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Kata Kunci: Kesenjangan biaya, Program Gizi, Perencanaan & Penganggaran
Increasing nutrition and overcoming the issues surrounding it is essential in increasing the quality of human resources in Indonesia. One of the important input aspects to achieve minimum standard services (SPM) is sufficient budget allocation. This study aims to uncover the discrepancy between budget realization and budget estimations of minimum standard services (SPM) for the nutrition program in 2016 and 2017; as well as to understand the planning and budgeting process. This was a qualitative study with a cross sectional design, utilizing resources of financial data and program implementation. Results of the study revealed that budget realization of nutrition program at Bekasi Municipal Health Office in 2016 and 2017 were Rp 3,931,449,461 and Rp. 9,146,251,165 respectively. The majority of the budget was directed to preventive programs where in 2016 comprised of 66.55% and in 2017 was 59.35% of the total nutrition budget. Total spending realized was higher than the yearly total budget estimations based on minimum standard services (SPM). There was excess in budget in 2016 of Rp. 2,152,354,011 and Rp. 6,798,429,672 in 2017. In-depth interviews revealed the planning process already includes extensive problem analysis, objective determination and activities identification. The budgeting process is already based on work performance due to it priority scale budgets and established. Bekasi Municipal Health Office should continue to pursue its commitment in improving health budget planning and budget efficiency.
Key words: Budget Gap, Nutrition Program,Health Planning and Budgeting
RSJPDHK adalah RS pemerintah di bawah Kementerian Kesehatan yang ditetapkan sebagai rumah sakit BLU (Badan Layanan Umum) Kementerian Kesehatan yang telah melaksanakan remunerasi sejak tahun 2008. Implementasi kebijakan remunerasi di RSJPDHK ditetapkan melalui keluarnya KMK 165 tahun 2008. Pada tahun 2011 yang mengatur sistem tunjangan kinerja. Tujuannya adalah melaksanakan reformasi birokrasi maka perlu diberikan tunjangan kinerja.
Dari hasil FGD dengan para dokter spesiaslis jantung RSJPDHK dan wawancara mendalam para informan bahwa KMK nomor 165 tahun 2008 dasarnya adalah PP 23 tahun 2005 tentang BLU sedangkan Permen PAN nomor 63 tahun 2011 tidak berdasarkan PP 23 tahun 2005 tentang BLU. Sehingga Permen PAN nomor 63 tahun 2011 dapat dipergunakan pada tatanan birokrasi dan tidak bisa dipergunakan untuk RS BLU. Keadaan tersebut akan berdampak terjadinya kesenjangan pada segala aplikasi pelaksanaan sistem remunerasi pada RS BLU.
Kesimpulan dari penelitian ini yaitu penerapan KMK nomor 165 tahun 2008 di RSJPDHK sudah tepat. Permen PAN nomor 63 tahun 2011tepat apabila diterapkan di institusi dengan tatanan birokrat.
Saran yang diberikan yaitu melakukan monitoring dan evaluasi pelaksanaan sistem remunerasi yang berjalan di RSJPDHK berdasarkan KMK No. 165 Tahun 2008 sebagai upaya penyempurnaan. Permen Pan No. 63 tahun 2011 harus dilengkapi dengan peraturan yang sesuai jika akan dilaksanakan pada institusi BLU.
National Cardiovascular Center Harapan Kita (NCCHK) is a public hospital which structurally located under Ministry of Health and defined as a Public Service Board. The Ministry of Health has been implemented the remuneration system since 2008. The implementation of these policies in NCCHK are set through a decree of the Minister of Finance No.165 in 2008. In 2011, the Minister of Administrative and Bureaucratic Reform published a decree No.63 to regulate the performance allowance.
The aim is, to implement a bureaucratic reform, it is necessary to give the performance allowance. To review the remuneration system based on a decree of the Minister of Finance No.165, 2008 which has been applied in NCCHK and the remuneration system based on a decree of the Minister of Administrative and Bureaucratic Reform No.63, 2011 which will be applied in governmental bodies. Perform a gap analysis between the remuneration system based on a decree of the Minister of Finance No.165, 2008 and a decree of the Minister of Administrative and Bureaucratic Reform No.63, 2011.
From the results of the focused group discussions with NCCHK cardiologists and in-depth interview with informants, it was conclude that a decree of the Minister of Finance No.165, 2008 is essentially based on a Government Ordinance No.23, 2005 about Public Service Board. However, a decree of the Minister of Administrative and Bureaucratic Reform No.63, 201 was not based on this Government Ordinance so that it cannot be used in a hospital that become a Public Service Board. This situation will end with the occurrence of gaps in the implementation of any applied system in the public-service-board hospital remuneration.
