Pemenuhan sembilan jenis tenaga kesehatan strategis di Puskesmas merupakan pilar utama pelayanan kesehatan primer. Kabupaten Sukabumi, sebagai wilayah terluas di Jawa Barat, menghadapi tantangan besar dalam pemenuhan standar ketenagaan minimal akibat kendala geografis dan fiskal daerah. Penelitian ini bertujuan mengevaluasi implementasi dan dampak kebijakan pemenuhan tenaga kesehatan di Kabupaten Sukabumi. Penelitian ini merupakan penelitian kualitatif dengan menggunakan pendekatan evaluasi kebijakan Model George C. Edward III (komunikasi, sumber daya, struktur birokrasi, disposisi) dan Teori William N. Dunn (kecukupan dan pemerataan). Pengumpulan data dilakukan melalui wawancara mendalam dan telaah dokumen di Dinas Kesehatan serta 3 Puskesmas sampel. Selain itu dilakukan analisis spasial sederhana sebagai visualisasi distribusi nakes menggunakan Geographic Information System (GIS). Hasil evaluasi menunjukkan proses komunikasi berjalan baik, namun terdapat inkonsistensi target nasional (sembilan nakes) dengan regulasi terbaru (tiga belas nakes) serta penutupan aplikasi rencana kebutuhan (Renbut). Hambatan kritis bersumber dari alokasi anggaran daerah (financial resources) yang terikat batas belanja pegawai APBD 30% berdasarkan Undang-Undang Hubungan Keuangan antara Pemerintah Pusat dan Pemerintahan Daerah (UU HKPD). Struktur birokrasi belum memiliki SOP mikro daerah untuk redistribusi nakes lokal, sementara aspek disposisi menunjukkan komitmen pelaksana yang tinggi namun terhambat skala prioritas formasi pemerintah daerah. Ditinjau dari aspek dampak, tingkat kecukupan sangat rendah, di mana hanya 12,07% Puskesmas memenuhi standar, dengan kekosongan kritis pada posisi Dokter Gigi dan Tenaga Gizi. Dari aspek pemerataan, terjadi ketimpangan distribusi nakes yang tajam antara wilayah perkotaan dan pelosok akibat hambatan geografis dan ketiadaan regulasi retensi. Penelitian ini disimpulkan implementasi kebijakan belum optimal dalam menjamin kecukupan dan pemerataan nakes. Disarankan kepada pemerintah daerah untuk menerbitkan Peraturan Bupati terkait redistribusi, mengoptimalkan program inovasi regional, dan membuka kuota formasi CASN berbasis pemetaan geolokalitas terpencil.

The provision of nine strategic health workers in Community Health Centers (Puskesmas) is a key pillar of primary health care. Sukabumi Regency, as the largest region in West Java, faces significant challenges in meeting minimum staffing standards due to regional geographic and fiscal constraints. This study aims to evaluate the implementation and impact of health worker provision policies in Sukabumi Regency. This study is a qualitative study using the George C. Edward III Model of policy evaluation (communication, resources, bureaucratic structure, disposition) and William N. Dunn's Theory (sufficiency and equity). Data collection was conducted through in-depth interviews and document reviews at the Health Office and three sample Community Health Centers. A simple spatial analysis was also conducted to visualize the distribution of health workers using a Geographic Information System (GIS). The evaluation results showed that the communication process was running well, but there were inconsistencies between the national target (nine health workers) and the latest regulation (thirteen health workers) and the closure of the needs plan (Renbut) application. Critical obstacles stem from regional budget allocations (financial resources) that are bound by a 30% APBD employee spending limit based on the Law on Financial Relations between the Central Government and Regional Governments (HKPD Law). The bureaucratic structure does not yet have a regional micro SOP for the redistribution of local health workers, while the disposition aspect shows a high commitment of implementers but is hampered by the priority scale of local government formations. In terms of impact, the adequacy level is very low, where only 12.07% of Community Health Centers meet the standards, with critical vacancies in the positions of Dentists and Nutritionists. From the aspect of equity, there is a sharp imbalance in the distribution of health workers between urban and remote areas due to geographical barriers and the absence of retention regulations. This study concludes that policy implementation is not optimal in ensuring the adequacy and equity of health workers. It is recommended that local governments issue a Regent Regulation regarding redistribution, optimize regional innovation programs, and open CASN formation quotas based on remote geolocality mapping.

