Implementasi kebijakan Safeguarding di Kabupaten Katingan Propinsi Kalimantan Tengah

PARLUHUTAN, drg. Julita Hendrartini, M.Kes

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. dan Manaj. Pe

Latar belakang: Pengawasan Program Jaminan Kesehatan Masyarakat Miskin (PJKMM) berdasarkan SK Menkes No : 332/Menkes/SK/V/2006 dilakukan oleh tim safeguarding . Tugas tim safeguarding adalah untuk menjaga dan menjamin pelaksanaan program agar efektif dan efisien sesuai dengan kendali mutu dan kendali biaya. Kegiatan yang dilakukan tim safeguarding adalah sosialisasi dan penyuluhan, memantau, membina, dan mengevaluasi program, serta menerima pengaduan dan mengelola laporan baik rumah sakit maupun puskesmas. Tujuan: Untuk mengetahui implementasi kebijakan safeguarding dalam pelaksanaan program jaminan kesehatan masyarakat miskin di Puskesmas Kabupaten Katingan. Metode: Penelitian ini merupakan penelitian studi kasus dengan pendekatan kualitatif. Subyek penelitian adalah Kepala Dinas, tim safeguarding dan Kepala Puskesmas. Variabel penelitian adalah tim safeguarding dan kegiatan tim safeguarding. Instrumen penelitian panduan wawancara mendalam. Hasil: Implementasi kebijakan safeguarding di Kabupaten Katingan belum optimal karena faktor lingkungan yaitu kebijakan pusat yang tidak konsisten. Faktor input juga mempengaruhi implementasi kebijakan safeguarding seperti dana dan sarana yang terbatas, SDM yang mempunyai tugas rangkap serta manajemen pendokumentasian PJKMM baik di puskesmas dan dinas kesehatan masih lemah. Kegiatan tim safeguarding hanya menjalankan sosialisasi Program Jaminan Kesehatan Masyarakat Miskin (PJKMM) terhadap petugas dan mengelola laporan dari puskesmas. Pemantauan, pembinaan dan evaluasi dan pengelolaan pengaduan masyarakat belum dilaksanakan. SDM tim safeguarding sudah sesuai dengan pedoman pelaksanaan Jaminan Pemeliharaan Kesehatan Masyarakat Miskin (ASKESKIN) 2006. Kesimpulan: Kinerja tim safeguarding belum optimal karena kendala dana dan lingkungan yang kurang mendukung.

Background: The monitoring of Poor Community Health Insurance Program according to decree of the Ministry of Health No. 332/Menkes/SK/V/2006 is carried out by safeguarding team. The duty of the team is to maintain and ensure the implementation of the program to be effective and efficient in accordance with control of quality and cost. Activities carried out by the team are socialization and dissemination of information, monitoring, maintenance and education of the program as well accommodating claims and monitoring reports of hospitals and community health centers. Objective: To identify the implementation of safeguarding policy in poor community health insurance program at Community Health Center of Katingan District. Method: This was a case study with qualitative approach. Subject of the study were head of health office, safeguarding team, and head of community health center. Variables of the study were safeguarding team and activities of the team. Research instrument used was indepth interview guide. Result: The implementation of safeguarding policy at District of Katingan had not been optimum due to environmental factor i,e. inconsistent national policy. Input factors also affected the implementation of safeguarding policy such as limited fund and facilities, human resources having dual responsibilities and weak management of documentation of poor community health insurance program either at the center and health office. The team had limited activities because they only did socialization of the program to staff and maintained reports from health centers. Monitoring, maintenance, evaluation and management of claims of the community had not been implemented. Human resources of team was relevant with the implementation guideline of poor community health care insurance 2006. Conclusion: Performance of the safeguarding team had not been optimum due to constraints in funding and non condusive environment

Kata Kunci : Layanan Kesehatan,Jaminan Kesehatan,Masyarakat Miskin, safeguarding, performance, poor community health insurance program