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Jurnal Kebijakan Kesehatan Indonesia

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Published by Universitas Gadjah Mada

ISSN : 2089 2624 EISSN : 2620 4703 DOI : -

Core Subject : Health,

Public Health

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Articles 8 Documents

Search results for , issue "Vol 2, No 3 (2013)" : 8 Documents clear

ANALISIS KEBIJAKAN DESA SIAGA DI KABUPATEN SLEMAN YOGYAKARTA Reni Merta Kusuma
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background: Mortality rate is one of indicators andrepresentations of welfare of an area. In order to solve highmortality rate problem, the government of Daerah IstimewaYogyakarta (DIY), including District of Sleman, is carrying outthe policy of alert village.Method: The study used literature review based onreferences and field data which were issued by Health Office.Result: The policy of alert village has less positive impact indecreasing maternal mortality rate and neonatal mortality rate,because health assurance scheme still does not meet theneeds of the people, both physical and non-physical. Thedegree of health still has not improved significantly. The policyof alert village needs inter-sectoral financial support. Financialallocation is still mistargeting. People needs vary from onevillage to another, so it is necessary to have competent andsmart health workers as the implementing agents of HealthDepartment. The policy of alert village is still not able to satisfyall stakeholders (government, health workers, and people),because the concept of satisfaction is closely related to theprinciple of justice.Conclusion: The policy of alert village is an effort to empowerthe people to be independent in overcoming their healthproblems. But, in District of Sleman the policy of alert village isclassified into unsuccessfull policy. This failure is caused byinsufficiet support in implementating the policy.Keyword: Policy of alert village, Health Office of District Sleman

STUDI PELAKSANAAN KEBIJAKAN PERATURAN DAERAH JAMINAN KESEHATAN DAERAH SUMATERA BARAT SAKATO DALAM MENGHADAPI UNDANG-UNDANG SISTEM JAMINAN SOSIAL NASIONAL DAN UNDANGUNDANG BADAN PENYELENGGARA JAMINAN SOSIAL TAHUN 2013 Tuty Ernawati
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

ABSTRACTBackground: Local health insurance (Jamkesda) is an effortmade by the Government of West Sumatra province to improvethe accessibility of health services for the poor or near poorwho are not accommodated in the quota of public healthinsurance (Jamkesmas). Jamkesda was implemented at thestart of 2007 until in 2011 using Governor Regulation WestSumatera Number 40 and Number 41 in 2007. After runningfor five years, there are still many problems in theimplementation. Later in 2011, the provincial parliament of WestSumatera exercised its rights of initiative and enacted LocalLegislation Number 10 year 2011 regarding the implementationof the Health Insurance West Sumatra Sakato. Afterwards,the implementation of Jamkesda West Sumatera Sakato refersto these regulations. The purpose of this study is to evaluatethe implementation of the new regulation of the Jamkesda WestSumatera Sakato in 2013.Methods : This study is a descriptive analysis with a qualitativeusing case study. Data collection is done at the ProvincialHealth Office / District Health Office / City selected, PT HealthInsurance, regional planning agency (Bappeda), and healthprovider. Qualitative data were collected through in-depthinterviews, and secondary data were collected throughdocument review.Result: The results of the study shows that implementation ofhealth insurance on West Sumatra Sakato still had not beenoptimal, namely how the selection of the participants; a lowpremium that is Rp.6.000/month/member by sharing fundingbetween provincial and district budgets / City budgets; thebenefits are not yet comprehensive enough; health providersis still limited in the region of West Sumatra province and onlyin public facilities; health workers has not been evenlydistributed; the team is still not functioning well; the monitoringand evaluation at every level Administrative as well associalization of Jamkesda are not optimal; and the existingpolicy has not referred to higher level policy.Conclusion: Implementation of Jamkesda West SumatraSakato does not go according to the existing policy. Amongothers, the selection of membership, quality of health care,lowpremiums, health facilities are limited, health workers have notbeen evenly distributed, and the monitoring and evaluationteam has not been established as per the guidelines.Suggestion: There is a need to evaluate Jamkesda WestSumatera Sakato policy so that the policies are notcontradicting. There is a need to form a Monev Team forJamkesda so that all parties have a sense of sharedresponsibility.Keywords: Local Regulation of Jamkesda, health financing,Provider Jamkesda.

