[en]_Pengalaman PATTIRO Bidang Kesehatan

7/21/2019 [en]_Pengalaman PATTIRO Bidang Kesehatan

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PATTIROs Experience in Health Program

Many hope that the decentralization in Indonesia, that has lasted for 16 years, will result in

improvements on the quality of public services and the use of public budget for the benefits

of society. Rooms of creativity will give regional government !emda" opportunities to

innovate the open public services. #ometimes it has to be started from society$s response that

controls the management of public services. %owever, generally people need to be reminded

of their rights to receive these services.

Improvement on health services is one of many important issues that require people$s

awareness massively, especially in the level of communities from the second half of the first

decade of the &'''s. (he two main ob)ectives of the health programs are* 1" strengthening

society$s awareness, whether it is in the level of communities, media and universities, to

understand more about their rights to health services and the responsibility of the government

as the administrator+ &" bolstering the enhancement of regional government$s capacity to

develop mechanisms and service programs to be better in quality, and easier to access.

!((IR-$s several important achievements are as follow*

1. Improving the civil society$s nowledge and capacity in participating in the planning,

budgeting, administration, and monitoring of health programs. /ivil society is able to

convey demands0suggestions0complaints to government and local district parliament

!R" so that health policies may solve the e2isting imbalance. 3nhancement is carried

out through training, health budget analysis worshops, surveys and )oint researches with

society on health services, discussions on the enhancement of Integrated #ervices !ost

!osyandu", public hearings and audiences on policy and budget maing, promotion of

rights for health services through mass media, the writing of a boo about the

achievements of health quality, and many more.

&. More government administrators act accountably by publishing various policies to meet

society$s needs and demands regarding the imbalance of health services. (his effort is

e2ecuted through worshop of composing the %ealth #ervice #tandards, giving

recommendations on health service system to the government !usesmas or community

health centers+ inas 4esehatan or 5ocal %ealth gency+ appeda or Regional

evelopment gency+ and local parliamentarians or

!R", suggesting budget allocation

to improve health services and many more.

7. Increasing budget allocations and improvements on health service infrastructures. !((IR-

ensures that the budget is sufficient for delivering the services through )oint identification

the society, analyzing the !, public campaigns, dialogue with policy maers, and

advocacy to influence the process of budget policy maing.

(he istribution of !((IR- 8etwor$s %ealth !rogram 32periences

8o. escription of Result Region0


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Intervention 9ear

1. Health Budget Advocac

(ogether with Membersof !osyandu

/ommunication :orum

:44!" advocating anincrease in budgetallocation for !osyandu.

udget allocation for !osyandu in ! started toincrease since &'';. efore &''", only IR

6''.''' for each !osyandu. #ince &''; it became IR

?''.'''+ IR 1,& million &''? = &'1'"+ IR 1,;million &'11 = &'1&"+ IR & million &'17"+ and IR&,< million &'1@"

#uraarta/ity,

&''; =

&'1@

Initiating and enhancingAender wareness :orumin #antri /ity :!A4#",in !ealongan Regency.

(his forum tracs the program suggested by the societyin the process of policy maing.

llocation for Maternal and 8eonatal #urvival!rogram were increased from IR >< million in &''?"to IR 1'' million in &'1'"

!ealonganRegency,&''?=

&'1'

dvocacy to increase

budget allocation for#ocial %ealth Insurance

in #emarang /ity

udget allocation for Bamesos #ocial #ecurity" in

#emarang /ity was increased, IR 1< billion &'1'",IR &< billion &'11", IR @' billion &'1&", IR @, sub=districts.

!ealongan /ity,

&''; =now

:acilitating the

establishment initiationof Members of !osyandu

/ommunication :orum:44!" in #uraarta /ity

since &'';.

:44! is capable of advocating the needs of

!-#98D to give a proposal about supplementaryfood program for the children under five years

old!M(" budget.

:44! is able to administer learning practices among

!osyandus, especially about participations in programrecommendation and discussion on !osyandu$sprogram planning, administration, and reporting.

!osyandu in the level of sub=village Ruun Earga =RE", !osyandu for -lder !eople.

#uraarta,

&'';

/ampaigning healthy lifebehaviors through the

enactment of Regionalregulation 8o. 1?0&'1&

about reas Eithout/igarette.

(en /ommunity /enters in !ealongan /abeah#elatan, l=4hoiriyah Eomen 8etwor, Areen eans,

:emale :isherman 5abor /ommittee, !ealongan!eople :orum, :ormal 5aborer, Areen #tudent,

actively voice the campaign of not smoing in anyplace, and use the provided spaces.

