scholarly journals Storage Management and Wastage of Reproductive Health Medicines in Public Health Facilities of West Wollega Zone, Ethiopia: Mixed Study

2021 ◽  
Author(s):  
Oliyad Kebede ◽  
Gizachew Tilahun ◽  
Desalegn Feyissa
Keyword(s):  
Reproductive Health ◽  
Storage Conditions ◽  
Storage Management ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional ◽  
Life Saving ◽  
Resource Stock ◽  
Poor Infrastructure ◽  
Expired Medicines

Abstract Background: Keeping proper storage conditions at health facilities is important to reduce pharmaceutical wastage caused by environmental factors. The expiration of medicines at the health facilities led to wastage of potentially life-saving drugs and unnecessary expenditure on the disposal of those expired medicines. Therefore, the aim of this study was to assess pharmaceutical stores and wastage of reproductive health medicines due to expirationMethod: A facility-based descriptive cross-sectional quantitative and qualitative study was conducted using a checklist, structured and semi-structured questionnaires.Results: Among 23 health facilities assessed, 17 (73.91%) (4(100%) hospitals and 13(68.42%) health centers) fulfilled desirable storage conditions. The total value of reproductive health medicines wasted due to expire in surveyed facilities was 357,920.52 ETB (12,323.81 US dollars) and the Percentage of Stock Wasted due to Expiration was 8.04%. Levonorgestrel 0.75mg tablet contributed highest percentage to expired medicines.Conclusion: Pharmaceutical stores in hospitals had equipment and furniture, fulfilled desirable storage conditions, whereas, significant number of the health centers’ medical store did not comply with the recommended storage conditions. Challenges of store management identified were poor infrastructure, administrative challenges, and shortage of human resource. Stock wasted due to expiration was high and the contributing challenge was non-need-based supply. So Ethiopian pharmaceutical Supply Agency should supply reproductive health medicines based on need and concerned government bodies should avail pharmaceutical store infrastructures, hire professionals, and follow health facilities administrations.

scholarly journals Storage management and wastage of reproductive health medicines and associated challenges in west Wollega zone of Ethiopia: a mixed cross-sectional descriptive study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oliyad Kebede ◽  
Gizachew Tilahun ◽  
Desalegn Feyissa
Keyword(s):  
Reproductive Health ◽  
Supply And Demand ◽  
Health Department ◽  
Storage Conditions ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional ◽  
Store Management ◽  
The Government

Abstract Background Keeping proper storage conditions at health facilities is vital to reduce pharmaceutical wastage caused by environmental factors. The expiration of medicines at the health facilities could lead to wastage of potentially life-saving drugs and unnecessary expenditure on the disposal of those expired medicines. Therefore, the aim of this study was to assess pharmaceutical stores and wastage of reproductive health medicines due to expiration in the west Wollega zone of Ethiopia. Method We conducted a facility-based cross-sectional study from 15th to 31st July 2019 using quantitative and qualitative data from West Wollega Zone of Ethiopia. Results Among 23 health facilities assessed, 17 (73.91%) (4(100%) hospitals and 13(68.42%) health centers) fulfilled desirable storage conditions. Hospitals’ stores had equipment and furniture, fulfilled desirable storage conditions, whereas, a significant number of the health centers’ stores did not comply with desirable storage conditions. Challenges of store management identified were poor store infrastructure and shortage of manpower. The total value of reproductive health medicines wasted due to expire in surveyed facilities was 357,920.52 ETB (12,323.81 US dollars) and the Percentage of Stock Wasted due to Expiration was 8.04%. Levonorgestrel 0.75 mg tablet is the highest in the percentage of stock wasted due to expiry. Factors contributing to wastage due to expiration were supply and demand imbalance. Conclusion Reproductive health medicines wasted due to expiration is high compared to the government of Ethiopia’s plan for the year 2018/19. This might imply that the monitoring of this plan is poor. Even though hospitals store management is good, there is a weakness in store management in health centers. This could be due to poor attention given to health centers. Therefore, west Wollega zonal health department should appropriately monitor the wastage of Reproductive health medicines and enforce health centers to follow appropriate storage guidelines. Hospitals and health centers should not accept medicines beyond their need to reduce expiry.

scholarly journals Perceptions and barriers toward sexual reproductive health services accessibility, availability and quality among adolescents in selected cities of Rwanda

