Proses Perencanaan dan Penganggaran Anggaran Pendapatan dan Belanja Daerah: Studi Konsistensi Proses Perencanaan dan Penganggaran Pemerintah Kota Pangkalpinang Tahun Anggaran 2018-2022

The consistency between planning and budgeting is important because it is a marker for local governments in assessing the performance of all government programs and activities, whether they are running well and according to the goals set. The difference in consistency in the Pangkalpinang City Government occurs from year to year. Still, there is a commitment from the Regional Head to build consistency between planning and budgeting to realize community welfare. This research has a purpose: to find out and analyze how the consistency between planning and budgeting in the 2018 to 2020 fiscal year is through an analysis of the planning process and the budgeting process to see what factors support this consistency. The research method used uses a qualitative approach and analysis through the Interactive Model of Miles and Huberman. The results obtained from the research are planning and budgeting process in the Pangkalpinang City Government is still not consistent. The research locus is at the Regional Development Planning and Research Agency of the Pangkalpinang City, Regional Finance Agency of Pangkalpinang City, and Regional House of Representatives Budget Agency of Pangkalpinang City. Each year, the consistency that occurs is different in the Regional Government Work Plan (Rencana Kerja Pemerintah Daerah or RKPD). The highest consistency is found at the end of the Regional Medium-Term Development Plan (Rencana Pembangunan Jangka Menengah Daerah or RPJMD), which in this research falls on the 2018 Regional Government Work Plan (RKPD).Konsistensi yang terjadi antara perencanaan dan penganggaran menjadi hal yang penting untuk diperhatikan karena menjadi penanda bagi pemerintah daerah dalam menilai kinerja seluruh program dan kegiatan pemerintah, apakah berjalan dengan baik dan sesuai dengan tujuan yang telah ditetapkan. Perbedaan konsistensi di Pemerintah Kota Pangkalpinang terjadi dari tahun ke tahun. Namun tetap ada komitmen dari Kepala Daerah untuk membangun konsistensi antara perencanaan dan penganggaran untuk mewujudkan kesejahteraan masyarakat. Penelitian ini memiliki tujuan: untuk mengetahui dan menganalisis bagaimana konsistensi antara perencanaan dan penganggaran pada tahun anggaran 2018 hingga 2020 melalui analisis proses perencanaan dan proses penganggaran untuk melihat faktor-faktor apa saja yang mendukung konsistensi tersebut. Metode penelitian yang digunakan menggunakan pendekatan kualitatif dan analisis melalui Model Interaktif Miles dan Huberman. Hasil yang diperoleh dari penelitian adalah proses  dan penganggaran di Pemerintah Kota Pangkalpinang masih belum konsisten. Lokus penelitian berada di Badan Perencanaan Pembangunan dan Penelitian Pengembangan Daerah Kota Pangkalpinang, Badan Keuangan Daerah Kota Pangkalpinang dan Badan Anggaran DPRD Kota Pangkalpinang. Konsistensi yang terjadi berbeda pada setiap tahun Rencana Kerja Pemerintah Daerah (RKPD). Konsistensi tertinggi terdapat pada bagian akhir Rencana Pembangunan Jangka Menengah Daerah (RPJMD) yang dalam penelitian ini jatuh pada Rencana Kerja Pemerintah Daerah (RKPD) tahun 2018

Socio-demographic factors associated with knowledge and uptake of family planning among women of reproductive age in a Rural Community of Abuja, Nigeria

