Kebijakan dan Strategi Dinas Kesehatan Kabupaten/kota dalam Mendukung Reformasi Puskesmas Studi di 6 Provinsi di Indonesia

Abstract

Background: Public health center reform as decentralization step in health sector had poured into SK Menkes Number128/Menkes/SK/II/2004 about Public Health Center Basic Policies. The aims of this research are to identified policy and strategy of District Health Office on Health Center Reform included health human resources reform, health effort reform, health financing reform, and health management reform. Methods: The research done in 6 provinces, by purposive sampling that is DI Yogyakarta, Bengkulu, South Kalimantan, South Sulawesi, East Kalimantan and Papua province Each province chosen 1 (one) regency and 1 (one) municipality. Health Center which performing reform chosen, amount of sample health center around 52 units. Data collecting done by indepth interview, secondary data and focus group dtscussion (FGD), and by descriptive analysis. Results: The result of research indicating that policy and strategy District Health Office insupporting health center reform, (a) in HRD reform performed through flattening health personnel with job contract, (b) in health center effort reform through improving health services access and revitalization, (c) in health financing reform performed with health center self-effort with autonomy as well as increasing APBD finance support for health, (d) and health management reform by clarifying authority sharing among provinces, regencies/municipalities, health center autonomy, health center services with Certification ISO 9001 and Community Based Health Effort (UKBM) revitalization. Therefore necessary done institutional established in regional and relation manner, as well as allocating health budget suitable with determined health development objectives