ABSTRAK Latar belakang. Menurut SDKI 2007 Angka Kematian Ibu 228/100.000 KH dan Angka Kematian Bayi 34/1000 KH, sementara target MDG?s adalah 102/100.000 KH dan 23/1.000 KH. Untuk mempercepat target MDG?s maka diluncurkanlah program Jampersal untuk mengatasi keterbatasan akses dan ketidaktersediaan biaya sesuai dengan surat edaran yang dikeluarkan Menteri Kesehatan Nomor TU/Menkes/E/391/11/2011 tentang Jaminan Persalinan tanggal 22 Februari 2011. Tujuan. Tujuan penelitian ini untuk mengetahui sejauh mana implementasi kebijakan jampersal di 3 puskesmas DKI Jakarta tahun 2012 berdasarkan variabel komunikasi, sumber daya, disposisi dan struktur birokrasi. Metode. Jenis penelitian ini adalah kualitatif dan dilaksanakan pada bulan Juni - Juli 2013 di 3 Puskesmas DKI Jakarta dengan jumlah informan sebanyak 11 orang. Hasil. Hasil analisa yang didapat menunjukkan bahwa implementasi kebijakan belum berjalan semaksimal mungkin. Angka kematian ibu yang masih tinggi dan alokasi dana yang tidak terserap kemungkinan disebabkan oleh keempat variabel tersebut, sehingga masih perlu adanya tindak lanjut baik dari pemerintah, pemda, dinas kesehatan provinsi dan kabupaten/kota serta puskesmas.

ABSTRACT Background. According to the IDHS 2007 Maternal Mortality 228/100.000 lb and Infant Mortality 34/100.000 lb, whilw the MDG?s is 102/100.000 lb and 23/100.000 lb. To accelerate the MDG?s target Jampersal program was launched to address the limitations of access and unavaiability costs in accordance with their circulair issued by the Minister of Health No. TU/Menkes/E/291/11/2011 on Delivery Guarantee dated February 22, 2011. Puspose. The purpose of this study to determine the extend of policy implemtation Jampersal in 3 health center DKI Jakarta in 2012 based on the communication, resources, disposition and bureaucratic structures variables. Method. This research is qualitative and held in June-July 2013 in the 3 health centers DKI Jakarta by the number of informants as many as 11 peoples. Results. Analysis results obtained show that the implementation of the policy has not been running as much as possible. Maternal mortality rates are still high and the allocation of funds that is not absorbed is probably caused by the four variables, so it is still the need for better follow-up of the goverment, local goberment, Province health offices and district health offices and community health center.

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

Angka Kematian Ibu (AKI) di Indonesia masih cukup tinggi. Sebagian besar terjadi selama melahirkan dan periode postpartum langsung dengan penyebab utama akibat komplikasi obstetrik. Pertolongan persalinan oleh tenaga kesehatan telah dikaitkan dengan upaya menurunkan angka kematian ibu, pemanfaatan pelayanan ini masih relatif rendah. Penelitian ini bertujuan untuk mengidentifikasi determinan pemanfaatan pelayanan berdasarkan karateristik individu. Penelitian ini menggunakan pendekatan cross sectional, dengan data primer yang dikumpulkan melalui penyebaran angket kepada 203 responden. Hasilnya menunjukkan ada hubungan antara pendapatan keluarga, sikap terhadap pelayanan kesehatan dan persepsi kebutuhan kesehatan yang dirasakan dengan pemanfataan pertolongan persalinan oleh tenaga kesehatan. Sikap merupakan determinan paling dominan terhadap pertolongan persalinan oleh tenaga kesehatan (p=0,000 OR=19,292 CI 95%=8,337–44,644). Sedangkan umur, tingkat pendidikan, pekerjaan, kepemilikan jaminan kesehatan, persepsi jarak dan waktu tempuh ke fasilitas kesehatan tidak teridentifikasi berhubungan secara signifikan. Disarankan kepada pihak puskesmas untuk meningkatkan koordinasi dengan berbagai pihak terkait, mengintegrasikan program kesehatan ibu dengan program lain, melibatkan masyarakat dalam mengidentifikasi masalah kesehatan, dan menyebarkan informasi pentingnya pertolongan persalinan oleh tenaga kesehatan. Kata Kunci: Pertolongan persalinan oleh tenaga kesehatan, sikap, persepsi.

Maternal Mortality Rate (MMR) in Indonesia is still quite high. Mostly occurred during delivery and immediate postpartum period due to the major cause of obstetric complications. Delivery assistance by health professionals has been associated with reducing maternal mortality effort, this service utilization is still relatively low. The aim of this study is to identify the determinants of health service utilization based on individual characteristics. Cross sectional approach was used with primary data that is collected by spread out the questionaire to 203 respondents with . The results showed that there is a relationship between family income, attitudes toward health care and perceptions to the need of heath service with the utilization of delivery assistance by health professionals. Attitude is the most dominant determinant of delivery assistance by health professional (p = 0.000 OR = 19.292 95% CI = 8.337 to 44.644). As for age, education level, occupation, property insurance, the perception of distance and travel time to health facilities was not significantly associated. The recommendation for the Cijeruk Health centre is to enhance coordination with relevant stakeholders, integrating maternal health program with other programs, involving the community in identifying health problems, and disseminate important information delivery assistance by health professionals. v Universitas Indonesia Keywords: Delivery asisstance by health personnel, attitudes, perceptions.

