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Indah Sri Wahyuni; Promotor: Tris Eryando; Kopromotor: Martya Rahmaniati Makful, Meiwita Paulina Budiharsana; Penguji: Besral, Kemal Nazaruddin Siregar, Popy Yuniar, Wendy Hartanto, Harimat Hendarwan
Abstrak:
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Pemanfaatan pelayanan kesehatan dalam persalinan sangat penting karena proses persalinan merupakan fase krusial dalam kehidupan ibu dan anak. Persalinan ditolong oleh tenaga kesehatan terlatih di fasyankes merupakan salah satu intervensi kunci dan terbukti untuk mengurangi 16-33% kematian ibu. Di Indonesia, cakupan pemanfaatan persalinan di fasyankes berdasarkan SKI 2023 sebesar 89.9% namun cakupan tersebut belum mencapai target dari renstra kemenkes 2020-2024 sebesar 95%. Data riskesdas 2013, 2018 dan SKI 2023 menunjukkan adanya variasi dalam cakupan persalinan di fasyankes antar kabupaten/kota di Pulau Jawa sehingga mencerminkan adanya disparitas wilayah. Tujuan penelitian ini mengetahui model spasial pemanfaatan persalinan di fasyankes untuk setiap kabupaten/kota di Pulau Jawa, Indonesia. Studi ekologi dilakukan pada 118 kabupeten/kota di Pulau Jawa tahun 2023. Data berbentuk agregat dan bersumber dari publikasi SKI 2023, data sebaran tenaga medis dan tenaga kesehatan, buku publikasi BPS dan profil kesehatan masing-masing provinsi di Pulau Jawa. Analisis data menggunakan Spatial Error Model (SEM) dan Geographically Weighted Regression (GWR). Hasil penelitian menunjukkan terdapat autokorelasi spasial positif dan membentuk pola pengelompokan spasial. Hasil SEM menunjukkan adanya dependensi spasial yang signifikan dan mampu menjelaskan 77,78% variasi antarwilayah dan membentuk pola residual yang mengelompok. Pada Model GWR mampu menjelaskan 87,28% variasi spasial pemanfaatan persalinan melalui kombinasi variabel independen. Hasil model menunjukkan bahwa determinan yang memengaruhi pemanfaatan persalinan di fasyankes yaitu penolong persalinan, kepemilikan jaminan kesehatan, penduduk miskin, kunjungan ANC, pendidikan ibu, rasio dokter dan rasio PKM memiliki pengaruh yang bervariasi secara spasial antar kab/kota. Variabel-variabel tersebut memiliki kekuatan pengaruh yang berbeda antar kab/kota di Pulau Jawa. Dari hasil penelitian ini diharapkan dapat menjadi bahan perencanaan bagi program kesehatan ibu yang lebih terarah khususnya dalam penetapan wilayah prioritas intervensi di Pulau Jawa.
The utilization of healthcare services during delivery is essential, because process is a crucial phase in the lives of both mother and child. Delivery assisted by skilled birth attendant in healthcare facilities is a key intervention proven to reduce maternal mortality by 16–33%. In Indonesia, the coverage of healthcare facility delivery based on the 2023 Indonesian Health Survey (SKI) is 89.9%; however, this has not yet reached the 95% target set by the Ministry of Health's 2020–2024 strategic plan. Data from Riskesdas 2013, 2018, and SKI 2023 indicate variations in facility-based delivery coverage across regencies/cities on Java Island, reflecting regional disparities. This study aims to determine the spatial model of healthcare facility delivery utilization for each regency/city on Java Island, Indonesia. An ecological study was conducted across 118 regencies/cities in Java in 2023. Aggregate data were sourced from the 2023 SKI publications, medical and health personnel distribution data, BPS (Statistics Indonesia) publications, and health profiles from each province in Java. Data were analyzed using the Spatial Error Model (SEM) and Geographically Weighted Regression (GWR).The results indicate a positive spatial autocorrelation, forming a spatial clustering pattern. The SEM results show significant spatial dependency, explaining 77,78% of the inter-regional variation and forming clustered residual patterns. The GWR model was able to explain 87,28% of the spatial variation in delivery utilization through a combination of independent variables. The model results demonstrate that determinants affecting healthcare facility delivery utilization namely skilled birth attendants, health insurance ownership, poverty levels, ANC (Antenatal Care) visits, maternal education, physician ratios, and community health center ratios have spatially varying influences across regencies/cities. These variables exhibit different levels of influence across different regions in Java. The findings of this study are expected to serve as a planning resource for more targeted maternal health programs, particularly in identifying priority areas for intervention on Java Island.