EVALUASI KEBIJAKAN JAMINAN PERSALINAN DI PROVINSI DAERAH ISTIMEWA YOGYAKARTA TAHUN 2012 Ummul Khair
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background: The Ministry of Health made a breakthroughthrough delivery care scheme as one solution to reducing theMMR and IMR called Jampersal. This policy is a deliveryassurance scheme intended for all pregnant women and newmothers in Indonesia who are not covered by any insuranceyet. Delivery care assurance scheme consist prenatal care,postnatal care including family planning postpartum andnewborn care. This program also applied in the special regionof Yogyakarta as one of the program in improving the health ofmothers and children. During the implementation in Yogyakarta,the program still has some obstacles.Objective: This study aimed to evaluate the delivery careassurance policy in the province of Yogyakarta.Methods: The research design used case study design. Theresearch was conducted in the province of Yogyakarta. whichThe sampling technique used was stratified sampling. The unitof analysis in this study is the health districts / municipalities,general hospitals, health centers and private practice midwiveswho administer Jampersal. Data collected by in-depthinterviews.Results: The result of this research shows that there aremany problems in terms of input, process and output. In termsof input, the problems are related to human resources, financial,means and policy. In terms of process, the problems are relatedto socialization, regulations of patient, process of claiming,referral system and funding. In terms of output, the problem isrelated to overcrowding, patient refusal, and complains fromthe consumer.Conclusion: This program is a good program for reduction ofinfant and maternal mortality rates, but still needs someimprovement. Improvements are needed in terms ofstrengthening cross-sector coordination, socialization of theprogram should be optimized, stregthening the electronic-basedreferral system, strengthening the commitment and motivationof personnel and improvement of health infrastructures.Keywords: Delivery Care Assurance Policy, Policy Evaluation.

ANALISIS IMPLEMENTASI KEBIJAKAN JAMINAN PERSALINAN DALAM MENINGKATKAN CAKUPAN PERSALINAN TENAGA KESEHATAN DI KABUPATEN SITUBONDO TAHUN 2013 Gurendro Putro
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background:The policy of Maternity Benefit for the Uninsured(Jampersal) is based on the philosophy to reduce maternalmortality and infant. The Minister of Health Regulation number2562/Menkes/Per/XII/2011 on A Maternity Benefit for theUninsured Persons’s Technical Guidelines ensures that thegovernment provides services to pregnant women withantenatal care (ANC), parturition and post-parturition for free,including the use of contraceptives post parturition.Objective:To know the confidence’s level of pregnant womenin seeking help for parturition from the health provider, theprovider commitment to Jampersal policy, and Jampersalsocialization in the community.Methods: Cross-sectional and purposive sampling are usedfor descriptive analysis. Data collection is conducted withinterview using a questionnaire to 40 mothers and 40 midwivesin the district Situbondo. Data is also collected throughsecondary data from the district health office Situbondo andhospital.Results: From the 40 respondents that had been interviewed,92.5% ask for help to providers, but as much as 7.5% ask forpartus help from traditional birth attendants. In addition, theJampersal still charged costs to maternal care to as many as12 people (30%). This is non-conforming to Jampersal policyof giving free maternal care. In Jampersal implementation inSitubondo, 50% of midwives have good commitment. While27.5% showed medium commitment and the remaining 22.5%is less committed. The magnitude of this commitment varies.Respondents with the age of 30-39 years shows excellentcommitment ( 55%), and those who work for 1-9 years arecommitted (50%). Socialization of Jampersal policy hasn’t beenoptimal. Jampersal is still not known by all pregnant womenyet. The term “free treatment” is confused with the health cardpolicy.Conclusion: There is a high trust level in pregnant womenwho asks for partus help (92.5%). Commitment of provider inrunning the Jampersal policy is still high. Jampersal socializationhasn’t reached the optimal level because people still do notunderstand the conditions of Jampersal.Suggestion: Since birth delivery by the traditional birth attendantsis still common, the midwife should work with traditionalbirth attendants in terms of infant care such as bathing, andgive incentives when collaborating in handling after partus.There is a need to improve midwife skills in detecting the riskof pregnancy and childbirth. Socialization Jampersal need toinvolve community leaders, and religion leaders.Keywords: Jampersal, pregnant women’ trust, Provider Commitment.

