scholarly journals Pengembangan Model Kebijakan Pelayanan Gratis di Puskesmas

Author(s):  
Iskandar Syah ◽  
Eryati Darwin ◽  
Hafni Bachtiar Bachtiar ◽  
Vera Pujani

Dengan adanya Peraturan Daerah Nomor 05 tahun 2009 lahirlah kebijakan pelayanan kesehatan gratis di kota Padang. Pelayanan kesehatan gratis ini merupakan dukungan pemerintahan kota kepada warganya untuk menyadari bahwa kesehatan merupakan kebutuhan dasar dan kebijakan ini mendapat dukungan dari Bazda (Badan Zakat Daerah). Tujuan dari penelitian ini adalah untuk menganalisis model pengembangan kebijakan pelayanan kesehatan gratis di kota Padang. Penelitian ini dilakukan dengan menggunakan pendekatan kualitatif dan kuantitatif. Data kualitatif diperoleh dari Dinas Kesehatan Kota Padang. Sedangkan data kuantitatif diperoleh melalui wawancara dan focus group disscussion (FGD). Enam pimpinan puskesmas dan tenaga kesehatan merupakan informan yang diwawancarai untuk mengidentifikasi variabel yang diselidiki. Pimpinan pemerintahan yang terkait dengan kebijakan ini juga dilibatkan untuk memperoleh data yang dibutuhkan, sedangkan kepuasan pasien tentang pelayanan kesehatan gratis ini diperoleh melalui FGD. Analisis terhadap semua data yang diperoleh dari informan dalam penelitian ini dilakukan secara multicase analisis. Penelitian ini menemukan bahwa pengembangan model kebijakan pelayanan kesehatan gratis yang ditawarkan adalah model pelayanan yang dapat memberikan manfaat maksimal bagi semua pihak yang terlibat termasuk pasien, puskesmas dan tenaga kesehatan.According to Peraturan Daerah Nomor 05 tahun 2009 toward the free health service in Padang city implied that the free service of health care was driven by the consideration of the city government as basic public needs and financially suported by Bazda (Badan Zakat Daerah). The objective of the study is to analyze the development of free health care policy model in Padang. The study was conducted by using quatitative and qualitative data. The quantitative data was obtained from the health agency office in Padang. Hence the qualitative data was obtained through interview and fofocus group discusion (FGD). The six puskesmas managers and health workers as the research informant were interviewd to identify the investigated variable. The related goverment leaders also were involved to make data collection comprehensivelly. In the meantime, satisfaction patients related to service delivery were investigated using FGD. All informant obtained were transcriped as picture for this research in the multicase analysis. This study found that the model development of free service policy offered is a model of service that can provide the maximum benefits for all aspects involved including patients, health centers, and health professionals.

2015 ◽  
Vol 9 ◽  
pp. 224-236
Author(s):  
Shiva Subedi

Government of Nepal has introduced Free Health Care Policy (FHCP) through different tiers of health delivery system in 2007. With the objective of understanding the perspectives of community stakeholders, health service providers, and the services users towards free care policy, a qualitative-quantitative study was conducted in selected communities of Myagdi district from December 2010 to January 2011. Although the majority of user group thought that free care service is good but only two-third of them had received free care. Shortage of free essential drugs at health facility centers, absence of health workers   and lack of clear information about free services or counseling on free services available at health facility centers are the most repeated issues raised by the service users. Similarly, the service providers had similar experiences and perceptions on FHCP. The majority of the community stakeholders also had positive perception on this implemented policy. They have observed that many facilities had shortage of drugs and people are not having free health care. Many health facilities lacked interaction on FHCP, and service users did not have equitable access to the services provided. Overall, though the free care was perceived to be good policy, its satisfactory implementation remains one of the challenges. Many of the areas relating to service delivery need to be strengthened. A reliable supply system of drugs and its regular monitoring mechanism can ensure the effective implementation of free health care services.


2019 ◽  
Vol 6 ◽  
pp. 2333794X1984391 ◽  
Author(s):  
Nhu Van Ha ◽  
Van Thi Anh Nguyen ◽  
Bui Thi My Anh ◽  
Thanh Duc Nguyen

Health insurance reform for children younger than 6 years of age was implemented in 2005. The study aimed to describe the health insurance card status, health care services use, and associated factors. The cross-sectional study was conducted with 210 Hmong mothers of children younger than 6 years of age, and of those, 118 mothers having an ill child in the previous 4 weeks were selected in this study. Descriptive statistics and multiple logistic regression were applied to predict the associated factors. In all, 42.9% of children had health insurance cards and 45.8% ill children accessed public health facilities. The factors included children’s age, mothers’ knowledge of the free health care policy, mothers’ knowledge about one sign of lung infection of their children associated with health insurance status, and health care services use. In conclusion, the 2005 reform of child health insurance policy has brought a modest impact on insurance coverage of children younger than 6 years of age and health care services use. Mothers’ knowledge of free health care policy should be improved.


