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"Penanganan pasangan ingin anak membutuhkan kesabaran dari pihak medis maupun pasien di samping kemampuan mendiagnosa serta pengobatan yang terarah. RSUP Dr. Hasan Sadikin mempunyai kelompok kerja ART (Assisted Reproduktif Technology) dengan surat keputusan Direktur Nomor: Kp 01.01.1.2.231.P tanggal 20 Nopember 1995, untuk mengembangkan Tim Ahli Bayi Tabung di Seksi Infertilitas SMF Kebidanan dan Penyakit Kandungan. Kememapuan penangann pasangan infertil di RSUP Dr. Hasan Sadikin masih jauh dari memadai, karena keterbatasan sarana, sedangkan kebutuhan akan pelayanan ART sudah mendesak. Penelitian ini dilakukan dengan tujuan memperoleh gambaran trend pelayanan infertilitas di RSUP Dr. Hasan Sadikin dan memilih model strategis yang tepat untuk di terapkan. Penelitian ini adalah operasional riset yang dianalisis secara kuantitatif dan kualitatif. Hasil penelitian dari analisia situasi menggambarkan total jumlah kunjungan pelayanan mengalami penurunan sekitar 19,21% dan dari total jumlah kasus, 87% kasus usia di bawah 35 tahun potensi untuk ditangani tuntas dan 67% kasuss memerlukan tindakan ART, pada periode tahun 1993-1997. Hasil analisis metode Dekamposisi menggambarkan faktor trend kunjungan menurun, sehingga sulituntukmerencanakan sasaran jangka panjang, dan Indeks Musim.memperlihatkan peningkatan hanya pada bulan Januari, Maret, Mai, Juni, Nopember dan Desember, sehingga baru dapat mereucanakan sasaran jangka pendek di pelayananinfertilitas. Hasil analisis metode Delphi menggambarkan derajat pelaksanaan rendah, akselerasi pelayanan lamban, adanya factor pendorong dan penghambat pelaksanaan serta masalah keuangan sebagai faktor kekuatan, kelemahan, ancaman dan peluang Seksi Pelayanan Infertilitas. Hasil analisis matrike SPACE dalam memposisikan strategi sebagai langkah awal pemilihan model strategi, yaitu pada Kuadran I: Agresif adalah pertumbuhan dan perkembangan. Pada penelitian ini dibahas dua strategi alternatif untuk memilih model strategi yang tepat, yaitu strategi umum/bisnis dan strategi operasional. Untuk mengembangkan pelayanan infertilitas di RSUP Dr. Hasan Sadikin saat ini dipilih strategi operasional dengan sasaran elemen kunci pengembangan di bidang pemasaran, keuangan, produksi/operasi, riset dan pengembangan, sumber daya manusia serta konsisten dengan target lahir bayi tabung, sehingga. dapat disusun program kerja berdasarkan pendekatan legislatif, edukatif, ekonomi, administratif dan teknis.

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Managing couples wishing to have children needs patience from the medical services as well as the patient besides ability to diagnose and well planned medical treatment. Dr. Hasan Sadikin Provincial Hospital developed has an ART (Assisted Reproductive Technology) team work through the Director's Decree: Kp. 01.01.2. 231.P date 20'h November 1995. This Team of Experts of Test-tube Babies at the Infertility Division, Obstetrics and Gynecology Department is developing it capability in managing infertile couples at Dr. Hasan Sadikin Provincial Hospital, however it still far from adequate, due to limited facilities, while the need for ART services is already urgently field.

This is an operational research study, utilizing quantitative and qualitative analysis, aiming at obtaining the trend of the infertility service demand at Dr. Hasan Sadikin Provincial Hospital, and selecting a correct strategy model to be applied.

The situational analysis of this study revealed for that a period of 1993-1997 there was a decrease of around 19,21% in the total number of visits; in which, 87 % of the cases of those under 35 years of age and were potential for complete treatment, while 67% of the cases needed an ART management.

Analysis by decomposition method revealed that the trend factor decreased, so that it was difficult to plan for a long term target, and that the season Index showed an increase only in the months of January, March, May, June, November, and December, so that only a short term plan could be planned in the infertility services.

