KOORDINASI PELAKSANAAN PEMBIAYAAN PROGRAM KESEHATAN IBU DAN ANAK DI KABUPATEN LOMBOK TENGAH PROVINSI NUSA TENGGARA BARAT TAHUN 2011

Lalu Najmul Erpan, Prof. dr. Laksono Trisnantoro,M.Sc.,PhD

2012 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Pembiayaan Kesehatan bersumber pemerintah sangat membantu jalannya sistem kesehatan pada era desentralisasi. Dana Alokasi Umum dan APBD ternyata tidak cukup untuk membiayai pelayanan kesehatan. Berbagai upaya dilakukan pemerintah dalam membiayai pelayanan kesehatan seperti Jamkesmas, Jampersal serta Bantuan Operasional Kesehatan (BOK). Hal ini dilakukan untuk mencapai MDGs 2015. Adanya koordinasi sejak perencanaan dan pelaksanaan serta Komitmen stakeholder dapat mempengaruhi proses pelayanan KIA. Koordinasi mutlak diperlukan untuk menjalankan kebijakan program dan mencegah tumpang tindih pembiayaan sehingga tujuan program dapat tercapai. Tujuan Penelitian: Mengevaluasi koordinasi perencanaan dan pelaksanaan serta komitmen stakeholder dalam pembiayaan kesehatan yang berkaitan dengan pelayanan KIA di Kabupaten Lombok Tengah. Metode Penelitian: Penelitian dengan analisis deskriftif menggunakan pendekatan kualitatif dengan rancangan study kasus. Pengambilan sampel dengan Purvosive sampling. Metode pengumpulan data dengan in-depth interview, observasi dan telaah dokumen. Hasil Penelitian: Koordinasi perencanaan pembiayaan KIA belum berjalan optimal, walaupun telah melibatkan peran lintas sektor dan lintas program namun pada perencanaan program organisasi profesi kesehatan tidak dilibatkan. Koordinasi pelaksanaan pembiayaan juga belum berjalan optimal. Meskipun tidak ada tumpang tindih pembiayaan dari beberapa sumber yang ada, hanya saja pada pelaksanaan kebijakan ditemukan iur biaya untuk rujukan maupun obat. Peran swasta tidak dilibatkan dalam pelaksanaan Jampersal. Komitmen stakeholder secara umum sudah optimal dibuktikan adanya kebijakan serta gerakan dalam percepatan pembangunan kesehatan khususnya KIA. Proses pelayanan KIA baik di pelayanan dasar maupun pelayanan lanjutan berjalan dengan baik. Kesimpulan: Koordinasi pelaksanaan pembiayaan Kesehatan Ibu dan Anak di Kabupaten Lombok Tengah dari dana BOK, Jampersal, Jamkesmas, PNPM GSC dan APBD belum berjalan optimal, sehingga perlu ditingkatkan lagi untuk mencegah terjadinya iur biaya. Organisasi profesi serta pelayanan kesehatan swasta belum dilibatkan dalam perencanaan maupun pelaksanaan program.

Background: Health financing provided by the government greatly helps the running of health system in the decentralized era. General Allocation Fund and Local Revenue and Expenditure Budget are apparently inadequate to finance health service. Some efforts have been made to finance health service such as Community Health Insurance (Jamkesmas), Childbirth Insurance (Jampersal), and Health Operational Aids (Bantuan Operasional Kesehatan/BOK). These are meant to reach Millennium Development Goals 2015. The practice of coordination from planning to implementation and commitment of stakeholders can affect the process of mother and child health service. Coordination is definitely needed to run the program policy and prevent redundancies in financing in order that the objective of the program can be achieved. Objective: To evaluate coordination of planning and implementation as well as commitment of stakeholders in relation to mother and child health service at District of Lombok Tengah. Method: The study was descriptive analytical. It used qualitative approach and case study design. Samples were taken purposively. Data were obtained through in-depth interview, observation and documentation study. Result: Coordination of planning of health financing at mother and child health has not been optimally, eventhough the accros sector and program were involved but the organizations of health professionals were not involved in program planning. Coordination of the implementation of health financing was also has not been optimally. Eventhough as indicated from absence of redundancies in financing from some different financial sources, however in the policy implementation there was cost sharing for referral and drugs. Private sectors were not involved in the implementation of Jampersal. Commitment of stakeholders was relatively optimum as reflected from the policy and action in health development acceleration particularly mother and child health. The process of mother and child health service either at primary and secondary level operated as well. Conclusion: Coordination of mother and child health financing implementation at District of Lombok Tengah funded through BOK, Jampersal, Jamkesmas, Community Empowerment National Program of Healthy and Smart Generation and Local Revenue and Expenditure Budget has not been optimally, that it need to be improved to eliminate cost sharing. Professional organizations and private health providers were not yet involved in the planning and implementation of the program.

Kata Kunci : Koordinasi, Komitmen Stakeholder, Pembiayaan Program KIA