Pengembangan Model Pelayanan Puskesmas Mandiri di Era Desentralisasi (Studi Kasus di Propinsi Kalimantan Timur)

Hoedijono, Sulistiyawati (2004) Pengembangan Model Pelayanan Puskesmas Mandiri di Era Desentralisasi (Studi Kasus di Propinsi Kalimantan Timur).

Abstract

The objectives of the study was to develop an autonomous health center through situation analysis of health center services and analysis of health center services design by health stakeholders. The study was done in Kalimantan Timur province, with sample of 4 health centers, 2 health centers in Kota Balikpapan and the other two in kabupaten Kutai Kertanegara. The study was exploratory, cross-sectional, data was collected with questionnaire, in-depth interview, and Focus Group Discussion (FGD). Analysis was done by tabulation and narrative technique. The result showed that health center has not given an optimal response in line with autonomous principles of health center. Situational analysis has shown that (1) health center still carried out 18 basic activities and has not separated between compulsory programs and innovative programs, (2) health center still employ the old management style (Perencanaan Tingkat Puskesmas, Lokakarya Mini, and Stratifikasi), and (3) there was no clear-cut separation of financing aspects between public goods and private goods. The design of an autonomous health center corresponding to local condition was a health center which was able to carry out ‘discretion of management’ in the way that a health center can determine the types of programs/services, able to compete in health services market by privatisizing private goods (out-patient clinics, laboratory, in-patient clinics), able to run an appropriate management effort corresponding to the type of programs/services to be managed. To anticipate negative impact of this market approach, the government should provide subsidy for the poor to maintain equity.

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