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"Considers what can be done to improve the quality of urban health services and make them more accessible to residents in low-income areas and slums. Noting that a shortage of resources for urban health is a problem everywhere, the report concentrates on organizational and administrative changes that can upgrade the quality of health centres, extend coverage to underserved populations, and reduce the inefficiencies that occur when hospitals are overburdened by patients suffering from minor complaints. The objective is to help health administrators and municipal authorities analyse the weaknesses in urban health systems, appraise options for strengthening primary health care, and introduce interventions that help obtain the maximum health gains from restricted budgets. Throughout the report, experiences in different cities around the world are used to illustrate both the shortcomings of many urban health systems and the specific changes that have brought improvements. The opening sections identify key issues in the organization of urban health systems and review the extent to which health systems in the worlds cities are providing primary health care, particularly for low-income communities. Details range from a list of mistakes frequently made by municipal and public health authorities, through an explanation of methods for collecting basic data, to a series of 10 questions to be asked when moving from an analysis of problems to a programme of action. Noting that almost half of the residents of cities in developing countries live in conditions of extreme poverty and squalor, the report cites evidence of an impending health crisis as urban populations continue to grow and the incidence of chronic diseases rises alongside traditional health problems and the added burdens of HIV infection and AIDS, alcohol and drug abuse, and injuries caused by violence and road accidents. The report also identifies weaknesses in urban health centres and health posts, which frequently suffer from a low standard of services and lack of credibility, and are often bypassed, resulting in an overloading of hospital services. Against this background, the report introduces the concept of reference health centres that would provide an extended range of high-quality, round-the-clock health services in defined catchment areas and link with hospitals for referral support. According to this concept, an urban reference health centre aims to support and strengthen local health centres in their role as providers of primary health care and to bring comprehensive medical care to local communities, making health services accessible to all city-dwellers on a more equitable basis. A review of experiences to date in developing such centres in various urban settings underscores the potential contribution that reference health centres can make to urban public health."

"Penelitian ini memiliki tujuan untuk menganalisis kualitas pelayanan kesehatan di Puskesmas Kecamatan Cakung. Penelitian ini merupakan penelitian deskripstif dengan menggunakan pendekatan kuantitatif. Hasil dari setiap indikator diukur pada lima poin skala ordinal: sangat baik, baik, cukup, buruk dan sangat buruk. Sampel diambil berdasarkan teknik sampling non probabilitas, secara accidental. Berdasarkan hasil analisa data pada setiap indikator didapatkan hasil bahwa indikator input dinilai cukup, indikator poses dinilai buruk dan indikator output dinilai cukup. Sehingga didapatkan hasil akhir bahwa kualitas pelayanan kesehatan di Puskesmas Kecamatan Cakung adalah cukup.

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This research aims to analyse the quality of health services at Cakung Subdistrict health center. This research is a descriptive research with quantitative approach. The outcome of every indicators was measured on five-point ordinal scales: Very Good, Good, Fair Enough, Bad and Very Bad. The sample was taken based on non probability sampling technique, in an accidental manner. Based on the analysis result on every indicators, the research result shows that input indicator is fair enough, process indicator is bad and output indicator is fair enough. So the final result shows that the quality of health services at Cakung Subdistrict health center is fair enough."

"Penelitian ini menggunakan desain Rapid Assesmenl Procedures (RAP) dengan menerapkan metoda pendekatan kualitatif yang bertujuan mcndapatkan infonnasi yang mendalam mcngcnai gambaran koniidensialitas yang ada di puskesmas PKPR “Y” dan “X” Jakarta Selatan. Penelitian melibatkan remaja sebagai klien PKPR dan provider serta para pcmbuat kebiiakan dari pusat hingga tingkat puskesmas. Terdapat kesenjangan pengetahuan mengenai sehat, kesehatan reprcduksi dan kesehatan reproduksi, akses informasi PKPR, hukum yang melindungi hak~hak klien, serta pemahaman kerahasiaan di antara remaja, provider dan pembuat kebiiakan selain itu ada perbedaan persepsi mengenai konfidcnsialitas di PKPR menurut remaja, pnovider, dan pembuat kebUakan. Terjadi kesenjangan antara standar peiayanan dengan implementasi di lapangan dalam peiaksanaan prinsiflprinsif kerahasiaan di PKPR.Disarankan kepada Kepada Departemen Kesehatan untuk: 1) membuat buku panduan pelayanan kesehatan remaja yang dapat menjamin kerahasiaan di PKPR. 2) Bekerja sama dan berkoordinasi dengan dcpartemen tcrkait seperti Depclagri, Dep, dan Depag dalam sosialisasi PKPR. 3) Menjadikan program peer educator dan peer counselor sebagai salah satu media dan stratcgi penyebaran infom1asi. Kepada Sudinkes dan Dinas Kesehatan terkait: 1) Menjadikan program peer educator dan peer counselor sebagai salah satu media dan strategi penyebaran informasi mengenai kesehatan reproduksi, 2) Mengevaluasi dan monitoring PKPR secara rutin, 3) Melakukan pelatihan mengenai konfidensialitas pada semua tim PKPR oleh ahli dan praktisi konseling. Bagi Puskcsmas PKPR: 1) Membuat standar pelayanan yang memasukkan sikap dan etika petugas selama pelayanan kesehatan remaja, 2) Membuat jadwal yang ramah remzja. Kepada LSM: Bekeria sama dengan puskesmas PKPR dalam sosialisasi kesehatan rcproduksi pada remaja dan maupun mcnjadi sarana mjukan PKPR. Organisasi Profesi: Menyusun dan memperbaharui standar pelaksanaan profesi yang terkait dengan pelayanan kesehatan yang konfidensial pada remaja. Bagi Peneliti lain: Perlu dilakukan lebih dalam lagi mengenai pengaruh dan dampak konfidensilitas dalam pelayanan remaja.

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The study used qualitative method which the objective is to gain infomation deeply on confidentiality at Adolescent Friendly Health Services (AFHS) in Primary Health Care “Y” and “X” South Jakarta. This study involved Adolescent who had treated in AFHS as an informant and providers and policy makers as key informants. There are still lacking knowledge on health, reproductive health, adolescent reproductive health, access of information on AFHS, client’s rights, policy of cIient’s rights and also definition of confidentiality among clients, providers, and decision makers. Beside there is a different perception on confidentiality among them. Still lacking between standard and implementation on confidentiality at AFHS. Suggestion for Ministry of Health: 1) Developing guideline confidentiality services at AFHS. 2) Collaboration with Ministry of Home Afairs, the Ministry of National Education of Indonesia, and Department of Religious AlTairs for socialization on AFI-IS and reproductive health. District Level Health Office: 1) Monitoring and evaluation periodically, 2) attempting training on confidentiality at adolescent services for AFHS workers by an expert. For Primary Health Care Services: I) Provide standard of services which include ethics and attitude on AFHS services, 2) provide friendly schedule for adolescents. NGOs: collaboration with primary health care which provides AFHS on socialization reproductive health and for referral services. Professional organization: developing and refresh guideline of professional services on confidentiality for adolescent services. Others researcher: needs for following up research on impact of confidentiality on adolescent services."