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Abstrak :
As a developing country, Indonesia is trying hard to progress towards becoming a developed nation. In the past few years, Indonesia has achieved impressive growth. In order to maintain it, Indonesia is spending a large amount of money for its physical development, for instance, the development of infrastructure projects. Consequently, project control is then needed to carry out the projects successfully. Therefore, project control plays an important role in the development of our country. Control is basically a process of trying to achieve conformity between goals and actions. It involves comparison of the performance to the plan. If significant differences take place, corrective actions should be taken. Project control is focused on three areas: time, cost, quality. Time control can be carried out by scheduling the project. Two methods used for scheduling are bar charting and networking technique. In bar charting, a project is divided into its major operations and the time to complete each operation is estimated. The operations are represented by bars arranged in the order of their early start time. Networking techniques are used on complex projects. An example of such a technique is Critical Path Method (CPM).

Abstrak :
Manajemen Terpadu Balita Sakit (MTBS) merupakan pendekatan yang menyeluruh, sistematis dan teringrasi antara semua program pelayanan kesehatan bagi bayi dan balita, mencakup pelayanan promotif, pelayanan preventif, dan pelayanan kuratif yang untuk memperbaiki dan meningkatkan kualitas manajemen program maupun manajemen kasus yang mengacu pada kualitas tata laksana kasus sehingga angka kematian bayi dan balita dapat diturunkan. Tujuan penelitian ini untuk memperoleh gambaran tingkat kepatuhan petugas terhadap prosedur MTBS dan faktor ? faktor yang mempengaruhinya di Kabupaten Nagan Raya. Penelitian ini dengan pendekatan kuantitatif menggunakan desain cross secsional dengan jumlah sampel 97 petugas pelaksana MTBS dan 291 pengamatan terhadap pelaksanaan prosedur MTBS di puskesmas dan puskesmas pembantu di Kabupaten Nagan Raya. Pengumpulan data dengan pengamatan langsung saat petugas melayani balita sakit dengan menggunakan daftar tilik dan wawancara dengan petugas MTBS. Hasil penelitian menunjukkan bahwa dengan cut off point kepatuhan 80 % , rata-rata tingkat kepatuhan petugas adalah 74,96 % dengan kepatuhan tertinggi 96,9 % dan terendah 22,7 %. Hasil uji statistik secara multivariat didapatkan faktor yang berhubungan dengan kepatuhan adalah beban kerja, sarana prasarana, dan komitmen pimpinan terhadap program MTBS. Sedangkan faktor pendidikan menjadi variabel konfonding dalam penelitian ini. Faktor yang paling dominan berpengaruh terhadap kepatuhan adalah faktor komitmen pimpinan, dimana diperoleh nilai OR 8,684, artinya petugas puskesmas dengan komitmen pimpinan yang baik akan berpeluang patuh 8,7 kali lebih besar dibandingkan dengan petugas yang komitmen pimpinannya rendah terhadap program MTBS setelah dikontrol oleh variabel beban kerja, sarana prasarana dan pendidikan. Bagi Dinas Kesehatan dan Puskesmas di Kabupaten Nagan Raya perlu meningkatkan komitmennya terhadap program MTBS dan mendistribusikan tanggung jawab yang proporsional bagi semua staf sesuai dengan prinsip ? prinsip manajemen mutu terpadu (Total Quality Manajemen) dan selalu melakukan perbaikan kinerja secara terus menerus dalam menerapkan prosedur MTBS dengan menggunakan siklus PDCA (Plan - Do - Check - Act). ......Integrated Management of Childhood illness (IMCI) is an integrated, systematic and total approach among all of babies and children under five years old health services programme, including promotion, preventive, and curative services to improve the programme management quality as well as cases handling that refer on cases management quality so that affected to the decreasing of infant and children under five years old mortality rate. The objectives of the study are to obtain the description of Health officer obey code of conduct rate regarding IMCI and confounding factor at Nagan Raya District. The study methods utilized quantitative approach with cross sectional design, total sample are 97 health officers that conducted IMCI and 291 observations regarding IMCI code of conduct at public health centre and sub-public health centre in Nagan Raya District. The data collected by direct observation during health officer serving the illness baby with using check list and interviewing the health officer that doing IMCI. The study output showed that obey cut off point is 80 %, the average obey rate of health officer is 74, 96 % with highest obey rate is 96, 9 % and the lowest is 22, 7 %. The output of statistical tested by multi variant found the factors that have relation to the obey code of conduct are working load, facilities of IMCI, and managerial commitment regarding IMCI Programme. The education level factor becomes a confounding variable in the study. The most dominant factor that influent the obey code of conduct is managerial commitment which is the OR value 8,684, that?s mean the health officer with managerial commitment that higher commitment affected to health officer IMCI to have 8,7 times more obey than the managerial commitment that has lower after controlled by working load, facilities, as well as education level variable. District Health Office and Public Health Centre in Nagan Raya District need to improve their commitment regarding IMCI programme and shall distribute proportional responsibility for whole staffs based on Total Quality Management principles and continues performance improvement in implementation of IMCI code of conduct by utilizing PDCA cycle (Plan - Do - Check - Act).

