Buletin Penelitian Sistem Kesehatan最新文献

{"title":"Hubungan Antara Rasio Bidan Dengan Kinerja Program Kesehatan Ibu Dan Anak Di Indonesia","authors":"R. Wulandari, A. Laksono","doi":"10.22435/hsr.v22i3.1740","DOIUrl":"https://doi.org/10.22435/hsr.v22i3.1740","url":null,"abstract":"The focus of Maternal and Child Health (MCH) performance review was based on the input ratio of midwives important for evaluation. This study was to identify the relationship between the ratio of midwives and the coverage of MCH program. The analysis involved Midwives per 100,000 population ratios as independent variables, and 5 dependent variables, namely fi rst visit (K1), fourth visit (K4), neonates visit (KN), puerperal visit (KF) and childbirth assisted by health workers. The analysis was by scatter plot diagrams. The ratio of midwives to standards was dominantlytohe West of Indonesia. Variability in the ratio of midwives between 41.53 to 225.90 midwives per 100,000 population. Jakarta, West Java, and NTB that have K1 coverage above 100%. However, the midwife ratio was below the standard. Jakarta and Jambi have K4 coverage above 100%. KN coverage above 100% was reached by Jakarta, West Java, Jambi, and Bali. Kaltara and Jakarta had KF coverage above 100%. None of province, except Jakarta, had childbirth coverage by health workers above 100%. Even though the ratio of midwives was still below the standard, some provinces were able to show better performance of MCH programs than those that met the ratio. It was necessary to expand benchmarking in provinces with good MCH program performance, though the ratio of midwives was below the standard. \u0000Abstrak \u0000Fokus kajian kinerja Kesehatan Ibu dan Anak (KIA) berdasarkan input rasio bidan penting untuk evaluasi. Tujuan penelitian untuk menjawab hubungan rasio bidan dengan cakupan program KIA. Analisis melibatkan rasio bidan per 100 ribu penduduk sebagai variabel independent, dan 5 variabel dependen, yaitu kunjungan 1 (K1), kunjungan 4 (K4), kunjungan neonatus (KN), kunjungan nifas (KF) dan persalinan yang ditolong tenaga kesehatan. Analisis hubungan dilakukan melalui diagram scatter plot. Rasio bidan sesuai standar cenderung ada di wilayah Barat. Variabilitas rasio bidan antara 41,53 sampai 225,90 bidan per 100.000 penduduk. Provinsi DKI Jakarta, Jabar, dan NTB yang memiliki cakupan K1 di atas 100%, meski rasio bidan di bawah standar. DKI Jakarta dan Jambi memiliki cakupan K4 di atas 100%. Cakupan KN di atas 100% dicapai oleh DKI Jakarta, Jabar, Jambi dan Bali. Kaltara dan DKI Jakarta memiliki cakupan KF di atas 100%. Tidak ada satu pun provinsi, kecuali DKI Jakarta, yang memiliki cakupan persalinan oleh tenaga kesehatan di atas 100%. Meski memiliki rasio bidan yang masih di bawah standar, beberapa provinsi mampu menunjukkan kinerja program KIA yang lebih baik dibanding yang sudah memenuhi rasio. Perlu lebih lanjut dengan melakukan benchmark pada provinsi yang memiliki kinerja program KIA baik, meski dengan rasio bidan di bawah standar.","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43894084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analisis Distribusi Tenaga Kesehatan (Dokter Perawat Dan Bidan) Di Indonesia Pada 2013 Dengan Menggunakan Gini Index","authors":"Asep Hermawan","doi":"10.22435/hsr.v22i3.1304","DOIUrl":"https://doi.org/10.22435/hsr.v22i3.1304","url":null,"abstract":"Equal distributions of physicians, nurses and midwives are the successful key to achieve the 12 public health indicators set by the World Health Organization. This study is to measure physicians, nurses and midwives inequality in Indonesia, 2013. Data for health workforce are obtained from routine data by the Board for Development and Empowerment of Human Resources for Health, 2013, and population data from Appendix 1 Books Code and Region Administration Data by Province, districs/cities and all Indonesian Sub-district, Ministry of Internal Affairs. Ratio per Population, Gini Index and Lorenz’s curve were used to analyze the inequality distribution of