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Prevalensi penyakit Tuberkulosis (Tb) di Indonesia masih sangat tinggi dimana negara ini menduduki posisi kelima jumlah insiden kasus Tb terbesar di dunia (WHO, 2010a) yang salah satu penyebabnya adalah ketidakpatuhan pengobatan penderita Tb yang berdampak terhadap ancaman kasus MDR-Tb dan XDR-Tb. Perilaku ini dapat disebabkan oleh inefektivitas peran pengawas menelan obat (PMO) dimana sebagian besar penunjukkannya diarahkan ke anggota keluarga dibanding petugas kesehatan. Penelitian bertujuan mengetahui pengaruh peran pengawas menelan obat dari anggota keluarga terhadap kepatuhan pengobatan penderita tuberkulosis. Desain penelitian ini termasuk observational dengan rancangan penelitian analytic cross sectional melibatkan 113 PMO yang berasal dari anggota keluarga penderita Tb dari wilayah enam puskesmas di Kota Pariaman menggunakan tehnik simple random sampling. Uji Regresi Logistik menunjukkan bahwa peran pendampingan berobat ulang ke puskesmas oleh PMO dari anggota keluarga memberikan pengaruh terbesar terhadap kepatuhan pengobatan penderita Tb (25,238; p-value 0,000) apabila dikontrol dengan tingkat pengetahuan PMO yang baik (7,341; p-value 0,003) dan atau kedekatan hubungan kekeluargaan PMO dengan penderita Tb (11,203; p-value 0,029). Dalam rangka meningkatkan efektivitas pengawasan pengobatan penderita Tb di Indonesia maka direkomendasikan reformulasi kebijakan pengendalian Tb terkait kriteria pemilihan PMO yang berasal dari anggota keluarga. Kata kunci: keluarga, kepatuhan, pengobatan, peran, pengawas, tuberculosis.
The prevalence of Tuberculosis (Tb) disease in Indonesia is still very high when the country came in fifth largest number of incident cases of Tb in the world (WHO, 2010a) that one reason is lack of patient medication compliance of Tb affect the threat of MDR-Tb and XDR-Tb. This behavior can be caused by the ineffectiveness of a treatment observer role (PMO) in which most of his appointment was directed to family members rather than healthcare workers. The study aims to determine the effect of a treatment observer role of family members on patient medication compliance of Tb. The design of this study include observational with cross sectional analytic study design involving 113 PMO from family members of patients with Tb of the six community health centers in the city of Pariaman through simple random sampling technique. Logistic regression test showed that repeated treatment mentoring role to the community health center by the PMO of the family members have the greatest influence on patient medication compliance Tb (25.238, p-value 0.000) when controlled by the level of knowledge of PMO (7.341, p-value 0.003) and or a close familial relationship between the PMO with Tb patients (11.203, p-value 0.029). In order to increase the effectiveness of the treatment of patients Tb control in Indonesia then recommended reformulation of TB control policies related to the selection criteria for the PMO which comes from a family member. Key words: family, compliance, treatment, medication, role, observer, tuberculosis
Program Keluarga Harapan (PKH) aims to improve the standard of living of the community by accommodating the utilization of health services. One health component that is required as a PKH Beneficiary Family (KPM) is that pregnant women must deliver in a health care facility. The purpose of this study is to look at the effect of PKH on the use of health facilities for delivery in Indonesia. This study used a cross sectional design using Susenas and Podes data in 2018 with a total sample of 8,636 mothers aged 15-49 who had had their last live deliver in the two-year period before the survey was conducted. The analysis uses the Propensity Score Matching (PSM) method with the Logit model that looks at the OR value. PKH has an influence on the use of maternity in health facilities. Dominant
factors that influence mothers in utilizing health facilities for deliveryh are urban residential areas, mothers and household heads with higher education, ownership of communication and information tools, ownership of transportation facilities and complementary assistance JKN-PBI. PKH implantation and other supporting factors have beneficial benefits quite large in order to help the community, especially the poor and vulnerable population to get the right to Utilize health care facilities for delivery.