Abstrak :
Analysis and monitoring system design of childhood illness management quality through Integrated Management of Childhood Illness (IMCI) approach in Public Health Center in District of Cianjur, West JavaThe Infant Mortality Rate (IMR) and Children Under Five Mortality Rate in District of Cianjur are still high. To accelerate the decreasing of both 1MR and Children Under Five Mortality Rate we have implemeted various efforts. One of them is to integrate illness management by having a new approach: The Integrated Management of Childhood Illness (IMCI). IMCI is an approach of Integrated Management of Childhood Illness which combines promotive, preventive, and curative services in five main cause of mortality in infants and children in developing countries, they are pneumonia, diarrhoea, measles, malaria, and malnutririon. Basically, IMCI is made to improve the health service quality of childhood illness. There are some important requirements in improving the health service quality such as input standards (health personel, equipment and drugs, fund), environment standards, and process standards. All requirements should be monitoring periodically to achieve better service quality. The aims of this research is to design monitoring system of childhood illness management through IMCI approach in District Health Center, Cianjur. In determining the variables to be used as monitoring indicators, first we should analyze variables related to childhood illness management quality served by health personel. In this research we use cross sectional as research design and chi square and logistic regression as statistic analysis. Based the analysis on several variables we get conclusion that there is relationship between health personel knowledge and childhood illness managemenet quality (p=),0l3); between supervision and childhood illness management quality (p = 0,008); and between complete equipment and drugs of IMCI and childhood illness management quality (p-0,001). Logistic regression test shows that the most significant variables to childhood illness management quality in PHC is the health personel knowledge and complete equipment and drugs. Variables use as monitoring indicators are health personel knowledge and complete equipment and drugs which are believed as most significant factors to childhood illness management quality; supervision, because it shows relationship through bivariat test. Based on analysis results, we prepare monitoring system design which can provide information on workers capabilities level of knowledge, complete facilities/instrument in Public Health Center based on type and existence of health personel supervision. The design is limited on input design, collection mechanism and data process, output design, spesification of need of hardware and software. Based on analysis results, we have some suggestions to the Head of District Health Office Cianjur, They are: Periodic monitoring on variables health personel knowledge; complete facilities (equipment and drugs) and existence of worker supervision; refreshing on childhood illness management through IMCI approach to improve health personel knowledge; completing IMCI drugs and equipment in Public Health Center. There are some suggestions regarding the results of monitoring system design, they are: The monitoring system management would be better performed by Health Planning and Information division; there should be any workers who-master computer program especially aplication program of windows, because this system is made in microsoft access program. Hardware technology in this monitoring system programme is: PC-DOS or MS-DOS operation system version 2.0 or higher; hard disk with minimum capacity of 500 MB, RAM 8 MB, at least one floppy drive, pentium processor 100 or higher. The computerized design should undergo several tests in order to anticipate mistakes in programming and to make it complete. In its implementation, we should do monitoring and evaluation on every step from data input, output and feedback of system to know whether the system has work smoothly.

