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Background and Objective: Public Health Service of Pagar Alam Town at autonomous era of area this time require a strategic plan of expected Human Resource Health in harmony with Vision Mission Public Health Service in range of time 2006 - 2010. This matter is base and also the target of this research. Methods: To be able to compile strategic plan of Human Resource Health in Pagar Alam Town, conducted by research of operational with Analysis Qualitative and Quantitative. Compilation of strategy through some phases. First phase (Input Stage) compose environmental analysis of external and internal Human Resource Health of Public Health Service of Pagar Alam Town pass/through Consensus Decision Making Group (CDMG). At phase both (Matching Stage), CDMG do analyze Internally - External Matrix and SWOT Matrix. At third phase (Decision Stage) analyze conducted by using QSPM to determine best strategy. Results: Result Research, at election of strategy alternative by pursuant to IE Matrix, known by position of Human Resource Public Health Service of Pagar Alam Town reside in cell of V with the meaning residing in on course Hold and Maintenance where suggested to strategy consist of Market Penetration and Product Development. As according to agreement at meeting of CDMG that factor of external becoming opportunity namely the existence of improvement of level education people of Pagar Alam Town, applying of it area autonomy and peripheral of his law, existence of development of information network, existence of commitment / support of Government of town in the effort development of Human Resource health. External factor becoming threat is : low PAD of Pagar Alam Town, supply of Human Resource too a few every year, disease of infection still high, medium education of health there is no. While internal environmental factor which become strength is motivation and devotion of SDMK the high enough, existence of improvement of SDMK following second education and training, low of reduction of SDMK and amenity of permit continue education. For the factor of weakness namely interest of SDMK still lower, there is no Protap/SOP, there is no separate budget post for the development of SDMK, budget still limited. Chosen strategy of Market Penetration priority is to improve professionalism of SDMK existing, giving wide of opportunity to improve to education, developing information network function, braiding cooperation with medium education of existing health profession. For the strategy of priority development product of is optimal of Existing SDMK, preparing SDM being based on health of environment, improving advocate to party taker of policy, proposing the existence of separate budget post for the development of SDMK, making Protap/SOP. Conclusions: In the effort realizing required by long-range target of commitment the highness, can look after cooperation and braid communications which do well by sector which play a part in intake of policy. While suggestion able to be given is to be Renstra development of this Human Resource Health can be socialized to all staff at meeting of routine or special. Then operational strategy follow-up can which have been made by researcher. To be earning in line with Vision Mission Public Health Service of Pagar Alam Town hence required by monitoring to execution of activity. Keywords: Strategic Plan, Human Resource Health, Public Health Service, Market Penetration, Product Development.
Background and Objective: Public Health Service of Pagar Alam Town at autonomous era of area this time require a strategic plan of expected Human Resource Health in harmony with Vision Mission Public Health Service in range of time 2006 - 2010. This matter is base and also the target of this research. Methods: To be able to compile strategic plan of Human Resource Health in Pagar Alam Town, conducted by research of operational with Analysis Qualitative and Quantitative. Compilation of strategy through some phases. First phase (Input Stage) compose environmental analysis of external and internal Human Resource Health of Public Health Service of Pagar Alam Town pass/through Consensus Decision Making Group (CDMG). At phase both (Matching Stage), CDMG do analyze Internally - External Matrix and SWOT Matrix. At third phase (Decision Stage) analyze conducted by using QSPM to determine best strategy. Results: Result Research, at election of strategy alternative by pursuant to IE Matrix, known by position of Human Resource Public Health Service of Pagar Alam Town reside in cell of V with the meaning residing in on course Hold and Maintenance where suggested to strategy consist of Market Penetration and Product Development. As according to agreement at meeting of CDMG that factor of external becoming opportunity namely the existence of improvement of level education people of Pagar Alam Town, applying of it area autonomy and peripheral of his law, existence of development of information network, existence of commitment / support of Government of town in the effort development of Human Resource health. External factor becoming threat is : low PAD of Pagar Alam Town, supply of Human Resource too a few every year, disease of infection still high, medium education of health there is no. While internal environmental factor which become strength is motivation and devotion of SDMK the high enough, existence of improvement of SDMK following second education and training, low of reduction of SDMK and amenity of permit continue education. For the factor of weakness namely interest of SDMK still lower, there is no Protap/SOP, there is no separate budget post for the development of SDMK, budget still limited. Chosen strategy of Market Penetration priority is to improve professionalism of SDMK existing, giving wide of opportunity to improve to education, developing information network function, braiding cooperation with medium education of existing health profession. For the strategy of priority development product of is optimal of Existing SDMK, preparing SDM being based on health of environment, improving advocate to party taker of policy, proposing the existence of separate budget post for the development of SDMK, making Protap/SOP. Conclusions: In the effort realizing required by long-range target of commitment the highness, can look after cooperation and braid communications which do well by sector which play a part in intake of policy. While suggestion able to be given is to be Renstra development of this Human Resource Health can be socialized to all staff at meeting of routine or special. Then operational strategy follow-up can which have been made by researcher. To be earning in line with Vision Mission Public Health Service of Pagar Alam Town hence required by monitoring to execution of activity. Keywords: Strategic Plan, Human Resource Health, Public Health Service, Market Penetration, Product Development.
