Perspective of Cikahuripan Villagers on Traditional Health Service Provisions in Government Regulation No. 103 Year 2014

Background: Traditional health service is one of the health services that is still currently used in Indonesia, especially in rural communities. The government has been regulating these services since 2014. Despite its long existence, there is a recent increase of potential regulation violation among traditional health service providers. This study aimed to explore the perspective of the Cikahuripan Villagers on Government Regulation on traditional health services.Methods: This was a qualitative study using in-depth interviews and direct observations on traditional health services in Cikahuripan Village. Sixteen informants consisting of 8 villagers who met the inclusion criteria and another 8 informants in the triangulation negative case analysis, member checking, peer debriefing, and observation was involved.Results: There were two different perspectives in the community on traditional health service provisions in the Government Regulation. Supporters of the regulation believed that the regulation would make traditional health services more responsive and safer, which would improve service quality and health benefits as well as imposing effective sanctions. In contrast, the opposition believed that regulations were too late, would make the costs for licensing expensive, and too complicated.Conclusion: There are two different public perspectives on the regulation of traditional health services, which are supporting and opposing the regulation. It is expected that the local government create a derivative of the regulation by making adjustment to the community’s situation

Patients’ Satisfaction in Public and Private Primary Health Care: A Study in Karawang Regency, West Java, Indonesia

Background: Primary health care is the foundation of the Sustainable Development Goals (SDGs) to achieve Universal Health Coverage (UHC). Patient satisfaction with the health services acquired is one of the factors to achieve the UHC target. This study aimed to determine patients’ satisfaction in public and private primary health care centers.Methods: This quantitative analytic study with a cross-sectional method was conducted in five sub-districts of Karawang Regency based on community satisfaction surveys. The instrument used was a standard questionnaire with nine dimensions and filled with a survey approach by the respondents. Data was transformed from ordinal to numeric using Rach modelling. Then, numerical data were analysed with Chi Square Test in IBM SPSS Statistic 23 Version to determine differential between public and private groups. Results: In total, 193 respondents were included of whom 123 patients were from public health centers (Pusat Kesehatan Masyarakat, Puskesmas) and 70 from private primary care (clinic). Three dimensions had differences in satisfaction, including the requirements (p=0.001); systems, mechanisms, and procedures (p=0.001); and service time (p=0.001). The other six dimensions such as cost (p=0.534); product specification type of service (p=0.213); implementer competence (p=0.163); implementer behavior (p=0.000); handling of complaints, suggestions, and advances (p=0.448); and facilities infrastructure (p=0.063) were not proven to have differences in satisfaction. Overall, patients’ satisfaction level at Puskesmas (67.5%) was lower than at clinics (88.6%) (p=0.001).Conclusion: Patients’ satisfaction with the Puskesmas is lower than the clinic. Further study with a larger sample size and more complete dimension is needed

Patients’ Satisfaction in Public and Private Primary Health Care: A Study in Karawang Regency, West Java, Indonesia

Background: Primary health care is the foundation of the Sustainable Development Goals (SDGs) to achieve Universal Health Coverage (UHC). Patient satisfaction with the health services acquired is one of the factors to achieve the UHC target. This study aimed to determine patients’ satisfaction in public and private primary health care centers.Methods: This quantitative analytic study with a cross-sectional method was conducted in five sub-districts of Karawang Regency based on community satisfaction surveys. The instrument used was a standard questionnaire with nine dimensions and filled with a survey approach by the respondents. Data was transformed from ordinal to numeric using Rach modelling. Then, numerical data were analysed with Chi Square Test in IBM SPSS Statistic 23 Version to determine differential between public and private groups. Results: In total, 193 respondents were included of whom 123 patients were from public health centers (Pusat Kesehatan Masyarakat, Puskesmas) and 70 from private primary care (clinic). Three dimensions had differences in satisfaction, including the requirements (p=0.001); systems, mechanisms, and procedures (p=0.001); and service time (p=0.001). The other six dimensions such as cost (p=0.534); product specification type of service (p=0.213); implementer competence (p=0.163); implementer behavior (p=0.000); handling of complaints, suggestions, and advances (p=0.448); and facilities infrastructure (p=0.063) were not proven to have differences in satisfaction. Overall, patients’ satisfaction level at Puskesmas (67.5%) was lower than at clinics (88.6%) (p=0.001).Conclusion: Patients’ satisfaction with the Puskesmas is lower than the clinic. Further study with a larger sample size and more complete dimension is needed