health workers. The fi ndings showed the ratio of midwives and nurses/100,000 population had met The National Medium Term Development Plan 2010-2014 target. However, the doctors were still far from the target. Analysis by Gini Index indicated the distribution of midwives is better than other health workers. The Nusa Tenggara Region has the highest inequality compared to other regions for doctors, nurses and midwives. By administrative, municipital are more equitable to all types of health workers. Regarding the status of underdeveloped areas, remote borders and islands (DTPK), The Non-DTPK areas are more evenly distributed compared to the DTPK. Ratio per population some health workers are suffi cient though are not distributed well. The distribution of health personnel should not merely use the ratio per population. The other distribution index such as the Gini Index and other distribution measures will provide better policy options. \u0000  \u0000Abstrak \u0000Distribusi dokter, perawat dan bidan yang merata merupakan salah satu kunci sukses untuk mencapai 12 indikator kesehatan masyarakat yang ditetapkan World Health Organization. Tujuan penelitian ini adalah menggambarkan pemerataan tenaga dokter, perawat dan bidan di Indonesia pada 2013. Sumber data tenaga kesehatan (dokter perawat dan bidan) diperoleh dari data rutin Badan Pengembangan dan Pendayagunaan Sumber Daya Manusia Kesehatan (BPPSDMK) 2013. Data jumlah penduduk diperoleh dari Lampiran 1 Buku Induk Kode dan Data Wilayah Administrasi Pemerintahan per Provinsi, Kabupaten/Kota dan Kecamatan Seluruh Indonesia milik Kementerian Dalam Negeri. Untuk menilai inequality distribusi tenaga kesehatan menggunakan rasio/populasi, Gini Index dan Kurva Lorenz. Hasil penelitian menunjukkan bahwa rasio bidan dan perawat/100.000 penduduk sudah memenuhi target RPJMN 2010-2014, sedangkan dokter masih jauh dari target. Analisis dengan Gini Index menunjukkan bahwa distribusi bidan lebih dibandingkan tenaga kesehatan lainnya. Regional Nusa Tenggara memiliki inequality tenaga yang tertinggi dibandingkan regional lainnya baik untuk dokter, perawat, dan bidan. Secara administratif, kota cenderung lebih merata untuk semua jenis tenaga kesehatan. Berdasarkan status daerah tertinggal, perbatasan dan kepulauan (DTPK), daerah non DTPK cenderung lebih merata dibandingkan DTPK. Walaupun ","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41997418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teori Kebutuhan Maslow Sebagai Rasionalisasi Pencegahan Kasus Aborsi Di Indonesia","authors":"Yurika Fauzia Wardhani, O. Oktarina","doi":"10.22435/hsr.v22i3.1354","DOIUrl":"https://doi.org/10.22435/hsr.v22i3.1354","url":null,"abstract":"The high rate of abortion in Indonesia makes abortion “buah simalakama”. On the one hand, abortion for non-medical reasons is strictly forbidden, but on the other hand illegal abortion increases mortality due to lack of medical facilities and infrastructure because most illegal abortions are done in traditional ways. The World Health Organization (WHO) determines that abortion is a reproductive health problem that needs attention and is a cause of suffering for women throughout the world. This study will analyze Maslow’s Theory of Needs as a rationalization of the reasons for informants to have an abortion. The method used is case analysis based on Maslow’s Theory of Needs. The results showed that, of the 131 informants who had an abortion to meet their security needs (both literally, fi nancially and otherwise) 48%, love / social needs were 37%, to meet physiological needs of 14.5%. Actions taken by informants for abortion were taking drugs 23%, drinking herbal medicine 9.2%, eating pineapple 3.8%, 2.3% vaginal medicine, 1.5% massage, 1.5% midwife consul, eating “tape” 0.76%, looking for health services 0.76%, while those who have not tried 21.4% and those who did not answer 35.9%. It was concluded that Maslow’s Needs Theory could be used to rationalize the reasons for informants having an abortion. \u0000Abstrak \u0000Tingginya angka aborsi di Indonesia menjadikan aborsi sebagai buah simalakama. Di satu sisi aborsi dengan alasan non medik dilarang keras, namun di sisi lain aborsi ilegal menjadi marak dan meningkatkan angka kematian. Kurangnya sarana dan prasarana medis menjadi penyebabnya karena sebagian besar aborsi ilegal dilakukan dengan cara tradisional. Organisasi Kesehatan Dunia (WHO) menentukan bahwa aborsi termasuk dalam masalah kesehatan reproduksi yang perlu mendapatkan perhatian dan merupakan penyebab penderitaan wanita di seluruh dunia. Penelitian ini akan menganalisis Teori Kebutuhan Maslow sebagai rasionalisasi alasan informan untuk melakukan aborsi. Metode yang dilakukan adalah analisis kasus berdasar Teori Kebutuhan Maslow. Hasil menunjukkan bahwa, dari 131 informan melakukan aborsi untuk memenuhi kebutuhan rasa aman (baik secara harafi ah, fi nancial, maupun lainnya) 48%, kebutuhan cinta/sosial 37%, untuk memenuhi kebutuhan fi siologis 14,5%. Tindakan yang dilakukan informan untuk aborsi adalah dengan minum obat-obatan 23%, minum jamu 9,2%, makan nanas 3,8%, obat pervaginam 2,3%, pijat 1,5%, konsul bidan 1,5%, makan tape 0,76%, mencari pelayanan kesehatan 0,76%, sedangkan yang belum berupaya 21,4% dan yang tidak menjawab 35,9%. Disimpulkan bahwa Teori Kebutuhan Maslow dapat digunakan untuk merasionalisasi alasan informan melakukan aborsi.","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45533229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gambaran Faktor Penyebab Rujukan Di Puskesmas Kota Depok","authors":"Iin Nurlinawati, Rosita Rosita, Sefrina Werni","doi":"10.22435/hsr.v22i3.512","DOIUrl":"https://doi.org/10.22435/hsr.v22i3.512","url":null,"abstract":"Referral System for Individual Health Services states that health services are conducted in stages according to medical needs, starting from basic, second, and then third level health . The BPJS standard on the referral ratio limitation from health center to hospital is 15%. A total of 22 out of 32 health centers (69%) in Depok have referral ratios above 15%. This study was to identify factors infl uencing high referral ratios at health centers in Depok..This study was implemented from March to October 2017 by cross sectional design. The population was 32 health centers in Depok. Samples were health centers in Depok registered by BPJS as FKTP. There were 12 health centers, each 6 with high and low referrals. The sample of health workers were providers such as: doctors and dentist, heads of health centers and health offi ces. The results showed that the most referenced disease was a refraction disorder, unspecifi ed. Most primary health care with a high referral ratio (> 15%) did not have the required compulsory services at the primary health care, especially emergency and laboratory services (66.7%). The type of health personnel was less than that at Permenkes 75 of 2014 (83.3%). Facilities and infrastructure in health center were out of standards. Less drugs supplies also affected to referral. Suggestion: The government needs to provide more types of services, numbers of health workers and infrastructure in order to support the capacity of the health centre as well as better services . \u0000Abstrak \u0000Sistem Rujukan Pelayanan Kesehatan Perorangan menyebutkan bahwa pelayanan kesehatan dilaksanakan secara berjenjang sesuai kebutuhan medis, dimulai dari pelayanan dasar ke pelayanan kesehatan tingkat kedua berlanjut ke tingkat ketiga. Standar BPJS mengenai batasan rasio rujukan puskesmas ke pelayanan kesehatan tingkat lanjut maksimal 15%. Sebanyak 22 puskesmas (69%) dari 32 puskesmas di Kota Depok yang memiliki rasio rujukan diatas 15%. Penelitian ini bertujuan untuk memberikan gambaran faktor yang mempengaruhi rasio rujukan tinggi di puskesmas Kota Depok. Penelitian dilaksanakan pada bulan Maret sampai Oktober 2017. Metode yang digunakan adalah cross sectional (potong lintang). Populasi penelitian sebanyak 32 puskesmas di Kota Depok. Sampel yang diambil adalah puskesmas Kota Depok yang telah terdaftar