Conclusion. The application of the decree of the Minister of Finance No.165,2008 is appropriate for public-service-board hospitals. The decree of the Minister of Administrative and Bureaucratic Reform No.63, 2011 is applicable when it is applied in institutions with bureaucratic order.
Human resources for health play an important role towards health development. One ofthe challenges faced in health development is the crisis in the availability of humanresources for health. Demand upon human resource for health continues to increase,therefore bigger efforts needed to be made in order to balance availability of humanresources for health. Efforts made by various countries in the world in combating thiscrisis by improving the human resource for health management system start fromplanning to evaluation. HRH planning holds great control in calculating the needs thatmust be met in the future. In compiling health human resource planning, an approach isneeded which can provide projections of future needs with the aim of providing abalance between the demand for HRH needs in the future and the availability. Theapproach or model adopted can prevent the shortage of HRH in the future. This researchis a qualitative study using literature review method with the PubMed, Lancet andGoogle Scholar as the databases. The Input Process Output (IPO) approach is alsocarried out so that the research conducted is well-directed. Results from this studyshows data from the Netherlands and Ireland as representatives from 10 countries withthe highest HDI numbers in the world in 2019 released by UNDP. The results providean overview of the methods used by the Netherlands and Ireland in HRH planning inorder to prevent the shortages of HHR availability in the future. Netherlands and Irelandprojected future needs by conducting a gap analysis accompanied by developingelements of the planning model used from the year planning began to the targeted year.From the results of this study, researchers get 3 important things that can be used as aplanning strategy to fulfill the needs of HRH at the national level, those strategy are bydetermining the elements for the planning model based on strategic issues; establishreliable data collection methods in order to guarantee data accuracy; and developingscenarios that consider developments in various sectors.Keywords :Health Workforce ; Workforce Planning ; Gap Analysis.
Puskesmas sebagai fasilitas pelayanan kesehatan tingkat pertama memiliki peran penting dalam mendukung program kesehatan masyarakat. Pemenuhan sumber daya manusia kesehatan (SDMK) yang mencakup jenis dan jumlah tenaga kesehatan sesuai standar menjadi syarat utama untuk menjamin pelayanan yang berkualitas. Penelitian ini bertujuan untuk menganalisis kecukupan jenis dan jumlah SDMK pada Puskesmas BLUD di Kota Depok tahun 2024 serta faktor-faktor yang memengaruhinya. Penelitian menggunakan pendekatan kualitatif dengan metode studi kasus melalui wawancara mendalam dan telaah dokumen pada enam Puskesmas terpilih serta instansi terkait di Kota Depok. Hasil menunjukkan bahwa masih terdapat kesenjangan antara jumlah SDMK eksisting dengan kebutuhan berdasarkan analisis jabatan dan beban kerja yang tertuang dalam dokumen perencanaan dan kebutuhan SDMK Kota Depok. Kesenjangan ini menyebabkan multitasking dan task shifting, yang berdampak pada beban kerja dan mutu layanan. Faktor yang memengaruhi pemenuhan SDMK meliputi sistem manajemen kepegawaian, kepemimpinan, kemitraan/jejaring, ketersediaan anggaran, pendidikan/pelatihan, serta kebijakan yang berlaku. Temuan juga menunjukkan bahwa fleksibilitas pengelolaan keuangan melalui BLUD belum dimanfaatkan secara optimal untuk mendukung pemenuhan SDMK. Diperlukan komitmen pemerintah daerah dalam perencanaan dan pengadaan SDMK secara strategis berbasis data dan analisis beban kerja untuk memastikan tersedianya tenaga kesehatan yang sesuai baik secara jumlah maupun jenis.
Community health centers (Puskesmas) as primary health care facilities play an important role in supporting public health programs. The fulfillment of health human resources (SDMK), which includes the type and number of health workers in accordance with standards, is a key requirement for ensuring quality services. This study aims to analyze the adequacy of the type and number of SDMK at BLUD Puskesmas in Depok City in 2024 and the factors that influence it. The study employs a qualitative approach using a case study method through in-depth interviews and document reviews at six selected Puskesmas and related institutions in Depok City. The results indicate that there is still a gap between the existing number of HHR and the needs based on job analysis and workload as outlined in Depok City's planning documents and HHR requirements. This gap leads to multitasking and task shifting, which impacts workload and service quality. Factors influencing the fulfillment of SDMK include human resource management systems, leadership, partnerships/networks, budget availability, education/training, and applicable policies. The findings also indicate that the flexibility of financial management through BLUD has not been optimally utilized to support the fulfillment of SDMK. A commitment from the local government is needed in strategic planning and procurement of SDMK based on data and workload analysis to ensure the availability of healthcare personnel that are appropriate in both quantity and type.
