Sustainability Capacity of HIV/AIDS Programmes in YOGYAKARTA, Indonesia

The Indonesian government established the prevalence target of HIV <0.50% in 2019 to control the spreading of HIV through the National Medium Term Development Plan. To ensure the sustainability of this development plan, a study of the strategic capacity of HIV/AIDS programmes is needed to provide an overview so that the program can be sustained over time. This study aimed to explore the sustainability capacity of HIV/AIDS programmes in Yogyakarta. This was a descriptive study utilizing a qualitative approach. The study involved 42 participants as key informants selected by a purposive sampling technique, and the data were examined using content analysis. By setting priorities of the local government supported by the Provincial Health Office and with the coordination of the Yogyakarta Province AIDS Commission, the programs are able to maintain sustainable HIV and AIDS programmes in Yogyakarta. Funding capacity, evaluation, programme adaptation and communication have not been optimal to ensure the sustainability. Stability of funding is the main obstacle to achieving the sustainability of HIV and AIDS programs. However, with good planning, partnership structure and sufficient organizational capacity, this approach can ensure the HIV and AIDS programmes will continue with the targets set by the Yogyakarta Provincial Health Office. The government in Yogyakarta needs to increase funding capacity, and improve communication to ensure sustainability. The strategy should include adaptation and evaluation of programs through strengthening private sector financing, formulating a communication plan and improving the capacity to respond to change

Sustainability Capacity of HIV/AIDS Programmes in Yogyakarta, Indonesia

The Indonesian government established the prevalence target of HIV <0.50% in 2019 to control the spreading of HIV through the National Medium Term Development Plan. To ensure the sustainability of this development plan, a study of the strategic capacity of HIV/AIDS programmes is needed to provide an overview so that the program can be sustained over time. This study aimed to explore the sustainability capacity of HIV/AIDS programmes in Yogyakarta. This was a descriptive study utilizing a qualitative approach. The study involved 42 participants as key informants selected by a purposive sampling technique, and the data were examined using content analysis. By setting priorities of the local government supported by the Provincial Health Office and with the coordination of the Yogyakarta Province AIDS Commission, the programs are able to maintain sustainable HIV and AIDS programmes in Yogyakarta. Funding capacity, evaluation, programme adaptation and communication have not been optimal to ensure the sustainability. Stability of funding is the main obstacle to achieving the sustainability of HIV and AIDS programs. However, with good planning, partnership structure and sufficient organizational capacity, this approach can ensure the HIV and AIDS programmes will continue with the targets set by the Yogyakarta Provincial Health Office. The government in Yogyakarta needs to increase funding capacity, and improve communication to ensure sustainability. The strategy should include adaptation and evaluation of programs through strengthening private sector financing, formulating a communication plan and improving the capacity to respond to change

Acceptability Notifikasi Wajib Tuberkulosis (TB) pada Dokter Praktik Mandiri dan Klinik Pratama Swasta di Kota Yogyakarta

Latar Belakang: Diperkirakan 68% kasus Tuberkulosis (TB) di Indonesia tidak dilaporkan atau tidak terdeteksi. TB merupakan penyakit yang harus dinotifikasi sejak dikeluarkannya Peraturan Menteri KesehatanNomor 67 Tahun 2016 tentang Penanggulangan Tuberkulosis. Berkaitan dengan notifikasi wajib kasus TB, dokter praktek mandiri dan klinik pratama swasta akan diwajibkan melaporkan kasus TB ke Puskesmas setempat. Pelibatan praktisi swasta memiliki dampak penting terhadap perbaikan program penemuan dan pengobatan TB dan pencegahan meluasnya kasus TB resisten obat. Kota Yogyakarta memiliki beban TB terbesar di DIY dan kepadatan penduduk yang tinggi dengan jumlah  praktisi swasta yang cukup besar. Belum terdapat penelitian yang menggali acceptability kebijakan notifikasi wajib TB pada dokter praktik mandiri dan klinik pratama swasta di Kota Yogyakarta.Tujuan: Mendeskripsikan acceptability kebijakan notifikasi wajib TB pada dokter praktik mandiri dan klinik pratama swasta di Kota Yogyakarta.Metode: Penelitian ini menggunakan rancangan kualitatif dengan metode deskriptif. Gambaran acceptability yang digunakan adalah acceptability prospektif dengan menggunakan kerangka Theorical Framework of Accceptability (TFA). Subjek penelitian adalah dokter praktik mandiri dan dokter klinik pratama swasta, beserta pimpinan klinik pratama swasta di Kota Yogyakarta, pemegang program TB Dinas Kesehatan Provinsi DIY dan Kota Yogyakarta, pemegang program TB Puskesmas, serta organisasi profesi (IDI). Metode pengumpulan data yang akan dilakukan adalah wawancara mendalam.Hasil: Gambaran acceptability (prospektif) kebijakan Notifikasi Wajib TB pada dokter praktik mandiri dan klinik pratama di Kota Yogyakarta dideskripsikan dalam sikap afektif, beban, etisitas, dan koherensi intervensi.Kesimpulan: Pendekatan awal yang tepat, pengenalan sikap afektif dan komunikasi berkelanjutan akan memperingan beban dan mengatasi masalah etisitas tentang notifikasi wajib TB. Selain itu pemahaman awal yang baik ditambah pemahaman lanjut yang komprehensif dan penguatan kapasitas menjadi modal penting bagi koherensi intervesi dalam acceptability notifikasi wajib TB pada praktisi swasta