Nigeria has a population of about 180 million, estimated to double in 22 years due to low uptake of family planning services. Low utilization of family planning is the major factor associated with high fertility pattern in Nigeria. This trend is higher among rural women in Northern Nigeria. Without a thorough understanding of, and due attention to the local context, utilization of family planning may continue to be low. Identification of correlates of family planning would be invaluable in designing strategies for ultimately improving uptake of family planning services. This study became relevant as no previous study on family planning has been carried out in Ushafa Community. The study was conducted at Ushafa community, a rural community, located in Bwari Area Council on the northern axis of the Federal Capital Territory (FCT) of Nigeria. The study was a descriptive cross-sectional study, conducted among women of reproductive age (15-49 years) who were permanent resident of Ushafa Community. Using proportion of contraceptive usage of 16% from a previous study, 240 women were recruited into the study by systematic sampling technique. Data was collected by means of a structured interviewer administered questionnaire, data was entered and analysed using statistical package for social sciences (SPSS) version 20. All tests were conducted using 2 tails while level of significance was set at 0.05. About a quarter of respondents (26.3%) knew that amenorrhoea could be a side effect of oral contraceptive pills, 51.1% knew that oral contraceptive pills must be taken daily, 58% were not using any form of family planning. Age (χ2 = 8.382, p = 0.01) and marital status (χ2 = 8.915, p = 0.01) were significantly associated with family planning knowledge. Level of education was significantly associated with current use of family planning (χ2 = 10.78, p = 0.03). Educational status was significantly associated with likelihood of using family planning in the future (χ2 = 8.64, p = 0.04). Although the respondents had fairly good knowledge of family planning, the study observed some misconceptions especially with respect to side effects and methodology of use of the commodities. Low uptake of family planning was observed among the respondents. Age and marital status were significantly associated with family planning knowledge; level of education was significantly associated with current use of family planning. There is need for incorporation of facts on usage and side effects of family planning in message disseminated by health workers in health facilities in Ushafa Community so as to correct misconceptions

Addressing cost and time barriers in chronic disease management through telemedicine: An exploratory research in select low-and middle-income countries

Despite evidence supporting telehealth provision in developed countries, there is limited evidence regarding its economic benefits for patients living in areas where access and cost present major barriers to health care, particularly in low- and middle-income countries (LMICs). This study explores the economic benefits of telemedicine for patients, in terms of cost and times savings, and its potential role in improving chronic disease outcomes. This retrospective cross-sectional study compared telemedicine services with hypothetical in-person consultations, with a focus on patient travel time and travel cost savings. A database containing teleconsultation visits (N = 25,182) conducted at health facilities in remote regions of Afghanistan, Pakistan, Tajikistan, and the Kyrgyz Republic, was analyzed. A two-sample homoscedastic t test was used to determine differences between the two groups. A one-way sensitivity analysis was also conducted, presuming in-person teleconsultations at 90%, 75%, and 50%. The study extracted data from 25,182 teleconsultation visits (12,814 males; 12,368 females). The cumulative patient savings through the program amounted to USD 9,175,132, and 1,876,146 h, or 213.1 years. A significant difference was seen between the two groups in terms of mean time savings (p-valu

Making fair choices on the path to universal health coverage: applying principles to difficult cases

Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC

Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting

Risk of severe SARS-CoV-2 infection in patients with autoimmune rheumatic diseases in Qatar: a cohort matched study

Background: It remains unclear whether patients with autoimmune rheumatic diseases (ARDs) are at a higher risk of poor outcomes from a SARS-CoV-2 infection. We evaluated whether patients with an ARDs infected with SARS-CoV-2 were at a higher risk of a poorer outcome than those without an ARDs. Methods: Patients with an ARDs infected with SARSCoV-2 were matched to control patients without a known ARDs. Matching was performed according to age (6 years) and sex at a case-to-control ratio of 1:3. Demographic and clinical data were extracted from the databases and were compared between the two groups. Severe SARS-CoV-2 infection was the primary outcome and was defined as the requirement for oxygen therapy support, the need for invasive or noninvasive mechanical ventilation, or the use of glucocorticoids. Results: A total of 141 patients with an ARDs were matched to 398 patients who formed the control group. The mean ages (SD) of the ARDs and nonARDs groups were 44.4 years (11.4) and 43.4 years (12.2). Women accounted for 58.8% of the ARDs group and 56.3% of the control group (p = 0.59). Demographics and comorbidities were balanced between the groups. ARDs included connective tissue disease in 43 (30.3%) patients, inflammatory arthritis in 92 (65.2%), and other ARDs in 8 (5.7%). ARDs medications included biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in 28 (15.6%) patients, conventional synthetic DMARDs in 95 (67.4%), and immunosuppressive antimetabolites in 13 (9.2%). The ARDs group had more respiratory and gastrointestinal symptoms related to SARS-CoV-2 infection than the control group (24.8% and 20.6% vs. 10% and 5.3%, respectively; p, 0.001 for both). Severe SARS-CoV2 infection was more common in the ARDs group than in the control group (14.9% vs. 5.8%; p, 0.001). Conclusions: In this single-center matched cohort study, patients with an ARDs experienced more respiratory and gastrointestinal symptoms related to SARS-CoV-2 infection and had more severe infection than those from the control group. Therefore, patients with an ARDs require close observation during the coronavirus disease 2019 pandemic

