Persepsi Stakeholder tentang pelayanan kesehatan masyarakat miskin di Kota Kupang Provinsi NTT

RETNOWATI, dr. Kristiani, SU

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

Latar Belakang: Organisasi Kesehatan Sedunia (WHO, 1948), Undang- Undang Dasar 1945 pasal 28 H dan Undang-Undang Nomor 23 / 1992 tentang Kesehatan menetapkan bahwa kesehatan adalah hak fundamental setiap warga negara. Krisis moneter yang terjadi sekitar tahun 1997 telah memberikan andil meningkatkan jumlah pendiuduk miskin di Kota Kupang (41,5%) dan biaya kesehatan sehingga menekan akses penduduk terutama penduduk miskin terhadap pelayanan kesehatan. Pelayanan kesehatan di Puskesmas dan Rumah sakit masih jauh yang diharapkan. Beberapa akses jenis pelayanan kesehatan masyarakat miskin yang masih rendah, mutu pelayanan yang belum optimal. Pemenuhan terhadap biaya pelayanan kesehatan semakin memerlukan pemikiran di era desentralisasi, karena tidak semua daerah mampu membiayai pelayanan kesehatan masyarakat miskinnya. Persepsi yang positif dari stakeholder akan mendukung keberhasilan program pelayanan kesehatan teriutama penduduk miskin. Tujuan penelitian: untuk mengetahui persepsi stakeholder tentang pelayanan kesehatan masyarakat miskin di Kota Kupang. Methode penelitian: Jenis penelitian ini adalah diskriptif dengan rancangan studi kasus menggunakan methode kualitatif. Cara pengumpulan data dengan pengamatan, wawancara serta penelusuran dokumen. Hasil wawancara dibuat transktip, dilakukan periksa silang dengan cara triangulasi dan dilakukan analisa data. Hasil: Program Pelayanan Kesehatan masyarakat miskin yang sudah berjalan dari tahun 1997 sampai dengan sekarang belum berjalan dengan baik dan masih bersifat “ Top Down “ oleh karena pamahaman program pelayanan hanya dipahami oleh kategori stakeholder pengambil kebijakan, pemberi pelayanan kesehatan dan pengelola dana, sementara kategori stakeholder masyarakat miskin yang merupakan target pelayanan tidak memahami program pelayanan kesehatan masyarakat miskin. Pelayanan yang diberikan baik di Puskesmas maupun di Rumah Sakit masih jauh dari yang diharapkan , selain kejelasan kepesertaan / status masyarakat miskin dan distribusi kartu yang belum valid juga dukungan pemerintah daerah yang sangat kecil yang menyebabkan masyarakat miskin harus mengeluarkan biaya tambahan. Akses sarana pelayanan kesehatan di Kota Kupang mudah dijangkau karena geografis yang mudah dan adanya inisiatif tabungan siaga kelurahan. Kesimpulan: Program pelayanan kesehatan masyarakat miskin masih perlu dilakukan pembenahan dan perbaikan mulai dari segi kebijakan, pendanaan maupun mutu pelayanan kesehatan.

Background: WHO, UUD 1945 section 28 H and regulation no. 23/1992 on health stated that health is a basic right for every citizen. Monetary crisis that took place around 1997 has increased the number of poor community in Kupang municipality (41,5%) and health cost so that community’s access especially poor community toward health service is decreased. Health service in Primary Health Care and hospital is still far from what it is expected. Access to health service types of poor community was still low and service quality was not yet optimum. The fulfillment toward health service cost need consideration in decentralization era as not all of the area is able to give funding on health service of poor community. Positive perception from stakeholder will support the successfulness of health service program especially poor community. Objective: This research was aimed to find out stakeholders perception regarding health service of poor community in Kupang municipality. Method: This was a descriptive research that used case study design and qualitative method. The data was collected by using observation, interview as well as document searching. The result of interview will be transcribed, cross tabulated with triangulation and analyzed. Result: The health service program of poor community which has run from the year 1997 up to now was not really understood by the community as the understanding of the service program only understood by stakeholder of care giver, decision maker and program manager and the still having the character “Top Down” while poor community which becomes the target did not understand the health service program that should becomes their rights. Service that was given in Primary Health Care or hospital was still far from what it is expected, besides clear explanation of participation/poor community status and invalid card distribution as well as lack of regional government support which caused the poor community expends additional charge. Health service facility in Kupang municipality was very accessible because of the easy geographic location and the deposit in the village. Conclusion: The health service program of poor community still needs Health Service Program of poor public which has run from the year 1997 up to now has not run carefully and still having the character " Top Down " because of pamahaman service program only be comprehended by category stakeholder policy taker, health service giver and fund organizer, whereas category stakeholder poor public which is target of service doesn't comprehend health service program of poor public.improvement from policy, funding or health service quality.

Kata Kunci : Layanan Kesehatan Masyarakat Miskin,Persepsi Stakeholder