pada BPJS sebagai FKTP sebanyak 12 puskesmas, 6 puskesmas dengan rujukan tinggi dan 6 puskesmas dengan rujukan rendah. Sampel tenaga kesehatan yang diwawancara meliputi pemberi pelayanan (dokter dan dokter gigi), kepala puskesmas dan Kepala Bidang Yankes Dinas Kesehatan. Hasil penelitian menunjukkan bahwa penyakit yang paling banyak dirujuk adalah disorder of refraction, unspecifi ed (kelainan refraksi mata). Sebagian besar puskesmas dengan rasio rujukannya tinggi (>15%) tidak memiliki kelengkapan pelayanan yang wajib ada di puskesmas terutama pelayanan gawat darurat dan laboratorium (66,7%). Jenis tenaga kesehatan kurang dari jumlah yang ada berdasarkan Permen","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41915258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ibu Hamil “Kemel” Pada Etnis Gayo Di Kecamatan Blang Pegayon Kabupaten Gayo Lues, Aceh","authors":"N. Pratiwi, Yunita Fitrianti, Syarifah Nuraini, Tety Rachmawati, A. Laksono","doi":"10.22435/hsr.v22i2.1693","DOIUrl":"https://doi.org/10.22435/hsr.v22i2.1693","url":null,"abstract":"The unique and enormous culture of concealed pregnancy or “Kemel” in Gayo ethnic, low coverage of antenatal care for pregnant women in health workers and high numbers of neonatal mortality, and infection in infants with low birth weight were social determinants of health issues existing in Aceh. These were urgently observed to fi gure out solution in reducing low examination of antenatal care by pregnant women in Gayo. Increasing the interest of researchers to conduct this research. This descriptive study was based on socio-cultural phenomena that aff ect a “Kemel” pregnant woman. The results showed ‘Kemel’ vulnerability perceptions were indicated by keeping the pregnancy as a secret in case of being used by those who do not like their pregnancies. ’Kemel’ perceived severity aff ects the safety of women pregnancies. Pregnant women may get some threats such as: malnutrition, lack of calorie energy, anemia, newborn with low birth weight, premature newborn, and infectious diseases. “Kemel” cues to action, pregnant women check theirpregnancies after 5 months pregnancy to a traditional birth attendant. Soon after TBA claimed their pregnancies, they refer to midwives. This the reason why examination of antenatal care were very low. Family role in the social structure, the culture of the Gayo, parents-in-law and parents of pregnant women, have a great contribution in making decisions such as pregnancy, childbirth and postpartum cares. A marriage tradition of the Gayo, was when a woman pawned into a part of male family, she must follow its habits and traditions. Thus, intervention by forming an agent of change are highly recommended by involving parent in law.  \u0000Abstrak \u0000Tingginya budaya merahasiakan kehamilan/”Kemel”pada etnis Gayo, rendahnya cakupan antenatal care ibu hamil pada petugas kesehatan dan tingginya kematian neonatal, infeksi pada bayi dengan Berat badan lahir rendah, menambah ketertarikan peneliti untuk melakukan penelitian ini. Metode penelitian adalah kualitatif, peneliti menganalisis berdasarkan fenomena sosial budaya yang dapat mempengaruhi seorang ibu hamil “Kemel”. Hasil menunjukkan Persepsi kerentanan ‘Kemel’, dengan merahasiakan kehamilannya, takut diguna-guna orang lain yang tidak suka kehamilannya. Perceived severity Kemel mempengaruhi keselamatan kehamilannya, ancaman pada ibu hamil: gizi kurang, Kurang Energi Kalori, anemia dan bayi dengan Berat Badan Lahir Rendah/BBLR, bayi lahir prematur dan serangan penyakit infeksi pada ibu hamil. Cues To Action Kemel, periksa kehamilan saat kehamilan berusia 5 bulan pada bidan kampong, setelah bidan kampong menyatakan hamil ia baru pergi ke bidan, hal inilah yang menjadi salah satu penyebab rendahnya pemeriksaanantenatal care pada ibu hamil. Peran keluarga dalam struktur sosial, budaya masyarakat Gayo, Mertua dan orang tua bumil sangat besar dalam menentukan keputusan segala sesuatu yang berkaitan dengan keputusan dalam perawatan kehamilan, persalinan dan