Health financing in Ghana

This study reviews Ghana's health financing system with a special emphasis on its National Health Insurance Scheme (NHIS). It suggests a number of options to reform the structural and operational features of Ghana’s NHIS to ensure its smooth transition to universal coverage and financial sustainability. Health financing reform options are developed in the context of Ghana’s health system configuration as well as its demographic, epidemiological, socioeconomic, labor-market, industrial-structure, political, and geographic realities. Findings show that for the NHIS to expand enrollment and become sustainable, more public resources will be needed

Proses Perencanaan Dan Penganggaran Penyusunan Anggaran Pendapatan Dan Belanja Daerah (Studi Tentang Konsistensi Antara Perencanaan Dan Penganggaran Dalam Penyusunan Anggaran Pendapatan Dan Belanja Daerah Di Pemerintah Kota Pangkalpinang Untuk Tahun Anggaran 2018-2020)

Perencanaan dan penganggaran pada Pemerintah Daerah merupakan suatu langkah yang berkesinambungan menuju keberhasilan suatu tujuan organisasi. Perencanaan yang baik akan membuat penganggaran menjadi lebih mudah dan terarah, diperlukan suatu konsistensi antara perencanaan dan penganggaran agar pelaksanaan pemerintahan dapat berjalan seiring sejalan, namun pada kenyataannya masih sering terjadi ketidakkonsistenan antara perencanaan dan penganggaran. Ketidakkonsistenan ini dapat terjadi baik antara RKPD dengan KUA PPAS atau KUA PPAS dengan APBD. Hal ini menjadi permasalahan yang harus diketahui penyebabnya, sehingga di kemudian hari, pemerintah dapat melakukan upaya dalam meningkatkan konsistensi tersebut. Penelitian ini dilaksanakan pada Pemerintah Kota Pangkalpinang dengan mengambil lokus pada Badan Perencanaan Pembangunan, Penelitian dan Pengembangan Kota Pangkalpinang sebagai leading sector sisi perencanaan serta Badan Keuangan Daerah sebagai leading sector penganggaran, selain itu Badan Anggaran DPRD Kota Pangkalpinang pun dilibatkan dalam mengkaji konsistensi tersebut. Penelitian yang dilakukan pada Pemerintah Kota Pangkalpinang menunjukkan. Penelitian ini bertujuan untuk mengetahui dan menganalisis tentang: (1) proses perencanaan pada RKPD dan KUA PPAS tahun anggaran 2018-2020 di Kota Pangkalpinang; (2) proses penganggaran APBD tahun anggaran 2018-2020 di Kota Pangkalpinang; (3) konsistensi perencanaan pada RKPD, KUA PPAS dan penganggaran APBD tahun anggaran 2018-2020 di Pemerintah Kota Pangkalpinang; dan (4) faktor-faktor yang menjadi pendukung dan penghambat dari konsistensi perencanaan pada RKPD, KUA PPAS dan penganggaran APBD tahun anggaran 2018-2020 di Pemerintah Kota Pangkalpinang. Dengan menggunakan pendekatan kualitatif, dan analisis Model Interaktif dari Miles dan Huberman, diperoleh hasil penelitian yaitu proses perencanaan di Pemerintah Kota Pangkalpinang telah sesuai dengan peraturan peundang- undangan yang berlaku dan telah dilaksanakan sesuai tahapan yang ditetapkan oleh peraturan tersebut. Proses perencanaan telah mencantumkan anggaran yang jelas pada pagu anggarannya disertai strategi yang terdapat pada Rencana Strategi di SKPD. Proses penganggaran di Pemerintah Kota Pangkalpinang telah mempedomani peraturan yang berlaku serta sesuai dengan pedoman penyusunan APBD yang telah ditetapkan. Penganggaran tersebut juga telah memenuhi prinsip dalam penganggaran. Prinsip tersebut terdiri dari partisipasi masyarakat, transparansi dan akuntabilitas anggaran, disiplin anggaran, keadilan anggaran, efisiensi dan efektifitas anggaran serta taat asas. Konsistensi