Pengaruh Tsunami terhadap kebijakan dan distribusi tenaga dokter dan perawat antar Kabupaten di Propinsi Nanggro Aceh Darussalam

FAUZI, M. Jamil, dr. Mubasysyir Hasanbasri, MA

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

Latar Belakang. Di Indonesia distribusi tenaga dokter dan perawat masih belum merata, termasuk di Kabupaten Aceh Utara. Sebelum tsunami jumlah antara tenaga dokter, perawat dengan rasio per 100.000 penduduk masih rendah. Setelah bencana tsunami menyebabkan kebutuhan tenaga medis dan paramedis semakin meningkat dan bantuan tenaga dari luar sifatnya sementara. Tujuan. Mengetahui pengaruh tsunami terhadap kebijakan dan distribusi dokter dan perawat di Kabupaten Aceh Utara. Metode. Penelitian deskriptif dengan rancangan studi kasus lokasi dan Unit analisis penelitian ini adalah Dinas Kesehatan Kabupaten Aceh Utara. Instrumen penelitian adalah panduan wawancara dan cek dokumen Hasil. Pendistribusian dokter dan perawat di Kabupaten Aceh Utara belum sesuai dengan standar sebelum tsunami akibat konflik politik yang berkepanjangan. Selama terjadi tsunami, tenaga kesehatan di pelayanan pemerintah tetap karena pelayanan untuk korban tsunami teratasi dengan adanya poskeslit yang disediakan oleh Depkes. Pada masa setelah tsunami jumlah perawat meningkat dan telah sesuai dengan standar, sedangkan tenaga kesehatan yang lain belum memenuhi standar tersebut. Kebijakan yang telah diambil oleh kabupaten Aceh Utara melarang mutasi tenaga kesehatan sebelum tsunami berdampak terhadap ketersediaan dokter di Puskesmas tetap. Pembangunan Poskeslit dengan tenaga kesehatan dari Depkes menyebabkan tenaga kesehatan di Puskesmas tidak terganggu. Rekruitmen perawat sesudah tsunami menyebabkan jumlah perawat dapat terpenuhi sesuai standar. Kebijakan gaji, tunjangan dan insentif yang diberikan kepada dokter dan perawat bersumber dari DAU dan APBD. PAD Kabupaten Aceh Utara tidak mempengaruhi pendistribusian tenaga dokter dan perawat. Pendistribusian tenaga dokter dan perawat lebih dipengaruhi oleh situasi politik. Kesimpulan. Ketersediaan dokter dan perawat di Kabupaten Aceh Utara tidak dipengaruhi oleh tsunami, karena kebijakan Pusat lebih dominan.

Background: In Indonesia the distribution of doctors and nurses is still uneven, including in the District of Aceh Utara. Before tsunami happened the ratio between the ratio doctors and nurses per 100,000 population is still relatively low. Tsunami calamity has caused increased need for medical and paramedical staff whereas external staff aids are just temporary. Objective: To identify the effect of tsunami to the policy and distribution of doctors and nurses at the District of Aceh Utara. Method: The study was descriptive with case study design. Location and analysis unit of the study was District Health Office of Aceh Utara. Research instruments were interview guide and document checklist. Result: The distribution of doctors and nurses of the District of Aceh Utara before tsunami had not been based on the standard due to everlasting political conflict. During tsunami calamity the number of health staff at public service remained the same because service for the tsunami victims was supported by the provision of satellite health posts by the Ministry of Health. After tsunami the number of nurses increased and had been relevant with the standard. However this did not happen to other health professionals. The policy made by the District of Aceh Utara not to allow mutation of health staff before tsunami had made the availability of doctors at the health center remain the same. The establishment of satellite health posts with health staff from the Ministry of Health did not cause problems in health staffing at the health center. Recruitment of nurses after tsunami made the number of nurses relevant with the standard. The policy in salary, allowance and incentives provided for doctors and nurses allocated from general allocation fund and local revenue and expenditure budget for health which came from local original revenue of the District of Aceh Utara did not affect the distribution of doctors and nurses. The distribution of doctors and nurses was affected more by political situation. Conclusion: Tsunami did not affect availability of doctors and nurses at the District of Aceh Utara because of dominant policy of the central government.

Kata Kunci : Kebijakan Layanan Kesehatan,Distribusi Dokter dan Perawat,Tsunami