Anggaran Program KIA dalam Rangka Pencapaian Standar Pelayanan Minimal (SPM) Puskesmas Sukamakmur Kabupaten Aceh Besar
SHOPHIAN, Edy, dr. Kristiani, SU
2008 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang : Kecukupan alokasi anggaran kesehatan menjadi faktor penting untuk mewujudkan pelaksanaan program KIA agar dapat mencapai standar pelayanan minimal: untuk itu perlu dilakukan analisis biaya operasional yang dapat dipakai untuk menentukan besarnya anggaran biaya yang seharusnya untuk program KIA, disamping itu juga melakukan wawancara dengan steakholder untuk mengetahui pendapat mereka mengenai pembiayaan program KIA di Puskesmas Sukamakmur Kabupaten Aceh Besar. Tujuan Penelitian : Penelitian ini bertujuan untuk menganalisis biaya operasional program KIA Puskesmas di Kecamatan Sukamakmur yakni dengan menghitung realisasi biaya tahun 2006 dan membandingkan dengan menghitung anggaran biaya program KIA untuk tahun 2008, serta untuk mengetahui tanggapan stakeholder tentang pembiayaan program KIA di Puskesmas Sukamamkmur. Metode Penelitian : Jenis Penelitian adalah penelitian deskriptif analitik dengan rancangan studi kasus. Penelitian ini menganalisis biaya operasional luar gedung dan mengasumsikan anggaran program KIA luar gedung dan dalam gedung berdasarkan Standar Pelayanan Minimal (SPM). Pendapat stakeholder diketahui dengan melakukan wawancara mendalam dengan Kepala Dinas Kesehatan, Kasie Perencanaan, Kasie KIA dinas kesehatan,Kepala Puskesmas, Bidan pengelola program KIA Puskesmas. Hasil : Realisasi biaya operasional program KIA tahun 2006 sebesar Rp.30.394.147,- dengan biaya langsung Rp.30.023.036,- dan biaya tidak langsung Rp.341.111,-. Asumsi anggaran operasional program KIA berdasarkan SPM adalah Rp. 52.781.439,- dengan biaya langsung Rp.52.185.879,- dan biaya tidak langsung Rp.595.560,-. Persentase kenaikan biaya hasil analisis program KIA di Puskesmas Sukamakmur terhadap asumsi anggaran berdasarkan SPM adalah sebesar 57,6%. Mernurut pendapat stakeholders, anggaran biaya kesehatan di Kabupaten Aceh Besar saat ini belum mampu mencapai target SPM. Adapun selama ini anggaran program KIA belum diperhitungkan dalam Rencana Anggaran Satuan Kerja (RASK) Puskesmas Sukamakmur. Kesimpulan : Untuk mencapai target SPM, diperlukan peningkatan biaya operasional program KIA dan anggaran untuk program KIA harus dimasukkan ke dalam RASK Puskesmas Sukamakmur
Background: Health budget allocation sufficiency is an important factor for the realization of mother and child health program in order to achieve standard of minimum service. Therefore it is necessary to analyze operational cost that can be used to determine the amount of recommended budget that should be allocated for mother and child health program and interview stakeholders to find out their opinion about the financing of mother and child health program at District of Aceh Besar. Objective: The study aimed to analyze operational cost of mother and child health program at the health center in Subdistrict of Sukamakmur by calculating budget realization in 2006 and compare it with budget allocation of mother and child health program in 2006 and to identify opinion of stakeholders about the financing of mother and child health program at Sukamakmur Health Center. Method: This was an analytic descriptive study with case study design. It analyzed outdoor operational cost and assumed budget of outdoor and indoor mother and child health program based on minimum service standard and opinion of stakeholders through indepth interview and normative activities of mother and child health program, and interview with head of health office, head of public health guidance section, head of health center, midwives of mother and child health management at the health center, and cashier at the health center. Result: The realization of operational cost of mother and child health program was Rp 16,234,708, comprising direct cost Rp 16,020,000 and indirect cost Rp 214,708. Assumption of operational budget of mother and child health program based on minimum service standard was Rp 25,374,850 comprising direct cost Rp 25,105,000 and indirect cost Rp 269,850. The percentage of cost increase of the result of analysis on mother and child health program at Sukamakmur Health Center against assumption of budget based on minimum service standard was 36%. According to stakeholders, budget of health finance at District of Aceh Besar was presently unable to reach the target of minimum service standard. So far budget of mother and child health program had not been included in activity unit budget plan of Sukamakmur Health Center. Conclusion: To achieve the target of minimum service standard it was necessary to increase operational cost of mother and child health program and budget of mother and child health program had to be included in activity unit budget plan of Sukamakmur Health Center.
Kata Kunci : Manajemen Anggaran,Pemanfaatan Anggaran,Program KIA, budget management, budget utilization, mother and child health program