ANALISIS KEBIJAKAN JAMINAN KESEHATAN KOTA BENGKULU DALAM UPAYA EFISIENSI DAN EFEKTIFITAS PELAYANAN DI PUSKESMAS Yandrizal Yandrizal; Betri Anita Anita; Desri Suryani
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background. Mayor of Bengkulu Regulation Number 13 Year2012 on The Implementation Guidelines for State HealthInsurance Assistance Costs (Jamkeskot) in Bengkulu city ismanaged by the Secretariate of the Government of CommunityWelfare Section in Bengkulu. The cost of referral health carein Provincial General Hospital could be made more efficient byoptimizing the role of community health centers as a curative,preventive and promotive health services. It is hoped to reducethe number of visits for treatment and referral to hospital. Thepurpose of this study is to analyze the City Health Insurancepolicies in an effort to improve the efficiency and effectivenessof primary health care and public health efforts to reduce thenumber of visits for treatment and referral to hospital.Method: The type of research is non-experimental research,or also called qualitative research. It is an exploratory researchto find a new role of the city government and AdministeringAgency to improve the efficiency and effectiveness of healthservices at the health center.Unit of Analysis: 1) Community Health Center Unit 20, 2)organizing: PT. Askes 2 person and Community Welfare section2 person, 3) the City: Head of the Community Welfare Section1 person, Bengkulu City Health Office 2 person. Data is collectedusing interview using questionnaire as the instrument, anddocuments review.Results: Bengkulu Jamkeskot policies have not applied theprinciple of insurance in which the organizers serves to controlthe quality and cost of health care provided in both basicservices/primary and referral services. Most of the healthcenters tend to refer patients (67%) that are still within theirauthorization to provide care. The reason being: the healthcenters have limited equipment and drugs, and some patientsdemanded to be referred due to perceived bad quality of serviceat the health centers. The Community Welfare section has notcoordinated with the City Health Office to conduct training forthe health center in an effort to increase the effectiveness ofservices.Recommendation: The City Government is to establish ateam to conduct technical guidance supervision to healthcenters to ensure that the health centers play the role ofgatekeeper and only refer patients that need complex care,providing medical equipment and drugs to the health centerswith proposed funding from Bengkulu City budget and provincialbudget. The Health Centers are to provide routine counselingon healthy behavior and IEC on nutrition and hygiene to everyposyandu. The City Health Office provides technical guidancein drafting POA for promotive and preventive activities to havemore focus in efforts to control the causes of disease. Improvepolicy management of Jamkeskot by submitting the managementto an administering body, so that the Jamkeskot can apply theinsurance principles where the strong help the weak, thehealthy help the sick, the rich help the poor; and also cancontrol the quality and cost of service.Keywords: Health Policy, Health Insurance, Gatekeeper

ANALISIS KEBIJAKAN PEMERINTAH DAERAH DALAM PENGEMBANGAN ‘JAMINAN SOSIAL KESEHATAN SUMATERA SELATAN SEMESTA’ MENYAMBUT UNIVERSAL HEALTH COVERAGE Misnaniarti Misnaniarti
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Background: The ‘Jamsoskes Sumsel Semesta’ is a localprogram that offered free medical treatment for health servicesfor the people of South Sumatra who do not have healthinsurance. Meanwhile, starting in 2014, the national Governmentwill implement the Universal Health Coverage as mandated bythe Social Security Law. As insurance have a principle ofindemnity where there should not be a duplicate social security,there should be no society that is assured by the two programswith the aim of speculating to make a profit. This study aims toexplore the implementation of the expansion plan of ‘JamsoskesSumsel Semesta’ to pave the way to Universal Health Coveragein 2014 in South Sumatera.Methods: This study was a qualitative policy research withexploratory design. The focus are policy content, context,actors, and policy processes. Data were collected by in-depthinterviews and observation. Sources of information obtainedfrom five informants from the institution of Provincial HealthOffice, Planning and Regional Development Agency of SouthSumatra, and Provincial Government who selected bypurposive technique based on considerations of participationin Jamsoskes. The analysis used is the analysis of policy.Results and Discussion: Based on the results of study it isfound that the South Sumatra provincial government willcontinue to provide the Jamsoskes program in 2014 as it is,managed by the Health Office. Some of the considerations arefor efficiency and flexibility and that it does not include all thepeople. Also, in the Presidential Decree No. 12 of 2013, thenational government still provides opportunities for local schemeto grow until 2019. Some development is done in Jamsoskesincluding improving the quality and quantity of health careproviders. Preparations are coordinated with Social SecurityAgency about number of contribution beneficiaries. One ofthe challenges is that the community rather go to the hospitaldirectly so it can interfere with the referral system.Conclusion: There has not been a lot of development effortundertaken by local government onJamsoskes in preparationfor the 2014 to welcome Universal Health Coverage. The SouthSumatra provincial government should develop further theservices under Jamsoskes as adjustments in welcoming theimplementation of the second phase of the National HealthInsurance.Keywords: Policy, Health Insurance, Jamsoskes, Efficiency