D-607
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Almira Fanny Rahmasari; Pembimbing: Adang Bachtiar; Penguji: Pujiyanto, Atmiroseva
Abstrak:
Latar Belakang: Kesehatan merupakan kebutuhan dasar manusia dan hak setiap warga negara yang dijamin oleh UUD 1945. Salah satu langkah strategis pemerintah dalam memastikan hak ini adalah melalui program Jaminan Kesehatan Nasional (JKN), yang dikelola oleh BPJS Kesehatan sejak 2014. Program ini bertujuan untuk mencapai cakupan kesehatan universal, meningkatkan akses, dan kesetaraan layanan kesehatan di Indonesia. Namun, pelaksanaan program ini menghadapi berbagai tantangan, seperti distribusi tenaga kesehatan yang tidak merata, keterbatasan infrastruktur, dan disparitas kualitas layanan. Data dari Profil Kesehatan Indonesia 2023 dan Survei Kesehatan Indonesia (SKI) 2023 menunjukkan bahwa fasilitas kesehatan tingkat pertama, seperti puskesmas, merupakan yang paling sering diakses masyarakat, meskipun aksesibilitas dan kualitas layanan masih menjadi isu utama. Berdasarkan Model Anderson, akses pelayanan kesehatan dipengaruhi oleh faktor predisposisi, pemungkin, dan kebutuhan. Penelitian ini menganalisis utilisasi fasilitas pelayanan kesehatan di Indonesia dengan menggunakan data SKI 2023, yang mencakup evaluasi tren akses dan pemanfaatan fasilitas kesehatan dalam lima tahun terakhir. Tujuan: Penelitian ini bertujuan Menganalisis utilisasi fasilitas kesehatan berdasarkan data SKI 2023. Metode: Penelitian ini menggunakan desain studi penampang dengan data sekunder dari SKI 2023. Populasi penelitian adalah peserta JKN yang tersebar di 38 provinsi. Analisis dilakukan melalui uji chi-square dan regresi logistic sederhana untuk mengidentifikasi hubungan antara variabel independen predisposisi (umur, jenis kelamin, tingkat pendidikan, dan status pekerjaan) dan enabling (kepemilikan jaminan kesehatan, waktu menuju fasilitas kesehatan dan biaya yang diperlukan menuju fasilitas kesehatan) dengan variabel dependen (pemanfaatan fasilitas kesehatan). Hasil: Hasil penelitian mengungkapkan terapat hubungan antara usia, jenis kelamin, pendidikan, kepemilikan jaminan kesehatan, waktu yang dibutuhkan untuk mencapai fasilitas kesehatan dan biaya yang dibutuhkan untuk mengunjungi fasilitas kesehatan dengan pemanfaatan fasilitas kesehatan dalam 1 tahun terakhir. Kesimpulan: Terdapat hubungan antara variable predisposisi dan enabling terhadap pemanfaatan fasilitas pelayanan kesehatan.
Background: Health is a basic human need and a fundamental right of every citizen, as guaranteed by the 1945 Constitution of Indonesia. One of the government's strategic efforts to ensure this right is through the National Health Insurance (JKN) program, managed by BPJS Kesehatan since 2014. This program aims to achieve universal health coverage, improve access, and ensure equity in healthcare services in Indonesia. However, the implementation of this program faces various challenges, such as unequal distribution of healthcare workers, limited infrastructure, and disparities in service quality. Data from the 2023 Indonesia Health Profile and the 2023 Indonesia Health Survey (SKI) show that primary healthcare facilities, such as puskesmas, are the most frequently accessed by the public, although accessibility and service quality remain key issues. According to Anderson's Model, access to healthcare services is influenced by predisposing, enabling, and need factors. This study analyzes the utilization of healthcare services in Indonesia using data from the 2023 SKI, which evaluates trends in access and utilization of healthcare facilities over the past five years. Objective: This study aims to analyze the utilization of healthcare services based on 2023 SKI data. Methods: This study employs a cross-sectional design using secondary data from the 2023 SKI. The study population consists of JKN participants spread across 38 provinces. Analysis was conducted using chi-square tests and simple logistic regression to identify the relationship between the independent variables (predisposing factors: age, gender, education level, and employment status; enabling factors: health insurance ownership, travel time to healthcare facilities, and costs required to access healthcare facilities) and the dependent variable (utilization of healthcare facilities). Results: The study revealed significant relationships between age, gender, education, health insurance ownership, travel time, and costs to access healthcare facilities and the utilization of healthcare services in the past year. Conclusion: There is a significant relationship between predisposing and enabling variables and the utilization of healthcare facilities.
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Background: Health is a basic human need and a fundamental right of every citizen, as guaranteed by the 1945 Constitution of Indonesia. One of the government's strategic efforts to ensure this right is through the National Health Insurance (JKN) program, managed by BPJS Kesehatan since 2014. This program aims to achieve universal health coverage, improve access, and ensure equity in healthcare services in Indonesia. However, the implementation of this program faces various challenges, such as unequal distribution of healthcare workers, limited infrastructure, and disparities in service quality. Data from the 2023 Indonesia Health Profile and the 2023 Indonesia Health Survey (SKI) show that primary healthcare facilities, such as puskesmas, are the most frequently accessed by the public, although accessibility and service quality remain key issues. According to Anderson's Model, access to healthcare services is influenced by predisposing, enabling, and need factors. This study analyzes the utilization of healthcare services in Indonesia using data from the 2023 SKI, which evaluates trends in access and utilization of healthcare facilities over the past five years. Objective: This study aims to analyze the utilization of healthcare services based on 2023 SKI data. Methods: This study employs a cross-sectional design using secondary data from the 2023 SKI. The study population consists of JKN participants spread across 38 provinces. Analysis was conducted using chi-square tests and simple logistic regression to identify the relationship between the independent variables (predisposing factors: age, gender, education level, and employment status; enabling factors: health insurance ownership, travel time to healthcare facilities, and costs required to access healthcare facilities) and the dependent variable (utilization of healthcare facilities). Results: The study revealed significant relationships between age, gender, education, health insurance ownership, travel time, and costs to access healthcare facilities and the utilization of healthcare services in the past year. Conclusion: There is a significant relationship between predisposing and enabling variables and the utilization of healthcare facilities.
S-11829
Depok : FKM UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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