Gambaran ketenagaan Puskesmas dan upaya redistribusinya di Kabupaten Lombok Tengah Propinsi Nusa Tenggara Barat

TAQIYUDDIN, Muhamad, dr. Kristiani, SU

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebijakan dan Manaj.

Latar belakang: Kebutuhan tenaga kesehatan di puskesmas diatur berdasarkan model puskesmas yang telah di tetapkan oleh Depkes RI 2004, dengan tujuan agar di setiap puskesmas jumlah tenaga dapat dipenuhi secara merata, sehingga dapat memberikan pelayanan yang optimal kepada masyarakat. Namun kenyataannya tenaga kesehatan di puskesmas Kabupaten Lombok Tengah, pendistribusiannya tidak merata. Untuk itulah peneliti melakukan penelitian untuk mengetahui gambaran tenaga kesehatan dan upaya redistribusi yang dilakukan. Tujuan Penelitian: Secara umum adalah untuk mengetahui gambaran tenaga kesehatan puskesmas dan upaya redistribusinya di Kabupaten Lombok Tengah. Metode Penelitian: Penelitian deskriptif dengan rancangan studi kasus tunggal holistik, menggunakan metode kualitatif. Lokasi penelitian di Puskesmas dan Dinas Kesehatan. Subjek penelitian Kepala Dinas, Kepala Tata Usaha Dinas, Ka Sub Bag Dinas, Kepala Puskesmas, Kepala Tata Usaha puskesmas dan Ka Sub Bid Kepegawaian dan Mutasi Badan Kepegawaian Daerah. Data di peroleh melalui wawancara mendalam dan cross chek dengan kenyataan yang ada. Analisis data secara kualitatif untuk mengetahui gambaran tenaga kesehatan dan upaya redistribusi yang dilakukan. Hasil penelitian: Keadaan tenaga kesehatan masih kurang, baik dari jumlah maupun spesifikasi pendidikan, jika dibandingkan dengan jumlah kebutuhan tenaga berdasarkan model puskesmas yang telah di tetapkan oleh Depkes RI 2004. Tenaga kesehatan yang paling kurang adalah asisten apoteker, ahli kesehatan masyarakat dan dokter gigi. Distribusi tenaga kesehatan sulit dilakukan secara merata, karena ketersediaan tenaga yang kurang, adanya intervensi-intervensi dari pihak-pihak yang berkepentingan dan tidak adanya kemauan dari tenaga yang ada untuk dipindah tugaskan ke tempat yang jauh, terutama jika jauh dari pusat kota. Upaya redistribusi yang dilakukan oleh Dinas Kesehatan adalah mutasi, promosi, rotasi mengangkat dokter dan bidan PTT, menambah jumlah formasi CPNS dan juga dengan meningkatkan kualitas sumber daya manusia yang ada. Kesimpulan: Tenaga kesehatan di puskesmas masih kurang, baik dilihat dari jumlah maupun spesifikasi pendidikannya, hal ini disebabkan adanya kendala-kendala dalam proses distribusi dan redistribusi tenaga.

Background: The need of health worker of Community Health Center was be regulated based on Community Health Center model that was established by Indonesian Republic Health Department (Depkes RI) 2004, with the aim in order that the amount of health worker in every community health center could be meet in evenly, so the center could provide the service to the public optimally. However, the fact that the health worker distribution in Community Health Center in Central Lombok have uneven. Therefore, the author performed the research to knowing the figure of health worker and their redistribution that have performed. Objectives: In general is to knowing the figure of health worker in Community Health Center and the effort of their redistribution in Central Lombok Regency. Methods: The research is descriptive research with holistic-single case study design, used qualitative method. The research location was in Community Health Center and Health Office (Dinas Kesehatan). The subject of research was the Office Head (Kepala Dinas), Office Administration Head (Kepala Tata Usaha Dinas), Office Sub-section Head (Ka Subbag Dinas), Head of Community Health Center, Administration Head of Community Health Center, and Sub-section Head of Staff and Mutation of Regional Staff Board. The data was obtained through in depth interview and cross check to the given fact. The data analysis used qualitative analysis to knowing the depiction of health worker and the redistribution effort that had performed. Results: The magnitude of health worker still in shortage, both in the number and education specification, if compared to the health worker need number based on Community Health Center Model that have established by Indonesian Republic Health Department 2004. The most lack of health worker was pharmacist assistant, health public expert and dentist. Health worker distribution was difficult to be performed evenly, because the lack of health worker availability, the intervention by stakeholder, and there are no willing of the health worker to have duty replacement to the remote region, especially if remote from city center. The redistribution effort that have be performed by Health Office was mutation, promotion, rotation by appointed the physician and PTT midwife, add the formation number of Civil Servant Candidate (CPNS) and by increasing the quality of given human resource. Conclusions: The health workers in Community Health Service was still in less both be viewed from number and education specification, this was caused by some obstacles in distribution process and redistribution of the health workers.

Kata Kunci : Kebijakan Kesehatan,Tenaga Puskesmas,Redistribusi