2020 ◽  
Author(s):  
Pacifique Ndayishimiye ◽  
Roseline Dzekem Dine ◽  
Aline Dukuze ◽  
Isabelle Kubwimana ◽  
Jean Baptiste Nyandwi ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health Services Accessibility ◽  
Community Outreach ◽  
Health Facilities ◽  
School Level ◽  
Female Participant ◽  
Reproductive Health Services ◽  
Cross Sectional ◽  
Sexual Reproductive Health

Abstract Background: A fifth of the global population is made up of adolescents. Sexual reproductive health needs for young people is largely ignored by existing health, education and other social programs. In Rwanda, there is still an increase in teen pregnancies, HIV/ STIs as well as reports on the lack of access to accurate SRH information. The study aimed to explore the perceptions and barriers toward sexual reproductive health services accessibility, availability and quality among adolescents in the second cities of Rwanda.Methods: Cross-sectional study was conducted in six selected cities of Rwanda. In-depth interviews were conducted using semi-structured questionnaires among 121 adolescents aged 10-19 years old living in six selected cities.Results : Majority of the participants were female 62.8% and aged between 15-17 years old 32.8%. Females adolescents were more aware, and adolescents with primary school level 62.5% were not aware about SRH services provision at health facilities. Adolescents were mostly aware about the availability of HIV testing and circumcision services at 102 ( 86.4%). Results indicate that utilization of SRH services remains low (34.7%) among adolescents. A recent utilization of a particular service was linked to a use in the past: “I am aware of my HIV status because I was tested when I was going to receive a transfusion at a hospital” (Female participant, Rwamagana). Family, socio-cultural, religious influences and lack of privacy, high costs for the services, unavailability of some services at private facilities as well as lack of comfortable separated rooms, were the barriers reported by adolescents that prevented them from utilising SRH services.Conclusion : Accessibility to SRH services for adolescents remains low and SRH services provision doesn’t offer confidentiality to adolescents who seek services at health facilities. Family influences, socio-cultural stigma and religious barriers remain a burden to adolescents’ SRH services utilization. Increasing community outreach and adolescent’s engagement is needed to enable access to accurate SRH information. Multidisciplinary stakeholders should collaborate and cooperate to address the stigma associated with access to SRH services for adolescents.

scholarly journals PERSEPSI REMAJA TERHADAP FAKTOR PENGHAMBAT PEMANFAATAN PELAYANAN KESEHATAN REPRODUKSI DI PUSKESMAS GAMBOK KABUPATEN SIJUNJUNG

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Vella Dwi Yani ◽  
Ova Emilia ◽  
Hari Kusnanto
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Physical Process ◽  
Qualitative Data ◽  
Psychosocial Factor ◽  
Reproductive Health Service ◽  
Health Centers ◽  
District Health ◽  
Cross Sectional ◽  
Cross Sectional Design

