卫生资源可用性对东努沙登加拉妇幼保健政策执行绩效的影响

Florentianus Tat, I. Irfan, M. Bait
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A quantitative research method for data collection was carried out in 11 districts in NTT and 104 public health centers ( pusat kesehatan masyarakat , puskesmas ) towards 235 health workers from August to December 2019. The results show that the health workers were categorized as insufficient/not available (mean value of 2.64), and puskemas did not have doctors, midwives, and nurses conforming to standards. There was also inadequacy in some aspects such as budget (average value of 2.45), medical devices (average value of 2.75), medicines and medical supplies, buildings, and transport. A correlation was found between resources and the performance of maternal and child health policies (p=0.00) with a coefficient correlation of 0.546. It indicates a strong and positive correlation, which means that if there is an increase in resources, maternal and child health policy implementation will also. Partial linear regression tests showed t arithmetic=13.304 >t table 1.97, which means that H 0 was rejected. It suggests a significant effect between resources and the performance of maternal and child health policy implementation in NTT. In conclusion, resources had a positively significant impact on the performance of maternal and child health policy in NTT. PENGARUH KETERSEDIAAN SUMBER DAYA KESEHATAN TERHADAP KINERJA IMPLEMENTASI KEBIJAKAN KESEHATAN IBU DAN ANAK DI NUSA TENGGARA TIMUR Permasalahan kesehatan ibu dan anak (KIA) terus menjadi prioritas masalah kesehatan di Indonesia khususnya di Nusa Tenggara Timur (NTT). Angka kematian ibu di NTT mencapai 159/100.000 kelahiran hidup (KH), sedangkan angka kematian bayi dan balita mencapai 32/1.000 KH dan 40/1.000 KH yang masing-masing di atas nilai nasional, yaitu 23/1.000 KH dan 32/1.000 KH. Kondisi tersebut mengindikasikan bahwa penerapan kebijakan KIA di NTT belum dilaksanakan secara maksimal. Salah satu penyebabnya adalah sumber daya manusia kesehatan yang memberikan pelayanan kesehatan kurang tersedia. Tujuan penelitian adalah mengidentifikasi pengaruh ketersediaan sumber daya manusia kesehatan terhadap kinerja penerapan kebijakan KIA di NTT. Metode penelitian adalah kuantitatif. Pengumpulan data dilakukan di 11 kabupaten dan 104 pusat kesehatan masyarakat (puskesmas) pada 235 tenaga kesehatan dari bulan Agustus hingga Desember 2019. Hasil penelitian menunjukkan bahwa tenaga kesehatan dikategorikan tidak cukup/tidak tersedia (nilai rerata 2,64) dan puskesmas tidak memiliki dokter, bidan, dan perawat sesuai standar. Selain itu, terdapat juga kekurangan di beberapa aspek seperti anggaran biaya (nilai rerata 2,45), alat kesehatan (nilai rerata 2,75), obat dan perbekalan kesehatan, alat medis, bangunan, serta alat transportasi. Korelasi ditemukan antara sumber daya dan kinerja penerapan kebijakan KIA (p=0,00) dengan koefisien korelasi 0,546. 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引用次数: 1

