The Impact of National Health Insurance Policy to the Implementation of Health Promotion Program on Public Health Center in Indonesia

Abstract

The National Health Insurance (NHI) Program was implemented in Indonesia on January 1 st 2014. This program definitely brings some changes into managerial aspect in public health center (PHC). This study aimed to determine an impact of NHI policy in the implementation of health promotion programs at PHC in South Tangerang City, Indonesia. This study was conducted using qualitative method during February and March 2016. The impact of NHI is seen on policy, budget, equipment, human resource and implementation of health promotion program. With purposive sampling method, six policy makers, eight service providers and eight service users were selected for in-depth interview. 17 documents were analyzed. Observation was conducted at four selected PHC's. Data analysis used thematic content analysis. There was no difference of PHC's functions before and after NHI period. Budget expended for health promotion programs increased after NHI was implemented which could represent an opportunity for PHC to innovate, procure materials and implement better health promotion programs. Capitation budget which could be used for executing health promotion program and some recently implemented health promotion programs in the NHI era evidences that NHI policy has a positive impact on the implementation of health promotion programs at PHC.Keywords: Health promotion program, national health insurance, public health center Abstrak Jaminan Kesehatan Nasional (JKN) telah diimplementasikan di Indonesia pada 1 Januari 2014. Hal tersebut membawa beberapa perubahan pada aspek manajerial pada pusat kesehatan masyarakat (puskesmas). Penelitian ini bertujuan untuk mengidentifikasi dampak dari kebijakan JKN terhadap implementasi program promosi kesehatan di puskesmas di Kota Tangerang Selatan, Indonesia. Penelitian menggunakan metode kualitatif. Data dikumpulkan pada Februari -Maret 2016. Dampak program dilihat dalam hal kebijakan, pendanaan, fasilitas, sumber daya manusia dan pelaksanaan program promosi kesehatan. Dengan menggunakan metode purposive sampling, enam pengambil kebijakan, delapan pemberi layanan dan delapan penerima layanan diambil sebagai informan dalam penelitian ini. Pada analisis dokumen, 17 dokumen telah dianalisis. Observasi dilakukan dengan melihat kegiatan yang dilakukan di empat puskesmas. Analisis data menggunakan analisis konten tematik. Tidak terdapat perbedaan dari fungsi puskesmas sebelum dan setelah adanya JKN. Dana yang digunakan untuk kegiatan promosi kesehatan telah mengalami peningkatan setelah implementasi kebijakan JKN dimana dana tersebut dapat digunakan untuk berinovasi, memberi peralatan dan melakukan promosi kesehatan dengan lebih baik. Dana kapitasi yang dapat digunakan untuk melaksanakan program promosi kesehatan dan beberapa kegiatan promosi kesehatan yang baru dilaksanakan pada saat era JKN menjadi bukti bahwa kebijakan JKN memiliki dampak positif terhadap pelaksanaan program promosi kesehatan di puskesmas.Kata kunci: Program promosi kesehatan, jaminan kesehatan nasional, pusat kesehatan masyarakat

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