Abstrak Perencanaan kebutuhan sumber daya manusia kesehatan (SDMK) berdasarkan Permenkes No. 33 Tahun 2015 tentang Pedoman Penyusunan Rencana Kebutuhan SDMK, belum berjalan baik. Tujuan studi ini adalah menilai kegiatan perencanaan kebutuhan SDMK yang berbasis bukti di kabupaten/kota. Berdasarkan temuan yang diperoleh dalam studi ini diharapkan dapat menjadi masukan kebijakan dalam proses perencanaan kebutuhan SDMK. Metode kajian ini berupa studi literatur terhadap luaran Riset Ketenagaan di Bidang Kesehatan (Risnakes), hasil-hasil penelitian yang relevan, kepustakaan dan dokumen-dokumen terkait perencanaan SDMK, baik di tingkat nasional maupun daerah. Analisis data dari hasil studi literatur dibuat menggunakan tematik analisis. Pengembangan subtema yang ditetapkan dalam tematik analisis difokuskan untuk menggali permasalahan pada aspek input, proses, dan output dari pelaksanaan perencanaan kebutuhan SDMK pada kabupaten/kota di Indonesia. Hasil kajian memperlihatkan, permasalahan perencanaan kebutuhan SDMK pada input meliputi kebijakan pemerintah daerah dan manajemen ASN yang kompleks, kompetensi tenaga perencana yang rendah, dukungan pembiayaan yang minim, serta pemanfaatan data dan sistem informasi yang belum optimal. Permasalahan pada proses mencakup belum dipahami dan dilaksanakannya penyusunan kebutuhan SDMK secara tepat. Permasalahan pada output adalah kesenjangan SDMK terkait kecukupan jumlah dan jenis tenaga kesehatan di tingkat kabupaten/kota di Indonesia. Menyikapi hal tersebut, pemerintah daerah sebaiknya melakukan perencanaan kebutuhan SDMK berbasis bukti, sehingga dokumen perencanaan mampu memproyeksikan kebutuhan SDMK yang sesuai dengan situasi kesehatan terkini. Kata kunci: SDM Kesehatan (SDMK); perencanaan SDMK, kebutuhan SDMK Abstract Planning for human health resources (HRK) based on Permenkes No. 33 of 2015 concerning Guidelines for the Preparation of HRH Needs Plans, has not gone well. The purpose of this study is to assess the evidence-based HR planning activities in the district / city. Based on the findings obtained in this study it is expected to be a policy input in the HRH needs planning process. The method of this study is in the form of a literature study of Workforce Research on Health Sector (Risnakes), relevance research results, literature and documents related to HRH planning both at national and regional levels. Data analysis of the results of the literature study was made using thematic analysis. The development of subthemes set in the thematic analysis is focused on exploring issues in the aspects of input, process, and output from the implementation of HRH needs planning in districts / cities in Indonesia. The results of the study show that HRK needs planning problems in the input include complex regional government and ASN management policies, low competency of planning personnel and lack of financial support and lack of optimal use of data and information systems. Problems in the process include not yet understood and implemented the preparation of HRH needs appropriately. The problem with outputs is the gap in HRH related to the adequacy of the number and type of health workers at the municipal district level in Indonesia. In response to this, local governments should plan evidence-based HRH planning, so that planning documents are able to project HRH needs in accordance with the current health situation. Keywords: Human Resources for Health (HRH), HRH planning, HRH Need
Background: The success of COVID-19 control in Indonesia comes to place with active community participation. Community's role in supporting the successful implementation of COVID-19 policy is critical to investigate. This study, therefore, aimed to determine community’s role in supporting the successful implementation of COVID-19 control policies.Method: This study is exploratory research with a cross-sectional approach. Seven Indonesian regencies as research locations were selected purposively. Quantitative data were collected from 2,010 positive-COVID-19 patients and their close contacts through a standardized self-administered questionnaire. In-depth interviews were employed with 79 health center officers. Content analysis was used to analyze the qualitative data, and descriptive analysis was for the quantitative data. Results: This study had a relatively balanced gender distribution. There were 26.9% at age of 6-19 years, and 80.9% were in close contact with COVID-19 patients. Most respondents were from primary health care centers, had a bachelor's degree, and had worked for less than five years. Their adherence to health protocols was lower than the group that was not exposed to COVID-19. Most respondents followed health protocols such as hygiene (92.9 %) and cough etiquette (91.5 %). However, COVID-19 quarantine compliance was still low (38.2%), and 90.8% of respondents mostly practiced self-isolation at home. COVID-19 control strategies in each region quite varied. A lack of public awareness and education, flexibility in policy implementation, and a poor reward and punishment system were barriers to COVID-19 control. The community's role in supporting COVID-19 control policies includes helping to communicate COVID-19 risks, assisting healthcare centers in monitoring COVID-19 self-isolation, providing and operating integrated isolation shelters for confirmed cases, and participating as a case tracer.
