AN EVALUATION ON THE POLICIES ON PUBLIC HEALTH WORKERS AS HEALTH PROFESSIONALS

Abstract. Law No. 36 of 2014 is a comprehensive law for health professionals. In that regulation, all health graduates that wish to practice their trade must have a letter of registration (STR). That policy also separated environmental health from public health. This was the reason why we decided to evaluate the policy that is related to public health professionals. This evaluation was a retrospective analysis that used in-depth interviews and literary research, respectively as primary and secondary data. From this research we discovered that public health graduates is has their own profession. And to obtain the right to practice their trade, they must pass the competence standard test. However, according to other regulations, only vocational or professional education graduates can participate in the test. Since there currently are no professional education institutions available for public health professionals, Minister of Health Regulation No. 41/2013 takes over. According to this law, all public health graduates will be provided an STR until there is a professional education institution. We also discovered that environmental health should NOT be separated from public health, since it is a large part of it. And therefore, the law must be amended. Abstrak. Undang-undang (UU) No. 36 Tahun 2014 mengatur tenaga kesehatan secara komprehensif. Dalam UU tersebut, semua tenaga kesehatan yang berpraktek wajib memiliki surat tanda registrasi (STR). Kebijakan juga telah memisahkan kesehatan lingkungan dari kesehatan masyarakat (kesmas). Oleh karena itu peneliti tertarik untuk melakukan evaluasi kebijakan khususnya terhadap konten kebijakan yang berhubungan dengan tenaga kesmas. Evaluasi isi kebijakan ini dilakukan dengan analisis retrospektif yang menggunakan wawancara mendalam dan telaah literatur sebagai data primer dan sekunder. Dari penelitian ini diketahui bahwa tenaga kesehatan masyarakat layak disebut sebagai sebuah profesi. Untuk mendapatkan STR, tenaga kesmas harus lulus ujian kompetensi. Tetapi, menurut peraturan yang berlaku, yang dapat mengikuti ujian kompetensi adalah lulusan pendidikan vokasi atau profesi. Namun, karena belum adanya pendidikan profesi untuk tenaga kesmas, maka untuk sementara Peraturan Menteri Kesehatan Nomor 41 Tahun 2013 digunakan sebagai solusi. Dimana semua lulusan institusi kesmas akan mendapatkan STR hingga terdapat institusi pendidikan yang menyelenggarakan pendidikan profesi. Selain itu ditemukan bahwa kesling sebenarnya merupakan bagian yang penting dari kesmas, baik dalam literatur maupun pendapat para ahli. Sehingga sebaiknya dilakukan revisi atau amandemen untuk UU tersebut

Implementasi Indikator Kinerja Propenas di Provinsi

TERSEDIA DALAM FIL

AN ANALYSIS ON THE PREPAREDNESS FOR IMPLEMENTING THE MINIMAL STANDARDS FOR SERVICE IN THE HEALTH FIELD AT DEPOK CITY IN 2017

Abstract. Health is one of the fundamental rights for every person, therefore it must be provided by the government. To guarantee the quality and type of health services, the Minimal Standards for Services (SPM) must be established. This includes the SPM for the productive age healthcare services (SPM BKUP). This type of healthcare is important since it covers about 60-70% of the current population. In this research, we analyzed the discrepancy between the reality and the ideal in the implementation of the SPM BKUP qualitatively through in-depth interviews, focus group discusions, and studying the related documents. We discovered that in Depok City 10 of the 13 indicators for implementation were incomplete. These were the Noncommunicable diseases (NCDs) risk factor conseling, technical trainings for the screening officer and web-based surveillance, NCDs integrated services, recording and reporting, monitoring and evaluation, communication, the attitude of the implementer, manpower, facilities, and funding. And that the other three indicators, incentives for the implementers that reached the target, standard operational procedures for the implementation of the SPM BKUP, and a specialized team for the implementation. Therefore, Depok City was only minimally prepared to implement the SPM.Abstrak. Kesehatan adalah hak yang sangat mendasar bagi manusia, untuk itu negara harus hadir dalam pemenuhannya. Dalam era otonomi daerah, Standar Pelayanan Minimal (SPM) bidang kesehatan menjadi jaminan penyelenggaraan pelayanan kesehatan dengan jenis dan mutu pelayanan dasar yang sama. Salah satu jenis layanan dasar adalah SPM bidang kesehatan pada usia produktif (SPM BKUP). Jenis layanan dasar ini bernilai strategis bagi kinerja Pemerintah Daerah, karena berdasarkan BPS (2017) komposisi penduduk usia produktif menempati proporsi 60-70% dari seluruh jumlah penduduk dan nilai strategis bagi pengendalian Penyakit Tidak Menular (PTM) karena bentuk skrining. Analisis kesiapan ditujukan untuk melihat seberapa besar jarak antara kondisi ideal dengan kenyataan yang sebenarnya. Penelitian ini menggunakan metode kualitatif dengan teknik WM, FGD dan telaah dokumen terkait.  Hasil penelitian didapatkan 10 dari 13 indikator kesiapan implementasi, belum lengkap dimiliki Kota Depok, meliputi konseling faktor risiko PTM, Pelatihan teknis petugas skrining dan surveilans berbasis web,  pelayanan terpadu PTM, pencatatan pelaporan, monitoring evaluasi, komunikasi, sikap pelaksana, ketersediaan SDM, fasilitas dan dana. Sementara 3 indikator yang belum sama sekali dimiliki yaitu insentif bagi pelaksana yang mencapai target, SOP pelaksanaan SPM BKUP dan Tim penanggung jawab penyelenggaraan SPM BKUP. Kesimpulan didapatkan bahwa Kota Depok memiliki kesiapan yang minimal dalam rangka implementasi SPM BKUP.

