Evaluasi Kebijakan Penempatan Tenaga Kesehatan di Puskesmas Sangat Terpencil di Kabupaten Buton

HERMAN, Prof. dr. Laksono Trisnantoro, MSc, PhD

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Salah satu unsur penting yang sangat menentukan dan diharapkan dapat menjadi inovator bagi upaya peningkatan mutu pelayanan kesehatan adalah tenaga kesehatan. Penempatan tenaga kesehatan khususnya di puskesmas sangat terpencil dimaksudkan untuk pemerataan pelayanan kesehatan, namun kenyataannya kebijakan penempatan tenaga kesehatan di puskesmas sangat terpencil di Kabupaten Buton belum merata, disamping itu minat dan motivasi tenaga kesehatan yang ditempatkan di puskesmas sangat terpencil sangat kurang, kalaupun ditempatkan tidak akan bertahan lama, yang dapat dilihat dari tingginya permintaan pindah tugas di daerah perkotaan sehingga terjadi penumpukan tenaga di puskesmas perkotaaan. Tujuan: Untuk mengetahui kebijakan penempatan tenaga kesehatan di puskesmas sangat terpencil Kabupaten Buton Metode: Merupakan penelitian deskriptif, dengan metode kualitatif untuk mengevaluasi kebijakan penempatan tenaga kesehatan di puskesmas sangat terpencil di Kabupaten Buton. Hasil : Kebijakan penempatan tenaga dokter, bidan dan perawat di puskesmas sangat terpencil didukung oleh sarana penunjang yakni rumah dinas dan kendaraan dinas. Kebijakan penempatan terkendala faktor geografis dan intervensi stakeholders didaerah. Tenaga dokter, bidan dan perawat yang ditempatkan tidak retensi tinggal dan bekerja di puskesmas sangat terpencil. Kecilnya penghasilan karena tidak tersedia insentif, pola pengembangan karir yang tidak jelas dan tidak adanya penghargaan bagi mereka yang bekerja di puskesmas sangat terpencil merupakan alasan penting untuk pindah. Perpindahan dilakukan baik antar puskesmas maupun lintas wilayah. Kebijakan penyediaan sarana penunjang belum mampu membuat tenaga retensi tinggal dan bekerja di puskesmas sangat terpencil. Kesimpulan : Kebijakan penempatan tenaga kesehatan belum dapat mengatasi kekurangan tenaga di puskesmas sangat terpencil. Tidak adanya insentif dan ketidakjelasan pengembangan karir dan penghargaan bagi mereka merupakan penyebab tenaga tidak retensi, sehingga di puskesmas sangat terpencil kekurangan tenaga.

Background: One of the important elements and very determining and expected can become innovator in the effort of increasing the quality of health service is health force. The placement of health force especially in the very remote public health center is meant for the generalization of health service, but in fact the placement of health force policy in the very remote public health center in Buton Regency is not yet flattened yet. Besides, the interest and motivation of those who are placed in the are very less, although they are placed, they will not go along way. What we can see is the height of duty switch request to the urban area resulting in the accumulation of health force in the urban public health center. Purpose: Knowing the placement of health force policy in the very remote public health center in Buton Regency. Method: It is a descriptive research, with qualitative method to evaluate the placement of health force policy in the very remote public health center in Buton Regency. Result: The placement of doctor, nurse, and midwife policy in the very remote public health center should be supported by supporting facilities namely office and office vehicle. The placement policy is influenced by geographical factor and the intervention of stakeholders in the Regency. Doctor, nurse and midwife forces placed in the very remote public health center do not have retention to stay and work in the very remote public health center. The so small income produced because of incentive unavailability, the indefinite of carrier development pattern and there is no appreciation for those who work in the very remote public health center are the main reason to request for a duty switch. The duty switch is conducted to the other public health center in the same region or to the other regency. The providing of supporting facilities policy is not able to make the health forces have retention to stay and work in the very remote public health center yet. Conclusion: The placement of health force policy can not overcome the lack of health force in the very remote public health center yet. The incentive unavailability and the indefinite of carrier development and the appreciation inexistence are the main reason why the health forces do not have retention, so that the very remote public health center lacks of health force.

Kata Kunci : Kebijakan penempatan, finansial, sarana penunjang, retensi tenaga, Placement policy, financial, supporting facilities, force retention