Evaluasi Implementasi Public Private Mix Pengendalian Tuberkulosis di Kabupaten Ende Provinsi Nusa Tenggara Timur Tahun 2012

https://doi.org/10.22146/jkki.36356

Maria Agustina P.Tondong(1*), Yodi Hasthayoga Mahendradhata(2), Riris Andono Ahmad(3)

(1) Staf Dinas Kesehatan Kabupaten Ende, Propinsi Nusa Tenggara Timur
(2) Program Studi Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta
(3) Staf Dinas Kesehatan Kabupaten Ende, Propinsi Nusa Tenggara Timur
(*) Corresponding Author

Abstract


governmental organizations in the implementation of quality DOTS known as Public Private Mix (PPM). Ende has executed the implementation of PPM DOTS approach involving government hospitals, private hospitals and private clinics since 2010, but the program has never been evaluated to determine the problem and found a solution to improve the performance of the TB control program in Ende. Objectives: To evaluate the implementation of the Public Private Mix (PPM) for TB control in Ende Methods: This study used a qualitative design, with descriptive case study approach, to describe the implementation of PPM for TB control in Ende, a district of East Nusa Tenggara Province. Result and Discussion: PPM implementation of TB control in Ende not run optimally, this showed by the low performance of the TB control program that is low TB case detection rate (CDR) <70%, although there was an increase in TB case detection (CDR) of 12% , treatment success rate <85%, the conversion rate <80% and the high dropout rate of TB patients> 10% in the last three years. Factors - factors that inhibited the implementation of PPM for TB control are shortage of human resources, insufficient budget, lack of logistics and facilities infrastructures of TB DOTS unit and dependence on donor resources, the absence of operational guidelines governing cooperation mechanisms, the lack of commitment of the government and partners in the implementation of PPM control TB, lack of communication and coordination between PPM network, caseholding of TB patients. Conclusion: Implementation of PPM TB Control has not been optimal as it has not improve the performance of the TB control program in the district of Ende yet.

 

Latar belakang: Salah satu komponen strategi stop TB adalah melibatkan seluruh penyedia layanan pemerintah, swasta, lembaga swadaya masyarakat dalam pelaksanaan DOTS yang berkualitas yang dikenal dengan Public Private Mix (PPM). Kabupaten Ende sejak tahun 2010 telah melaksanakan pendekatan PPM dalam pelaksanaan DOTS yang melibatkan rumah sakit pemerintah, rumah sakit swasta dan balai pengobatan swasta, namun belum pernah dilakukan evaluasi untuk mengetahui permasalahan dan ditemukan solusi untuk memperbaiki kinerja program pengendalian TB di Kabupaten Ende. Tujuan Penelitian: Untuk mengevaluasi implementasi Public Private Mix (PPM) pengendalian TB di Kabupaten Ende. Metode Penelitian: Penelitian ini menggunakan rancangan kualitatif, dengan pendekatan studi kasus deskriptif, untuk menggambarkan pelaksanaan PPM pengendalian TB di Kabupaten Ende Provinsi Nusa Tenggara Timur. Hasil dan Pembahasan: Implementasi PPM pengendalian TB di Kabupaten Ende belum berjalan optimal, ini terlihat dari masih rendahnya kinerja program pengendalian TB yaitu rendahnya angka penemuan kasus TB (CDR) < 70%, meskipun ada peningkatan penemuan kasus TB (CDR) sebesar 12 %, angka keberhasilan pengobatan < 85%, angka konversi < 80% dan tingginya angka drop out pasien TB > 10% dalam kurun waktu tiga tahun terakhir. Faktor – faktor yang menghambat implementasi PPM pengendalian TB adalah keterbatasan sumber daya manusia, anggaran, logistik TB dan sarana prasarana unit DOTS serta ketergantungan sumber daya terhadap pihak donor, tidak adanya pedoman operasional yang mengatur mekanisme kerjasama, kurangnya komitmen pemerintah maupun mitra dalam implementasi PPM pengendalian TB, kurangnya komunikasi dan koordinasi antara jejaring PPM dalam menjaga keteraturan dan keberlangsungan pengobatan penderita TB.

Kesimpulan: Implementasi PPM Pengendalian TB belum berjalan optimal karena belum dapat meningkatkan kinerja Program Pengendalian TB di Kabupaten Ende

 


Keywords


Evaluation; Implementation; Public private mix (PPM); Tuberculosis; Evaluasi; Implementasi; Public private mix (PPM); Tuberkulosis.