Analysis by the Delphi method revealed a low level of implementation, a slow acceleration of service, the presence of enchancing and delaying factors in the implementation, and also financial problems as factors of strength, weakness, threat, and opportunity in the infertility services.

Result of SPACE matrix analysis in positioning strategy as an initial step in the selection of a strategy model, is as follows Quadrant I: Aggressive is growth and development.

In this study two alternative strategies were analyzed to choose the right strategy model, i.e. general business strategy and operational strategy to develop the infertility services at Dr. Hasan Sadikin Provincial Hospital. At present the operational strategy was selection with the development key element as the target in the aspect of marketing, finance, production/operation, research and development, human resources, and consistent with the birth of test-tube babies as target, so as to allow the compilation of a working program based on a legislative, educative, economic, administrative, and technical approach."

"Hasil laporan Sub Direktorat Imunisasi Depkes RI bersama WHO tentang studi pengukuran keamanan penyuntikan di empat porpinsi di Indonesia (1999) menunjukkan bahwa 37,5% syringe tidak steril, 22,5% bagian jarum tidak steril ketika akan digunakan dan 28,5% bagian jarum dan syringe yang steril tersentuh waktu pemakaian. Di samping itu Laporan Tahunan Imunisasi 1998/1999 menunjukkan bahwa berdasarkan hasil survei Badan Litbangkes Depkes RI menunjukkan bahwa 40-50% praktek imunisasi tidak aman termasuk pelaksanaan Bulan Imunisasi Anak Sekolah (BIAS). Hal ini menyangkut kepatuhan petugas pelaksana pelayanan imunisasi. Tujuan penelitian ini adalah diperolehnya informasi tentang tingkat kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi dan faktor-faktor yang berhubungan dengan kepatuhan petugas tersebut di puskesmas Kota Pontianak Propinsi Kalimantan Barat Tahun 2000. Desain penelitian ini menggunakan pendekatan kuantitatif dengan rancangan potong lintang (cross sectional). Pengamatan dilakukan di 20 Puskesmas di Kota Pontianak sebanyak 100 orang petugas pelaksana pelayanan imunisasi di Puskesmas atau di Posyandu. Pengumpulan data dilaksanakan dengan menggunakan daftar tilik untuk pengamatan kepatuhan petugas, setiap petugas diamati sebanyak tiga kali. Setelah selesai pengamatan dilakukan wawancara tentang hal yang berkaitan dengan faktor-faktor yang berhubungan dengan kepatuhan petugas. Hasil analisis univariat kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi nilai total menunjukkan yang patuh sebesar 53,0 %. Pengamatan kepatuhan dilakukan pada tiga komponen kegiatan yang hasilnya menunjukkan bahwa petugas yang patuh terhadap proses pencatatan 81,0%, proses penyuntikan 79,0%, tetapi yang patuh pada proses penyuluhan 8,0%. Petugas dengan tingkat pengetahuan baik lebih sedikit dari yang tingkat pengetahuannya kurang, sebagian besar berpengetahuan baik tentang jadwal imunisasi, sebaliknya sebagian besar berpengatuhan kurang tentang cara imunisasi. Hasil analisis bivariat menunjukkan adanya hubungan yang bermakna antara pengetahuan dengan kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi. Petugas yang berpengetahuan baik yang patuh sebanyak 68,1% dan yang pengetahuan kurang yang patuh 39,6%. Variabel pengetahuan menunjukkan faktor yang paling dominan berhubungan dengan kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi. Saran, perlu adanya upaya peningkatan kepatuhan petugas dengan peningkatan pengetahuan tentang pelaksanaan pelayanan imunisasi melalui pelatihan, pertemuan maupun supervisi.

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Report of Immunization Sub Directorate of the Ministry of Health Republic of Indonesia in a joint project with WHO (World Health Organization) concerning study on measurement of injection safety in four provinces in Indonesia (1999) shows that 37.5% of syringe were not sterile, 22.5% of the needles to use were not sterile and 28.5 % of sterile needles and syringe were touched during their use. In addition, the Immunization Annual Report 1998/1999, based on a survey conducted by National Institute of Health Research and Development of the Ministry of Health Republic of Indonesia, reveals that 4U°/o-50% of the immunization practice were not safe, including the implementation of Bulan lmunisasi Anak Sekolah (BIAS) or School Immunization Program. This finding correlates with the staff compliance in delivering immunization service.