Perspektif Stakeholder Terhadap Sustainability Program TB di Kota Semarang

ABSTRAK Latar Belakang: Missing case TB di Indonesia tahun 2017 mencapai 36%. Case Notification Rate (CNR) Kota Semarang ditahun 2017 mengalami kenaikan pesat sebesar 328 per 100.000 penduduk dengan Success Rate (SR) sebesar 80,38%, masih dibawah target nasional. Dukungan pendanaan terbesar pembiayaan program TB Kota Semarang tahun 2017 dari donor sebesar 71% sedangkan APBD hanya mencapai 29%.  Strategi penanggulangan TB di Kota Semarang mengacu pada RAD untuk kesinambungan Program TB. Ancaman sustainability Program TB terkait stabilitas pendanaan yaitu akan berakhirnya dana donor serta belum pernah dilakukanya monev RAD. Hal ini yang melatarbelakangi pentingnya mengetahui perspektif stakeholder terhadap sustainability Program TB di Kota Semarang.Tujuan: Penelitian ini bertujuan untuk mengeksplorasi perspektif stakeholder terhadap kapasitas sustainability terkait dengan stabilitas pendanaan dan strategi pembiayaan Program TB di Kota Semarang.Metode Penelitian: Penelitian ini merupakan jenis penelitian deskriptif dengan menggunakan rancangan pendekatan kualitatif. Penelitian menggunakan purposive sampling dengan subjek penelitian berjumlah 21 orang. Pengumpulan data dilakukan dengan wawancara mendalam dan analisis data dilakukan dengan content analysis.Hasil Penelitian: Temuan ini mengungkap stabilitas pendanaan untuk keberlanjutan program telah terlihat dari peningkatan alokasi APBD dan sebaran alokasi pendanaan ditingkat kecamatan. Pandangan negatif terkait belum konsistensi RKA dinkes dengan RAD TB dan adanya gap antara kebutuhan Program TB dengan ketersedian anggaran. Pandangan optimis kesinambungan pendanaan sebagai program prioritas, sedangkan pesimis disebabkan ketergantungan pada donor tinggi dan belum dilakukan monev pelaksanaan RAD TB. Strategi pengumpulan dana lebih focus pada sumber pendanaan pemerintah sedangkan strategi penganggaran dengan melakukan advokasi menjadi program prioritas dan penerbitan Perda TB.  Kesimpulan: Penelitian ini menunjukan stakeholder optimis telah terbentuk stabilitas pendanaaan meskipun tanpa dasar pelaksanaan fungsi monev. Strategi pengumpulan dana dengan mengoptimalkan APBD, memanfaatkan BOK dan integrasi ke sistem JKN. Strategi penganggaran memerlukan advokasi, penyusunan perencanaan efektif dan efisensi serta penguatan regulasi melalui Perda TB. Kata Kunci: Perspektif Stakeholder;Stabilitas Pendanaan; Sustainability; Program TB

