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"ABSTRAKPenelitian ini bertujuan untuk menilai hasil pengukuran kemampuan dokterIndonesia di Fasilitas Kesehatan Tingkat Pertama FKTP dengan menggunakankuesioner yang disusun oleh Kementerian Kesehatan. Kuesioner penilaiankemampuan diri sendiri tersebut berisi kompetensi/kemampuan dokter menatalaksana 155 penyakit. Secara spesifik, penelitian ini dilakukan untuk mengetahuihubungan antara jenis kelamin, jenis perguruan tinggi, program internsip, programPTT, lama praktek dan daerah praktek dengan kemampuan dokter. Penelitian inimenggunakan desain cross-sectional yang melibatkan 285 dokter di 28kabupaten/kota yang tersebar di 22 provinsi di seluruh Indonesia.Hasil penelitian ini menunjukkan bahwa jenis perguruan tinggi , program PTT danprogram internsip berhubungan secara signifikan p < 0,05 dengan kemampuandokter menata laksana 155 penyakit di Fasilitas Kesehatan Tingkat Primer.Saat ini dibutuhkan suatu Kebijakan Nasional yang kuat di bidang Kesehatanyang mengedepankan pentingnya peranan dokter di Fasilitas Kesehatan TingkatPertama untuk meningkatkan capaian kesehatan.Kata kunci: kemampuan dokter, jenis kelamin, jenis perguruan tinggi,program internsip, program PTT, lama praktik, daerahpraktik

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ABSTRACTThis study aimed to assess Indonesian physicians self perceived activities inprimary care setting using questionnaires, constructed by the MOH. Selfassessmentquestionnaires comprise of competencies abilities of treating 155diseases. In specific, this study is to explore the association between gender, typeof college, internship program, PTT program, years of practice, and region ofpractice towards physician activities in treating diseases in a primary health care.This study is a cross sectional that involved 285 physicians in 28 districts in 22provinces across Indonesia.Results indicated that type of college, internship and PTT program aresignificantly related p .05 to physician abilities to treat 155 diseases at theprimary health care. A strong national health policy that requires the essential roleof primary care physicians in health outcome is urgently needed.Keywords physician activities, gender, type of college, intership program,PTT program, years of practice, region of practice"

"Tesis ini membahas pengaruh pemaparan hasil survei kepuasan pasien yangditampilkan dalam bentuk analisis diagram kartesius terhadap peningkatankepuasan pasien. Penelitian dilakukan di poli umum Puskesmas I Cilongok terakreditasi madya dan Puskesmas Jatilawang terakreditasi utama. Respondenpada penelitian ini adalah pasien dewasa yang memanfaatkan fasilitas kesehatanpoli umum yang berjumlah 480 orang. Penelitian ini adalah Quasi Eksperimendengan model rancangan pre test ndash; post test design. Hasil penelitian menunjukkankarakteristik sosiodemografi responden pada survei awal dan survei akhir terdapattidak homogenitas pada umur dan jenis kelamin sedangkan hasil pemaparan hasilanalisis diagram kartesius kepuasan pasien berpengaruh secara bermakna terhadappeningkatan kepuasan pasien di poli umum Puskesmas I Cilongok dan PuskesmasJatilawang setelah dilakukan intervensi. Hasil lainnya yaitu adanya perbedaanyang bermakna antara kepuasan pasien di Puskesmas I Cilongok yangterakreditasi madya dengan kepuasan pasien di Puskesmas Jatilawang yangterakreditasi utama. Selain itu intervensi berupa pemaparan hasil analisis diagramkartesius kepuasan pasien berpengaruh terhadap pergeseran atribut kepuasanpasien di kuadran A prioritas pada Puskesmas I Cilongok dari 6 atribut menjadi4 atribut dan pada Puskesmas Jatilawang dari 1 Atribut menjadi 3 atributsedangkan pada kuadran D berlebih juga mengalami pergeseran pada PuskesmasI Cilongok dari 2 atribut menjadi 2 atribut dan pada Puskesmas Jatilawang dari 7atribut menjadi tidak ada.