This study was aimed at gathering information regarding level of staff compliance to the implementation guidelines of immunization service and factors that correlate with such staff compliance at all Puskesmas (community health centers) in Pontianak City, West Kalimantan Province, Year 2000.

The study design employed a qualitative approach with a cross sectional method. Observation was conducted at 20 Puskesmas in Pontianak City over 100 operatives or staffs of immunization service at Puskesmas or Posyandu (Integrated-Service Shelter). Data collection was conducted by using checklist to observe the staffs? compliance. Each staff was observed for three times. Following the observation, interviews were set to dig information on factors that correlate with the staffs? compliance to the guidelines.

Result of univariat analysis of the staffs compliance to the guideline shows that 53.0% of the staffs compliance to the guidelines. The observation over the staffs compliance was focused on three components of activities, The results describes that 81.0% of the staffs compliance to recording process, 79.0% of the staffs compliance to injection procedures, and only 8.0% of them compliance to the program dissemination session. The number of knowledgeable staff was far littler that the opposite staff, a lot of the staffs acknowledged the immunization schedule, while most of them were less informed about appropriate immunization procedures.

The bivarians analysis result shows that there is a significant correlation between knowledge level of the staffs and their compliance to the implementation guidelines of the immunization service. 68.1% of the knowledgeable staff's compliance to the guidelines while 39.6% of the less knowledgeable staff-'s compliance to the guidelines. Knowledge variable proved to be the most dominant factor that correlated with the staffs compliance to the implementation guidelines of immunization service. As recommendations, there should be improvement of the staffs? compliance to the guidelines by increasing their knowledge of the guidelines through regular training, meetings or supervisions."

"Dengan adanya Peraturan Daerah Nomor 05 tahun 2009 lahirlah kebijakan pelayanan kesehatan gratis di kota Padang. Pelayanan kesehatan gratis ini merupakan dukungan pemerintahan kota kepada warganya untuk menyadari bahwa kesehatan merupakan kebutuhan dasar dan kebijakan ini mendapat dukungan dari Bazda (Badan Zakat Daerah). Tujuan dari penelitian ini adalah untuk menganalisis model pengembangan kebijakan pelayanan kesehatan gratis di kota Padang. Penelitian ini dilakukan dengan menggunakan pendekatan kualitatif dan kuantitatif. Data kualitatif diperoleh dari Dinas Kesehatan Kota Padang. Sedangkan data kuantitatif diperoleh melalui wawancara dan focus group disscussion (FGD). Enam pimpinan puskesmas dan tenaga kesehatan merupakan informan yang diwawancarai untuk mengidentifikasi variabel yang diselidiki. Pimpinan pemerintahan yang terkait dengan kebijakan ini juga dilibatkan untuk memperoleh data yang dibutuhkan, sedangkan kepuasan pasien tentang pelayanan kesehatan gratis ini diperoleh melalui FGD. Analisis terhadap semua data yang diperoleh dari informan dalam penelitian ini dilakukan secara multicase analisis. Penelitian ini menemukan bahwa pengembangan model kebijakan pelayanan kesehatan gratis yang ditawarkan adalah model pelayanan yang dapat memberikan manfaat maksimal bagi semua pihak yang terlibat termasuk pasien, puskesmas dan tenaga kesehatan.

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According to Peraturan Daerah Nomor 05 tahun 2009 toward the free health service in Padang city implied that the free service of health care was driven by the consideration of the city government as basic public needs and financially suported by Bazda (Badan Zakat Daerah). The objective of the study is to analyze the development of free health care policy model in Padang. The study was conducted by using quatitative and qualitative data. The quantitative data was obtained from the health agency office in Padang. Hence the qualitative data was obtained through interview and focus group discusion (FGD). The six puskesmas managers and health workers as the research informant were interviewd to identify the investigated variable. The related goverment leaders also were involved to make data collection comprehensivelly. In the meantime, satisfaction patients related to service delivery were investigated using FGD. All informant obtained were transcriped as picture for this research in the multicase analysis. This study found that the model development of free service policy offered is a model of service that can provide the maximum benefits for all aspects involved including patients, health centers, and health professionals."