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"There are many challenges women face to be able to give birth in health facilities in many parts ofIndonesia. This study explores the roles and observations of close-to-community maternal health providers and othercommunity members on potential barriers faced by women to deliver in health facilities in two districts within TheArchipelago. Methods: Employing an explorative qualitative approach, 110 semi-structured interviews and 7 focusgroup discussions were conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province, and in 8 villagesin Cianjur, in the West Java province. The participants included village midwives, Posyandu volunteer (village healthvolunteers), traditional birth attendants (TBAs), mothers, men, village heads and district health officials. Results: Themain findings were mostly similar in the two study areas. However, there were some key differences. Preference forTBA care, traditional beliefs, a lack of responsiveness of health providers to local traditions, distance, cost of travel andindirect costs of accompanying family members were all barriers to patients attending health facilities for the birth oftheir child. TBAs were the preferred health providers in most cases due to their close proximity at the time of childbirthand their adherence to traditional practices during pregnancy and delivery. Conclusions: Improving collaborationsbetween midwives and TBAs, and responsiveness to traditional practices within health facilities and effective healthpromotion campaigns about the benefits of giving birth in health facilities may increase the use of health facilities inboth study areas."

"Background: There are many challenges women face to be able to give birth in health facilities in many parts ofIndonesia. This study explores the roles and observations of close-to-community maternal health providers and othercommunity members on potential barriers faced by women to deliver in health facilities in two districts within TheArchipelago. Methods: Employing an explorative qualitative approach, 110 semi-structured interviews and 7 focusgroup discussions were conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province, and in 8 villagesin Cianjur, in the West Java province. The participants included village midwives, Posyandu volunteer (village healthvolunteers), traditional birth attendants (TBAs), mothers, men, village heads and district health officials. Results: Themain findings were mostly similar in the two study areas. However, there were some key differences. Preference forTBA care, traditional beliefs, a lack of responsiveness of health providers to local traditions, distance, cost of travel andindirect costs of accompanying family members were all barriers to patients attending health facilities for the birth oftheir child. TBAs were the preferred health providers in most cases due to their close proximity at the time of childbirthand their adherence to traditional practices during pregnancy and delivery. Conclusions: Improving collaborationsbetween midwives and TBAs, and responsiveness to traditional practices within health facilities and effective healthpromotion campaigns about the benefits of giving birth in health facilities may increase the use of health facilities inboth study areas."

"The National Health Insurance (NHI) Program was implemented in Indonesia on January 1st 2014. This program definitely brings some changes into managerialaspect in public health center (PHC). This study aimed to determine an impact of NHI policy in the implementation of health promotion programs at PHCin South Tangerang City, Indonesia. This study was conducted using qualitative method during February and March 2016. The impact of NHI is seen on policy,budget, equipment, human resource and implementation of health promotion program. With purposive sampling method, six policy makers, eight serviceproviders and eight service users were selected for in-depth interview. 17 documents were analyzed. Observation was conducted at four selected PHC’s.Data analysis used thematic content analysis. There was no difference of PHC’s functions before and after NHI period. Budget expended for health promotionprograms increased after NHI was implemented which could represent an opportunity for PHC to innovate, procure materials and implement better healthpromotion programs. Capitation budget which could be used for executing health promotion program and some recently implemented health promotion programsin the NHI era evidences that NHI policy has a positive impact on the implementation of health promotion programs at PHC.Jaminan Kesehatan Nasional (JKN) telah diimplementasikan di Indonesia pada 1 Januari 2014. Hal tersebut membawa beberapa perubahan pada aspekmanajerial pada pusat kesehatan masyarakat (puskesmas). Penelitian ini bertujuan untuk mengidentifikasi dampak dari kebijakan JKN terhadap implementasiprogram promosi kesehatan di puskesmas di Kota Tangerang Selatan, Indonesia. Penelitian menggunakan metode kualitatif. Data dikumpulkan padaFebruari – Maret 2016. Dampak program dilihat dalam hal kebijakan, pendanaan, fasilitas, sumber daya manusia dan pelaksanaan program promosi kesehatan.Dengan menggunakan metode purposive sampling, enam pengambil kebijakan, delapan pemberi layanan dan delapan penerima layanan diambil sebagaiinforman dalam penelitian ini. Pada analisis dokumen, 17 dokumen telah dianalisis. Observasi dilakukan dengan melihat kegiatan yang dilakukan diempat puskesmas. Analisis data menggunakan analisis konten tematik. Tidak terdapat perbedaan dari fungsi puskesmas sebelum dan setelah adanya JKN.Dana yang digunakan untuk kegiatan promosi kesehatan telah mengalami peningkatan setelah implementasi kebijakan JKN dimana dana tersebut dapat digunakanuntuk berinovasi, memberi peralatan dan melakukan promosi kesehatan dengan lebih baik. Dana kapitasi yang dapat digunakan untuk melaksanakanprogram promosi kesehatan dan beberapa kegiatan promosi kesehatan yang baru dilaksanakan pada saat era JKN menjadi bukti bahwa kebijakan JKN memilikidampak positif terhadap pelaksanaan program promosi kesehatan di puskesmas"

"ABSTRAKThe accreditation of health centers is an endeavor by the Ministry of Health to improve the quality and performance of health centers regulated by Permenkes No. 4/2015. Of the 38 health centers in Brebes, only 10 has been accredited. We wish to discover how prepared are the health centers to be accredited based on the resources available and pre-accreditation survey. Data was obtained through in-depth interviews and documentary research. Results indicated that there was sufficient funds, facilities and equipment for the accreditation. However, the assessment scores for human resources sufficiency and documentary completeness was low.ABSTRAKAkreditasi Puskesmas merupakan upaya peningkatan mutu dan kinerja pelayanan puskesmas yang diatur oleh Permenkes Nomor 46 Tahun 2015. Dari 38 puskesmas di Kabupaten Brebes, hanya 10 puskesmas yang sudah terakreditasi. Penelitian ini bertujuan untuk mengetahui seberapa siapkah Puskesmas di Kabupaten Brebes untuk menghadapi akreditasi berdasarkan variabel sumber daya dan tahapan kesiapan survei pra-akreditasi. Data dikumpulkan melalui wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan bahwa ketersediaan dana, sarana dan prasarana dinilai cukup siap untuk mendukung penilaian akreditasi puskesmas, namun hasil skoring assessment pada keterpemenuhan kompetensi SDM dan kelengkapan dokumen masih rendah."