Berdasarkan Peraturan Menteri Kesehatan Nomor 43 Tahun 2019 Tentang Pusat Kesehatan Masyarakat, Puskesmas menyelenggarakan Upaya Kesehatan Masyarakat (UKM) dan Upaya Kesehatan Perseorangan (UKP) tingkat pertama, dengan mengutamakan upaya promotif dan preventif tanpa mengabaikan upaya kuratif maupun rehabilitatif. Di era Jaminan Kesehatan Nasional, fungsi puskesmas lebih banyak melakukan pengobatan dari pada pencegahan penyakit. Puskesmas memiliki Puskesmas Pembantu sebagai jaringan yang sebenarnya dapat memperkuat UKM dan UKP di tingkat Desa/Kelurahan jika Puskesmas Pembantu menjadi Fasilitas Kesehatan Tingkat Pertama (FKTP). Namun, belum ada kebijakan tentang puskesmas pembantu dapat menjadi FKTP. Penelitian ini menggunakan metode penelitian kualitatif dengan Pendekatan teori proses analisis kebijakan William N. Dunn. Lokasi penelitian di Puskesmas Perkotaan (Kota Solok), Puskesmas Perdesaan (Kabupaten Tanah Datar), Puskesmas Terpencil (Kabupaten Solok Selatan), serta di Direktorat Tata Kelola Kesehatan Masyarakat Kementerian Kesehatan yang dilaksanakan pada bulan juni sampai juli 2023. Penelitian dilaksanakan dengan wancara mendalam terhadap 9 orang Kepala Puskesmas, 9 orang penanggungjawab Puskesmas Pembantu, 9 orang Masyarakat, Plt. Direktur Tata Kelola Masyarakat, dan Fokus Group Discussion (FGD) terhadap 4 orang Tim Kerja Kebijakan Puskesmas dan Integrasi Layanan Primer, serta telaah dokumen. Temuan penelitian mengungkapkan, Puskesmas memiliki beban kerja yang berat dan lebih fokus pada pelayanan pengobatan, akses masyarakat terhadap FKTP belum semuanya mudah dijangkau oleh masyarakat, belum ada kebijakan yang mengatur wewenang Puskesmas Pembantu sebagai FKTP, dan sebenarnya Puskesmas Pembantu telah layak dijadikan FKTP Klinik Pratama. Diharapkan ada Peraturan Menteri Kesehatan tentang Puskesmas Pembantu menjadi FKTP Klinik Pratama untuk memperkuat Upaya Kesehatan Masyarakat dan Upaya Kesehatan Perorangan yang terintegrasi di tingkat Desa/Kelurahan.
Based on the Regulation of the Minister of Health Number 43 of 2019 concerning Puskesmas, the Puskesmas organizes first-level Public Health Efforts (UKM) and Individual Health Efforts (UKP), with priority on promotive and preventive efforts without neglecting curative and rehabilitative efforts. In the era of the National Health Insurance, the function of the puskesmas was more to treat disease than to prevent disease. The health center has a sub-health center as a network which can actually strengthen UKM and UKP at the Village/Kelurahan level if the sub-health center becomes a First Level Health Facility (FKTP). However, there is no policy regarding how auxiliary puskesmas can become FKTPs. This study uses qualitative research methods with William N. Dunn's policy analysis process theory approach. The research locations were Urban Health Centers (Solok City), Rural Health Centers (Tanah Datar Regency), Remote Health Centers (South Solok Regency), as well as at the Ministry of Health's Directorate of Public Health Management which was conducted from June to July 2023. The research was conducted with in-depth interviews with 9 Heads of Health Centers, 9 people in charge of Supporting Health Centers, 9 people from the Community, Plt. Director of Community Governance, and Focus Group Discussion (FGD) of 4 Community Health Center Policy Work Teams and Integration of Primary Services, as well as document review. The research findings revealed that Puskesmas have a heavy workload and are more focused on medical services, not all of the community's access to FKTPs are easy for the community to reach, there is no policy that regulates the authority of Puskesmas Pembantu as FKTPs, and actually Puskesmas Pembantu are appropriate to be made Primary Clinic FKTPs. It is hoped that there will be a Regulation of the Minister of Health regarding Puskesmas Pembantu to become Primary Clinic FKTPs to strengthen Integrated Public Health Efforts and Individual Health Efforts at the Village level. |
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