Effectiveness Of Failure Modes Effect Analysis (FMEA)

One of the prevention efforts of medical errors that occur in health services is by identifying the potential failure of the service before the failure occurs. FMEA is one way to identify the risks of failure. Therefore, the authors wanted to find out whether FMEA was effective for reducing medical error based on previous studies. This article was a literature review using references in an online database such as EBSCOhost. The author found 280 articles while searching by using the keyword “FMEA”. After filtered by publication period from 2012 to 2017, full text and language, finally got 7 articles. Finally, the author used the three most relevant literature. FMEA was proven to decrease the potential failure rate after follow-up to failure was done in service process, so medical error can be prevented. In the application of FMEA, bias can occur during the determination of potential failure and determination of scoring on RPN. Therefore, it is expected that the team involved in making FMEA experts in the process of service to be designed. FMEA could prevent medical errors by determining potential failures before failure occurs

USER PERCEPTIONS OF THE QUALITY OF THE PEDULILINDUNGI APPLICATION BASED ON THE DIMENSIONS OF ELECTRONIC SERVICE QUALITY (E-SERVICE QUALITY) DURING THE COVID-19 PANDEMIC

The use of a contact tracing application is one of the efforts made to overcome the global COVID-19 pandemic with an increasing number of cases. The contact tracing application used in Indonesia is PeduliLindungi which is one of the requirements for accessing public areas, which was initially applied to the Java-Bali region. However, in its use, there are still challenges that affect the quality of electronic services. This study aims to analyze user perceptions of the service quality of the PeduliLindungi application based on the E-Servqual dimension. The method used is observational with a quantitative approach using a cross-sectional design. The results showed that overall, the user's perception of the quality of the PeduliLindungi application was good with positive ratings on the service quality dimensions of the PeduliLindungi application. The dimensions that have a significant relationship to the user's perception of the quality of the PeduliLindungi (ESQ) application are the dimension of user experience (EXP) and user trust (TRU). The dimension of reliability (REL), responsiveness (RES), ease of use (EOU), privacy (PRI), system availability (SA), application design (WD), and information quality (IQ) do not have a significant relationship to user perceptions of the quality of the PeduliLindungi (ESQ) application. Suggestions that can be given are to improve and improve the system and technical functions and improve security for user data

Risk factors and trends analysis of unwanted pregnancy in Indonesia

Unwanted pregnancy has serious and adverse health, social, and economic impacts, as well as the risk of maternal and child mortality. In Indonesia, unwanted pregnancy is one of the most troubling public health problems and a major reproductive health problem. The sample consisted of 2002 (12,612), 2007 (14,471), 2012 (14,212), and 2017 (8,838), so the total sample was 50,233 couples of childbearing age by random sample method. This study was analyzed using logistic regression analysis. Unintended pregnancies were associated with maternal age, age at first marriage, number of children, maternal education, contraceptive use, contraceptive failure, residence, and the interval between pregnancies. Unwanted pregnancies at the mother's vulnerable age have increased over the past 10 years and decreased after entering the last 5 years, tend to be stable and constant at the age of first marriage. About one and a half women in Indonesia encounter unwanted pregnancies. Unwanted pregnancies fluctuate over 20 years. Women, especially the most vulnerable should be empowered to avoid unwanted pregnancies for their awareness and independence. Programs to expand access and quality of information and counseling centers, access and quality of women's health services, and specific reproductive health services as needed

Socio-Economics of Childhood Pulmonary Tuberculosis with Adult Tuberculosis Household Contacts in Daerah Istimewa Yogyakarta Province