Akses pelayanan kesehatan dianggap berkontribusi pada status kesehatan. Propinsi Sumatera Barat merupakan salah satu propinsi dengan unmet need yang tinggi, artinya banyak penduduk yang membutuhkan pelayanan kesehatan tetapi mereka tidak dapat memperoleh pelayanan kesehatan. Berdasarkan data BPS (2003) terdapat 27,6% penduduk tanpa akses pelayanan kesehatan. Pada tahun 2003 ada sebanyak 16,90% penduduk yang mempunyai keluhan kesehatan dan tidak diobati. Akses pelayanan kesehatan biasanya diukur dengan melihat tingkat penggunaan pelayanan kesehatan. Banyak faktor yang mempengaruhi akses pelayanan kesehatan, diantaranya adalah jenis kelamin, pendidikan, umur, pekerjaan, pendapatan, jaminan kesehatan, wilayah tempat tinggal, pengalaman kesehatan, keluhan kesehatan, tingkat keparahan penyakit, jarak fasilitas kesehatan, dan transportasi. Penelitian ini mencoba untuk mengetahui dan memahami akses penduduk Sumatera Barat ke pelayanan kesehatan dengan menggunakan data sekunder yang diperoleh dari data Survei Sosial Ekonomi Nasional 2004 (SUSENAS 2004) yang terdiri dari kuesioner kor (VSEN2004K) dan dan kuesioner modul perumahan dan kesehatan (VSEN2004MPK). Populasi target dalam penelitian ini adalah penduduk Sumatera Barat. Sampel penelitian adalah individu yang menjadi sampel Susenas 2004 dalam hal ini adalah responden terpilih. Akses pelayanan kesehatan diukur dengan melihat penggunaan pelayanan kesehatan. Analisis bivariat dilakukan untuk mengetahui faktor-faktor yang berhubungan dengan akses pelayanan kesehatan. Uji statistik yang digunakan untuk analisis bivariat adalah uji kai kuadrat dan uji t. Analisis multivariat dilakukan untuk mengetahui probabilitas dan rasio odds penggunaan pelayanan kesehatan. Uji statistik yang digunakan adalah uji regresi logistik. Hasil penelitian dibagi dalam dua kelompok yaitu penggunaan pelayanan rawat jalan dan pelayanan rawat inap. Penggunaan pelayanan rawat jalan sebesar 16,90% dan rawat inap sebesar 1,68%. Faktor-faktor yang berhubungan dengan akses pelayanan rawat jalan adalah jenis kelamin, pendidikan, umur, pekerjaan, pendapatan, jaminan kesehatan, wilayah tempat tinggal, pengalaman sakit, keluhan kesehatan, tingkat keparahan penyakit. Adapun faktor-faktor yang berhubungan akses pelayanan rawat inap adalah jenis kelamin, pendidikan, pekerjaan, dan wilayah tempat tinggal. Di dalam penelitian ini juga ditemukan bahwa perempuan lebih rendah dalam penggunaan pelayanan rawat jalan dibandingkan laki-laki. Penduduk yang tinggal di kota lebih rendah dalam penggunaan pelayanan rawat jalan dibandingkan penuduk yang tinggal di desa. Jaminan kesehatan meningkatkan penggunaan pelayanan rawat jalan demikian juga dengan keluhan kesehatan (batuk, pilek, sakit lainnya) dan tingkat keparahan pennyakit meningkatkan penggunaan pelayanan rawat jalan. Jarak ke fasilitas kesehatan menjadi faktor penghambat penggunaan pelayanan rawat jalan. Pada pelayanan rawat inap, penduduk yang bekerja mempunyai peluang lebih rendah dibandingkan penduduk yang tidak bekerja dalam menggunakan pelayanan rawat inap. Penyakit asma merupakan keluhan utama untuk menggunakan pelayanan rawat inap. Saran yang dapat diberikan adalah mendekatkan pelayanan kesehatan kepada masyarakat, penyebaran tenaga kesehatan yang merata, memberikan kesempatan pelayanan kesehatan swasta untuk dapat berkembang, dan penyediaan fasilitas kesehatan pada perusahaan, peningkatan kualitas pelayanan kesehatan yang mudah diakses seperti Puskesmas Pembantu, Polindes dan meningkatkan cakupan asuransi kesehatan kepada masyarakat yang belum tercakup dalam askes PNS, Jamsostek, dan askeskin.