The challenges of drug and food control require the BPOM Technical Operation Unit (UPT) to work optimally amid limited resources. The analysis of the relative efficiency of the BPOM Technical Operation Unit in 2019 was carried out with the aim of improving the planning, budgeting, and strategic policies of BPOM to improve performance at each UPT. Calculation of relative efficiency using the DEA (Data Envelopment Analysis) method. This study uses a mixed method with a cross sectional research design. The research sample was 31 UPT BPOM that met the requirements as a DMU (Desicion Making Unit), and 10 informants for the deepening of the process that were missed in the analysis using the DEA method. First, a sensitivity analysis was conducted to determine the input and output variables that could be included in the study. The results of the sensitivity analysis, there are 3 inputs and 4 outputs that can be analyzed by the DEA method. The results of the DEA analysis showed that there were 15 efficient UPTs and 16 inefficient UPTs. The results of the deepening of the process are known that the efficient and inefficient UPT have implemented efficiency strategies well, such as saving on official travel by paying at cost, involving human resources in other fields if there is a high workload in one field, the policy of providing overtime pay is only in the field of sample testing and administration, budget optimization with budget revisions. In relation to cross-sectoral, efficient UPT implements ways to involve higher institutions so that there is awareness from related cross-sectors. In the priority program for safety food in the village and the safety food in the market, UPTs which is not efficient, simplifies the process and makes regular visits. DEA is a method of relative efficiency analysis with the concept of maximizing the ratio of output and input. The existence of a VRS (Variable return to Scale) model that has considered the process that is expected to eliminate the shortcomings contained in the calculations using the DEA method, but because the calculations are carried out mechanically, it is necessary to deepen the process to explore things that are not obtained from the calculations, especially for organizations that are involves considerable external factors
Pimpinan puncak Badan POM telah menyadari pentingnya sosialisasi budaya oranisasi ke seluruh pegawai, yaitu Kredibilitas, Kecepatan, Kexjasama tim dan Profesionalisme, sehingga panting untuk mcngembangkan intnunent yang benar untuk mengukur dan mengevaluasi budya organisasi di Balai / Balai Besar POM di Indonesia. I-Iasil analisa rata - rata situasi saat ini pada budaya organisasi Balai / Balai Besar POM adalah 3,16 dengan nilai rata-rata yang tinggi pada profesionalisme yaitu 3,24 dan kecepatan yaitu 3,24 sedangkan nilai rata -rata terendah adalah ketja sama tim dengan nilai 3,06. Dapat diunltkan kuamya budaya organisasi Badan POM saat ini adalah profesionalisme = kecepatan > kredibilitas > kerja sama tim. Dari hasil estimasi interval dapat dilihat bahwa 95% diyakini rata -rata situsasi saat ini budaya organisasi Balai /Balai Besar POM adalah diantara 3,13 Sampai dengan 3,l9. Budaya organisasi yang berlaku di Balai / Balai Besar POM di Indonesia tidak dipengaruhi oleh jenis kelamin, pendidikan, lama kelja, umur. Budaya Organisasi tersebut dipengaruhi oleh status pemikahan dan jabatan. Instrumen penelitian yang digunakan untuk mengukur Budaya Organisasi Badan POM di Balai / Balai Besar POM di Indonesia adalah instrumen penilaian yang valid dan reliable.
Top management in The National Agency of Drug and Food Conn-ol realized the importance of socialized organization culture to all its member, which are Credibility, Speed, Team Work, and Professionalism, therefore it’s necessary to develop correct instruments to assess and evaluate organization culture in Provincial Agency of Drug and Food Control. For these above purpose, study in focus of instruments development of organization culture in some of Provincial Agency in Indonesia became necessary. Average result value of this organization culture research in Provincial Agency is 3,l6, categorized strong organizational culture, with highest average value are in Professionalism (3,24), and Speed (3,24), while the lowest average value is Team Work (3,06). This result in sequence is Professionalism = Speed > Credibility > Team Work. The lowest organization culture has value 1,83 while the highest has value 4. From analysis Of interval estimation of 95%, could be quantifiable concluded that organization culture of Provincial Agency is between 3,13 unti13,l9. There is no significant level in Education factor, Sex factor, Age factor, and also in Working Duration factor. There is significant level in organization culture between Structural Position and General Functional Position. The marriage status has significant influence in organization culture. Final conclusion of this research is that the instruments of research which be used in this study to measure organization culture are valid and reliable.
