Monitoring kinerja puskesmas dalam sistem kontrak internal kepala puskesmas di Jakarta

Eko Sriyanto; Mubasysyir Hasanbasri; Dwi Handono Sulistyo

doi:10.22146/bkm.25627

Monitoring kinerja puskesmas dalam sistem kontrak internal kepala puskesmas di Jakarta

https://doi.org/10.22146/bkm.25627

Eko Sriyanto^(1*), Mubasysyir Hasanbasri⁽²⁾, Dwi Handono Sulistyo⁽³⁾

(1) Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan Universitas Gadjah Mada
(2) Departemen Biostatistik, Epidemiologi dan Kesehatan Populasi, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan Universitas Gadjah Mada
(3) Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan Universitas Gadjah Mada
(*) Corresponding Author

Abstract

Performance monitoring of primary health centers chief internal contracting system in Jakarta

Purpose: This study aimed to describe internet-based electronic monitoring control mechanisms and problems that occur in policy implementation at the regional public service agency in Jakarta.

Methods: A qualitative research with exploratory technique was conducted using semi-structured interviews, observation and document research. The research subjects were 12 people. The informants were chosen by purposive sampling. Data analysis used content analysis methods.

Results: Results showed that attendance and performance of staff recorded in the system helped in managerial duties, the items of work have been standardized on the application of e-kinerja together with the points for incentives. While the number of human resources were less, omissions in time limit entry performance which resulted in non-payment of incentives served to encourage officers to report the activities in proper time. There were problems with the community in the form of false complaints of moral hazard but there is no filter mechanism against the false complaints.

Conclusion: The results showed it difficult for health centers to prevent the complaints of moral hazard in the presence of a multi-layered monitoring system both internally and externally.

Keywords

internal contracts; resource position of primary health centers chief; performance-based incentive; monitoring

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References

Heard A, Nath DK, Loevinsohn B. Contracting urban primary healthcare services in Bangladesh–effect on use, efficiency, equity and quality of care. Tropical Medicine & International Health. 2013 Jul 1;18(7):861-70.
Soeters R, Peerenboom PB, Mushagalusa P, Kimanuka C. Performance-based financing experiment improved health care in the Democratic Republic of Congo. Health Affairs. 2011 Aug 1;30(8):1518-27.
Zhou H, Zhang W, Zhang S, Wang F, Zhong Y, Gu L, Qu Z, Liang X, Sa Z, Wang X, Tian D. Health providers’ perspectives on delivering public health services under the contract service policy in rural China: evidence from Xinjian County. BMC health services research. 2015 Dec;15(1):75.
Hipgrave DB, Hort K. Dual practice by doctors working in South and East Asia: a review of its origins, scope and impact, and the options for regulation. Health policy and planning. 2013 Oct 21;29(6):703-16.
Ashmore J, Gilson L. Conceptualizing the impacts of dual practice on the retention of public sector specialists-evidence from South Africa. Human resources for health. 2015 Dec;13(1):3.
Cockcroft A, Khan A, Ansari NM, Omer K, Hamel C, Andersson N. Does contracting of health care in Afghanistan work? Public and service-users' perceptions and experience. BMC health services research. 2011 Dec;11(2):S11.
World Health Organization. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. World Health Organization; 2010.
Peters DH, editor. Improving health service delivery in developing countries: from evidence to action. World Bank Publications; 2009.
Mikkers M, Ryan P. Optimisation of healthcare contracts: Tensions between standardisation and innovation: comment on" Competition in healthcare: Good, bad or ugly?". International journal of health policy and management. 2016 Feb;5(2):121.
Soeters R, Griffiths F. Improving government health services through contract management: a case from Cambodia. Health policy and planning. 2003 Mar 1;18(1):74-83.
Khim K, Annear PL. Strengthening district health service management and delivery through internal contracting: lessons from pilot projects in Cambodia. Social Science & Medicine. 2013 Nov 1;96:241-9.
Frimpong JA, Helleringer S, Awoonor‐Williams JK, Yeji F, Phillips JF. Does supervision improve health worker productivity? Evidence from the Upper East Region of Ghana. Tropical Medicine & International Health. 2011 Oct 1;16(10):1225-33.
Mkoka, D.A., Mahiti, G.R., Kiwara, A., Mwangu, M., Goicolea, I. and Hurtig, A.K., 2015. “Once the government employs you, it forgets you”: Health workers’ and managers’ perspectives on factors influencing working conditions for provision of maternal health care services in a rural district of Tanzania. Human resources for health, 13(1), p.77.
Eldridge C, Palmer N. Performance-based payment: some reflections on the discourse, evidence and unanswered questions. Health policy and planning. 2009 Feb 7;24(3):160-6.
Witter S, Zulfiqur T, Javeed S, Khan A, Bari A. Paying health workers for performance in Battagram district, Pakistan. Human Resources for Health. 2011 Dec;9(1):23.
Khim K. Are health workers motivated by income? Job motivation of Cambodian primary health workers implementing performance-based financing. Global health action. 2016 Dec 1;9(1):31068.
Deussom R, Jaskiewicz W, Dwyer S, Tulenko K. Holding Health Workers Accountable: Governance Approaches to Reducing Absenteeism. CapacityPlus Technical Brief, IntraHealth, Washington, DC. 2012 May.
World Health Organization. The world health report 2006: working together for health. World Health Organization; 2006 Mar 23.
Henderson LN, Tulloch J. Incentives for retaining and motivating health workers in Pacific and Asian countries. Human resources for health. 2008 Dec;6(1):18.
Huillery E, Seban J. Pay-for-Performance, motivation and final output in the health sector: Experimental evidence from the Democratic Republic of Congo. Sciences Po Economics Discussion Papers. 2014 Apr 29.
Brinkerhoff DW, Bossert TJ. Health governance: principal–agent linkages and health system strengthening. Health Policy and Planning. 2013 Feb 13;29(6):685-93.