The access to health services is considered contributing to health status. West Sumatra is one of provinces with high unmet need, which means that there are many people in the province needing health services but they are not able to have them. Based on data from BPS (Central Bureau of Statistics) (2003) there were 27.6% of the people without access to the services. In 2003, 16.90% of the people complained their health but they were not cured. The access to health services is generally measured by studying the level of health service utilization. A variety of factors affect the access to health services, among others, sex, education, age, occupation, income, health insurance, residence area, health experience, health complaints, severity of illness, distance to health facilities, and transportation. This research attempts to find out and understand the access of West Sumatra's people to health services using secondary data from National Social and Economic Survey (SUSENAS) 2004 which consist of core questionnaire (VSEN2004K) and questionnaire of housing and health module (VSEN2004MPK). The population is West Sumatra's people. The samples are selected respondents, which were the samples of Susenas 2004. The access was measured by observing the utilization of health services. Bivariate analysis was conducted to find out factors related to health service access. Statistical tests used in the bivariate analysis are chi-square test and t test. Multivariate analysis was conducted to find out the probability and odds ratio of health service utilization. Statistical test used is logistic regression test. The results of the research are divided into two groups, namely outpatient service and in-patient service. The utilization of outpatient service is 16.90% and of in-patient service is 1.68%. Factors related to the access of outpatient service are sex, education, age, occupation, income, health insurance, residence area, health experience, health complaints, and severity of illness. Factors related to in-patient service are sex, education, occupation, and residence. It was found that the utilization of outpatient service by women is lower compared to men. The utilization is lower for people who live in towns than those who live in villages. Health insurance increases the utilization of outpatient services and so do health complaints (cough, influenza, other illnesses) and severity of illness. The distance to health facilities is a constraint factor to the utilization of outpatient service. People who work have a lower probability to use the in-patient services compared to those who do not. Asthma is major complaint for the in-patient service utilization. What can be suggested are approaching health services to people, distributing health personnel equally, giving opportunity to private health service to develop, providing health facilities at company, improving the quality of health service which is easily accessed such as Puskesmas Pembantu (branch of conununity health center), Polindes (polyclinic in villages) and increasing the coverage of health insurance for people who have not been covered in the health insurance of PNS (civil servants), Jamsostek (social insurance for workforce), and Askeskin.