DAPATKAH KITA BERPERAN SERTA MENJAWAB TANTANGAN KEBUTUHAN KEBIJAKAN BERBASIS BUKTI? Shita Listya Dewi
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Para pembuat kebijakan perlu mempertimbangkanbanyak faktor untuk membuat kebijakan sistemkesehatan (misalnya, hambatan kelembagaan, konflikkepentintangn para pemangku kepentingankepentinganyang dipengaruhi oleh suatu kebijakan,dan nilai-nilai serta preferensi publik), namun hasilpenelitian empiris juga dapat membantu. Hasil penelitianempiris dapat menyediakan dukungan buktiatas apa yang efisien dan efektif dan apa yang tidakefisien dan tidak efektif serta strategi apa yang direkomendasikanuntuk mengatasinya. Dengan katalain, hasil penelitian empiris akan memberitahu merekauntuk memperkuat atau memperbaiki secaraterus menerus upaya reformasi sistem kesehatanagar mencapati efektivitas dan efisiensi program,layanan, dan obat-obatan secara optimal untuk masyarakattarget yang membutuhkan. Harapannya,kebijakan yang dihasilkan dengan mendapatmasukan dari penelitian empiris akan merupakankebijakan berbasis bukti.Oleh karena itu, para pembuat kebijakan danpara stakeholder memerlukan akses langsung keberbagai jenis penelitian empiris untuk mengambilkeputusan berdasarkan informasi yang lengkap tentangberbagai pertanyaan dan masalah yang merekamiliki mengenai sistem kesehatan, tata kelola danstrategi implementasi. Di lain pihak, para penelitikebijakan dan lembaga penelitian perlu mendukungdan mengupayakan penggunaan hasil penelitianempiris pada tingkat masyarakat, penyedia, organisasi,dan pembuat kebijakan. Namun, adanya hasilpenelitian empiris dan adanya akses terhadap hasilpenelitian empiris tidak serta merta menjawab kebutuhanpara pengambil kebijakan. Ketepatan waktudari hasil penelitian adalah salah satu dari dua faktoryang penting. Para peneliti dan lembaga penelitianperlu secara sistematis mengidentifikasi gap didalam pengetahuan dan literature tentang sistemkesehatan kemudian melakukan serta menghasilkanmasukan penelitian baru sesuai dengan konteksnyadan tepat waktu.Faktor kedua yang juga penting adalah: parapembuat kebijakan akan menilai seberapa banyakkepercayaan dapat mereka tempatkan terhadapkualitas dari penelitian tersebut, local applicabilitynya,serta nilai tambah (value added) dari hasil penelitiantersebut dibanding penelitian-penelitian sejenislain atau sebelumnya.Dengan demikian, upaya lebih besar harus diarahkanpada beberapa prioritas untuk meningkatkankegunaan dari penelitian tentang sistem kesehatandan dukungan yang diperlukan oleh para pembuatkebijakan dan para pemangku kepentingan. Pertama,ada kebutuhan untuk mendukung upaya-upayasistematis untuk melakukan penelitian kontekstualyang tepat waktu secara teratur. Kedua, perlunyaupaya advokasi hasil penelitian empiris untukmemastikan bahwa para pembuat kebijakan dan parastakeholder memiliki akses ke terbaru terhadap hasilpenelitian empiris. Ketiga, ada kebutuhan untuk meningkatkankualitas dari penelitian itu sendiri. Terakhir,ada kebutuhan untuk ketersediaan serangkaianberbagai topik-topik yang berhubungan dengantata kelola, keuangan dan pelayanan di dalam sistemkesehatan termasuk topik-topik yang selama ini masihkurang ‘disentuh’ misalnya pelayanan long termcare, geriatric, dsb, serta strategi implementasi yangdapat mendukung perubahan dalam sistemkesehatan.Sepanjang tahun 2012-2013 ini, Pusat Kebijakandan Manajemen Kesehatan telah melangsungkanpelatihan berbasis web bagi para peneliti kebijakankesehatan. Penelitian telah berlangsung untuk beberapaangkatan. Pelatihan mencakup pengenalanterhadap konsep penelitian kebijakan, perspektif penelitiankebijakan, serta advokasi hasil penelitiankebijakan. Dari setiap angkatan yang mengikuti pelatihanini, telah dipilih lima peserta yang mendapatkandukungan dana untuk melakukan penelitiankebijakan sesuai proposal yang disusunnya. Parapemenang kemudian disaring lagi untuk menentukansiapa yang memperoleh beasiswa untuk mempresentasikanhasil penelitiannya di Forum NasionalIV Jaringan Kebijakan Kesehatan Indonesia di Kupangpada bulan September 2013. Namun, bagi yangbelum terpilih untuk melakukan presentasi, tetap diberisarana untuk mendiseminasikan hasil penelitianmereka yaitu melalui edisi JKKI kali ini dan edisiberikutnya.Walau pun masih jauh dari sempurna, namunini merupakan sebagian kecil dari sumbangsih untukmenjawab empat tantangan yang telah diuraikan sebelumnya, dengan cara (1) mendukung dilakukannyapenelitian kontekstual yang tepat waktu, (2) menyediakansarana untuk diseminasi dan advokasihasil penelitian kebijakan, (3) berupaya meningkatkankualitas penelitian kebijakan, dan (4) memastikantersedianya berbagai ragam topik penelitiankebijakan. Semoga terselenggaranya kegiatan inimendorong dan memotivasi para peneliti kebijakandan lembaga penelitian kesehatan untuk terus memperjuangkanupaya perbaikan sistem kesehatan.Selamat membaca.