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This thesis discusses the effect of exposure of patient satisfaction survey resultswhich is shown in the form of Cartesian diagram analysis to increase consumersatisfaction. The research was conducted in the general public health center ofcilongok 1 middle accredited and jatilawang health center main accredited .Respondents in this study were adult patients who using public health facilitieswhich amounted to 48 people. This research is quasi experiment with pre testdesign model post test design. The result of the research showed that the resultof the analysis of cartesian diagram of patient satisfaction had a significant effecton the increase of patient satisfaction in the general polyclinic of general publichealth center 1 Cilongok and general public health center jatilawang afterintervention, with p value 0,006 for general public health center 1 Cilongok and pvalue 0.0001 for general public health center jatilawang. Other result that there isa significant difference between patient satisfaction at general public health centerI Cilongok which middle accredited with patient satisfaction at general publichealth center jatilawang which main accredited with p value 0.0001. Besides thatintervention in the form of exposure result of analysis of cartesian patient diagramhave an effect on patient attribute shift in quadrant A priority at general publichealth center 1 Cilongok from 6 attribute become 4 attribute and at general publichealth center jatilawang from 1 attribute become 3 attribute."

"Undang-Undang Kesehatan Nomor 36 tahun 2009 menyatakan bahwa setiap anak berhak memperoleh imunisasi dasar sesuai dengan ketentuan untuk mencegah terjadinya penyakit yang dapat dihindari melalui imunisasi. Pemerintah juga wajib memberikan imunisasi dasar lengkap kepada setiap bayi dan anak. Pada tahun 2017, Kota Depok berstatus KLB difteri dengan 12 kasus suspect difteri dan 1 orang meninggal. Kota Depok merupakan wilayah yang berpotensi transmisi penyakit menular tinggi karena padat penduduk dan mobilitas tinggi. Imunisasi Dasar Lengkap (IDL) merupakan salah satu program dari kebijakan imunisasi yang lama dilaksanakan namun belum menemui keberhasilan yang diharapkan. Analisis implementasi ditujukan untuk melihat bagaimana pengimplementasian program imunisasi dasar lengkap di Puskesmas. Penelitian ini adalah penelitian kualitatif dengan teknik wawancara mendalam dan telaah dokumen terkait, sesuai dengan teori implementasi kebijakan Van Meter dan Van Horn berdasarkan 6 (enam) variabel.Hasil penelitian didapatkan bahwa standar dan sasaran kebijakan belum tercapai sepenuhnya. Sumber daya terkendala berdasarkan indikator insentif yang belum dirasakan secara optimal dalam menunjang optimalnya penyelenggaraan IDL di Puskesmas. Komunikasi antar organisasi pelaksana baik. Karakteristik pelaksana terkendala dengan keterbatasan SDM. Sikap pelaksana mendukung. Kondisi ekonomi dan politik baik, namun kondisi sosial belum mendukung. Kesimpulan didapatkan bahwa implementasi IDL di Kota Depok masih memiliki kendala di setiap variabelnya dan perlu dilakukan proses pemenuhan variabel yang kurang. Rekomendasi penelitian ini yaitu keberhasilan implementasi akan dicapai bila dilakukan perbaikan dari kekurangan, baik dari sisi standar dan sasaran, sumber daya, komunikasi antar organisasi pelaksana, karakteristik pelaksana, sikap pelaksana, dan kondisi sosial, ekonomi, politik. Hambatan program yang ada bisa diatasi dengan mengoptimalkan wewenang Puskesmas sebagai pembina wilayah.

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Health Law Number 36 of 2009 states that every child deserved in basic immunization according the provisions to prevent the occurrence of diseases that can be avoided through immunization. The government is also required to provide a complete basic immunization to every baby and child. In 2017, Depok became outbreak with 12 cases suspect diphtheria and 1 person died. The city of Depok is an area with high transmission potential for communicable diseases due to high population and high mobility. Complete Basic Immunization (IDL) is one of the old immunization policy implemented but has not met the expected success. Complete Basic Immunization Program is one of the old immunization policy programs implemented but has not met the expected success. The implementation analysis is intended to see how the implementation of the complete basic immunization program at the Puskesmas. This research is a qualitative research with in- depth interview technique and related document study which using the policy implementation theory of Van Meter and Van Horn based on 6 (six) variables.