Factors Related to the Intention to Cigarette Smoking among Junior High School Students in Jatinangor Subdistrict, West Java

Background: Cigarette smoking is known to harm the health of smokers and causes the death of millions people around the world. Smoking initiation in Indonesia is begun early especially during teenagers year. The aim of the study was to analyze the factors related to the intention to cigarette smoking among Junior High School students in Jatinangor subdistrict.Methods: A quantitative method with cross sectional study was conducted in the junior high school setting during the period of September to November 2013. Inclusion criterias were students aged 13­15 years old and did not smoke. Four factors were measured in this study, which were attitudes toward cigarette smoking, parents who smoke, peers influence and advertisement where each factor had 5 questions with ‘Yes’ or ‘No’ answers. Data were collected through self-administered questionnaire among 226 students using stratified random sampling. Statistical analysis of the variables was using chi square test.Results: As much as 44.25% of the respondents had intention and 55.75% had no intention to cigarette smoking. This study showed significant relation among attitudes, parents who smoke, peers influence and advertisements with the intention to cigarette smoking.Conclusions: Half of the respondents have intention to cigarette smoking and the most factors related to it are peers influence. DOI: 10.15850/amj.v2n3.52

Evaluasi kebijakan pembangunan puskesmas pembantu di Propinsi Kalimantan Tengah

Background: The objective of health development is improving community health status through increasing public access to health services. One of strategy is by supporting facilities forhealth service by developing auxiliary health center for all remote district at Central Kalimantan Province. Central Kalimantan Province with 1,9 million of population, consisted of 14 district, 1348 villages, 805 auxiliary health center. It means that only 59% village have facilities for health service such as auxiliary health center.Objectives: This research aimed to know how formulation process and implementation of policy of developing auxiliary health center by using provincial funds.Method: It was descriptive case study using mainly method qualitative designed by semi structured in-depth interview and document study. Research subject is stakeholder at levelprovince and chosen district. This research executed in Province Public Health Service of Central Kalimantan and one chosen district.Result: Development of secondary health center in Central Kalimantan Province is the realization of Central Kalimantan Province local decree number 12 and 13 year 2005 fulfilmenton RPJPD and RPJMD. Initially, the budgeting concept was planned by Tugas Pembantuan mechanism, but this mechanism was not agreed. This scheme was a top down program fromprovince government. Problems occurred in the implementation are 1). Bad monitoring, 2). Lack of reporting by developer, 3). Remote location of, 4). Varieties in cost of production, 5). Shortage health care workforce, 6). Equipments unmatched the need of health care provider. Evaluation is executed, but only concerning physical progress problem. In the meantime, there was increased allocation of DAK fund in each district.Conclusion: Development of auxiliary health center in Central Kalimantan Province which funded by province fund, is not required by district. There was no agenda surrounding development of auxiliary health center. The role of stakeholder in compilation of agenda setting for this policy was only a normative role

Policy evaluation of developing auxiliary health center in Central Kalimantan province