perawatan nifas. Suatu tradisi perk","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45374975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hubungan Antara Kemampuan Reproduksi, Kepemilikan Anak, Tempat Tinggal, Pendidikan Dan Status Bekerja Pada Wanita Sudah Menikah Dengan Pemakaian Kontrasepsi Hormonal Di Indonesia Tahun 2017","authors":"Diyah Herowati, Mugeni Sugiharto","doi":"10.22435/hsr.v22i2.1553","DOIUrl":"https://doi.org/10.22435/hsr.v22i2.1553","url":null,"abstract":"Hormonal contraception type such as: injections, pills and implants is a type of contraception used by married women in Indonesia, because the contraception is very eff ective for preventing pregnancy and very easy to use. Nevertheless, each type has diff erent side eff ects. This study is to analyse the relationship between reproductive ability, child ownership, residence, education and work status for married women with hormonal contraceptive use. This quantitative study obtained the data from the Indonesian Demographic Health Survey 2017 which was analyzed by bivariate correlation tests and displayed descriptively in a table form. The results indicated signifi cant among reproductive capacity, location of residence, ownership of the number of children and employment of married women with hormonal contraception use. However the education variable had no relationship. Hormonal contraception type was concluded as a type of contraception that eff ectively prevents pregnancy. Married women used more injectable contraception, then pills and implants. They are advised to use injectable contraception as it eff ectively prevents pregnancies, reduces side eff ects, and is easy to use.Thus, they have to gain correct information fi rst from health workers \u0000ABSTRAK \u0000Kontrasepsi hormonal, seperti suntik, pil dan implant adalah jenis alat kontrasepsi yang di gunakan oleh wanita yang sudah menikah di Indonesia, karena sangat efektif mencegah kehamilan dan mudah penggunaannya, namun memiliki efek samping yang berbeda. Penelitian ini bertujuan untuk menganalisis hubungan antara kemampuan reproduksi, kepemilikan anak, tempat tinggal, pendidikan dan status bekerja pada wanita sudah menikah dengan penggunaan alat kontrasepsi hormonal. Jenis penelitian kuantitatif menggunakan data SDKI tahun 2017 yang di analisis dengan uji korelasi bivariat dan deskriptif ditampilkan dalam bentuk tabel. Analisis menunjukkan, bahwa terdapat hubungan signifi kan antara kemampuan reproduksi, lokasi tempat tinggal, kepemilikan jumlah anak dan pekerjaan wanita menikah dengan penggunaan kontrasepsi hormonal, akan tetapi variabel pendidikan tidak ada hubungan. Kontrasepsi hormonal disimpulkan sebagai jenis kontrasepsi yang efektif mencegah kehamilan. Wanita menikah lebih banyak menggunakan kontrasepsi suntik, kemudian pil dan implant. Wanita menikah disarankan untuk menggunakan kontrasepsi suntik, karena efektif mencegahkehamilan, efek samping yang ringan dan mudah penggunaannya, tetapi perlu memperoleh informasi yang benar terlebih dahulu dari petugas kesehatan.","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48890857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daftar Isi","authors":"Hsr Managerxot","doi":"10.22435/hsr.v22i2.2080","DOIUrl":"https://doi.org/10.22435/hsr.v22i2.2080","url":null,"abstract":"","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45557704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Riset Implementasi (Implementation Research) Sebagai Metodologi Riset Untuk Mengawal Kebijakan","authors":"S. Siswanto","doi":"10.22435/hsr.v22i2.2050","DOIUrl":"https://doi.org/10.22435/hsr.v22i2.2050","url":null,"abstract":"The appropriate approach for operational research is by using problem solving cycle model, comprising (i) measuring the magnitude of the problem, (ii) identifying the causes of the problem, (iii) developing the solution, (iv) implementing program/ intervention, and (v) evaluating the program. Within a scientific perspective, in every phase of problem solving cycle, it