The results obtained that the standard and objective have not been fully achieved. Resources are constrained by incentive indicators that have not been felt optimally in supporting the optimal implementation of complete basic immunization in Puskesmas. Inter- organizational communication is good. Characteristic of implementing agencies are constrained by human resource constraints. Disposition of implementors supported, but still found some implementers who are not orderly. Economic and political conditions are good, but social condition are not yet supportive. Conclusion found that implementation of complete basic immunization in Depok still has constraints in each variable and need to be done process of fulfillment of less variable. The recommendation of this research is the success of implementation will be achieved if the improvement of deficiency, both from the side of standard and objective, policy resources, interorganizational communication, characteristic of implementing agencies, disposition of implementors, and social, economy, political condition. Barriers to existing programs can be overcome by optimizing the Puskesmas's authority as a regional coach."

"Faktor penyebab tingginya AKI (346/100.000KH) yaitu belum tercapainya indikator pertolongan persalinan di fasilitas kesehatan. Pertolongan persalinan di fasilitas kesehatan dipengaruhi oleh faktor individu dan provinsi. Penelitian ini bertujuan melihat pengaruh dan besar kontribusi faktor individu dan provinsi terhadap pertolongan persalinan di enam provinsi di Indonesia berdasarkan data SDKI dan profil kesehatan Indonesia tahun 2012. Hasil analisis multilevel regresi logistik multinomial menunjukan, determinan pertolongan persalinan meliputi asuhan kehamilan, daerah, asuransi kesehatan, indeks kepemilikan, pekerjaan suami, pekerjaan, pendidikan ibu, paritas, umur, rasio bidan, rasio puskesmas, rasio tempat tidur rumah sakit dan kepadatan penduduk. Faktor provinsi menurunkan 24.22% variasi pertolongan persalinan di Indonesia.

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The high maternal mortality rate (346 per 100.000 live birth) in Indonesia is caused by several factors, one of it is that Indonesia has not been achieved the indicator of aid deliveries in health facilities. This study aims to look at the influence and the contribution of individual factors and province factor on deliveries in six provinces in Indonesia based on data from Demographic and Health Survey and health profiles of Indonesia in 2012. Based on the analysis of multilevel multinomial logistic regression, the determinant of delivery aid is the individual factors include the antenatal care, regions, health insurance, household wealth index, husband's occupation, employment and education of women of childbearing age, parity and the age of them. The determinant factor of the province covers the ratio of health centers, the ratio of beds and population density. Contextual variables (province factors) decrease 24.22% variation deliveries at six provinces in Indonesia."

"Tesis ini membahas pelaksanaan Pelayanan Kesehatan Bergerak (PKB) untuk mendekatkan akses pelayanan kesehatan ke masyarakat di kawasan terpencil dan sangat terpencil. Pencatatan dan Pelaporan PKB dilakukan dengan metode paper based, sehingga memiliki beberapa risiko yang dapat menghambat keberlangsungan data dari pengumpulan, pencatatan, dan sampai proses pelaporan. Tujuan penelitian ini untuk mengembangkan sistem informasi pencatatan dan pelaporan PKB dengan memanfaatkan teknologi telepon bergerak (mobile phone). Metode pengembangan sistem menggunakan teknik SDLC dengan model RAD dengan menggunakan teknik prototyping. Hasil penelitian menyajikan bahwa pemanfaatan telepon bergerak (mobile phone) berbasis android sebagai alat bantu dalam pengumpulan data pelaksanaan pencatatan dan pelaporan PKB dapat dijalankan secara offline. Prototipe sistem informasi ini dapat berjalan lebih efisien dari sisi waktu, pengiriman data ke server membuat data lebih aman, memudahkan para Tim Pelayanan Kesehatan Bergerak (TPKB) untuk menginput data sebagai bahan pelaporan.