Background: The objective of health development is improving community health status through increasing public access to health services. One of strategy is by supporting facilities for health service by developing auxiliary health center for all remote district at Central Kalimantan Province. Central Kalimantan Province with 1,9 million of population, consisted of 14 district, 1348 villages, 805 auxiliary health center. It means that only 59% village have facilities for health service such as auxiliary health center. Objectives: This research aimed to know how formulation process and implementation of policy of developing auxiliary health center by using provincial funds. Method: It was descriptive case study using mainly method qualitative designed by semi structured in-depth interview and document study. Research subject is stakeholder at level province and chosen district. This research executed in Province Public Health Service of Central Kalimantan and one chosen district. Result: Development of secondary health center in Central Kalimantan Province is the realization of Central Kalimantan Province local decree number 12 and 13 year 2005 fulfilment on RPJPD and RPJMD. Initially, the budgeting concept was planned by Tugas Pembantuan mechanism, but this mechanism was not agreed. This scheme was a top down program from province government. Problems occurred in the implementation are 1). Bad monitoring, 2). Lack of reporting by developer, 3). Remote location of, 4). Varieties in cost of production, 5). Shortage health care workforce, 6). Equipments unmatched the need of health care provider. Evaluation is executed, but only concerning physical progress problem. In the meantime, there was increased allocation of DAK fund in each district. Conclusion: Development of auxiliary health center in Central Kalimantan Province which funded by province fund, is not required by district. There was no agenda surrounding development of auxiliary health center. The role of stakeholder in compilation of agenda setting for this policy was only a normative role

Existence of Antibiotics in Stalls at Jatiroke Village, Jatinangor Sub District

Background: Improper use of antibiotics can lead to lack of drug efficacy against bacteria, and cause resistance to the antibiotics itself. Antibiotics are classified into prescription drugs that should not be available over the counter because of its dangerous effect. It is important to study the presence of antibiotics in traditional stalls. Objective of this study was to investigate existence of antibiotics in stalls, and to investigate reasons of stall- owners for selling antibiotics.Methods: This study used mixed method design, and sequential explanatory approach, and conducted direct observation, spatial mapping, and interview with stall-owners selling drugs in Jatiroke village, Jatinangor sub district from September to November 2013. Total sampling was conducted in this study.Results: Fifty percent from 24 surveyed stalls sold Antibiotics Amoxicillin. The map showed stalls selling antibiotics at roadside. Amoxicillin sold package with Dexamethasone and Non-Steroid Anti Inflammatory Drugs (NSAID) was soldby several stalls. Shopkeepers sold antibiotics due to lack of knowledge about thedrug, need for self-medication, demand, and availability of drugs supply.Conclusions: Antibiotics can be found in several stalls in Jatiroke village, and improper of use of this drug can lead to resistance and less efficacy for treating infections. Although the Act for prescription drugs still exists, low of monitoring and enforcement the regulation by the Badan Pengawas Obat dan Makanan (BPOM) may be one of many factors that influence the existence of antibiotics in the stalls. [AMJ.2016;3(2):239–43]DOI: 10.15850/amj.v3n2.77

KEBIJAKAN NASIONAL DALAM KONTEKS LOKAL: TANTANGAN IMPLEMENTASI KEBIJAKAN DESA SIAGA DAN RUJUKAN PELAYANAN KESEHATAN DI KABUPATEN KEPULAUAN YAPEN PAPUA

Background:One of the policies in health to achieve IndonesiaSehat 2010 was the development of desa siaga that wasbased on Decree of Ministry of Health number 564/MENKES/SK/VIII/2006 regarding the guidance on the implementation ofDesa Siaga. Desa Siaga is a community based health effortthat involved community self funding agency such as PKK,religious organization, and private sector.Method:This was a qualitative descriptive research that usedexplanatory analysis with case study design. The researchinformant was district government, health office, communityleaders and public figure as well as health care provider. Thedata was collected with interview, observation anddocumentation. Data analysis was conducted with case studyanalysis.Result: This research showed that the implementation of DesaSiaga was with top–down method that used social mobilizationapproach. The district government and community was verymuch supporting the policy of Desa Siaga. Difficult geographiclocation, limited human resources in health and limited fundingwere the main obstacles in the implementation of Desa Siagapolicy and health service referral. The main problem of referralimplementation was transportation and funding. The readinessof community and village aparatur to assist the poor communitywas still very minimum.Conclusion: This research proven that Desa Siaga programwas very important for community in the district of Yapenarchipelago. Nevertheless, difficulties in geographiccondition,limited human resources in health as well as limited fundinghas resulted in difficulties in the implementation of Desa Siagapolicy and health service referral in the district of Yapenarchipelago. The regional and central government have notbeen able to respond to the needs of Desa Siaga.Keyword: Policy Implementation, Desa siaga, Papua