antara perencanaan dan penganggaran di Pemerintah Kota Pangkalpinang masih belum konsisten. Konsistensi tersebut berbeda pada tiap tahun RKPD. Konsistensi tertinggi terdapat pada akhir masa RPJMD yang mana pada penelitian ini jatuh pada RKPD tahun 2018. Sebagai awal dari RPJMD tahun 2018-2023, tahun 2019 merupakan tahun transisi dari pemerintahan kepala daerah yang terpilih dimana konsistensi pada tahun ini sedikit menurun. Tahun 2020 merupakan tahun kedua dari RPJMD tahun 2018-2023, pada tahun ini tingkat konsistensi semakin menurun. Pagu indikatif yang semakin menurun menjadi faktor yang menghambat bagi konsistensi tahun tersebut.. Ketergantungan Pemerintah Kota Pangkalpinang terhadap dana dari pusat sangat besar yaitu mencapai lebih dari 70%, sehingga membuat daerah tidak leluasa dalam menentukan anggaran di daerah. Faktor pendukung dari konsistensi terdiri dari pagu indikatif yang konstan, RKPD yang telah ditetapkan, pemahaman antara TAPD dan Badan Anggaran, dan output atau keluaran yang berwujud hasil kerja, sedangkan faktor penghambat dari konsistensi terdiri dari pagu indikatif menurut pihak legislatif Faktor penghambat lainnya yaitu kemampuan PAD yang terbatas, dana perimbangan yang belum pasti jumlahnya, bencana baik sosial maupun alam, responsifitas dari SKPD yang lambat, nomenklatur dan kode program yang belum selaras antara Bappedalitbang, SKPD pengampu serta Bakeuda, adanya unsur politik yang mempengaruhi kebijakan, terjadinya mutasi pejabat yang terlalu sering, ego sektoral SKPD yang terlalu tinggi dan yang terakhir adalah jadwal pembahasan anggaran yang terlalu singkat

Trend of antibiotic consumption and its association with influenza-like illnesses in France between 2004 and 2018

International audienceAbstract Background Antibiotic consumption has been reported to be driven by the treatment of respiratory tract infections. Our objectives were to describe the trend of antibiotic consumption in France compared with that of other European countries; to describe the evolution of each antibiotic class in France; and to explore the relationship between antibiotic consumption and incidence of influenza-like illnesses. Methods In this observational study, antibiotic consumption was reported as defined daily doses per 1000 inhabitants per day in the community and hospital sectors in descriptive and graphical formats, using data from the European Surveillance of Antimicrobial Consumption Network database. The total consumption and the consumption of different classes of antibiotics in France according to time and influenza-like illnesses were studied using multiple linear regression models. Results The total consumption of antibiotics in France was constant over the 15 years. It was driven by the community sector (92.8%) and was higher than the consumption of other European Union countries (P-value < 0.001). The beta-lactam penicillins were the most consumed antibiotic class and the only class that increased with time. The multiple linear regression models showed a positive correlation between antibiotic consumption in the community sector and incidence of influenza-like illnesses [B = 0.170, 95% CI (0.088–0.252)]. Similar significant results were shown between other antibiotic classes used in the management of influenza-like illnesses (other beta-lactams, and macrolides, lincosamides and streptogramins) and influenza-like illnesses. Conclusion Our results suggest that antibiotics used in the management of respiratory tract infections might be involved in the irrational use of antibiotics