The Context of Policy Implementation Jamkesda in Framework National Universal Health Coverage

Background: Implementation of the National Social Security System with the National Health Insurance began to be implemented in January 2014 for ensure health of the entire society gradually, known as the Universal Health Coverage. On the other side, some local governments still maintain their own organized the Regional Health Security (Jamkesda). Thus the question arises, how to position the organization of this Jamkesda if the government has committed to ensure the entire population? Therefore, it is necessary to study how the context of implementation Jamkesda in the framework universal health. Method: This paper used a study literature from various sources related to policies of the Jamkesda and the National Health Insurance. Analysis of policy which has done in context of the implementation Jamkesda from the legal aspects, situational and structural. Results: Implementation Jamkesda basically not violate the policy context of National Social Security System Law. The Law No. 32 of 2004 became the basis for local governments to develop Jamkesda as a form of responsibility in carrying out development in the field of health. From the situational aspect, condition coverage JKN participants who have not reach the entire population became reinforcement and encouragement local government to maintain Jamkesda with consideration to serve people who do not guaranteed to Universal Health Coverage achieved in 2019. From the structural aspect, need to adjust the type of service Jamkesda at JKN already include universal population. The local governments can add services benefit in the form of complementary and or supplementary so there is no duplication. Conclusion: The context of Jamkesda policy implementation still need to be implemented in framework of national health insurance based on consideration of the legal aspects, situational and structural. It\u27s recommended to local governments for considering of integration the Jamkesda into JKN, so that implementation can be more sustainable and consistent with national programme

Development and Empowerment of Health Human Resources the Important Aspect in Decentralization

Since the decentralization applied in Indonesia, the district has flexibility to organize aspects of government that includes several sectors, including the health sector. One aspect need to examine carefully the impact of decentralization in the health sector is in the management of Human Resources. This paper highlights some aspects of change in health human resources in the decentralization, used literature study. Improving the quality of service will be related also to increase the quality of human resources as the health service providers. Improving the quality of human resources must be done starting from the preparation stage until utilization. Development and empowerment of human resource in decentralization includes three main elements, including planning, procurement and utilization of health human resources. Decentralization cause positive changes in human resource management functions in a organizations at the provincial and district. Hopefully with this can be input in the service in health institutions and can be used as information in support of policies on human resources development to improve services to patients

Outpatient Care Utilization among Elderly in South Sumatra Based on National Social-Economic Survey Data

Implementation of National Health Insurance is thought to be the cause ofincreasing number of visits to health facilities, especially in elderly peoplewho tend to be in sick. This study aims to analyze the outpatient utilizationby elderly in South Sumatera region. Study design was cross-sectional.Samples was elderly in South Sumatra (n = 2,833 people). Study done on2016, using data from Survei Sosial Ekonomi Nasional (Susenas) at 2015. Dataanalysis used chi-square test and multiple logistic regression. Based on thestudy known that outpatient utilization of elderly in all health facilitiesduring the past month amounted to 29.2%. Providers selected when elderlyneeded of outpatient treatment, most often visited to the doctor'spractice/midwife's practice (46.2%), and puskesmas (24.2%). Elderly whohas private health insurance have a tendency was 1.9 times greater (OR=1.9)to utilize outpatient compared to elderly who do not have insurance. Itsconcluded that variables associated with outpatient care utilization are:health insurance membership (OR=1.9) and work activity (OR=1.5). It isrecommended for elderly to remain active in their activities so that they canrealize the healthy and active aging and reduce the sick visits to healthfacilities

ANALISIS KEBIJAKAN PEMERINTAH DAERAH DALAM PENGEMBANGAN ‘JAMINAN SOSIAL KESEHATAN SUMATERA SELATAN SEMESTA’ MENYAMBUT UNIVERSAL HEALTH COVERAGE

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, Efficienc

Aspek Penting Akreditasi Puskesmas dalam Mendukung Implementasi Jaminan Kesehatan Nasional

Abstrak Puskesmas memegang peran yang sangat penting dalam penyelenggaraan pelayanan kesehatan di Indonesia. Puskesmas dituntut untuk dapat menjamin perbaikan mutu, peningkatan kinerja dan penerapan manajemen risiko yang dilaksanakan secara berkesinambungan, sehingga perlu dilakukan penilaian melalui mekanisme akreditasi. Tujuan penulisan makalah ini adalah untuk mengkaji aspek penting penyelenggaraan akreditasi Puskesmas dalam mendukung implementasi Jaminan Kesehatan Nasional (JKN). Makalah ini merupakan studi kebijakan menggunakan literature review. Informasi diambil dari berbagai sumber terdiri dari kebijakan, pedoman dan hasil penelitian terkait akreditasi Puskesmas. Berdasarkan kajian diketahui bahwa Puskesmas wajib untuk diakreditasi secara berkala paling sedikit tiga tahun sekali, sebagai salah satu syarat fasilitas kesehatan tingkat pertama di JKN. Akreditasi dilakukan melalui tahap survei akreditasi dan penetapan akreditasi. Puskemas melakukan persiapan sebelumnya antara lain menyiapkan dokumen eksternal dan internal, termasuk melakukan studi banding untuk persiapan akreditasi. Persiapan lainnya adalah melakukan pendampingan dan Self Assessment. Pelaksanaan akreditasi di Puskesmas merupakan aspek penting dalam mendukung implementasi JKN sekaligus merupakan upaya meningkatkan kualitas layanan Puskesmas. Rekomendasi bagi Puskesmas untuk dapat melakukan persiapan secara konprehensif sebelum menyelenggarakan penilaian akreditasi. Pelayanan kesehatan yang dilakukan sesuai arah panduan akreditasi secara konsisten dan berkelanjutan, pada akhirnya dapat meningkatkan kualitas pelayanan dan kepuasan pasien secara berkesinambungan. Kata Kunci: Akreditasi, Kredensialing, Mutu, Puskesmas. Abstract Puskesmas have an important role in the implementation of health services in Indonesia. Puskesmas are required to guarantee the quality improvement, performance improvement and implementation of risk management are carried out sustainably, so it needs to be assessed through accreditation mechanism. The purpose of this paper is to review the important aspects of the implementation of Puskesmas accreditation in supporting the implementation of the National Health Insurance (JKN). This is a policy study using literature review. Information taken from various sources consists of policies, guidelines and research results related to Puskesmas accreditation. Based on this study known that Puskesmas are obliged to be accredited periodically at least every three years, requirements as First Level Health Facilities. Accreditation done through several stages such as accreditation survey and accreditation decision. Previously Puskemas do the preparation consist of preparing external and internal documents, including conducting comparative studies for preparation of accreditation. Other preparation are accompaniment and Self Assessment. Implementation of accreditation in Puskesmas are an important aspect in supporting the implementation of JKN as well as an effort to improve the services quality of Puskesmas. Recommendation for Puskesmas to do preparation comprehensively before implementation accreditation assessment. Health services that implementation based on the accreditation guidelines consistently and continuously, finally can improve the quality of service and patient satisfaction on sustainably. Keywords: neonatal, emergency, hospital, referal syste

