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Pusat Kesehatan Masyarakat (Puskesmas) adalah sarana kesehatan terdepan yang memberi pelayanan kesehatan termasuk gizi kepada masyarakat. Upaya perbaikan gizi melalui puskesmas bertujuan untuk menangulangi masalah gizi dan meningkatkan status gizi masyarakat. Di Puskesmas Kecamatan upaya perbaikan gizi dilaksanakan oleh Ahli Gizi, namun di Puskesmas Kelurahan upaya perbaikan gizi dilaksanakan oleh beberapa macam tenaga gizi puskesmas seperti Ahli Gizi, Pembantu Ahli Gizi, bidan, perawat, atau tenaga kesehatan lainnya. Upaya perbaikan gizi melalui Puskesmas Kelurahan, belum dapat dilaksanakan secara efektif karena belum semua Puskesmas Kelurahan memiliki tenaga gizi yang professional dalam bidang gizi, kemampuan terbatas, dan masalah gizi yang dihadapi sangat luas. Mengingat bahwa di Propinsi DKI Jakarta belum pernah dilakukan penelitian terhadap kinerja petugas gizi puskesmas kelurahan dalam kegiatan gizi posyandu, serta mengacu kepada penelitian sebelumnya di tempat lain, maka perlu dilakukan penelitian agar diperoleh informasi bagaimana gambaran kinerja petugas gizi puskesmas kelurahan dalam kegiatan gizi posyandu dan faktor-faktor yang mempengaruhinya. Rancangan penelitian yang digunakan adalah Cross sectional dengan pendekatan pengukuran kuantitatif dan kualitatif. Sampel penelitian adalah seluruh petugas gizi puskesmas kelurahan di Propinsi DK.1 Jakarta yang berjumlah 274 orang petugas gizi puskesmas kelurahan. Hasil penelitian menunjukkan 48,9 % kinerja petugas gizi puskesmas kelurahan balk dan 51,1 % kinerja buruk. Sebanyak 46,4 % petugas gizi puskesmas kelurahan melakukan kegiatan gizi posyandu dengan balk dan 53,6 % melakukan kegiatan gizi posyandu tidak balk. Berdasarkan analisis multivariat dengan uji Regresi Logistik Ganda, didapat adanya hubungan yang bermakna dengan kinerja petugas gizi puskesmas kelurahan adalah kegiatan gizi posyandu, pendidikan petugas, lama kerja petugas, supervisi petugas gizi puskesmas kecamatan, dan pembinaan Kepala Puskesmas Kelurahan. Sedangkan yang berhubungan secara statistik dengan kegiatan gizi posyandu adalah usia petugas, sarana transportasi, sarana kegiatan, beban tugas dan pembinaan Kepala Puskesmas Kelurahan. Penelitian ini menyarankan bahwa untuk meningkatkan kinerja petugas gizi puskesmas kelurahan dalam kegiatan gizi posyandu perlu dilakukan pengaturan pegawai di puskesmas kelurahan dimana petugas yang berusia < 44 tahun ditugaskan sebagai petugas gizi dan untuk meningkatkan kinerjanya dapat ditingkatkan pendidikannya sampai jenjang D3 atau S1 gizi. Disamping itu untuk menunjang dalam pelaksanaan kegiatan gizi di posyandu perlu didukung dengan sarana transportasi berupa sepeda motor atau dana transportasi. Peranan pembinaan Kepala Puskesmas Kelurahan sangat mendukung terhadap peningkatan kinerja petugas gizi puskesmas kelurahan. Untuk menyampaikan informasi dari tingkat Sudinkes atau Dinas Kesehatan maka supervisi Petugas Gizi Puskesmas Kecamatan sangat membantu dalam rangka pembinaan untuk meningkatkan kinerja petugas gizi Puskesmas Kelurahan.
Primary Health Centres (Puskesmas) is the frontier of health care services including nutrition services. The nutrition program through Puskesmas is aimed to overcome nutrition problem and improve nutritional status of the population. In sub-district Puskemas, the nutrition program is conducted by a nutritionist. However, in Puskesmas kelurahan, the program is conducted by various staff qualifications, such as nutritionist, assistant nutritionist, midwives, nurses, or other health care professionals. Nutrition program in Puskesmas has not been properly conducted as not all Puskesmas Kelurahan have the appropriate nutritionist, or have limited skill, while the nutrition problem is very wide. As there has been no known studies in the performance of the nutrition staff in the Posyandu activities in DKI Jakarta, it is thought that such studies is important to be conducted. The design used in this study is a Cross Sectional study with quantitative and qualitative approach. Samples were drawn from a population of 274 nutrition staff in Puskesmas kelurahan. The result was that 48.9% of respondents showed good performance and 46.4% conducted good nutrition activities in the Posyandu. Multivariate analysis with double logistic regression showed significant relationship between performance of nutrition staff with (I) nutrition activities in Posyandu, (2) education level, (3) length of services, (4) supervision from Puskesmas Kecamatan, and (5) guidance from head of the Puskesmas. Statistically significant relationships were found between Posyandu nutrition activities and (1) age of staff, (2) availability of transportation means, (3) equipments availability, (4) workload, and (5) guidance from head of the Puskesmas. The study suggested that to improve nutrition staff performance in Posyandu nutrition activities it is necessary to manage the staff so that appointed nutrition staff would be less than 44 years in age. To improve the performance it is suggested to increase education level of the staff to at least diploma level or a degree in nutrition. Availability of transportation vehicles or sufficient find for transportation is also recommended to improve the Posyandu activities. Guidance from head of the Puskesmas is also necessary to improve the performance of the staff. Supervision from the Puskesmas Kecamatan nutritionist is also important to communicate information from district health office in order to improve performance of the star.