2015 ◽  
Vol 31 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Sophie Witter ◽  
Haja Wurie ◽  
Maria Paola Bertone

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Sohel R. Choudhury ◽  
Sheikh Mohammed Shariful Islam ◽  
Abu S. Abdullah

Abstract Background The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh. Methods We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n = 4); key informant interviews with central level health policymakers/ managers (n = 15) and focus group discussions with CHWs (4 FGDs; total n = 29). Participants in a stakeholder consultative meeting included members from the government (n = 4), non-government organisations (n = 2), private sector (n = 1) and universities (n = 2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses. Results The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation. Conclusion Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.


2018 ◽  
Vol 2 (1) ◽  
pp. 35-41
Author(s):  
Hary Iskandar ◽  
Sabir Alwy ◽  
Nurul Hudi

The use of patient medical records for hospital payment claims is in essence contrary to the medical records confidentiality rules. This study aims to review the judicial use of medical records in the verification of health care financing in the era of national health insurance. This research uses descriptive study method with normative juridical approach. Qualitative data comes from literature review such as primary, secondary and tertiary law. This study indicates that verifiers with the status of health workers have the legal authority to use patient information in medical records as they relate to the profession. Medical secrets can be opened in the context of quality control and health care costs. Quality control through medical audit, and cost control with health service utilization. This study recommends that verifiers be selected from medical personnel and therefore have the authority to open a medical record.


2018 ◽  
Vol 2 (1) ◽  
pp. 35-41
Author(s):  
Hary Iskandar ◽  
Sabir Alwy ◽  
Nurul Hudi

The use of patient medical records for hospital payment claims is in essence contrary to the medical records confidentiality rules. This study aims to review the judicial use of medical records in the verification of health care financing in the era of national health insurance. This research uses descriptive study method with normative juridical approach. Qualitative data comes from literature review such as primary, secondary and tertiary law. This study indicates that verifiers with the status of health workers have the legal authority to use patient information in medical records as they relate to the profession. Medical secrets can be opened in the context of quality control and health care costs. Quality control through medical audit, and cost control with health service utilization. This study recommends that verifiers be selected from medical personnel and therefore have the authority to open a medical record.


2020 ◽  
Vol 10 (2) ◽  
pp. 1-5
Author(s):  
Sushila Baral ◽  
Sony Pandey ◽  
Rajesh kumar Yadav ◽  
Sudarshan Subedi

Free Health Service is a priority program and a boon to all citizens mostly for the poor and marginalized groups. It is a timely and exemplary program of government but some people have deviation in their normal behaviour as services have been provided free. A descriptive cross-sectional approach was done to assess moral hazard on free health care services by consumers. An interview schedule was used to collect quantitative data and in depth interview with health workers for qualitative data in selected eleven health facilities. The study showed the prevalence of moral hazards of free health care services by the consumers. Two-third (65%) respondents had medicines at home. Around one-third (33%) of respondent had self demanded for the medicines. Two-third (67.6%) doesn't seek for health services during health problems. One-fourth (23.6%) had poster at home for non IEC purpose. Age, education level, travelling time to health facility, occupation, and satisfaction towards services were significantly associated with availability of medicines at home. Age, education level, health workers behaviour were significantly associated with self demand of medicines. Peoples are misutilizing the services as, government bear the burden of cost. There was deviation in the normal behaviour of the peoples due to no registration fees and free drugs availability. Many people like to take medicines and have a notion that there is a pills for every ill as a result they self demand for the medicines and mostly don’t consume full dose which can develop drug resistance. Visit to health facilities to collect medicines at home have increase unnecessary burden to health facilities and also increase in morbidity status. The result can inform developing proper policy and safety measures to drop off moral hazard on free health care services.


2016 ◽  
Vol 1 (1) ◽  
pp. 75
Author(s):  
Muhammad Zuhri ◽  
Basri Basri

The vision of Aceh Government in 2012-2017 is Aceh are dignified, prosperous, just, and independent based on the legislation of Aceh government as a form of Memorandum of Understanding. One of the visions of Aceh government 2012- 2017 is the improved welfare of Acehnese people through quality health services through increasing life expectancy, infant mortality, decreasing the prevalence of malnutrition as well as the effectiveness of the treatment of infectious diseases to the achievement of the MDG’s. Model policies adopted by the Aceh government is monitoring and track record of cases, tv monitor, routine and case sms, a special program policy model, and the model of budget balancing. Model policies adopted by the district/city government is making a supporting program, All Village Midwives Must Live in the Village, deliveries assistance is performed by professional health workers, adjustment to the ability of APBK. Support new regulation of Regent Regulation (Perbub) on Malaria Elimination and No Smoking Area. MDG’s target is not entirely in accordance with the indicator being built, because it requires adjustments in accordance with the ability of both district or city areas. Regulatory support is not adequate to support the achievement of the MDG’s in the field of health.


2020 ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Shohel R Choudhury ◽  
Sheikh Mohammad Shariful Islam ◽  
Abu Abdullah

Abstract Background: The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh.Methods: We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n=4); key informant interviews with central level health policymakers/ managers (n=15) and focus group discussions with CHWs (4 FGDs; total n=29). Participants in a stakeholder consultative meeting included members from the government (n=4), non-government organisations (n=2), private sector (n=1) and universities (n=2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses.Results: The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation.Conclusion: Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.


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