Swakelola puskesmas di Kabupaten Mukomuko Provinsi Bengkulu
JUNAIDI, Heri, dr. Mubasysyir Hasanbasri, MA
2009 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: Dampak dari otonomi daerah dan perimbangan keuangan antara daerah dan pusat, akan mempengaruhi derajat kesehatan masyarakat di suatu daerah pemekaran, jika pemerintah daerah memberikan dana pembangunan kesehatan relatif lebih kecil dibandingkan dengan sektor lainnya. Puskesmas sebagai ujung tombak pembangunan dibidang kesehatan, masih merupakan pilihan untuk mengatasi masalah kesehatan masyarakat di Kabupaten Mukomuko Provinsi Bengkulu. Puskesmas perlu mengembangkan diri menjadi swakelola sebagai upaya meningkatkan sumber-sumber pendapatan guna meningkatkan mutu pelayanan di era otonomi daerah sekarang ini. Tujuan: untuk mengetahui bagaimana penerapan kebijakan swakelola puskesmas di kabupaten Mukomuko. Metode: Jenis penelitian adalah deskriptif kualitatif, penelitian ini menggunakan rancangan studi kasus. Data diperoleh dengan wawancara mendalam, Focus Group Disscusion, (FGD) dan check dokumen. Subyek penelitian adalah pejabat yang bekerja di lingkungan Pemerintah Daerah dan Dinas Kesehatan Kabupaten Mukomuko yang terdiri dari 5 orang yaitu Ketua DPRD Komisi A, Kepala Bappeda, Kepala Dinas Kesehatan, Kepala Bidang Dinas Kesehatan yang membawahi keuangan, Kepala seksi keuangan di Dinas Kesehatan. Selain itu, responden juga melibatkan Kepala Puskesmas dan pengelola keuangan di 5 puskesmas yaitu Puskesmas Mukomuko, Puskesmas Lubuk Pinang, Puskesmas Penarik, Puksesmas Bantal, Puskesmas Air Rami. Hasil: Puskesmas yang ada di Kabupaten Mukomuko selama ini telah menjalankan bentuk swakelola terbatas dilihat dari wewenang pengelolaan pengembalian 60% pendapatan puskesmas, walaupun regulasi swakelola puskesmas sampai saat ini belum ada. Pengelolaan keuangan di puskesmas mukomuko dipegang oleh 3 orang bendahara yaitu bendahara penerima (rutin), bendahara pengeluaran, dan bendahara jamkesmas. Pendapatan fungsional puskesmas sudah lebih dari cukup dengan hasil kerjasama kontrak dengan pihak lain maupun hasil kunjungan pasien serta dana lebih dari jamkesmas, ini menunjukkan puskesmas mampu membiayai operasional program rutin. Kesimpulan: Regulasi puskesmas swakelola di Kabupaten Mukomuko masih dalam tahap advokasi.
Background: the Impact of autonomy of the area and the balance of finance between the area and the centre, will influence the level of the health of the community in an expansion district, if the regional government gave the development fund of the relative health smaller compared with the other sector. The community health centre as the tip of the development spear sector the health, still was the choice to overcome a problem of the health of the community in the Regency of Mukomuko Bengkulu Province. The community health centre must develop itself to self-management as efforts to increase sources of the income in order to increases the quality of the service in the autonomy era of the area now. Purpose: The study aimed to know how the application of the self-management policy in the community health centre at the Mukomuko regency. Method: The research kind was descriptive qualitative, this research used the case study plan. The data was received with the deep interview, Focus Group Disscusion, (FGD) and check the document. The subject of the research was the official who worked in the Regional Government's environment and the health service of the Mukomuko Regency that consisted of 5 people that is Chairman DPRD KOMISI A, Head of Bappeda, Head of Health Department, Head of the health department Field that supervised finance, the financial Section Head in the health Service. Moreover, the respondent also involved the Head of the Community Health Centre and the financial manager in 5 community health centres that is the Mukomuko Community Health Centre, Lubuk Penang Community Health Centre, Penarik Community Health Centre, Bantal Community Health Centre, Air Rami Community Health Center. Results: The available Community Health Centre in the Mukomuko Regency until now undertook the form self-management limited was seen from the authority of the return management 60% the income of the community health centre, although the regulation self-management the community health centre until this was not yet available. The financial management in the community health centre Mukomuko was held by 3 treasurers that is the recipient's treasurer (the routine), the issuing treasurer, and the treasurer Jamkesmas. The functional income of the community health centre already more than enough with results of the contract co-operation with the other side and results of the patient's visit as well as the fund more than Jamkesmas, this showed the community health centre could finance operational the routine program. Conclusion: The community health centre Regulation self-management in the Mukomuko Regency still in the advocacy stage.
Kata Kunci : Swakelola puskesmas,Kebijakan pemerintah daerah, Self-management the Community Health Centre, the policy of the Regional Government