Kota Bogor merupakan salah satu dari17 kab./kota dengan prevalensi hipertensi lebih tinggi dari prevalensi Jawa Barat yaitu 41,0%, menempati urutan pertama di antara semua penyakit PTM di Kota Bogor. Dari 25 Puskesmas di Kota Bogor, baru 24% yang mencapai target SPM dengan rentang nilai capaian antara 23,7% hingga 126,4%. Malcolm Baldrige National Quality Award merupakan kerangka kerja sistem manajemen mutu organisasi yang mampu mengidentifikasi kekuatan-kekuatan dari semua aspek dalam organisasi terkait kepemimpinan, perencanaan strategis, fokus pada pelanggan, pengukuran analisis dan manajemen pengetahuan, fokus pada sumber daya manusia, dan fokus pada proses untuk melihat hubungan dengan hasil kinerja program pencegahan dan pengendalian Hipertensi di Puskesmas Kota Bogor. Tujuan dari penelitian ini adalah mengetahui kinerja program pencegahan dan pengendalian hipertensi di Puskesmas Kota berdasarkan kriteria Malcolm Baldrige serta melihat hubungan kriteria Malcolm Baldrige dengan hasil kinerja program pencegahan dan pengendalian hipertensi di Puskesmas Kota Bogor. Metode penelitian yang digunakan adalah metode kuantitatif dengan desain potong lintang menggunakan instrumen kuesioner Malcolm Baldrige National Quality Award. Populasi penelitian adalah seluruh Puskesmas di Kota Bogor yang berjumlah 25 Puskesmas dengan responden 6 karyawan setiap Puskesmas.Analisis data menggunakan analisis univariat dan bivariat dengan uji statistik chi-square. Hasil kinerja program P2 hipertensi berdasarkan kriteria Malcolm Baldrige didapatkan bahwa terdapat hubungan yang signifikan secara statistik dari 6 kriteria Malcolm Baldrige terhadap kinerja program P2 Hipertensi dengan nilai p value <0,05. Hasil analisis juga menunjukkan nilai OR tertinggi adalah variabel fokus pada SDM (OR = 60,0; CI 95%: 4,72-763,01). Untuk meningkatkan program P2 Hipertensi di Puskesmas Kota Bogor diharapkan dapat mengoptimalkan pembinaan Puskesmas melalui Tim Pembina Cluster Binaan secara terpadu menggunakan acuan self-assessment yang telah dibuat oleh Puskesmas dengan pendekatan Malcolm Baldrige. Kata kunci: Malcolm Baldrige, kinerja, program pencegahan dan pengendalian hipertensi, Puskesmas

Bogor City is one of 17 regencies/cities with a prevalence of hypertension higher than the prevalence of West Java, namely 41.0%, ranks first among all PTM diseases in Bogor City. Of the 25 Puskesmas in Bogor City, only 24% achieved the Minimum Service Standards target with a range of achievement values between 23.7% to 126.4%. Malcolm Baldrige National Quality Award is an organizational quality management system framework that is able to identify the strengths of all aspects of the organization related to leadership, strategic planning, customer focus, measurement analysis and knowledge management, focus on human resources, and focus on processes for see the relationship with the results of the performance of the Hypertension prevention and control program at the Bogor City Health Center. The purpose of this study was to determine the performance of the hypertension prevention and control program at the City Health Center based on the Malcolm Baldrige criteria and to see the relationship between the Malcolm Baldrige criteria and the results of the performance of the hypertension prevention and control program at the Bogor City Health Center. The research method used is a quantitative method with a cross-sectional design using the Malcolm Baldrige National Quality Award questionnaire instrument. The research population was all Public Health Centers in Bogor City, totaling 25 health centers with 6 employees in each Puskesmas. Data analysis used univariate and bivariate analysis with chi-square statistical test. The results of the performance of the P2 hypertension program based on the Malcolm Baldrige criteria found that there was a statistically significant relationship from the 6 Malcolm Baldrige criteria to the performance of the P2 Hypertension program with a p value <0.05. The results of the analysis also showed that the highest OR value was the variable focused on HR (OR = 60.0; 95% CI: 4.72-763.01). To improve the P2 Hypertension program at the City Health Center, it is hoped that it can optimize the development of the Community Health Center through the Integrated Development Cluster Development Team using the self-assessment reference that has been made by the Puskesmas with the Malcolm Baldrige approach. Key words: Malcolm Baldrige, performance, hypertension prevention and control program, public health center

Tarif detemnination at Public Health Center, Lahat Regency, has not been based on the analysis result of unit cost, local paying ability and willingness so iiir. The eifective tariifhas been Rp. 300,- since the commence of regional regulation No. 25, 1987. The analysis of local paying ability and willingness toward the tariif of health services has the objective to get public health center tariH` based on the description of local paying ability and willingness at public health center of Merapi ll, Met-api distric, Lahat Regency, in the year 2001. This research applies descriptive analysis with cross sectional design. Data collecting was conducted by holding interviews based on questionnaires, which refer to National-Social Economic Survey of the year 1999 towards families at public Health Center of Mcrapi II. The result of this research is described through analysis of local percentage that is marginalized (or neglected) from health service of certain tariff From the research, it is found that there are two kinds of tariff which are based on examiner (medical examiner), those are, first, tariff of Rp. 1000 for checking up by nurse and 1 - 3 kinds of medicine, and second, tari{I` of Rp. 2000 checking up by doctor with 1 - 3 kinds of medicine. Locals who are marginalized or neglected can be supported by giving (or extending) health cards.