Model Pemanfaatan Program Pelayanan Kesehatan Tradisional dengan Pendekatan Transcultural Nursing Care di Puskesmas Kabupaten Boyolali, Jawa Tengah, Indonesia

SRI MUMPUNI YUNIARSIH, Prof. dr. Yodi Mahendradhata, M.Sc., Ph.D., FRSPH; 5. Dr. Dra. Retna Siwi Padmawati.,MA; Ema Madyaningrum, S.Kep., Ns., M.Kes., Ph.D

2025 | Disertasi | S3 Kedokteran Umum

Pelayanan kesehatan tradisional merupakan bagian dari sistem kesehatan nasional yang terus dikembangkan sebagai alternatif dan pelengkap layanan konvensional. Meskipun telah diterapkan di berbagai Puskesmas, pemanfaatannya masih belum optimal, terutama karena kurangnya pendekatan budaya yang sesuai dengan konteks masyarakat setempat. Penelitian ini bertujuan untuk mengembangkan model pemanfaatan pelayanan kesehatan tradisional dengan pendekatan Transcultural Nursing Care (TNC) di lima Puskesmas di Kabupaten Boyolali.

Penelitian ini merupakan penelitian kualitatif dengan pendekatan Participatory Action Research (PAR) yang meliputi tahap diagnostic, planning, acting dan evaluation. Partisipan dalam penelitian ini terdiri dari petugas kesehatan yang terlibat langsung maupun tidak langsung dalam pelayanan kesehatan tradisional, pasien yang minimal pernah 1 kali menggunakan layanan kesehatan tradisional di puskesmas, dan praktisi pengobat tradisional yang berpraktik di wilayah kerja puskesmas lokasi penelitian. Pengumpulan data dilakukan melalui pengambilan data sekunder, focus group discussion, in-depth interview, self-assessment dan observasi.

Hasil penelitian menunjukkan bahwa penerapan model TNC mampu meningkatkan jumlah kunjungan, kepuasan pasien, serta kompetensi budaya petugas. Tingkat penerimaan terhadap layanan juga meningkat, ditandai dengan pemahaman dan kepercayaan diri petugas dalam pelayanan serta keterbukaan terhadap integrasi pengobatan tradisional dengan pendekatan yang menghormati nilai budaya lokal. Faktor-faktor yang mendukung keberhasilan model ini antara lain pelatihan intensif, dukungan kebijakan lokal, tersedianya pedoman teknis, serta minat masyarakat yang tinggi terhadap layanan berbasis budaya. Namun demikian, tantangan yang dihadapi mencakup keterbatasan sumber daya manusia terlatih serta kurangnya sosialisasi dan edukasi tentang eksistensi dan manfaat klinik kesehatan tradisional.

Model ini memberikan kontribusi penting dalam pengembangan sistem layanan kesehatan primer yang lebih inklusif dan berorientasi budaya. Implikasi dari penelitian ini tidak hanya relevan bagi tenaga keperawatan, tetapi juga bagi pengambil kebijakan, manajemen fasilitas kesehatan, dan pendidik kesehatan masyarakat dalam merancang intervensi yang adaptif terhadap keragaman nilai dan kepercayaan masyarakat.

Traditional health care is an integral part of the national health system, continuously developed as an alternative and complement to conventional services. Although it has been implemented in various public health centers (PHC), its utilization remains suboptimal, primarily due to the lack of culturally appropriate approaches aligned with the local community context. This study aims to develop a model for the utilization of traditional health services using the Transcultural Nursing Care (TNC) approach in five PHCs in Boyolali District.

This research is a qualitative study employing a Participatory Action Research (PAR) approach, consisting of diagnostic, planning, acting, and evaluation phases. Participants included health workers (both directly and indirectly involved in traditional health services), patients who had used traditional services at least once, and traditional healers practicing within the operational areas of the selected PHC. Data were collected through secondary data review, focus group discussions, in-depth interviews, self-assessments, and observations.

The findings revealed that the implementation of the TNC model led to an increase in patient visits, patient satisfaction, and the cultural competence of health workers. Acceptance of the services also improved, as demonstrated by greater understanding, confidence, and openness among health workers in integrating traditional medicine with approaches that respect local cultural values. Supporting factors for the model’s success included intensive training, local policy support, availability of technical guidelines, and strong community interest in culturally-based services. However, challenges included limited trained human resources and insufficient public outreach and education regarding the existence and benefits of traditional health clinics.

This model offers a valuable contribution to the development of a more inclusive and culturally responsive primary health care system. The implications of this study are relevant not only for nursing practice but also for policymakers, health facility managers, and public health educators in designing interventions that are sensitive to cultural diversity and community beliefs

Kata Kunci : pelayanan kesehatan tradisional, keperawatan transkultural, penerimaan layanan, kompetensi budaya, Puskesmas