References

WHO. Global Tuberculosis Control Report 2011. Geneva. 2011.

Departemen Kesehatan RI. Laporan Riset Kesehatan Dasar (RISKESDAS) Tahun 2007 Propinsi NTT. Departemen Kesehatan RI. Jakarta. 2008.

WHO. Engaging All Health Care Provides In TB Control:Guidance On Implementing Public Privat Mix Approaches, Geneva. 2006.

Dinkes Kabupaten Ende. Laporan Tahun 2007- 2011, Ende:Dinas Kesehatan Kabupaten Ende. 2011.

Irawati SR, Basri C, Arias MS, Prihartini S, Rintiswati N, Voskens J, Kimerling ME. Hospital DOTS Linkage in Indonesia : a model for DOTS expansion into government and private hospitals, Int J 7 Lung Dis. 2007;11(1):33-39

Kemenkes RI. Pedoman Nasional Pengendalian Tuberkulosis, Kementerian Kesehatan Republik Indonesia. Jakarta. 2011.

Mahendradhata Y, Lambert ML, Vandeun A, Matthys F, Boelaert,Van der Stuyift F. Stong General Health Care System: a prerequisite to reach global tuberculosis control targets, Int J Health Plann Mgmt, 2003;83:53–65.

Subarsono AG. Analisis Kebijakan Publik. Pustaka Belajar. Yogyakarta. 2005.

Newell JN, Pande SB, Baral SC, Bam DS, Malla

P. Leaderships, Management and Technical Lesson Learnt From a success public privat

partnerships for TB Control in Nepal, Int J Tuberc Lung Dis. 2005;9:1013-1017.

Fahmi I, Andono R, Hasanbasri M. (2007) Desain Organisasi Penanggulangan Tuberkulosis, Implementasi Strategi DOTS di Tapanuli Selatan, Jurnal Manajemen Pelayanan Kesehatan, 2007;18(02).

Nugroho R. Public Policy:Dinamika Kebijakan, Analisis Kebijakan, Manajemen Kebijakan. PT Alex Media Komputindo, Kompas Gramedia. Jakarta. 2012.

Kemenkes RI. Pedoman Exit Strategi Dana Hibah Global Fund AIDS. Tuberkulosis dan Malaria. Direktorat Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan Republik Indonesia. Jakarta. 2012.

Departemen Kesehatan RI. Pedoman Nasional Penanggulangan Tuberkulosis. Departemen Kesehatan RI. Jakarta. 2007.

Probandari A, Lindholm L, Stendlud H, Utarini A, Hurting AK. (2010) Missed Oportunity For Standardrized Diagnosisand Treatment Patients in Hospital Involved in Public Privat Mix for Directly Observed Treatment Short–Course Strategy in Indonesia, BMC Health Services Research Journal. 2010;10:113.

Purwanto EA dan Sulistyastuti DR. Implementasi Kebijakan Publik, Konsep dan Aplikasinya di Indonesia, Gava Media. Yogyakarta. 2012.

WHO. Public Privat Mix for DOTS:Pratical tools to help implementation, Geneva. 2003.

Lonnorth K. Uplear M. Arora VK. Juvekar S. Lan NTN. Mwaniki D. Pathania V. Public Privat Mix for DOTS Implementation:what makes it work? Bulletin W orld Health Organization. 2004;82:580-86.

WHO. Public Privat Mix TB Care and Control: A Tool Kit, Geneva. 2010.

Wildridge V. Childst S. Madget B. How to create successful partnerships – a rewiew of the literature. Health Information and Library Journal. 2004;21: 3-19.

Departemen Kesehatan RI. Pedoman Penerapan DOTS di Rumah Sakit, Departemen Kesehatan RI. Jakarta. 2007.

Probandari A. Utarini A. Hurting AK. Achieving Quality in the Directly Observed Treatment Short–Course (DOTS) strategi implementation process: a challenge for Hospital Public Privat Mix, Glob Health Action Journal. 2008;17:1.

Upklear M. Involving Private Health Care providers in delivery of TB care:global strategi, Tuberkulosis. 2003;83:156-164.



DOI: https://doi.org/10.22146/jkki.36356

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