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"ABSTRAKBy 2015, 68% of deaths in Indonesia are due to non-communicable diseases (NCD) and are forecast to increase to 74% by 2030. Riskesdas data of 2013 show that 69.6% of cases of diabetes mellitus and 63.2% of cases of hypertension have not been diagnosed. The government has been trying to proactively make efforts to prevent NCD through the implementation of Posbindu (Integrated Health Post) NCD, but visit Posbindu NCD in the work area of Pasir Mulya Puskesmas, Bogor City is very diverse. The purpose of this study is to analyze the factors of management, communication, partnership, and innovation in the implementation of Posbindu NCD and determinants of the implementation of Posbindu NCD. We conducted in-depth interviews, focus group discussions, document review and observation at two Posbindu NCD with the highest number of visits and the lowest in Gunung Batu Village, Bogor City in 2017. We interviewed 15 informants, consisting of cadres, in charge of NCD Puskesmas, in charge of Puskesmas Pembantu and supervisor of Posbindu NCD. This research found 4 factors, namely management (human resources, fund, and facilities), innovation, communication and partnership that influence the result of Posbindu implementation. Therefore, to run effectively the Posbindu NCD program, then 4 of those factors need to be optimized.ABSTRAKPada tahun 2015 sebanyak 68% kematian di Indonesia disebabkan penyakit tidak menular (PTM) dan diproyeksi meningkat menjadi 74% tahun 2030. Data Riskesdas tahun 2013 menunjukkan bahwa 69,6% kasus diabetes melitus dan 63,2% kasus hipertensi belum terdiagnosis. Pemerintah proaktif melakukan upaya pencegahan PTM melaluipelaksanaan Posbindu PTM. Data kunjungan Posbindu PTM di wilayah kerja Puskesmas Pasir Mulya, Kota Bogor menunjukkan jumlah yang sangat beragam. Tujuan penelitian adalah menganalisis faktor manajemen, komunikasi, kemitraan, dan inovasi dalam pelaksanaan Posbindu PTM dan faktor penentu pelaksanaan Posbindu PTM. Disainpenelitian adalah studi kualitatif dengan metode wawancara mendalam, focus group discussion (FGD), telaah dokumen, dan observasi di dua Posbindu PTM dengan jumlah kunjungan tertinggi dan terendah di Kelurahan Gunung Batu, Kota Bogor tahun 2017. Informan penelitian sebanyak 15 orang yang terdiri dari kader, penanggung jawab program PTM Puskesmas, penanggung jawab Puskesmas Pembantu dan pembina Posbindu PTM. Penelitian menemukan terdapat perbedaan manajemen (SDM, dana, dan sarana), inovasi, komunikasi dan kemitraan antara Posbindu RW 1 dan RW 7 yang memengaruhi hasil pelaksanaan Posbindu PTM. Keempat faktor tersebut pada Posbindu dengan kunjungan terbanyak berjalan lebih optimal dibandingkan dengan Posbindu dengan kunjungan terendah. Agar program PosbinduPTM dapat berjalan efektif maka perlu optimalisasi faktor manajemen, inovasi, komunikasi dan kemitraan."

