Kemitraan antara Pemerintah dan Netherlands Leprosy Relief Association dalam program penanggulangan TB di Kabupaten Minahasa

TUEGEH, Meyvi Johana, Prof.dr. Hari Kusnanto J., DrPH

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: NSL adalah LSM dari Belanda yang melakukan kemitraan dengan pemerintah dalam program penanggulangan tuberkulosis (TB) di Kabupaten Minahasa. Namun tidak semua mitra dilibatkan dan ada ketergantungan terhadap donor. Tujuan penelitian: untuk mengetahui proses kemitraan dan faktor- faktor yang mempengaruhi kemitraan antara pemerintah dan NSL dalam program penanggulangan TB di Kabupaten Minahasa. Metode Penelitian: Penelitian ini merupakan penelitian kualitatif dengan rancangan studi kasus. Variabel penelitian adalah faktor pendukung dan penghambat kemitraan dan proses kemitraan. Sampel penelitian dipilih secara purposive sampling dan data dikumpulkan dengan observasi, wawancara mendalam dan melalui diskusi kelompok terarah. Hasil: Semua responden menyatakan tidak pernah dilakukan pertemuan yang melibatkan dinas kesehatan kabupaten, puskesmas, rumah sakit dan NSL secara bersama- sama. Kegiatan program TB masih menjadi bagian satu atau dua orang dan mengacu dari Dinas Kesehatan Provinsi dan belum adanya pembiayaan yang berasal dari Pemerintah Kabupaten Minahasa. Faktor- faktor yang mempengaruhi kemitraan didapatkan adalah tujuan dan sasaran program dipahami semua mitra tapi aturan operasional kurang disosialisasikan, pengambilan keputusan tidak melibatkan puskesmas dan rumah sakit. Semua mitra memiliki peran dalam pelaksanaan program tetapi ada yang tidak melaksanakan tugas sesuai tanggungjawabnya, pelaksana program tidak memahami keberadan NSL, masih adanya dominasi dinas kesehatan provinsi dan pengelolaan keuangan yang tidak melibatkan puskesmas dan rumah sakit. Kesimpulan: Belum ada keterlibatan aktif semua mitra, program TB belum terintegrasi dengan program kesehatan lainnya, dan masih adanya dominasi dinas kesehatan provinsi. Faktor pendukung mengalami gangguan dan kerjasama dengan NSL hanya dipahami oleh beberapa pejabat teras Dinas Kesehatan Kabupaten kabupaten.

Background: The Netherlands Leprosy Relief Association is a non government organization which builds a partnership with government in tuberculosis (TB) control program at Minahasa District. However, not all partners are involved and there is dependence on donors. Objectives: The study was meant to identify partnership process and factors influencing partnership between the government and other parties involved in TB control program at Minahasa District, including NSL. Methods: This was a qualitative research using a case study design. Variables of the study were supporting and obstructing factors of partnership and the process of partnership. Samples were purposively selected and data were collected through observations, in-depth interview and focus group discussions. Result: All respondents stated that no meeting had been held which involved district health office, community health centers and the non government actors. Activities of TB program were part of the tasks carried out by one or two individuals and responsible to provincial health office. No fund provided by the government of Minahasa District. Factors influencing agreement to partnership were: understanding of program’s goal and targets by all partners but operational arrangement had never been socialized, decision making did not involve community health centers and hospitals. All partners were involved in program implementation but some of them did not do the work in line with their responsibilities, program executors did not understand the non government institutes, the dominant role of provincial health office and financial management which did not involve community health centers and hospitals in operational decision making. Conclusion: All partners were not actively involved, TB program had not been integrated with other health programs and dominated by provincial health office. Supporting factors were subject to some obstacles and cooperation with NSL was understood only by some officials at district health office.

Kata Kunci : Manajemen Layanan Kesehatan,Penanggulangan TB,Pola Kemitraan Pemerintah, partnership, tuberculosis, qualitative research