摘要

孕产妇和儿童健康问题仍然是印度尼西亚的优先健康问题,特别是在东努沙登加拉(NTT)。NTT的孕产妇死亡率已达到159/10万活产,婴儿和五岁以下儿童的死亡率已达到32/1000活产和40/1000活产,分别高于国家的23/1000活产和32/1000活生的数值。它表明,NTT的卫生和妇幼保健政策没有得到最大限度的执行。原因之一是缺乏提供卫生服务的可用卫生工作者资源。研究目的是确定卫生资源的可用性对NTT妇幼卫生政策执行绩效的影响。2019年8月至12月,在NTT的11个区和104个公共卫生中心(公共卫生中心,puskemas)对235名卫生工作者进行了数据收集的定量研究方法。结果显示,卫生工作者被归类为不足/不可用(平均值为2.64),脓疱病没有符合标准的医生、助产士和护士。在预算(平均值2.45)、医疗器械(平均值2.75)、药品和医疗用品、建筑和运输等方面也存在不足。资源与妇幼保健政策绩效之间存在相关性(p=0.00),相关系数为0.546。这表明了一种强烈的正相关关系,这意味着如果资源增加,妇幼保健政策的执行也将增加。偏线性回归检验表明,t算术=13.304>t表1.97,这意味着H 0被拒绝。这表明资源与NTT妇幼保健政策执行绩效之间存在显著影响。总之,资源对NTT妇幼保健政策的执行产生了积极的显著影响。母亲和儿童的健康问题仍然是印度尼西亚的一个优先健康问题,尤其是在南努沙岛。NTT的孕产妇死亡人数达到159/100000活产,而婴儿和新闻死亡人数分别达到32/1000 KH和40/1000 KH,分别高于国家数值,即23/1000 KH和32/1000 KH。其中一个原因是提供较差卫生服务的人力卫生资源。本研究的目的是确定人力卫生资源可用性对NTT中KIA政策执行绩效的影响。研究方法是定量的。2019年8月至12月,数据收集在11个集群和235个卫生中心的104个公共卫生中心(中心)进行。研究结果表明,健康能量被归类为不足/不可用(平均值2.64),图书馆没有医生、农民和标准护士。此外,在成本预算(平均2.45)、卫生工具(平均2.75)、药品和卫生用品、医疗工具、建筑和运输工具等方面也存在不足。资源与KIA政策执行绩效之间存在相关性(p=0.00),相关系数为0.546。这意味着这种相关性是非常强和积极的,这意味着如果资源增加,那么执行KIA政策的绩效也会提高。偏线性回归测试显示t计数=13304>t表1.97,这意味着H 0被拒绝。这表明资源与NTT省KIA政策执行绩效之间存在显著影响。总之,资源对NTT的KIA政策执行绩效具有重大的积极影响。
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The Availability of Health Resources on the Performance of Maternal and Child Health Policy Implementation in East Nusa Tenggara
Maternal and child health problems continue to be priority health issues in Indonesia, especially in East Nusa Tenggara (NTT). The maternal mortality rate in NTT has reached 159/100,000 live births, while infant and under-five mortality rates have reached 32/1000 live births and 40/1,000 live births, respectively above the national value of 23/1000 live births and 32/1,000 live births. It indicates that the health and maternal and child health policies in NTT have not been maximally implemented. One of the causes is the lack of available health worker resources that provide health services. The research objective is to identify the effect of health resources' availability on the performance of maternal and child health policy implementation in NTT. A quantitative research method for data collection was carried out in 11 districts in NTT and 104 public health centers ( pusat kesehatan masyarakat , puskesmas ) towards 235 health workers from August to December 2019. The results show that the health workers were categorized as insufficient/not available (mean value of 2.64), and puskemas did not have doctors, midwives, and nurses conforming to standards. There was also inadequacy in some aspects such as budget (average value of 2.45), medical devices (average value of 2.75), medicines and medical supplies, buildings, and transport. A correlation was found between resources and the performance of maternal and child health policies (p=0.00) with a coefficient correlation of 0.546. It indicates a strong and positive correlation, which means that if there is an increase in resources, maternal and child health policy implementation will also. Partial linear regression tests showed t arithmetic=13.304 >t table 1.97, which means that H 0 was rejected. It suggests a significant effect between resources and the performance of maternal and child health policy implementation in NTT. In conclusion, resources had a positively significant impact on the performance of maternal and child health policy in NTT. PENGARUH KETERSEDIAAN SUMBER DAYA KESEHATAN TERHADAP KINERJA IMPLEMENTASI KEBIJAKAN KESEHATAN IBU DAN ANAK DI NUSA TENGGARA TIMUR Permasalahan kesehatan ibu dan anak (KIA) terus menjadi prioritas masalah kesehatan di Indonesia khususnya di Nusa Tenggara Timur (NTT). Angka kematian ibu di NTT mencapai 159/100.000 kelahiran hidup (KH), sedangkan angka kematian bayi dan balita mencapai 32/1.000 KH dan 40/1.000 KH yang masing-masing di atas nilai nasional, yaitu 23/1.000 KH dan 32/1.000 KH. Kondisi tersebut mengindikasikan bahwa penerapan kebijakan KIA di NTT belum dilaksanakan secara maksimal. Salah satu penyebabnya adalah sumber daya manusia kesehatan yang memberikan pelayanan kesehatan kurang tersedia. Tujuan penelitian adalah mengidentifikasi pengaruh ketersediaan sumber daya manusia kesehatan terhadap kinerja penerapan kebijakan KIA di NTT. Metode penelitian adalah kuantitatif. Pengumpulan data dilakukan di 11 kabupaten dan 104 pusat kesehatan masyarakat (puskesmas) pada 235 tenaga kesehatan dari bulan Agustus hingga Desember 2019. Hasil penelitian menunjukkan bahwa tenaga kesehatan dikategorikan tidak cukup/tidak tersedia (nilai rerata 2,64) dan puskesmas tidak memiliki dokter, bidan, dan perawat sesuai standar. Selain itu, terdapat juga kekurangan di beberapa aspek seperti anggaran biaya (nilai rerata 2,45), alat kesehatan (nilai rerata 2,75), obat dan perbekalan kesehatan, alat medis, bangunan, serta alat transportasi. Korelasi ditemukan antara sumber daya dan kinerja penerapan kebijakan KIA (p=0,00) dengan koefisien korelasi 0,546. Hal ini berarti korelasi cukup kuat dan positif, artinya jika sumber daya ditingkatkan maka kinerja implementasi kebijakan KIA juga meningkat. Uji regresi linier parsial menunjukkan t hitung=13,304 >t tabel 1,97 yang bermakna H 0 ditolak. Hal ini menunjukkan pengaruh yang signifikan antara sumber daya dan kinerja penerapan kebijakan KIA di Provinsi NTT. Simpulan, sumber daya berpengaruh signifikan positif terhadap kinerja penerapan kebijakan KIA di NTT.
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