"Utilisasi pelayanan kesehatan dipengaruhi oleh banyak faktor seperti geografi , sosio-ekonomi, jender, budaya, dan mutu pelayanan. Studi ini berguna untuk memformulasikan kebijakan yang memihak orang miskin. Studi ini menggunakan data Susenas 1998 yang mencakup 205.000 rumah-tangga. Analisis data dilakukan untuk merespon isu equity di Indonesia, dengan penekanan khusus pada keadilan dalam akses.Studi menemukan 88,8% penduduk perkotaan dan 94,3% penduduk perdesaan membayar biaya pelayanan kesehatan secara tunai. Pengeluaran rumah-tangga untuk kesehatan pada kelompok yang paling miskin di perkotaan mencapai 13% dari pengeluaran non-makanan dan di perdesaan 12%. Sementara, pada kelompok sosio-ekonomi paling kaya, angkanya adalah 10% di perkotaan dan 14% di perdesaan. Sebagian besar penduduk miskin (hampir 90%) mengeluarkan kurang dari seperempat (25%) porsi pengeluaran non-makanannya untuk kesehatan.Secara umum, rumah-tangga menghabiskan antara 6-15% dan 20-71% dari pengeluaran non-makanannya, berturut-turut untuk biaya rawat jalan dan biaya rawat inap. Rumah-tangga yang membelanjakan lebih dari 50% pengeluaran non-makanan untuk rawat jalan adalah 3,63% di perkotaan dan 4,31% di perdesaan. Data ini menunjukkan bahwa jumlah rumah-tangga yang mengalami pengeluaran katastropik untuk rawat jalan relatif sedikit. Namun untuk biaya rawat inap, hampir 77% rumah-tangga mengeluarkan lebih dari separuh (>50%) pengeluaran non-makanan sebulan. Pengeluaran katastropik ini mempengaruhi 72,88% rumah-tangga di perkotaan dan 80,98% di perdesaan. Jelas bahwa penduduk memiliki risiko fi nansial sangat tinggi dalam menghadapi kemungkinan kerugian karena sakit. Oleh karena sebagian besar penduduk Indonesia tidak terjamin, gejala ini akan menjadi beban bagi mereka.

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Health expenditure patterns by marginal and vulnerable groups. Utilization of health care is infl uenced by many factors. Most important are geography, socioeconomic, gender inequality, culture, and quality of care. This study aimed at providing policy formulations evidence based in formation for RRO poor, The study is a cross sectional study using National Socioeconomic Survey data set of 1998 representing about 205.000 households. This analysis is conducted to respond the equity issue in Indonesia, with particular emphasize to equity of access (health services use).The study revealed that in urban areas 88.8% of the people pay the outpatient services from their out-of-pocket, while in rural the fi gure is 94.3%. The data shows that in urban areas, among the lowest group, expenditure for health placed about 13% of non-food expenditure. In rural areas the health expenditure accounted to around an average of 12% non-food expenditure. For the highest group of socioeconomic status, expenses on health reached only 10% of non-food expenditure. In rural areas, the highest group has spent for health about 14% of their non-food expenses. Most of the poor (almost 90%) have spent for health below a quarter of non-food expenses.In general, households have spent about 6-15% and 20-71% of their non-food expenses for outpatient and in-patient respectively. Those who spent more than 50% of their non-food expenditure for outpatient is accounted to 3.63% of the households in urban and 4.31% in rural areas. A relatively small percentage of the households in urban and rural areas used a catastrophic spending for outpatient care. Nevertheless, almost 77% of them in urban and rural areas have spent more than 50% of their non-food expenditures per month for inpatient care. This catastrophic spending has affected 72.88% of the households in the urban area and 80.98% in rural areas. Apparently the fi nancial risk is very high for the people in responding the probability of loss due to sickness. Since most Indonesian people are not insured, this phenomenon will become a burden for them."

"ABSTRAKInstitutional delivery has an impact on the decline in maternal mortality rate. In Indonesia, institutional delivery increases every year, but there are still 30% to 37% mothers who deliver at home. Unfortunately, the increase is not in line with maternal mortality reduction, so that Indonesia does not achieve the fifth MDGs goal. To achieve Universal Health Coverage, Indonesia implements National Health Insurance (NHI). NHI integrates four types of health insurance, namely Askes/ASABRI, Jamsostek, Jamkesmas and Jamkesda. One of its benefits is maternal health services. Health insurance can address financial barriers on delivery in health facility. By using secondary data of National Basic Health Research 2013 and Village Potential 2011 data, this study aimed to analyze effect of health insurance on institutional delivery in Indonesia. Samples were 39,942 women aged 15-49 years old who gave birth to their last child during 2010-2013. The study used econometric approach by applying probit and bivariate probit as estimation model to estimate the effect with consideration to endogeneity issue of health insurance. The results found that health insurance was likely to increase institutional delivery by 39.52%. In conclusion, women who have health insurance prefer to deliver birth at health facility compared to those who do not have health insurance."