KUALITAS LAYANAN TUBERKULOSIS MENURUT SUDUT PANDANG PASIEN DI RUMAH SAKIT PEMERINTAH DAN SWASTA DI JAKARTA UTARA

Background: Patient’s perspective on the quality Tuberculosis(TB) care has received more attentions nowadays. While DOTSstrategy has been expanded in Indonesian public and privatehospitals since 2000, the quality evaluation from the patients’perspective is lacking.Objectives: To measure the quality of TB service from thepatient perspective in public and private hospitals in NorthJakarta.Method: This was a cross-sectional study design in twohospitals. The sample of patients in public and private hospitalswere 156 and 68 respectively. Data were collected usingQuality of Care as seen through the Eyes of the Patient (QUOTETB)instrument and analyzed desciptively.Result:In both hospitals, seven aspects should be improved(i.e. waiting time, safe drinking water, cost for services,transport support, food aid,TB-HIV and HIV prevention) .Patients in the public hospital perceived discrimination ofservices. Moreover six aspects of service should be improvedin private hospital (i.e. consistency of service, opening hours,TB service availability, additional charges, TB-HIV as well asHIV testing and treatment).Conclusion: Quality improvements for TB service in hospitalare needed. Hospitals should provide better facilities andenvironment, conduct cost analysis, improve TB-HIV service,adhere to the TB service procedure and improve providerpatientrelationship.Keywords: tuberculosis, patient perspective, quali ty ofservice, QUOTE-T

Analysis of Policy Implementation of Minimum Service Standards in the Field of Health Indicators of Health Services for People with Diabetes Mellitus in Magelang Regency

In order to overcome diabetes, the government set some laws and regulations. One of them is Government Regulation Number 2 of 2018 concerning minimum service standards. SPM for Health is regulated in Permenkes number 4 of 2019. District / City Health SPM consists of 12 indicators. One of the indicators is health care in patients with diabetes mellitus according to the standard. Magelang regency is the third lowest Regency in 2020 with achievements of only 41.9 percent and 59.75 percent in 2021. Necessary analysis related factors inhibiting and supporting implementation. This study was conducted by the method of Qualitative content analysis. Using in-depth interview techniques, field observation and secondary data retrieval.The results of the study there are variations between the achievement of SPM Puskesmas. factors inhibiting the achievement of SPM in the field of health indicators of health services in patients with diabetes mellitus in Magelang regency is the lack of availability of budget, infrastructure and Human Resources, community characteristics and lack of understanding and knowledge both from the organizers and users. Supporting factors for the achievement of SPM in the field of health indicators of health services for people with diabetes mellitus in Magelang regency are leadership support and the chosen policy strategy

Public Acceptance on Hypnotheraphy as a Complementary Alternative Health Service

Despite the pros and cons, the practice of hypnotherapy is growing in Indonesia. How are the hypnotherapy clients aware about hypnotherapy? Is the process of acceptance in line with the pattern of adoption of the innovation? Theoretically, there are five stages of the process of adoption of an innovation: awareness, interest, evaluation, first-trial, and confirmation. This study was conducted in four major cities in Java. A sequential-explanatory mixed method was applied. There were two stages for this method, quantitative survey and then followed by qualitative study. The conclusion suggested that the acceptance of hypnotherapy by clients depended on its effectiveness in helping them to cope with their problems. The finding also corroborated and slightly added to the five-stages theory of the process of innovation adoption. The most effective communication channel in the process of adopting hypnotherapy was face-to-face and interpersonal, with the hypnotherapy clients as diffusion agents. The most important message in the context of developing the hypnotherapist profession was that hypnotherapy is an evidence-based professional service

KEBIJAKAN DAN IMPLEMENTASI BANTUAN LUAR NEGERI AUSAID DI TIMOR LESTE: EVALUASI TERHADAP PROYEK DUKUNGAN RENCANA STRATEGIK SEKTOR KESEHATAN

Background: The Ministry of Health of Timor-Leste has realizedthat they should work together with other stakeholders toachieve their vision and mission due to insufficient humanresources and budget. Therefore, the Ministry of Health hasestablished collaboration with AusAid and other developmentpartners through mechanism of coordination. However, themechanism is not yet implemented fully.Objective: To evaluate foreign aid policy in coordinating AusAiddonor and development partners to fund human resource developmentprogram (in the HSSP-SP project) through the mechanismof coordination in the Ministry of Health of Timor-Leste.Method: This was a qualitative study with a case-study design.The respondents were 16 people, consisting of 13 personsfrom the Ministry of Health and 3 persons from AusAid,World Bank and development partners.Result and Discussion: The Department of Partnership Managementhad not been optimum in managing and controlling theproject/program and activities of the donors and working partners.The approved action plan and budget were relevantwith the proposal made by the Ministry of Health but planningfor human resource development was unclear and was notbased on the work force gap faced and priority in humanresource development. The project had impact on human resourcedevelopment but the process of staff re-placementwas not in line with the principle of the right man on the rightplace. Regular consultative meeting could facilitate the approvalof action plan and budget for human resource development.However, the mechanism of coordination was less effectivebecause there was no specific instrument or mechanismto do alignment and harmonization and it only focused oncollective gain and there was too much pressure and demandto staff from both the Ministry of Health and partners. Constraintsand challenges from political aspect and human resourcecapacity had hampered the process of coordinatingAusAid and working partners.Conclusion: The implementation of foreign aid policy to coordinateAusAid and development partners to fund human resourcedevelopment (in HSSP-SP project) following the mechanismof coordination in the Ministry of Health of Timor-Lestehad run well enough but still received lack of support fromhuman resource development planning based on institutionaldevelopment.Keywords: policy evaluation, mechanism of coordination,human resource development, donor agenc

