Analisis Implementasi Kebijakan Standar Pelayanan Minimum Bidang Kesehatan Penderita Diabetes melitus di Kabupaten Magelang
Nika Maya Agustina, dr Yodi Mahendradhata,M.Sc,FRSPH.,Ph.D.; dr Likke Prawidya Putri, MPH, Ph.D
2023 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN
Latar belakang : Dalam
rangka menanggulangi diabetes, pemerintah menetapkan beberapa peraturan
perundang-undangan. Salah satunya yaitu Peraturan Pemerintah Nomor 2 Tahun 2018
Tentang Standar Pelayanan Minimal yang menyebutkan bahwa Standar Pelayanan
Minimal (SPM). Standar teknis pemenuhan mutu pelayanan dasar pada
SPM Bidang Kesehatan diatur dalam Permenkes Nomor 4 Tahun 2019. SPM Kesehatan Daerah Kabupaten/Kota terdiri dari 12
indikator. Salah satu indikatornya adalah pelayanan kesehatan
pada penderita diabetes melitus sesuai standar. Kabupaten Magelang merupakan
kabupaten terendah ketiga tahun 2020 dengan capaian hanya 41,9 persen dan 59, 75 persen pada tahun
2021. Masalah yang dikemukakan di awal belum dapat
diatasi dan mungkin ada potensi yang belum dapat dipergunakan sehingga diperlukan
penelitian mendalam.
Tujuan penelitian : mengeksplorasi faktor penghambat dan factor pendukung capaian kinerja implementasi
kebijakan SPM pelayanan kesehatan penderita diabetes melitus di Kabupaten
Magelang.
Metode penelitian :
Penelitian
ini dilakukan dengan metode Qualitative
content analysis. Subjek penelitian berjumlah 18 orang diambil dengan menggunakan teknik
purposive. Menggunakan teknik wawancara mendalam, observasi lapangan dan
pengambilan data sekunder.
Hasil penelitian : Implementasi kebijakan SPM sudah berjaln sejak tahun 2020. Pandemi
covid-19 dan keterbatasan anggaran, sarana prasarana dan SDM menjadi salah satu
penghambat implementasi SPM di Kabupaten Magelang. Namun dukungan kepemimpinan
dengan strategi kebijakan integrasi serta monitoring dan evaluasi secara
berkala dapat meningkatkan capaian kinerja di beberapa Puskemas. Dukungan
lintas sector juga menjadi kunci keberhasilan implementasi SPM di Kabupaten
Magelang. Perilaku sehat masyarakat kurang antusias dalam mengakses pelayanan,
walaupun sudah ada upaya tenaga kesehatan untuk jemput bola. Pemahaman serta
pengetahuan baik dari segi pengguna dan penyelenggara masih kurang dibuktikan
denga nada miss persepsi berkaitan pedoman yang ada.
Kesimpulan : Terdapat variasi capaian SPM antar
Puskesmas. faktor penghambat pencapaian SPM bidang
kesehatan indicator pelayanan kesehatan pada penderita diabetes melitus di
Kabupaten Magelang yaitu kesiapan
implementasi meliputi kurangnya ketersediaan anggaran, sarana prasarana dan
sumber daya manusia, karakteristik masyarakat serta kurangnya pemahaman dan
pengetahuan baik dari pihak penyelenggara maupun pengguna. Faktor
pendukung pencapaian SPM bidang kesehatan indicator pelayanan kesehatan pada
penderita diabetes melitus di Kabupaten Magelang yaitu dukungan kepemimpinan
dan strategi kebijakan yang dipilih.
Background: In order to overcome diabetes, the government set
some laws and regulations. One of them is PP Number 2 of 2018 concerning
minimum service standards which states that minimum service standards (SPM).Technical standards for fulfilling the quality of
basic services in the health sector SPM are regulated in Permenkes number 4 of
2019. District / City Health SPM consists of 12
indicators. One of the indicators is health care in patients
with diabetes mellitus according to the standard. Magelang regency is the third
lowest Regencyin2020 with achievements of only 41.9 percent and 59.75 percent in 2021. The problems raised at the
beginning can not be overcome and there may be potential that can not be used
so that in-depth research is needed.
Objective: Exploring the inhibiting factors and supporting factors for the performance of the implementation
of SPM policy for health services for people with diabetes mellitus in Magelang
regency.
Methods: This study was conducted by the
method of Qualitative content analysis. Subjects were 18
people taken using purposive technique. Using in-depth interview techniques,
field observation and secondary data retrieval.
Results: The
implementation of SPM policy has been running since 2020. Pandemic covid-19 and
lack of budget, infrastructure and human resources are one of the obstacles to
the implementation of SPM in Magelang regency. However leadership support with
integration policy strategies and regular monitoring and evaluation can improve
performance achievements in several Public Health Center. Cross-sector support
is also the key to the successful implementation of SPM in Magelang regency.
Healthy behavior of the community is less enthusiastic in accessing services,
although there have been efforts by health workers to pick up the people.
Understanding and knowledge both in terms of users and organizers are still
less evidenced by the tone of miss perception related pedoman yang to existing
guidelines.
Conclusion: There are variations in the access of SPM
between Public Health Center. Factors inhibiting
the achievement of SPM in the field of health indicators of health services for
people with diabetes mellitus in Magelang regency namely readiness for implementation include the lack of
availability of budget, infrastructure and Human Resources, community
characteristics and lack of understanding and knowledge both from the
organizers and users. Supporting factors
for the achievement of SPM in the field of health indicators of health services
for patients with diabetes mellitus in Magelang regency are leadership support
and the chosen policy strategy.
Kata Kunci : Diabetes melitus, Dukungan dan hambatan, Implementasi kebijakan SPM / Diabetes mellitus, Policy Implementation, Support and barriers