needs research, including the fourth phase i.e. implementing program/ intervention. Research that provide scientific evidence for better implementation is labeled as Implementation Research. As a methodological approach, Implementation Research belongs to critical realism paradigm that is possible to use mixed method (combination of qualitative and quantitative), or stand alone of qualitative method, or quantitative method. The role of Implementation Research is very crucial for better implementation or for better scale-up of the program by understanding the implementation process as well as the impact of the program under concern. Participatory action research, as one of the Implementation Research approach, can be used as an appropriate methodology for better implementation in the real context of the new policy (new program) by tailoring the implementation process (management process) with the real world situation in terms of policy actors, organizational situation, human resources variable, community variable, as well as, resources variable. \u0000Abstrak \u0000Pendekatan yang tepat untuk riset operasioanl adalah melalui siklus pemecahan masalah terdiri dari (i) mengukur besaran masalah, (ii) mencari penyebab masalah, (iii) mengembangkan solusi, (iv) implementasi intervensi/ program, dan (v) evaluasi program. Dalam perspektif ilmiah, maka dalam setiap tahapan siklus pemecahan masalah memerlukan penelitian, termasuk tahap keempat yakni tahapan implementasi program. Penelitian yang menyediakan bukti ilmiah untuk implementasi program disebut dengan Riset Implementasi (Implementation Research).  Sebagai pendekatan metodologi, Riset Implementasi termasuk dalam paradigma realisme kritis (critical realism), yang memungkinkan untuk menggunakan metoda campuran (mixed method) (kombinasi kuantitatif dan kualitatif), atau secara senidri hanya menggunakan kuantitatif, atau kualitatif saja. Peran Riset Implementasi menjadi sangat penting untuk mendapatkan cara-cara implementasi yang lebih baik, atau dalam rangka memperluas jangkauan progam, guna mempelajari proses implementasi dan melihat dampak program sebagaimana diinginkan. Riset tindak partisipatif (Participatory action research), dapat dipergunakan sebagai metodologi yang tepat untuk mendapatkan cara-cara implementasi yang lebih baik dalam konteks penerapan kebijakan/ progam baru, dengan menyesuaikan proses implementasi (proses manajemen) disesuaikan dengan situasi dunia nyata di lapangan, berkaitan dengan aktor kebijakan, situasi organisasi, variasi sumber daya manusia, variasi masyarakat, maupun variasi sumber daya lainnya.","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46347309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifikasi Praktik Kefarmasian Yang Sesuai Dengan Kebutuhan Pasien Dan Fasilitas Pelayanan Kesehatan","authors":"Selma Siahaan, R. Handayani","doi":"10.22435/hsr.v22i2.285","DOIUrl":"https://doi.org/10.22435/hsr.v22i2.285","url":null,"abstract":"The study of pharmaceutical practices in health care facilities was conducted in 2016. It aimed to identify pharmaceutical practices needed by patients and health care facilities. The study sites were in Central Java, Bali, South Kalimantan, and South Sulawesi. In each provinces, the study was conducted in one urban and one rural district areas. The sample locations were both government and private hospitals, health centers and pharmacies. The study design study was cross sectional. Data collection was carried out by in-depth interview to responsible pharmacists who did medicines management, and exit interview to patients after they received medicines services from government hospitals and primary health cares. The results showed that pharmaceutical practices needed by the health care facilities were good medicines planning andprocurement that can maintain the continuity of the availability of medicine stocks needed for patients, and the ability in managing medicines effi ciently and eff ectively. Moreover, the pharmaceutical practices needed by the communities