Determinan penggunaan kelambu berinsektisida di Bengkulu: analisis riskesdas

Determinant factors affecting the use of insecticide-treated nets in Bengkulu: analysis from basic health survey 2013PurposeThis study aimed to identify determinant factors that influence the use of insecticide-treated nets and to evaluate the effectivity of the mosquito nets usage, in pregnant women and young children in Bengkulu, based on  basic health survey 2013.MethodThis study used a cross-sectional design. Study population were all members of households in Bengkulu that used insecticide-treated nets, based on basic health survey 2013.ResultsThere were no significant correlations between employment status, education, vulnerable children, use of community health center, housing, and use of wire gauze with insecticide-treated nets. Multivariate logistic regression tests showed that there were some socio-demographic variables, behavior, and environment that affected mosquito net usage.ConclusionSocial determinants of demographic factors, behavioral determinant factors, environmental determinant factors, and presence of children affected the use of insecticide-treated nets, but the use of mosquito nets was not effective against vulnerable groups (pregnant women).Tujuan: Penelitian ini mengidentifikasi faktor yang mempengaruhi penggunaan kelambu berinsektisida terutama bagi ibu hamil dan balita di Bengkulu.Metode: Penelitian berbasis data sekunder riskesdas tahun 2013.Hasil: Status pekerjaan, pendidikan, balita, pemanfaatan puskesmas, tempat tinggal, penggunaan kawat kassa berhubungan dengan penggunaan kelambu berinsektisida. Sosial demografi, perilaku dan lingkungan adalah faktor-faktor dominan yang berpengaruh.Kesimpulan: Ada pengaruh sosial demografi, faktor perilaku dan lingkungan terhadap penggunaan kelambu berinsektisida, namun tidak efektif bagi ibu hamil

Faktor yang berhubungan dengan non-konversi BTA positif pada pengobatan tuberkulosis paru di kota Semarang

Tujuan: Penelitian untuk mengidentifikasi faktor yang berhubungan dengan tidak terkonversinya BTA positif pada pengobatan kasus baru.Metode: Penelitian case control melibatkan 128 kasus dan 128 kontrol. Analisa data dengan uji chi square dan regresi logistik.Hasil: Terdapat lima faktor yang signifikan yaitu umur (p=0.023; 95% CI 1.055-4.464; OR=2.143), jenis kelamin (p=0.003; 95% CI 1.269-3.696; OR=2.164), efek samping obat (p=0.031; 95% CI 0.953-45.959), penyakit penyerta (p=0.001; 95% CI 1.598-9.306; OR=3.702) dan gradasi hasil BTA (p=0.000; 95% CI 2.663-9.862; OR=5.063). Gradasi hasil BTA yang terkuat berhubungan setelah dikontrol jenis kelamin dan penyakit penyerta (p=0.000; OR=5.922; 95% CI:3.074-11.410).Kesimpulan: Faktor yang berhubungan adalah umur, jenis kelamin, efek samping obat, penyakit penyerta dan gradasi hasil BTA. Ada tiga faktor yang terbukti secara bersama-sama mempengaruhi adalah gradasi hasil BTA, penyakit penyerta dan jenis kelamin.Factors related to non-conversion smear positive among patients with pulmonary tuberculosis in the city of SemarangPurposeThe purpose of this study was to identify factors related to non-conversion of smear positive in treatment of new tuberculosis cases. MethodsThis study used a case control design and sampling by proportional random sampling technique. Samples were patients with smear grade positive pulmonary tuberculosis who were new cases of intensive phase of treatment and have repeated sputum examination. The numbers of samples in this research were 128 sample cases and 128 controls. ResultsThe factors associated with the conversion of smear positive pulmonary tuberculosis treatment of new cases were age, sex, drug side effects, comorbidities and gradation smear results. The three variables that proved to jointly influence the incidence of smear positive conversion in the treatment of new cases of pulmonary tuberculosis were sputum smear results gradation, comorbidities and gender. ConclusionIt is necessary to design an appropriate drug taking supervisor for patients with positive smear positive results with +2 and +3 gradations and patients with comorbidities (HIV, hepatitis, diabetes mellitus)