membuat pedoman pelaksanaan kebijakan larangan merokok di Kementerian Kesehatan. Kata kunci : Rokok, hukum, kebijakan
ABSTRACT
This thesis discusses the implementation of policies banning smoking on the health ministries. Government has issued several laws and regulations related to controlling the impact of smoking, one of which the law number 36 of 2009 on health. Until now the implementation of these policies have not shown significant results. Prevalence of smokers from year to year continues to grow. Environment of their own health ministries have implemented a smoking ban policy optimally. This research design is qualitative explanatory. Results showed that the weak points of policies banning smoking in an office environment the ministry of health is the lack of law enforcement. Highly recommended to the authorities to immediately create policy guidelines for the implementation of smoking bans in the Ministry of Health. Keywords : Cigarette, laws, regulations