Kata kunci: Perencanaan Kebutuhan, SDM Kesehatan, Penyuluh Kesehatan Masyarakat, Dinas Kesehatan Provinsi DKI Jakarta, needs-based
The focus of this study is about Health Human Resource Planning of Public Health Promotor in Dinas Kesehatan Provinsi DKI Jakarta services. Dinas Kesehatan Provinsi DKI Jakarta use ABK Kesehatan method for calculating Health Promotor needs. However, we still found some errors dalam menentukan the variables. Based on the theory, that the most effective method for calculation Health Human Resource needs is the needs-based approach. The purpose of this study is to find out how the processes run, what factors influence the processes, and the gaps in Health Promotor Human Resource Planning in Dinas Kesehatan Provinsi DKI Jakarta. This research uses qualitative method by utilizing secondary data from various sources. This study explains the formulas, steps, and the application of needs-based approach for calculating the needs of Health Promotor in Dinas Kesehatan DKI Jakarta. From this study it can be concluded that the needs-based approach is suitable for calculating the needs of other Public Health Workers. This approach can be used as a further step from the ABK Kesehatan method that has been used before. The needs-based calculation is performed by adding a target population variable to its calculation.
Key words : Human Resource Planning, Health Worker, Health Promotor, Dinas Kesehatan Provinsi DKI Jakarta, Needs-Based
Jaminan pelayanan persalinan bagi masyarakat miskin bertujuan untuk meningkatkan akses terhadap pelayanan persalinan dalam rangka menurunkan AKI dan AKB. Analisis ini bertujuan mengevalusi pelaksanaan kebijakan jaminan pelayanan persalinan untuk akses masyarakat miskin di Provinsi DKI Jakarta. Penelitian dilakukan di DKI Jakarta dengan studi kasus pelayanan di Puskesmas Kecamatan Penjaringan pada bulan Juni 2013. Pendekatan kualitatif dilakukan dengan wawancara mendalam dan Focus Group Discussion (FGD). Pedoman wawancara dibuat berdasarkan metode implemantasi kebijakan George Edward III yang terdiri dari komunikasi, sumberdaya, struktur birokrasi dan disposisi. Masyarakat miskin mudah mengakses pelayanan persalinan di Puskesmas. Tetapi tetap dibutuhkan perbaikan metode komunikasi ke masyarakat.
Guarantee of service delivery for the poor aims to improve access to maternity services in order to reduce the MMR and IMR. This analysis aims to evaluate the implementation of policies to guarantee labour care access for the poor in Jakarta. The study was conducted in Jakarta with a case study in health centers Penjaringan service in June 2013. A qualitative approach was done by in-depth interviews and Focus Group Discussion (FGD). Interview guidance is based on the model of public policy implementation by George Edward III consisting of communication, resources, bureaucratic structure and disposition. Poor society can easily access labour service in the health center. But still, improvement to the method of communication is needed.
ABSTRAK
Nama : Karmellia Nikke Darnesti
Program Studi : Ilmu Kesehatan Masyarakat
Judul : Analisis Kinerja Unit Pelayanan Gigi Puskesmas Kelurahan di
Wilayah Kecamatan Koja Jakarta Utara Tahun 2018
Pembimbing : Prastuti Soewondo, S.E., MPH., Ph.D
Lebih dari 50% penduduk di Indonesia memiliki permasalahan gigi dan mulut, ironisnya
berdasarkan Riskesdas 2018, hanya sekitar 10% yang mampu mendapat akses ke layanan
kesehatan gigi. Rifaskes 2011 mengindikasikan cakupan program usaha kesehatan gigi
berbasis masyarakat di puskesmas masih sangat rendah, termasuk di wilayah DKI Jakarta.
