TANTANGAN MASALAH SOSIAL DAN GEOGRAFI DALAM PENGELOLAAN LAYANAN KESEHATAN DI DTPK: STUDI KASUS DI PUSKESMAS TEMAJUK KABUPATEN SAMBAS KALIMANTAN BARAT
IKA ARDINA, Dr. Mubasysyir Hasanbasri, MA
2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKATLatar Belakang: Kondisi penduduk yang tinggal di daerah perbatasan adalah unik karena mereka relatif jauh dari fasilitas kesehatan dalam negeri dan bisa memiliki akses pada fasilitas kesehatan di luar negeri (Malaysia). Kehadiran negara bagi penduduk di sana sangat penting dan, karena itu, puskesmas pemberi layanan terdepan yang perlu mendapat perhatian yang besar. Meski penelitian sosial kesehatan sudah mulai banyak dibuat, model health system dalam penyelenggaraan puskesmas di DTPK yang cocok situasi dan kapasitas daerah belum mendapat perhatian. Khususnya daya tanggap dalam pelayanan kesehatan bagi masyarakat di DTPK. Tujuan: Mengeksplorasi masalah sosial dan geografi yang dapat mempengaruhi akses layanan kesehatan dan mencari strategi penguatan sistem puskesmas di daerah terpencil, perbatasan dan kepulauan (DTPK). Metode: Penelitian kualitatif dengan embedded single case study (Yin 2011) dengan data melalui wawancara mendalam dan kajian terhadap dokumen administrasi dan pelaporan puskesmas serta observasi lapangan. Hasil: Daya tanggap sistem pelayanan kesehatan masyarakat di puskesmas Temajuk berdasarkan kerangka konsep health system responsiveness didapatkan bahwa layanan yang diberikan tenaga kesehatan dan kader dengan beban kerja sudah sesuai namun kesesuaian tugas di luar pelayanan langsung masih berat dikarenakan pelaporan manajemen. Kualitas fasilitas pelayanan kesehatan di puskesmas sudah memadai. Upaya penjangkauan pelayanan kesehatan dari puskesmas belum tampak efektif berjalan. Upaya pencarian pelayanan kesehatan dari masyarakat, dimana masyarakat tau layanan kesehatan puskesmas adalah tujuan utama jika sakit. Tantangan pelayanan kesehatan lebih berpengaruh pada tantangan sosial, dimana masyarakat masih perlu pemahaman lebih terkait masalah kesehatan yang mereka hadapi. Kepercayaan masyarakat dalam pemanfaatan fasilitas kesehatan sudah sesuai dengan harapan puskesmas, adanya kerjasama dan merangkul layanan kesehatan lain di wilayah kerja puskesmas. serta dukungan lintas sektor juga sudah mendapat perhatian yang sesuai. Kesimpulan: Upaya menjangkau pelayanan kesehatan dari puskesmas belum dapat dikatakan efektif, karena upaya yang dilakukan oleh tenaga kesehatan belum mampu memberikan terobosan bagi masyarakat untuk memanfaatkan pelayanan langsung ke puskesmas. Masih perlu adanya pemahaman dan kesadaran masyarakat dalam penggunaan dan pemanfaatan layanan.
Background: The condition of the population living in border areas is unique because they are relatively far from domestic health facilities and can have access to health facilities abroad (Malaysia). The presence of the state for the people there is very important and, because of that, it is the primary health care provider that needs to receive great attention. Although a lot of social health research has started to be made, the health system model in the implementation of the Puskesmas (Public Health Center) in DTPK (Remote, Underdeveloped Areas, Borders and Islands) that fits the situation and regional capacity has not received attention. Especially responsiveness in health services for the community in DTPK. Objective: The purpose of this study was to explore social and geographical issues that could affect health care and seek strategies to support the Public Health Center system in DTPK Methods: This study uses a qualitative method with an embedded single case study research design or usually called a single interwoven case study design (Yin 2011). This research was conducted by exploring in depth the process of health services running at the Temajuk Public Health Center as the working area of the public health center in DTPK Results: The responsiveness of the public health service system at the Temajuk Public Health Center based on the framework of the concept of health system responsiveness found that the services provided by health workers and cadres with workloads were appropriate but the suitability of tasks outside of direct services was still difficult due to management reporting. The quality of health care facilities at the Public Health Center is adequate. Efforts to reach health services from the Public Health Center have not seemed to be effective. Efforts to seek health services from the community, where the community knows health services at the Public Health Center is the main goal if you are sick. The challenges of health services are more influential on social challenges, where people still need more understanding regarding the health problems they face. Public trust in the utilization of health facilities is in line with the expectations of the Public Health Center, there is cooperation and embracing other health services in the work area of the Public Health Center and cross-sectoral support has also received appropriate attention. Conclusion: Efforts to reach health services from the Public Health Center cannot be said to be effective, because the efforts made by effective health workers have not been able to provide a breakthrough for the community to take advantage of direct services to the Public Health Center. There is still a need for public understanding and awareness in the use of services.
Kata Kunci : Public health center, health facilities, health services, responsiveness, DTPK