Stunting merupakan permasalahan serius di seluruh dunia. Prevalensi stunting di Indonesia tahun 2023 sebesar 21,5% menurun 0,1% dari tahun 2022. Prevalensi stunting di DKI Jakarta sebesar 17,6% meningkat 2,8% dari tahun 2022 sedangkan Jakarta utara memiliki kenaikan prevalensi stunting terendah dari 4 Kota Administrasi di DKI Jakarta yaitu 1,3% dari tahun 2022 dengan prevalensi stunting sebesar 19,8%. Jakarta utara memiliki kebijakan berupa modul aksi cegah stunting yaitu Jakarta Utara menuju Zero Stunting. Berdasarkan data BPS tahun 2023, terdapat 13,33% perempuan usia 10 tahun ketas di Jakarta Utara yang tidak menyelesaikan pendidikannya dan terdapat 7,24% penduduk miskin di Jakarta Utara. Berdasarkan Perpres RI No. 72 Tahun 2021 tentang Percepatan Penurunan Stunting, target prevalensi stunting tahun 2024 sebesar 14%. Jakarta Utara masih memiliki gap sebesar 5,8% untuk mencapai target 14% prevalensi stunting di tahun 2024. Oleh karena itu dilakukan penelitian mengenai analisis implementasi kebijakan stunting di Jakarta Utara dari aspek ekonomi berupa program pemberian susu, telur untuk balita bermasalah gizi, makanan tambahan bagi ibu hamil Kurang Energi Kronik (KEK) dan aspek pendidikan melalui edukasi stunting kepada ibu hamil dan orang tua balita sebagai upaya pencegahan dan penanggulangan stunting. Model implemntasi kebijakan yang digunakan adalah model Van Meter Van Horn. Penelitian ini adalah penelitian kualitatif dengan pendekatan studi kasus. Pengambilan data melalui wawancara mendalam kepada 15 informan dari instansi pemerintah, orang tua balita dan ibu hamil serta FGD kepada kader posyandu di wilayah Cilincing dan Tanjung priok sebagai lokasi penelitian. Hasil penelitian dari aspek ekonomi pemberian susu dan telur bagi balita bermasalah gizi pada tahun 2023 berkontribusi terhadap pencegahan dan penanganan balita stunting di Jakarta Utara. Hal ini dapat dilihat dari 72,11% balita weight faltering mengalami kenaikan berat badan, 59,01% balita under weight sudah tidak under weight, 54,9% balita gizi kurang sudah tidak gizi kurang  dan 45,34% gizi buruk sudah tidak menjadi gizi buruk serta 149 balita stunting sudah tidak menjadi stunting berdasarkan status gizi. Dari aspek pendidikan pemberian edukasi mengenai stunting kepada ibu hamil kurang optimal karena hanya 9,93% ibu hamil mendapatkan edukasi melalui kelas ibu yang dianggarkan oleh puskesmas di Jakarta Utara, namun semua orang tua balita bermasalah gizi sudah mendapatkan edukasi mengenai stunting. Diperlukan edukasi mengenai pencegahan dan penanganan stunting secara masif kepada ibu hamil dan orang tua balita serta perlu adanya regulasi mengenai pemberian pangan tinggi protein hewani bagi ibu hamil dan balita bermasalah gizi dan bagi balita dari keluarga dengan penghasilan di bawah UMP

Stunting is a serious problem throughout the world. The prevalence of stunting in Indonesia in 2023 is 21.5%, a decrease of 0.1% from 2022. The prevalence of stunting in DKI Jakarta is 17.6%, an increase of 2.8% from 2022, while North Jakarta has the lowest increase in stunting prevalence of the 4 Administrative Cities in DKI Jakarta, namely 1.3% from 2022 with a stunting prevalence of 19.8%. North Jakarta has a policy in the form of an action module to prevent stunting, namely North Jakarta towards Zero Stunting. Based on BPS data for 2023, there are 13.33% of women aged 10 years and above in North Jakarta who have not completed their education and there are 7.24% of poor people in North Jakarta. Based on RI Presidential Decree No. 72 of 2021 concerning the Acceleration of Reducing Stunting, the target for stunting prevalence in 2024 is 14%. North Jakarta still has a gap of 5.8% to achieve the target of 14% stunting prevalence in 2024. Therefore research was conducted regarding the analysis of the implementation of stunting policies in North Jakarta from an economic aspect in the form of programs providing milk, eggs for toddlers with nutritional problems, additional food. for pregnant women with Chronic Energy Deficiency (KEK) and educational aspects through stunting education for pregnant women and parents of toddlers as an effort to prevent and overcome stunting. The policy implementation model used is the Van Meter Van Horn model. This research is qualitative research with a case study approach. Data were collected through in-depth interviews with 15 informants from government agencies, parents of toddlers and pregnant women as well as FGDs with posyandu cadres in the Cilincing and Tanjung Priok areas as research locations. The results of research from the economic aspect of providing milk and eggs to toddlers with nutritional problems in 2023 will contribute to the prevention and handling of stunting toddlers in North Jakarta. This can be seen from 72.11% of underweight toddlers experiencing weight gain, 59.01% of underweight toddlers are no longer underweight, 54.9% of underweight toddlers are no longer underweight and 45.34% of underweight toddlers are no longer underweight. malnutrition and 149 stunted toddlers were no longer stunted based on nutritional status. From an educational aspect, providing education about stunting to pregnant women is less than optimal because only 9.93% of pregnant women receive education through maternal classes budgeted for by the community health center in North Jakarta, but all parents of toddlers with nutritional problems have received education about stunting. Massive education regarding the prevention and handling of stunting is needed for pregnant women and parents of toddlers and there is a need for regulations regarding providing food high in animal protein for pregnant women and toddlers with nutritional problems and for toddlers from families with incomes below the UMP