Evaluasi kebijakan penggunaan dana alokasi khusus (DAK) dalam pengembangan puskesmas pada daerah terpencil, tertinggal, perbatasan dan kepulauan di Kabupaten Kepulauan Aru

PARANNUAN, Yohanis, Prof. dr. Laksono Trisnantoro, M.Sc., Ph.D

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Desentralisasi kesehatan merupakan strategi pemerintah pusat dalam solusi mengurangi, kesenjangan pelayanan kesehatan publik antara pusat dan daerah, dengan mengucurkan APBN melalui dana perimbangan DAK bidang kesehatan yang mengacu pada juknis Depkes dengan memprioritaskan sarana prasarana kesehatan. Kabupaten Kepulauan Aru dimekarkan sesuai UU No.40/2003 dan termasuk kategori DTPK, Pepres No. 78/2005. Luas wilayah 54.395 km² dan 547 pulau, jumlah penduduk 82.873 jiwa. Pada RPJMD kabupaten tahun 2006-2011 memuat arah kebijakan keuangan daerah, strategi pembangunan daerah, kebijakan umum dan Program SKPD. Tujuan: mengetahui bagaimana hasil Evaluasi kebijakan penggunaan DAK dalam pengembangan puskesmas di Kabupaten kepulauan Aru 2005-2008. Metode: Penelitian ini menggunakan metode kualitatif dengan rancangan penelitian studi kasus deskriptif. Data primer dikumpulkan melalui wawancara mendalam, data sekunder adalah dokumen RPJM Daerah, Renstra Dinas Kesehatan, DIPA atau DPA SKPD. Hasil: Kebijakan penggunaan DAK bidang kesehatan di Kabupaten Kepulauan Aru sudah efisien, merata, responsivitas dan tepat. Masalah yang dihadapi adalah biaya operasional belum mencukupi. Kesimpulan: Evaluasi Kebijakan penggunaan DAK di Kabupaten Kepulauan Aru sudah merata, tepat sasarannya dan salah satu solusi mengurangi permasalahan kesehatan. Pembangunan sarana fisik lebih diutamakan dari pada Alkes (80%:20%). Biaya operasional belum cukup.

Background: Decentralization of health is a strategy of central government to minimize gap in public health service between the central and local government in the provision of national expenditure and revenue budget through balancing budget of special allocation budget in health that refers to technical guideline of the Ministry of Health by making health facilities a priority. District of Kepulauan Aru is an extension district based on Act No. 40/2003 and belongs to isolated, border and archipelago area based on President Regulation No. 78/2005. The area of District of Kepulauan Aru is 54,395 km2 consisting of 547 islands and 82,873 inhabitants. Local Middle Term Development Planning of District of Kepualauan Aru 2006 – 2011 explains the direction of local finance policy, local development strategy, general policy and local working unit program. Objective: To identify the result of evaluation on special allocation budget utilization policy for the development of health centers at District of Kepulauan Aru 2005 – 2008. Method: The descriptive qualitative study used a case study design. Primary data were obtained from indepth interview and secondary data from indepth documents of local middle term development planning, strategic planning of the health office, list of budget project or documents of budget utilization of local working unit. Result: The policy of special allocation budget for health at District of Kepulauan Aru was efficient, comprehensive and accurate. The problem that persisted was inadequate operational cost. Conclusion: Evaluation on the policy of special allocation budget for health at District of Kepulauan Aru was comprehensive, right to the target and a solution to minimize health problems. Development of physical facility was a priority than health instruments (80%: 20%). Operational cost was still inadequate.

Kata Kunci : Efisiensi,Kecukupan,Pemerataan,Responsivitas dan ketepatan,efficiency, adequacy, fair distribution, responsiveness, accuracy