Indeks Pembangunan Kesehatan Masyarakat tahun 2013 menempatkanKabupaten Cianjur terendah di Jawa Barat, dan Kota Sukabumi terjadi penurunanpaling signifikan di Provinsi Jawa Barat. Tujuan studi ini untuk menjelaskanimplementasi kebijakan urusan kesehatan di Kabupaten Cianjur dan KotaSukabumi serta mengetahui faktor-faktor yang mempengaruhinya. Penelitiandengan pendekatan postpositivisme menggunakan metode kualitatif. Hasilpenelitian implementasi kebijakan urusan kesehatan di Kabupaten Cianjurmenunjukkan belum validnya data masyarakat miskin untuk program pembiayaankesehatan, adanya hutang Pemerintah Daerah ke fasilitas kesehatan, anggarankesehatan belum 10 , akses masyarakat ke fasilitas kesehatan masih sulit,rujukan puskesmas ke rumah sakit masih tinggi, kurangnya jumlah sumber dayamanusia kesehatan dan kualitas kompetensinya yang rendah, serta belum adaperencanaan dan program pengembangan sumber daya manusia kesehatan.Sementara Kota Sukabumi implementasi kebijakan urusan kesehatan yangmeliputi pembiayaan kesehatan, fasilitas kesehatan, dan sumber daya manusiakesehatan sudah berjalan dengan baik, namun yang masih harus diperhatikanadalah program pengembangan sumber daya manusia kesehatan yang belumberjalan. Faktor kepemimpinan, komunikasi, dan sosio cultural menjadi faktordominan yang mempengaruhi implementasi kebijakan desentralisasi urusankesehatan berdasarkan konsep factors affecting implementation ofdecentralization policies yang dikemukan oleh Cheema dan Rondinelli.Kata Kunci : Kesehatan, Desentralisasi, Implementasi Kebijakan, PembiayaanKesehatan, Fasilitas Kesehatan, Sumber Daya Manusia Kesehatan, KabupatenCianjur, Kota Sukabumi
West Java is one of the provincial area in Indonesia which consist of 25 districtsand cities. Based on 2013 Indonesian Public Health Development Index IPHDI ,there were two areas in West Java with major public health developmentconcerns. District of Cianjur has the lowest IPHDI rank in 2013, while City ofSukabumi experienced a significant decrease in IPDHI rank from 2007 to 2013.This study aimed to analyze implementation of health affair policy and to identifyfactors that affecting it in Cianjur and Sukabumi by using post positivismapproach and qualitative method. The results of the implementation of healthaffairs policy in Cianjur showed that the accurate data on poor society for healthfinancing program was not established, the presence of local government debt tohealth facilities, health budget has not covered 10 of the total budget, difficultiesin accessing health facilities, the number of referral from Puskesmas to hospitalwas high, the number and quality of competence in health human resources waslow, and human health resources development plan and program were notavailable. On the other hand, even though Sukabumi had significant decrease inIPDHI rank, this research found out that Sukabumi has established a wellperformedimplementation of health affairs policy which consist of healthfinancing programs, health facilities and health human resources. However,Sukabumi had to consider to implement the human health resource programswhich were not yet started. Overall, the findings from Cianjur and Sukabumishowed that leadership, communication and sociocultural are the dominant factorswhich influence the implementation of health affairs policy decentralization basedon factors affecting implementation of decentralization policies conceptbyCheema dan Rondinelli.Key words Healthy, Desentralization, Policy Implementation, Health Financing,Health Facility, Human Health Resources, Cianjur, Sukabumi |
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