Puskesmas merupakan satuan organisasi fungsional yang menyelenggarakan upaya kesehatan yang bersifat menyeluruh, terpadu, merata, serta dapat diterima dan terjangkau oleh masyarakat. Untuk melaksanakan kegialannya, pembiayan puskesmas selama ini sebagian besar bersumber dari pemerintah pusat, sedangkan sebagian lagi dibiayai oleh pemerintah daerah. Tuntutan masyarakat terhadap pelayanan kesehatan yang bermutu semakin tinggi, sementara alokalasi biaya operasional puskesmas yang diberikan oleh pemerintah semakin menurun. Untuk itu, pihak departemen kesehatan menetapkan konsep swadana sebagai satu jalan keluarnya. Puskesmas swadana diberikan kewenangan mengelola scluruh dana penerimaan fungsional puskesmas untuk digunakan bagi pembiayaan operasional puskesmas sehari-hari. Selain itu, konsep swadana merupakan penjabaran dari tujuan otonomi daerah dalam meningkatakan mutu pelayanan secara efektif dan efisien. Pada saat ini,. Puskesmas Putri Ayu memiliki kunjungan pasien yang tinggi, lokasi yang strategis dan sumber daya manusia yang cukup berkualitas. Kondisi yang cukup kondusif ini menjadikannya layak dikembangkan menjadi puskesmas swadana sekaligus menjadi contoh puskesmas swadana di Kota Jambi. Dalam upaya pengembangan ini diperlukan sualu perencanaan strategi yang disesuaikan dengan visi dan misi Dinas Kesehatan Kota Jambi dalam mencapai Jambi sehat 2008. Untuk dapat menyusun perencanaan strategi dilakukan penelitian operasional dengan analisis kualitatif melalui wawancara mendalam terhadap sejumlah pihak penentu kebijakan kesehatan. Sejumlah pihak tersebut adalah Walikota, DPRD, Kepala Dinas Kesehatan Kota, Kepala Dinas Kesehatan Propinsi dan unsur pelaksana Puskesmas Putri Ayu. Consensus Decision Making Group (CDMG) yang beranggotakan para pelaksana inti Puskesmas Putri Ayu menetapkan beberapa strategi terbaik dengan menggunakan SWOT matrik dan QSPM sebagaimana yang ditelili dalam penelitian ini. Hasil penelitian pemilihan alternatif strategi berdasarkan hasil IE memperlihatkan bahwa posisi Puskesmas Putri Ayu berada pada kuadran II. Hal itu menunjukan bahwa posisinya berada dalam grow and build sesuai dengan rategi intensif dan integrative yang dianjurkan. Strategi intensif yang dimaksud adalah market penetration, market development dan product development, sedangkan strategi integratif mencakup backward integration, and forward integration dan horizontal integration. Penelitian ini menyimpulkan bahwa Puskesmas Putri Ayu memiliki peluang yang besar dengan dukungan internal dan eksternal yang kuat, walaupun masih menghadapi pesaing yang cukup kompetitif. Dengan demikian, berbagai upaya masih diperlukan untuk meningkatkan mutu pelayanannya. Sebagai saran dan tindak lanjut, strategi yng telah dipilih hendaknya dioperasikan dengan optimal dengan dukungan berbagai pihak. Daftar bacaan: 40 (1982-2002)
Strategy Planning Of Developing Putri Ayu Public Health Service In Jambi Municipality Into Self Financing Public Health Service In 2002 Public health center (PHC) is functional organizational unit, which conducts health services in comprehensive, integrated and well-distributed way, also both accepted and accessible to the society. So far, it is mostly financed by Central Government to perform its activity. Province Authority pays only little amount. The society requirement to the qualified health service gets higher and higher, meanwhile PHC operational finance allotment given by the government decreases. Therefore, Health Department establishes self-financing concept as one of solutions. Self-financing PHC manages its functional revenues to cover its daily operational finance. In addition, the concept is enforced from district authority purpose in order to improve the service quality effectively and efficiently. Now that Putri Ayu PHC has high patient visit, strategic location and adequate human power, if is worth being developed into self-financing PHC, even self-financing PHC model in Jambi Municipality. As for its development, it is important to set strategy planning matched the vision and mission of Jamb Municipality Health Office in order to reach Healthy Jamb 2008. In this respect, there should be an operational research by using qualitative analysis through dept interview to the certain health decision-making officers. The officers are Mayor, District parliament, Head of Municipality Health Office, Head of Provincial Health office, operating officers of Putri Ayu PHC. Consensus Decision Making Group (CDMG) whose membership are chief operating officers of Putri Ayu PHC decides some best strategic based on SWOT matrices and QSPM as revealed in this research. The research result of deciding alternative strategy based on IE result show that Putri Ayu PHC position is at quadrant II. It shows that its position is on growing and building phase fulfilling the recommended intensive and integrative strategies. The intensive strategy covers market penetration, market development and product development, while integrated strategy consists of backward integration, forward integration and horizontal integration. The research concludes that Putri Ayu PHC has great chance with internal and external support, meanwhile it is facet with competitive rivals. Therefore, it needs developing efforts in order to improve its service quality. As for advice and follow up, officers should implement the chosen strategies with others' supports.