Background: Since the tuberculosis (TB) disease in children constitutes a global health problem that has long been neglected, this study sought to predict socioeconomic factors as public-health determinants that could protect children who were exposed to TB in their household. Method: A case-control study of 132 children (under 14 years old) who shared their household with adults suffering from pulmonary TB was conducted in the Province of Daerah Istimewa Yogyakarta. This study consisted of an interview and anthropometry measurement for the controls screening test, while the cases were monitored by pediatricians with a scoring system childhood TB diagnosis from the secondary hospital database. A multiple logistic regression was used to analyze the results. Results: A healthy housing condition, predicted by a naturally illuminated luminary bedroom prevented the incidence of the childhood TB disease (p = 0.043) even if exposed to adult TB in their environment (p = 0.775). Conclusions: Healthy housing factors with good sunlight protected children especially at the early stage, when there were active pulmonary TB adult household contacts. Ventilation and morning sunlight facilitated air circulation, vitality and the body’s immune system towards TB protection

Analisis Implementasi Integrasi Layanan PPIA HIV ke Layanan Antenatal di Kota Depok 2017

Pencegahan penularan HIV dari ibu ke anak (PPIA) pada ibu hamil merupakan kegiatan essensial  pada layanan antenatal, sehingga adanya integrasi akan lebih efektif untuk meningkatkan jangkauan ibu hamil melakukan skrining HIV yang bertujuan mencegah penularan secara vertikal dari ibu ke anak. Analisis Implementasi ditujukan untuk melihat pelaksanaan skrining HIV pada ibu hamil terintegrasi dalam layanan antenatal terpadu di Kota Depok 2017. Metode pada penelitian ini adalah kualitatif dengan teknik pegambilan data WM, FGD dan telaah dokumen.Hasil dari penelitian didapatkan aspek komunikasi berupa sosialisasi pedoman pelaksanaan kebijakan belum optimal terutama untuk layanan swasta. Dari sisi dana tidak dilakukannya  alokasi  anggaran spesifik program PPIA mempengaruhi implementasi, kewenangan petugas pelaksana sudah optimal,  belum tersedianya struktur birokrasi yaitu SOP dan fragmentasi untuk layanan terintegrasi, lingkungan sosial berupa dukungan masyarakat, layanan kesehatan swasta yang belum optimal dan masih adanya stigma negatif. Kesimpulan didapatkan bahwa implementasi integrasi layanan PPIA ke layanan antenatal belum optimal hal ini didukung konseling pra-tes dan pasca tes belum efektif, cakupan skrining HIV bumil masih rendah, mekanisme rujukan yang belum berjalan dengan baik dan proses pencatatan dan pelaporan serta monitoring evaluasi yang belum terintegrasi. Direkomendasikan melakukan pemetaan kegiatan yang  sudah dilakukan, membuat regulasi dan roadmap perencanaan kegiatan yang bertujuan untuk perluasan layanan dan dapat menggandeng sektor swasta.  Prevention of HIV transmission from mother to child (PMTCT) in pregnant women is an activity on antenatal services, the existence of integration would be more effective to increase coverage of pregnant women do HIV screening aimed at preventing contagion vertically from mother to child. Analysis of Implementation aimed to see the implementation of HIV screening of pregnant women integrated to antenatal care in Depok, 2017. Method is qualitative data develop techniques with WM, FGD and review documents. The result is socialization program policies especially for private service not optimal. A special budget allocation of PMTCT has not been made thus affecting the implementation, the Authority managing officers are already optimally, bureaucratic structure which consists of SOP and fragmentation of policy not available, the social environment in the form of community support, private health services that has not been optimized and still the existence of negative stigma. The conclusions obtained that the implementation of the Integration PMTCT to antenatal care has not been optimal this is supported counselling pre-test and post test has not been effective, HIV screening coverage bumil is still low, the referral mechanism has not been going well and the process of recording and reporting as well as monitoring evaluations that have not been integrated. Recommended doing mapping activities already done, making regulation and roadmap planning activities aimed at the expansion of the services and may be working with the private sector

Analysis of Leadership Flexibility Capability of District/City Public Health Department in North Sumatra

Leadership has an important role in the organization as leader is in charge of supervising and controlling the course of an organization. Ability to lead in mobilizing and empowering employees will affect the performance of the organization. This behavior has a significant impact on the attitudes, behavior and performance of employees. The results of the study showed there is a significant relationship between characteristics such as age (p = 0.004), education(p = 0.034), work experience (p = 0.000), the experience of the organization (p = 0.000), and educational hierarchy (p =0.000) for leadership flexibility. Sex variable is not significant to the leadership flexibility (p = 0.801). There is a relationship with the flexibility of directive leadership style (p = 0.027), supportive leadership style (p = 0.046), and participative leadership style (p = 0.009) with the flexibility of leadership. There is aso a relationship between achievement-oriented leadership style and leadership flexibility (p = 0.000). There is a relationship between the individual characteristics of leadership style and versatility with variable: educational level of leadership (p = 0.021; OR = 19.265). The result suggests that we need more organized seminars / work shop / scientific studies that stimulate the realization of learning about leadership flexibility in improving the performance of the District/City Health Office and it is necessary to study theperformance of the head of the Department of Health assessment intensively and periodicall