Health services still have to deal with high turnover of health worker as a common issue in developing countries. Generally, the retention problem has a significant impact on continuing adequate health care to people especially in remote areas. For that reason, The Nusantara Sehat became the government's priority program to fulfill the health worker needs in boundary areas nowadays. Since 2017, the program has individual nusantara sehat (ISN) assignment as an additional scheme beside the team based approach to fulfill the national health worker standard in primary health care. Therefore, it was necessary to provide an overview of the retention of INS assignment as an affirmative program in remote areas in Indonesia. The research was performed to explore the relationship between job satisfaction and retention of the INS personnel. The research was conducted a quantitative methods. Electronic questionnaires were distributed to individual nusantara sehat at December 2018. Total 444 questionnaires was returned in the survey and answered completely. The research found that 88.3% of the INS personnel reported as good retention and 44.4% of respondents had high job satisfaction. The Chi-squares test showed the significant relationship between the INS personnel's retention and job satisfaction (p value=0.001, OR=3.09). The study identified the crucial satisfier factors were related to socio-cultural situation. In the other hand, organizational conditions were considered as the important dissatisfied factors to health workers retention. Thus, it was important to develop the health workers' management scheme based on their location condition and basic supporting needs. The specific approach according the regional characteristics need to be applied to retain the health worker retention and satisfaction in remote areas. The government also needs to setting up the remote areas-oriented health education initiatives.
Data from the national health survey (Riskesdas), Ministry of Health Republic of Indonesia showed there's increasing the proportion of risk common mental disorders (CMD) in people aged > 15 years from 6.0% (in 2013) to 9.8% (in 2018). This study is to determine the prevalence of CMD among health worker after joined as individual Nusantara Sehat (NSI) staff di remote primary health care and also to determine the relationship between socio-demographic factors, work stressors, and CMD. A cross-sectional study involving the target population NSI in remote primary health care was conducted on December 2018. A socio-demographic, the 20-item self-reporting questionnaire (SRQ), the 30 item-survey diagnostic stress (SDS) questionnaire were self-administered. The presence of CMD was considered when the subject answers "yes" to 6 statements or more in SRQ-20. The χ2 test was used to analyze data statistically. In total, 449 NSI staff participated in the study. Generally, the prevalence of CMDs among NSI staff was 21.4% (n=96). Nurses are known to tend to have a lower prevalence while the dentists tend to have the highest prevalence compared with other group types of health worker in terms of CMD. The results of statistical tests showed that marital status has a significant affect to CMD (p<0.05) and 5 from 6 stressors were assessed was statistically associated with CMD (p<0.01). Intervention for NSI is needed to restore their mental health conditions in order to better working conditions. An in-depth analysis of the causes of stress is needed, especially in the health workers with high CMD to reduce work stressors. As an addition, Ministry of Health should develop a coping stress management guidelines for health workers and strengthened stress monitoring implementation to support sustainable health services in remote areas.
<b>Introduction:</b> COVID-19 spreads quickly, especially in densely populated countries like Indonesia. Understanding transmission factors can support in reducing transmission rates. The purpose of this study is to analyze the various factors that may contribute to the transmission of COVID-19 in Indonesia, especially in the first wave of pandemic.<br /> <b>Methods: </b>This was a cross sectional study design. The sample was selected from the new all record data or the database for recording COVID-19 cases at the health office at the research location by online system. The research was conducted in seven districts and cities across three provinces to obtain an overview of transmission in each regional characteristic. The number of samples was as high as 2,010, with confirmed cases and close contacts in Banda Aceh City, Aceh Besar District, Semarang City, Magelang District, Ternate City, South Halmahera District, and Tidore Islands City. Data analysis was done descriptively and were analyzed using Chi-square and logistic regression with SPSS software.<br /> <b>Results: </b>The multivariate analysis shows that five dominant factors the risk of COVID-19 transmission, there are, age, employment status, activities outside the home, medical history, and vaccination status. Age group of 20-39 years (odds ratio [OR]=1.6-1.7; 95% confidence interval [CI] 1.07-2.71), working of employment status (OR=1.51; 95% CI 1.10-2.07), have a comorbid in medical history (OR=2.39; 95% CI 1.67-3.4), have activities outside home (OR=1.82, 95% CI 1.39-2.39), and have not been vaccinated of COVID-19 (OR=3.03; 95% CI 3.37-3.87) were significantly related with an increased risk of COVID-19 transmission.<br /> <b>Conclusions: </b>productive age,<b> </b>work and activities outside the home, having comorbidities, and not having received COVID-19 vaccination are all risk factors for COVID-19 exposure. Eliminating all of these factors at the same time will undoubtedly be difficult. As a result, cross-sectoral collaboration is needed to control the spread of COVID-19 at the community and individual levels, as well as to support policy interventions to accelerate the elimination of COVID-19 cases.