IMPLEMENTASI KEBIJAKAN KESEHATAN “LIBAS 2+” SEBAGAI UPAYA MENURUNKAN ANGKA KEMATIAN IBU DAN BAYI DI KABUPATEN SAMPANG Ali Imron
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 3 (2013)
Publisher : Center for Health Policy and Management

Introduction: The issue of MDGs 4 and 5 that targets reducingthe AKI and AKB by three-quarters between 1990 and 2015seems difficult to achieve if there are no immediate concretesteps. Areas with the highest AKI and AKB are SampangRegency. Looking at the empirical conditions, it is necessary toidentify the factors that led to the high AKI and AKB in SampangRegency. There is an existing health policy in Sampang districtthrough LIBAS (Lima Bebas) 2+, but it needs to be monitoredand evaluated to ensure policy implementation went well. Thisstudy aims to assess the implementation of the Libas programsand identify socio-cultural factors that influence health policyimplementation.Methods: This study used qualitative methods that took placeat the Puskesmas Camplong, Sampang Regency. Informantswere selected purposively. The research data was collectedby participating observation, in-depth interviews, and focusgroup discussions. The finding was analyzed using descriptiveanalysis.Results: Sociologically, the implementation of policy to reduceAKI and AKB in Sampang Regency is one of which is influencedby the shaman midwife partnerships, especially in the deliveryprocess. Increasing public confidence in midwives indicatesstrengthening social relations. 5T programs (weigh, tension,tablet Fe, weigh abdominal size, and height) is helpful to controlthe development of maternal pregnancy. “Healthy Babies 24Hours” SMS number serves as a control and monitoring indelivery care. Nonetheless, culturally, traditional culturalconstruction of Madura, particularly the coastal communities,still entrenched so that the construction of knowledge aboutreproductive health is still weak. Shaman massage, herbalmedicine, pregnancy myths, and charismatic central figureare prominent. Social relation between local actors is still weak,so is the local actors support.Conclusion: Strong local culture values and weak socialrelationship and support of local actors as a result of programimplementation LIBAS2+ reduce AKI and AKB efforts inSampang Regency had not been effective.Keywords: health policy, LIBAS 2+, social relationship, localculture

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