!ealongan /ity,

&'1& =now

#urvey on the #ociety

#atisfaction Inde2(oward the #ervices fromBeneponto Regency$s

!usesmas.1

Recommendations based on the findings of this survey

are being followed up by the Aovernment. (he followups are as follow*

1. !reviously, mbulances were often

monopolized by the %ead of !usesmas andwere not available when they were needed.

8ow, ambulances are ready all the time with aclear branding and completed with call center11


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Dser ased #urveyD#" in 5eba Regency

!usesmas /isalamRangas itung and

!usesmas o)ong

Mani" by assistedsociety group.

1. !riority findings* the number of doctors was notbalanced yet, lac in the number of midwives,

!usesmas were not being taen care of, noqueuing number, limited supply of medicine,

and service hours did not follow the rules.

&. Ehat !usesmas did as a follow up for thesurvey* the procurement of toilets for patients,queuing number, information board, and a bo2

of complaints0suggestions in !usesmaso)ong Mani. -ne additional doctor in

!usesmas /isalam, improvement on the levelof hygiene withJumat Bersih/lean :riday"

movement.

5ebaRegency,

&'';

Dser ased #urveyD#" on #ervices in!usesmas in Magelang

Regency !usesmas#alam and !usesmas

(empuran"

(he main problem in !usesmas (empuran with ruralcharacteristics" was the need of building improvement.-n the other hand, the problem in !usesmas #alam

with urban characteristics and already possessed I#-?''' certificate" was the services. (he level of

society$s satisfaction toward the services from!usesmas #alam was low.

MagelangRegency,&'';

/itizen Report /ard/R/" of %ealth #ector in5eba Regency

:indings* #ervices coverage of Cillage Midwives isonly >> G+ Dp to &7G of the villages have not beencovered. (he service rate of village midwives couldnot be afforded by the society. (he result is that the

rate of using the midwives$ service for giving births isonly 1?G+ meanwhile, >>G respondents chooseparaji

shaman" to help them, @G choose both shamans andmidwives".

(he rate of maternal and infant mortality 4I and4" is still high until &'[email protected]

5ebaRegency,&'';

:acilitating theestablishment of/ommunity /enters in ;&villages and the (unatea

/risis /enter 5!M" inBeneponto Regency.

(he society intensively performs monitoring andparticipates in the improvements of health services.

(unatea // functions as a medium for the society tomonitor public services, especially in the field of

health.

Benepontoregency,&'1& untilnow.

/itizen %ealth udgetevelopment with the

/omic boos about an easy way to read health budgetwere distributed widely to the community as well as

8(!rovince,

7 Maternal immortality rate along &'17 in anten !rovince was as much as &16 individuals per

1''.''' births, or in other words in every 1''.''' births there were at least &16 mothers died due

to complication and the process of giving birth 77 cases in 5eba Regency, 7< in !andeglang

Regency, in #erang Regency, 7? in (angerang Regency, 1& in the /ilegon, 1> in the #erang, ? in

(angerang and ? in #outh (angerang (angsel". round 6' percent from 7


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communities. boos about health budget in ompu Regency, Eest5ombo, 8orth 5ombo, and ima

&'1&=&'17

Eomen Report /ard#urvey ER/" of %ealth

#ector in the /ity of#emarang

@@,7G of the respondents stated that they people reallyneeded infrastructures+ &&,>G respondents stated that

posyandu members needed incentives. MunicipalAovernment in #emarang followed up by increasingthe effectiveness of !-#98D$s -perationalEoring Aroup and allocating IR &


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:acilitating the:ormulation of Minimum

#ervice #tandards #!M"for %ealth #ervices.

Minimum #ervice #tandards #!M" in #uraarta /itywas set and used as a standard in the planning,

budgeting, and development of health in #uraarta/ity.

#uraarta/ity,

&'';

(echnical ssistance forthe:ormulation of#tandard -perating!rocedure #-!" for the

#ervices from 5ocal%ealth gency

(he result was < #-!s that had already been approved.(hose < #-!s are as followed* %ealth Information#ervice, %ealth !romotion !rogram Reporting+Aeneral Aovernment, Aeneral dministration, and

#tudy (as in #uraarta 5ocal %ealth gency.

#uraarta/ity,&'17

(echnical ssistance forthe :ormulation of Dnit/ost on %ealth Minimum#ervice #tandards

(he result was Dnit /ost for services in relation to thehealth of mother and child. It was then used in &'17 informulating ! &'1@ for 5ocal %ealth gency.

#uraarta/ity,&'17

Reflection. %uge imbalance still e2ists between efforts performed by regional government

with the hopes0needs of the society regarding health services. -ne of the reasons is that the

policy of decentralization that shifted the responsibilities for health affairs from central

government to regional government was not followed by the balance of its budget

management.

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