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Angka Kematian Bayi (AKB) dan Angka Kematian Balita (AKABA) di Kabupaten Cianjur masih tinggi. Untuk mempercepat penurunan AKB dan AKABA tersebut berbagai upaya telah dijalankan, dan salah satu strateginya adalah memadukan penanganan penyakit yang selama ini masih berjalan terpisah-pisah dengan melakukan pendekatan baru yaitu Manajemen Terpadu Balita Sakit (MTBS). MTBS adalah suatu pendekatan keterpaduan balita sakit, yang memadukan pelayanan promotif, preventif serta kuratif pada lima penyakit penyebab utama kematian pada bayi dan balita di negara berkembang, yaitu pnemonia, diare, campak dan malaria serta malnutrisi. MTBS pada prinsipnya untuk memperbaiki kualitas pelayanan kesehatan pada balita sakit. Untuk terlaksananya kualitas pelayanan kesehatan ada persyaratannya, yaitu antara lain standar masukan (petugas, sarana, dana), standar lingkungan, dan standar proses. Persyaratan tersebut hams selalu dipantau secara berkala agar kualitas pelayanan selalu terjaga. Di Kabupaten Cianjur kualitas pelayanan kesehatan pada balita dengan melakukan tatalaksana kasus pada balita sakit melalui pendekatan MTBS memperlihatkan adanya penurunan. Selain itu, pemantauan yang dilakukan masih tertuju pada bagaimana kualitas tatalaksana kasus dilakukan' oleh petugas (proses), sementara terhadap masukan (input) dan lingkungan belum dilakukan. Tujuan penelitian ini adalah merancang sistem pemantauan kualitas tatalaksana balita sakit melalui pendekatan MTBS di Puskesmas Kabupaten Cianjur. Untuk menetapkan variabel yang akan dijadikan indikator pemantauan, terlebih dahulu dilakukan analisis terhadap variabel yang berhubungan dengan kualitas tatalaksana balita sakit oleh petugas Puskesmas. Analisis dilakukan dengan menggunakan pendekatan penelitian. Disain penelitian yang digunakan adalah cross sectional dan analisis statistiknya menggunakan Chi square dan regresi logistik Dari analisis terhadap beberapa variabel diperoleh basil bahwa adanya hubungan antara pengetahuan petugas dengan kualitas tatalaksana balita sakit (p = 0,013); ada hubungan antara supervisi dengan kualitas tatalaksana balita sakit (p = 0,008); ada hubungan antara kelengkapan sarana MTBS dengan kualitas tatalaksana balita sakit (p = 0,001). Selanjutnya uji regresi logistik menunjukkan bahwa variabel yang paling berpengaruh terhadap kualitas tatalaksana balita sakit di Puskesmas adalah variabel pengetahuan petugas dan kelengkapan sarana. Variabel yang dijadikan indikator pemantauan, selain pengetahuan petugas dan kelengkapan sarana yang diketahui paling kuat pengaruhnya terhadap kualitas tatalaksana balita sakit, variabel supervisi juga disertakan karena pada uji bivariat terbukti berhubungan. Berdasarkan basil analisis diatas, selanjutnya disusun rancangan sistem pemantauanyang dapat menyajikan informasi mengenai tingkat kapabilitas petugas dan aspekengetahuan, kelengkapan sarana/peralatan di Puskesmas berdasarkan jenisnya, dan ada tidaknya supervisi terhadap petugas. Rancangan sistem yang disusun dibatasi pada rancangan input, mekanisme pengumpuian dan pengolahan data, rancangan output, spesifikasi kebutuhan hardware dan software. Berdasarkan hasil analisis, saran untuk Kepala Dinas Kesehatan Kabupaten Cianjur adalah sebagai berikut: Dilakukan pemantauan secara berkala terhadap variabel pengetahuan petugas, kelengkapan sarana, dan ada tidaknya supervisi terhadap petugas; dilaksanakan penyegaran tentang tatalaksana balita sakit melalui pendekatan MTBS pada petugas Puskesmas; melengkapi sarana MTBS pads Puskesmas yang sarananya tidak lengkap. Selanjutnya