During COVID-19 pandemic, puskesmas (community health center) made various efforts in accordance with technical instructions issued by the Ministry of Health.. As an effort to prevent transmission from patients to officers and vice versa, the use of Personal Protective Equipment (PPE) is mandatory. This study aimed to determine the behavior of using PPE as an effort to prevent COVID-19, especially in health centers in remote and very remote areas. The research design used was a cross-sectional study carried out at health centers in remote and very remote areas in 21 provinces, 66 districts. The data collection tool was in the form of a google form which was distributed through the special assignment personnel for Nusantara Sehat placement in 2019. The Google form was filled out by health workers at health centers, both Nusantara Sehat personnel and not. The data collection period was May-June 2020. The results showed that the behavior of health workers in remote and very remote community health centers in using complete PPE was not good. The use of PPE was generally high in personnel who provide services to patients, especially doctors and dentists. The reason respondents did not/sometimes use PPE was the limited number of PPE. The results of bivariate test using Chi-square test showed that involvement as a member of the Covid-19 task force team and marital status were significantly related to the behavior of using complete PPE. Meanwhile, the type of assignment (UKP and UKM), and gender were not statistically related. In an effort to prevent the spread of Covid-19, it is recommended that health workers at health centers improve the behavior of using PPE properly according to standards. For this reason, the Health Office should prioritize the procurement and distribution of PPE, and provide adequate training to health care professionals in its use. Abstrak Pada masa pandemi COVID-19, puskesmas melakukan berbagai upaya pencegahan penularan sesuai dengan petunjuk teknis yang diterbitkan Kementerian Kesehatan. Dalam upaya pencegahan penularan dari pasien ke petugas dan juga sebaliknya, penggunaan Alat Pelindung Diri (APD) menjadi wajib. Penelitian ini bertujuan untuk mengetahui perilaku penggunaan APD dalam upaya pencegahan COVID-19 terutama di puskesmas kawasan terpencil dan sangat terpencil. Desain penelitian yang digunakan adalah potong lintang, dilakukan pada puskesmas daerah terpencil dan sangat terpencil di 21 provinsi, 66 kabupaten. Alat pengumpul data berupa google form yang disebarkan melalui tenaga penugasan khusus Nusantara Sehat penempatan tahun 2019. Google form diisi oleh tenaga kesehatan di puskesmas baik tenaga Nusantara Sehat ataupun bukan. Rentang waktu pengumpulan data selama bulan Mei-Juni 2020. Hasil penelitian menunjukkan bahwa perilaku tenaga kesehatan di puskesmas daerah terpencil dan sangat terpencil dalam memakai APD secara lengkap, belum baik. Penggunaan APD secara umum tinggi pada tenaga yang memberikan pelayanan kepada pasien terutama dokter dan dokter gigi. Alasan responden tidak/kadang-kadang menggunakan APD adalah adanya keterbatasan jumlah APD. Hasil uji bivariat dengan menggunakan Chi-square test memperlihatkan bahwaketerlibatan sebagai anggota tim satgas COVID-19 dan status perkawinan berhubungan secara signifikan dengan perilaku penggunaan APD secara lengkap. Sementara jenis penugasan (UKP dan UKM), dan jenis kelamin secara statistik tidak berhubungan. Dalam upaya pencegahan penyebaran COVID-19, disarankan agar tenaga kesehatan di puskesmas meningkatkan perilaku penggunaan APD secara baik dan sesuai dengan standar. Untuk itu Dinas Kesehatan agar memprioritaskan pengadaan dan distribusi APD, dan memberikan pelatihan yang memadai kepada profesional perawatan kesehatan dalam penggunaannya.
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