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The focus of this study discusses the implementation mobile health services program to bring health service access closer to the community in remote and very remote area. Recording and reporting mobile health service with the paper based method, there is the risk of this method on delays the availability of the data for analysis, introduces errors during the transcription process until data reporting. The purpose of this study is to produce a system of information based on mobile phone for recording ad reporting mobile health services program with mobile phone technology. The method used in software engineering is DLC with RAD model, while for the method of designing systems using prototyping. Collecting data using mobile technology made the process more efficient in term of time, especially when the data is uploaded to a properly administered server, makes the data much more secure, more effective to use for mobile health clinic team or health provider for data collection."

"Tesis ini bertujuan untuk menganalisis implementasi Program Indonesia Sehat denganpendekatan keluarga PIS-PK di Kabupaten Bandung tahun 2017. Proses implementasikebijakan dilihat dari unsur proses kebijakan, komunikasi, ketersediaan sumberdayatenaga, biaya, fasilitas yang dibutuhkan, proses disposisi, dan struktur birokrasi ditingkat dinas kesehatan dan di puskesmas. Selain itu peneliti juga menganalisa faktorkondisi sosial, ekonomi dan politik terkait peran dan dukunganstakeholder terhadapimplementasi program keluarga sehat ini. Desain penelitian ini adalah penelitiankualitatif dengan metode deskriptif eksploratif. Penelitian ini dilaksanakan di dinas kesehatan dan 12 puskesmas percontohan di wilayah Kabupaten Bandung. Metode pengambilan data menggunakan metode wawancara mendalam dan focus group discussion FGD kepada beberapa informan yang dipilih purposif sampling, informan dari dinas kesehatan dan puskesmas serta melakukan trianggulasi data dengan telaahdokumen. Hasil penelitian didapatkan bahwa disposisi dan persepsi yang kurang dari pengambil keputusan key decision maker di dinas kesehatan mengakibatkan kurangnya dukungan dan komitmen sehingga memberikan dampak kurangnya komunikasi, tidak berjalannya koordinasi, dan tidak jelasnya struktur birokrasi. Kurangnya komunikasi di dinas kesehatan mempengaruhi proses perencanaan, pembiayaan, pelaksanaan sampai monitoring evaluasi. Komunikasi yang kurang efektif mempegaruhi keterlibatan lintas sektoral di tingkat Kabupaten Bandung. Implementasi program keluarga sehat di puskesmas tidak berjalan optimal. Hambatan utama implementasi di puskesmas karena keterbatasan tenaga dan anggaran. Meskipun sebagian besar puskesmas percontohan sudah melaksanakan beberapa tahapan pelaksanaan program, dari target pendataan keluarga yang ditetapkan sebesar 30 ditahun 2017, hasil cakupan sementara hanya mampu mencapai kurang dari 5. Disposisi dan komunikasi menjadi faktor yang sangat mempengaruhi implementasi program di tingkat dinas kesehatan. Sedangkan faktor ketenagaan dan pembiayaan merupakan faktor penghambat utama implementasi program ditingkat puskesmas. Persepsi dan sikap dari organisasi profesi PPNI dan IBI dan institusi pendidikan terkait program ini cukup baik dan mendukung. Studi ini diharapkan mampu menjadi bahan masukan kepada dinas kesehatan untuk meningkatkan manajemen program terutama dalam proses komunikasi, koordinasi, perencanaan dan pembiayaan dan distribusi tenaga kesehatan dalam implementasi program.

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Aim. This thesis aims to analyze the policy implementation of the Indonesian HealthProgram with Family Approach PIS PK in Bandung Regency in 2017. The process of policy implementation is seen from the elements of policy process, communication, availability of resource,manpower, cost, facilities needed, disposition process and bureaucracy structure at the the Health Center Office and the community health center. This study is also to analyze social, economic, and political factors related to the role and support of stakeholders towards the implementation of the program. Methods. This study was a qualitative research with descriptive design. This research was conducted in the the Health Center Office and twelve community health centers in Bandung Regency area. Data were collected using in depth interview and Focus Group Discussion FGD with informants from those institutions selected using purposive sampling. Data triangulation with document review was performed to ensure the trustworthiness.