berdasarkan basil model rancangan sistem pemantauan yang dikembangkan, beberapa saran yang dikemukakan adalah sebagai berikut: Pengelolaan Sistem Pemantauan ini sebaiknya dilaksanakan oleh Urusan Perencanaan dan Informasi Kesehatan; ada tenaga yang menguasai komputer terutama yang menguasai program aplikasi yang berbasis windows mengingat sistem ini dibuat dalam program microsoft accsess; Teknologi perangkat keras yang diperlukan untuk pemrograman sistem pemantauan ini adalah: Sistem operasi PC-DOS atau MS-DOS versi 2.0 atau lebih tinggi, hard disk berkapasitas minimum 500 MB, RAM 8 MB, minimum sebuah floppy drive, processor pentium 100 atau lebih; rancangan yang dibuat secara komputerisasi hares diujicobakan terlebih dahulu agar kesalahan-kesalahan yang terjadi dalam pembuatan program dapat diketahui dan dilakukan penyempurnaan-penyempurnaan; Dalam implementasinya, perlu dilakukan pemantauan dan evaluasi terhadap tiap tahapan mulai dari input data sampai output dan feedback dari sistem yang berjalan

Abstrak :
Tuberkulosis resisten obat merupakan satu dari sepuluh penyakit penyebab kematian. Jakarta Timur merupakan wilayah dengan jumlah penduduk tertinggi di DKI Jakarta dan beban Tuberkulosis resisten obat di Jakarta Timur meningkat setiap tahunnya. Penelitian ini bertujuan untuk mengetahui bagaimana pelaksanaan manajemen terpadu dalam meningkatkan kinerja pengendalian tuberkulosis resisten obat di Jakarta Timur. Jenis penelitian ini adalah penelitian kualitatif dengan metode Rapid Assessment Procedure (RAP). Hasil penelitian menunjukkan manajemen terpadu dilaksanakan secara simultan dari perencanaan, pengorganisasian, penggerakan dan monitoring dalam memanfaatkan sumber daya pengendalian TB RO yang terbatas dengan menitik beratkan pada jejaring internal dan eksternal untuk meningkatkan kinerja pengendalian TB RO. Kinerja pengendalian Tuberkulosis resisten obat di Jakarta Timur belum optimal karena tidak semua pasien terkonfirmasi Tuberkulosis resisten obat mengikuti program pengobatan dan angka keberhasilan pengobatan masih rendah. Suku Dinas Kesehatan Jakarta Timur perlu meningkatkan program preventif promotif, berinvestasi mengembangkan jenis pelayanan penunjang di RSUD dan mengembangkan sistem survailans Tuberkulosis resisten obat untuk meningkatkan kinerja pengendalian Tuberkulosis resisten obat di Jakarta Timur. ......Drug-resistant tuberculosis is one of ten diseases that cause death. East Jakarta is the region with the highest population in DKI Jakarta and the burden of drug resistant tuberculosis in East Jakarta is increasing every year. This study aims to find out how the implementation of integrated management in improving the performance of drug resistant tuberculosis control in East Jakarta. This type of research is a qualitative study using the Rapid Assessment Procedure (RAP) method. The results showed that integrated management was carried out simultaneously from planning, organizing, leading and monitoring in utilizing limited TB RO control resources by focusing on internal and external networks to improve TB RO control performance. The performance of controlling drug resistant tuberculosis in East Jakarta is not optimal because not all patients confirmed drug resistant tuberculosis is following the treatment program and the success rate of treatment is still low. The East Jakarta Health Office needs to increase promotive preventive programs, invest in developing supporting services in hospitals and develop drug resistant tuberculosis surveillance sistems to improve the performance of drug resistant tuberculosis control in East Jakarta.