ANALISA HUBUNGAN PENGARUH KOMPENSASI DAN MOTIVASI TENAGA KEPERAWATAN TERHADAP KINERJA PERAWAT DI RUMAH SAKIT UMUM DAERAH SUNGAI LILIN

Tujuan: Mengetahui hubungan faktor kompensasi dan motivasi tenaga keperawatan terhadap kinerja perawat di Rumah Sakit Umum Daerah Sungai Lilin.Metode: Metode penelitian menggunakan desain crossectional dengan sampel sebanyak 43 reponden yang merupakan perawat di RSUD Sungai Lilin. Data yang terkumpul dianalisis menggunakan uji chi-square.Hasil: Hasil penelitan diperoleh terdapat hubungan yang signifikan antara kompensasi dengan kinerja perawat (p-value = 0,028) dan terdapat hubungan yang signifikan antara motivasi dengan kinerja perawat (pvalue = 0,007). Kompensasi dan motivasi diperkirakan menjadi risiko terjadinya kinerja yang kurang baik pada perawat di RSUD Sungai lilin, berdasarkan hasil analisis diperoleh prevalence ratio sebesar 1,522 (95% CI: 1,041-2,224) artinya ketika seorang perawat mendapatkan kompensasi yang rendah makan berisiko 1,533kali untuk memiliki kinerja yang kurang baik, sedangkan untuk motivasi diperoleh prevalence ratio sebesar 1,744 (95% CI: 1,099-2,767), artinya ketika perawat mempunyai motivasi kerja yang rendah maka berisiko 1,744 kali untuk mempunyai kinerja yang kurang baik.Simpulan: Kinerja yang baik dapat membantu perawat untuk mencapai tujuan dengan lebih baik, sehingga adanya kompensasi yang tinggi dan motivasi yang tinggi diharapkan dapat meningkatkan kinerja perawat RSUD Sungai Lilin.Kata kunci: Kinerja, Kompensasi, Motivas

Analisis Implementasi Kebijakan Vaksinasi Covid-19 pada Ibu Hamil dan Lansia di Kabupaten Batanghari

Risiko komplikasi akibat COVID-19 lebih tinggi pada kelompok masyarakat rentan, seperti lansia dan ibu hamil. Pemutusan rangkaian penularan dan perlindungan terhadap masyarakat dari penularan COVID-19 dapat dilakukan dengan pembentukan herd immunity melalui vaksinasi. Distribusi vaksin tidak merata di seluruh dunia, termasuk Indonesia mengakibatkan keterlambatan vaksinasi dan menyebabkan muncul varian baru. Tujuan penelitian ini untuk menganalisis implementasi kebijakan vaksinasi COVID-19 pada ibu hamil dan lansia di Kabupaten Batanghari. Metode penelitian yang digunakan kualitatif dengan studi kasus dan analisis tematik yaitu Braun & Clarke. Penelitian ini sebanyak 17 informan yaitu Kepala Dinas Kesehatan, Kepala Puskesmas, Vaksinator, Ibu Hamil, dan Lansia. Lokasi penelitian di Puskesmas Penerokan, Puskesmas Sungai Rengas, Puskesmas Kuranji dan Puskesmas Batin. Waktu penelitian Maret-Mei 2022. Hasil penelitian ditemukan lima tema yaitu komunikasi, sumber daya, disposisi, struktur birokrasi, dan dukungan masyarakat. Peran komunikasi terdapat tiga yaitu transmisi, kejelasan dan konsistensi, dari faktor transmisi terdapat subtema yaitu koordinasi antara Dinas Kesehatan dengan Puskesmas sudah efektif. Peran disposisi dijalani secara konsisten. Peran struktur birokrasi yaitu adanya Standar Operating Prosedures Permenkes RI. Peran dukungan masyarakat yaitu sebagian masyarakat mendukung adanya vaksinasi Covid-19, namun masih ada masyarakat yang tidak bersedia di vaksin. Diharapkan staf Puskesmas menyadari akan pentingnya screening sebelum melakukan vaksin kepada pasien dan menambah sumber daya yang dapat digunakan untuk mendukung keberhasilan implementasi kebijakan program vaksinasi Covid-19 pada ibu hamil dan lansia