Results. The result of the research showed that lack of disposition and perception of key decision makers inthe Health Center Office levelresulted in the lack of support and commitment, which caused of lack of communication, coordination and clarity of bureaucratic structure. The lack of communication at the level of the Health Center Office affected the process of planning, financing, implementation and evaluation as well as influenced cross sectoral engagement at Bandung district level. The implementation of health family program at the community health center was not optimal. The main obstacles to the implementation were limited manpower and budget. Although most community health centers had implemented several stages of program implementation, however, from 30 of the target of the program in 2017, the coverage only reached less than 5.

Conclusion. Disposition and communication were the main factors affecting the implementation of programs at the Health Center Office level. While manpower and financing were the main factors inhibiting the implementation of the program at the community health center level. However, perceptions and attitudes of professional organizations Indonesian National Nurses Association and Indonesian Midwifery Association and the educational institutions related to this program were quite good and supportive.This study recomend to health center office to improving of communication and coordination in Bandung District level and re organizing and distributing of manpower such as nurse, midwifery, public health, sanitarian, and nutritionist to support this program."

"Perkesmas adalah upaya kesehatan yang terintegrasi dengan semua upaya kesehatan Puskesmas, ditujukan kepada individu, keluarga, kelompok dan masyarakat untuk mencapai kemandirian dalam upaya kesehatannya. Tujuan dari penelitian ini menganalisis secara mendalam mutu pelaksanaan program perkesmas di Kabupaten Ogan Ilir. Metode penelitian menggunakan pendekatan kualitatif. Informan penelitian adalah Kepala seksi pelayanan kesehatan primer dan pelayanan kesehatan tradisional, Pemegang program Dinas Kesehatan Kabupaten Ogan Ilir, Kepala UPTD Puskesmas Tanjung Raja, Kepala UPTD Puskesmas Rantau Alai, Pemegang Program Promkes, Kesling, Kesehatan Ibu Anak dan Keluarga Berencana, Pemegang Program Pencegahan dan Pengendalian Penyakit, Pemegang Program Gizi dan Keluarga Binaan Perkesmas. Metode pengumpulan data menggunakan wawancara, diskusi kelompok terarah, observasi dan telaah dokumen. Hasil penelitian terdiri dari komponen input, proses dan output. Komponen input, meliputi sumber daya manusia masih belum mencukupi, pelatihan perkesmas belum pernah dilakukan, sarana dan prasarana masih belum lengkap, pendanaan dinilai cukup, kebijakan secara keseluruhan tidak bermasalah. Komponen proses, meliputi perencanaan belum berjalan cukup baik, pengorganisasian sudah optimal, pelaksanaan perkesmas masih banyak kendala, pengawasan belum optimal. Komponen output perkesmas adalah pencapaian keluarga rawan yang dibina masih dibawah target. Maka dapat disimpulkan bahwa penyelenggaraan perkesmas di Kabupaten Ogan Ilir belum baik.

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Public Health Nursing is an effort of health that integrates with all health community center, aimed for individuals, families, groups and communities to achieve independence in their health endeavors. The purpose of this study to analyze in depth implementation quality of public health nursing programin Ogan Ilir District. The research method used qualitative approach. The research informants were Head of Primary Health Service and Traditional Health Service Section, Program Holder of Ogan Ilir District Health Office, Head of Tanjung Raja Public Health Center, Head of Rantau Alai Public Health Center, Holder Health Promotion Program, Holder Environmental Health Program, Holder Maternal Child and Family Health Program, Holder of Disease Prevention and Control program, Nutrition program and Family built community health care. Methods of data collection were interviews, focus group discussions, observations and document reviews. The results consisted of input, process and output components. Input components, including in sufficient human resources, no public health nursing training, facilities and infrastructure were incomplete, funding was adequate, overall policy was not problematic. Components of the process, including the planning had not run well enough, the organization was good, the implementation of perkesmas were still many obstacles, and monitoring was not optimal. The component of the output of the public health office was the achievement of vulnerable families that developed on below target. So it can be concluded that the implementation of public health nursing in Ogan Ilir District has not been good."