Penelitian ini bertujuan untuk melakukan kajian atas kinerja unit pelayanan gigi
puskesmas kelurahan di wilayah Kecamatan Koja. Pendekatan wawancara mendalam,
observasi, dan telaah dokumen dilakukan pada dua jenis unit pelayanan gigi yang ada di
puskesmas kelurahan wilayah Kecamatan Koja. Terdapat dua skema, yaitu Pola I yang
memiliki dokter gigi saja dan Pola III memiliki dokter gigi dan terapis gigi. Hasil
penelitian menyatakan bahwa unit pelayanan gigi pola III memiliki kinerja pelayanan gigi
yang lebih baik karena dapat menangani lebih banyak pasien dan tindakan, serta dapat
memenuhi program Usaha Kesehatan Gigi Sekolah (UKGS) dan Upaya Kesehatan Gigi
Masyarakat (UKGM). Sebaliknya, unit pelayanan gigi pola I hanya dapat memenuhi
program UKGS dan menangani jumlah pasien yang lebih sedikit. Adanya kompetisi
waktu antara program kesehatan gigi masyarakat dan poli gigi membuat dokter gigi
kesulitan memenuhi semua pelayanan gigi. Pelaksanaan program UKGS maupun UKGM
yang dipenuhi hanya terbatas pada penyuluhan singkat dan pemeriksaan sederhana yang
dilaksanakan sekedar memenuhi target. Akibatnya, permasalahan gigi dapat terus
berkembang menjadi penyakit yang semakin parah dan membutuhkan perawatan lebih
kompleks. Hasil kajian juga menguak bahwa tindakan mayoritas, yaitu mumifikasi,
kurang sesuai dengan standar perawatan yang dibutuhkan karena keterbatasan sumber
daya. Disamping itu, tugas manajemen puskesmas ternyata menambah beban kerja dokter
gigi dan mempengaruhi kinerja unit pelayanan gigi. Kolaborasi dokter gigi dengan terapis
gigi akan meningkatkan kinerja unit pelayanan gigi karena dapat mengakomodasi
kenaikan permintaan pelayanan, membantu melaksanakan semua upaya kesehatan gigi,
dan meningkatkan kualitas pelayanan dalam era Jaminan Kesehatan Nasional (JKN).
Kata kunci: kinerja, pelayanan gigi, puskesmas, dokter gigi, terapis gigi
ABSTRACT
Name : Karmellia Nikke Darnesti
Study Program : Public Health Science
Title : Analysis of Dental Medical Unit Performance in Puskesmas
Kelurahan at Koja District North Jakarta 2018
Counsellor : Prastuti Soewondo, S.E., MPH., Ph.D
More than 50% of the population in Indonesia were reported to have dental problems,
ironically based on Riskesdas 2018, only around 10% are able to get access to dental
services. Rifaskes 2011 has indicated the coverage of the community-based oral health
program at the Puskesmas is quietly low, even in the DKI Jakarta. This study aims to
analyze the performance of the dental medical unit at the puskesmas kelurahan in Koja
District area. The approach is through in-depth interviews, observations, and document
studies were carried out on two types of dental medical units that mostly be divided into
Pattern I with only dentist and Pattern III which have dentist and dental therapist. The
results of the study indicated that Pattern III had higher dental service performance
primarily because it could handle more patients and type of treatments also could carry
out School-based Oral Health (UKGS) and Community-based Oral Health (UKGM)
programs. In contrast, Pattern I only fulfill the UKGS program and handle fewer patients.
Clash of time between community-based program and dental poly makes it difficult for
dentists to fulfill all dental services. The implementation of the UKGS and UKGM
programs which only brief counseling and screening tended merely meet the targets so
that dental problems become more severe then require more complex treatments. The
study also revealed that the mummification, which were among the most frequent
treatment, were not in accordance with the standard of care due to limited resources. In
addition, management duties within puskesmas adds further workload of dentists and
influenced the performance of dental service. Dentist collaboration with dental therapist
will improve the performance of the dental service, allowing them to accommodate the
increase in demand, support implementation of all dental health efforts, and improve
dental service quality in the era of National Health Insurance (JKN).
Keywords : dental services; performance; puskesmas; dentist; dental therapist
This study aims to determine the efforts made by puskesmas so that patients of the Refer Back Program are obedient in carrying out control at the Puskesmas Kec. Sawah Besar DKI Jakarta. Qualitative data were obtained through in-depth interviews, observations, and document reviews to analyze the efforts made by the Puskesmas Kec. Sawah Besar so that Program R patients referred to Balik obeyed the control. The variables used are input variables consisting of variables of Health Workers, Health Facilities. Process variables consist of Refer-Back, Monitoring and Evaluation Program Procedures. The output variable consists of the control compliance of participants Program Rand Balik. In terms of inputs, Health Workers, Health Facilities are identified as roles and efforts made by health workers to be able to provide good services to Program Rujuk Balik patients such as providing socialization to patients Program Rujuk Balik, good facilities and infrastructure while in terms of the process it was identified that the Patients of the Referral Program can already understand well about the stages in conducting the referral program. From this incident, it can be identified that good efforts are made by the health center of the large rice field so that the patient complies with the control.