were medicines completeness, quick services, as well as simple and complete medicines information. It is recommended that pharmacists should be trained on comprehensive medicines planning, strategy to anticipate the emptiness of medicines including lead times, and communication skills to the patients. In addition, IT supports for pharmacy services development is also needed. \u0000Abstrak \u0000Telah dilakukan studi mengenai praktik kefarmasian di fasilitas pelayanan kesehatan yang bertujuan mengidentifikasi pelayanan kefarmasian yang dibutuhkan pasien dan fasilitas pelayanan kesehatan. Kegiatan studi dilaksanakan di Jawa Tengah, Bali, Kalimantan Selatan, Sulawesi Selatan. Dari masing-masing propinsi di atas dipilih satu kota dan satu kabupaten. Studi dilakukan pada tahun 2016. Lokasi penelitian adalah rumah sakit pemerintah, rumah sakit swasta, puskesmas dan apotek dengan desain potong lintang. Pengumpulan data dilakukan melalui wawancara mendalam terhadap apoteker penanggung jawab/pengelola obat, dan exit interview terhadap pasien rumah sakit pemerintah dan puskesmas yang baru selesai menerima pelayanan obat. Hasil penelitian menunjukkan praktik kefarmasian yang dibutuhkan oleh fasilitas pelayanan kesehatan adalah perencanaan dan pengadaan obat yang baik yang dapat menjaga kesinambungan ketersediaan stok obat yang diperlukan bagi pelayanan ke pasien serta pengelolaan obat yang efektif dan efi sien. Praktikkefarmasian yang dibutuhkan masyarakat adalah tersedianya obat lengkap, kecepatan pelayanan, dan informasi obat yang singkat padat. Disarankan perlunya pelatihan perencanaan obat yang lebih komprehensif, kiat-kiat mengantisipasi kekosongan obat dan lamanya pengiriman, serta pelatihan cara berkomunikasi yang baik kepada pasien secara menyeluruh. Selain itu, dukungan teknologi informasi bagi pengembangan pelayanan farmasi juga dibutuhkan. \u0000 ","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42537677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analisis Implementasi Kebijakan Program Pengendalian Resistensi Antimikroba (PPRA)","authors":"R. Rukmini, Selma Siahaan, Ida Diana Sari","doi":"10.22435/hsr.v22i2.1038","DOIUrl":"https://doi.org/10.22435/hsr.v22i2.1038","url":null,"abstract":"Antimicrobial resistance has become a problem in Indonesia. The Ministry of Health has established a policy ofAntimicrobial Resistance (AMR) Control Program in hospitals to resolve the issue. A qualitative case study was conducted at Dr. RSUP Wahidin Sudirohusodo hospital, Makassar in 2018 to analyze the implementation of AMR control program. The data were collected through in-depth interviews and analyzed descriptively. The study showed that policy AMR control program has not be carefully implemented. The function of AMR control program team is to make policies and guidelines for antibiotic use, to make surveillance of germ patterns and antibiotic sensitivity, clinical audits of antibiotic use, to conduct studies/research and to make evaluation that is reported to the Hospital Director. However, this AMR control program has not been optimally implemented due to many challenges such as lack of budget, lack of commitment and internal coordination between the AMR control program team members. Implementation of AMR control program in this hosptal management is not optimal. The Program dissemination and AMR team activities were not evenly distributed. High workload, inadequate infrastructure and antibiotic resistance issues of the referred patients. As a conclusion AMRcontrol program policy in RSUP. Wahidin Sudirohusodo, Makassar, has not been properly disseminated and implemented. Coordination, dissemination and discussion forums on PPRA policies internally and externally with cross-sectoral hospitals are needed to improve antimicrobial resistance control commitment.  \u0000  \u0000 ","PeriodicalId":42108,"journal":{"name":"Buletin Penelitian Sistem Kesehatan","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45453212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}