PERSEPSI REMAJA TERHADAP FAKTOR PENGHAMBATPEMANFAATAN PELAYANAN KESEHATAN REPRODUKSIDI PUSKESMAS GAMBOK KABUPATEN SIJUNJUNGVella Dwi Yani, Ova Emilia, Hari KusnantoABSTRACTBackground: Reproductive health service is an important component that has to be improved globally becauseteenagers often lack basic information about reproductive health. Despite the need for reproductive health serviceonly a few teenagers utilize the service due to several constraints in having reproductive and sexual health serviceas a result of limited access to the service and negative perception about center of reproductive health service.Data of Sijunjung District Health Office Sumatera Barat show that only 20% of teenagers utilize reproductivehealth service available. Whereas cases in teenagers indicate that 9.2% of teenagers have had premarital sexualintercourse and 40% are married at teenage period (<20 years) and 10% is caused by unwanted pregnancy.Objective: To study the perception of teenagers about physical, process, economic and psychosocial factors asobstacles in the utilization of reproductive health service.Method: The study was observational with cross sectional design and descriptive quantitative approach thatused qualitative data obtained from indepth interview. Subject of the study were students of SMU 1 and 2 of 14-16 years old around the working area of Health Centers that have health service for teenagers with as many as131 respondents.Result and Discussion: Perception of teenagers about physical, process and economic factors showed that themajority had good perception so these factors were not obstacles for teenagers in utilizing reproductive healthservice. The majority of teenagers (68%) had bad perception about psychosocial factor so this was an obstacle inthe utilization of reproductive health service.Conclusion: Obstacles in the utilization of reproductive health service at the health center were caused bypsychosocial factor because of shame and unwillingness to tell the problem to staff that was considered asstrangers. Teenagers also doubted the confidentiality of the problem they told to the staff.Keywords: perception, teenagers, reproductive health, utilizationABSTRAKLatar belakang: Pelayanan kesehatan reproduksi merupakan komponen penting yang harus diperbaiki secaraglobal. Remaja sering kali kekurangan informasi dasar tentang kesehatan reproduksi. Meskipun kebutuhanpelayanan kesehatan reproduksi tinggi namun pemanfaatannya masih rendah karena berbagai hambatanmemperoleh pelayanan dan juga adanya persepsi negatif terhadap pusat pelayanan kesehatan reproduksi. Datadari dinas Kesehatan kabupaten Sijunjung Sumatera Barat menunjukkan hanya 20% remaja yang memanfaatkanpelayanan kesehatan reproduksi. Sedangkan kasus dan masalah kesehatan reproduksi menunjukkan 9,2% sudahberhubungan seks sebelum menikah, dan 40% menikah pada usia remaja (<20 tahun) serta 10% mengakibatkankehamilan tak dikehendaki.Tujuan: Untuk mempelajari persepsi remaja terhadap faktor fisik, proses, ekonomi dan psikososial untukmemanfaatkan pelayanan kesehatan reproduksi remaja.melalui wawancara mendalam.Subyek penelitian adalah siswa SMA kelas 1 dan 2 usia 14-16 tahun di wilayahkerja puskesmas sebanyak 131 responden.Hasil dan Pembahasan: Mayoritas remaja memiliki persepsi baik terhadap faktor fisik, proses, dan ekonomi. Tigafaktor bukanmerupakan penghambatmemperoleh layanan kesehatan reproduksi. Sementara itu faktor psikososialdianggap sebagai penghambat (68%) untuk memanfaatkan pelayanan kesehatan reproduksi.Kesimpulan: Hambatan pemanfaatan layanan kesehatan reproduksi adalah faktor psikososial karena malu dantidak percaya untuk menceritakan masalah pada petugas kesehatan yang tidak dikenal. Remaja juga meragukankerahasiaan masalah yang diungkapkan.Kata kunci: persepsi, remaja, kesehatan reproduksi, pemanfaatan

scholarly journals Quality of Medical Records in Public Health Facilities of Jimma Zone, Oromia Regional State, Southwest, Ethiopia 2021

2021 ◽  
Author(s):  
Nigusu Endashaw ◽  
Bezawit Birhanu ◽  
Melese Teka ◽  
Gelila Abrham
Keyword(s):  
Public Health ◽  
Medical Records ◽  
Quantitative Data ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional ◽  
Southwest Ethiopia ◽  
Public Health Facilities ◽  
Jimma Zone

Abstract Background: Comprehensive medical records are cornerstones in the quality and efficiency of patient care, as they can provide a complete and accurate chronology of treatments, patient results, and future plans for care. The study was aimed to assess the quality of medical records in public health facilities of Jimma Zone. Methods: A facility-based cross-sectional quantitative study design supplemented by a qualitative method was used from May 30 to July 29, 2020. A total of 384 medical records were reviewed by using the facility inventory form for quantitative data. The data was entered by EPI data 3.1 and analyzed by SPSS 23 and descriptive statistics were used to present the findings. Qualitative data were triangulated with the quantitative data.Result: The majority of the health facility has a shortage of trained and qualified recording personnel in the medical record department. Among 36 health facilities, only one facility have printer in the record room and 3(8%) of them have tracer card. The overall quality of medical records in terms of content completeness as per the standard of health facilities requirements for districts, hospitals, and health centers were 30.62%, 39.49%, 25.79% respectively. Conclusion: The majority of medical records had poor completeness of administrative data, clinical, financial, and legal contents. The overall quality of medical records in Jimma Zone was very low for components of the quality of medical records as per the standard of health facilities requirements.

scholarly journals Disposal Practice of Unfit Medicines in Nongovernmental Hospitals and Private Medicine Outlets Located in Mwanza, Tanzania

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Stanley Mwita ◽  
Godfrey Ngonela ◽  
Deogratias Katabalo
Keyword(s):  
Social Sciences ◽  
Management Practice ◽  
Cross Sectional Study ◽  
Storage Management ◽  
Health Facilities ◽  
Chi Square ◽  
Cross Sectional ◽  
Software Comparison ◽  
Study Population ◽  
Private Medicine

Introduction. For a medicine to qualify as safe and effective and to be of good quality, it should be properly labelled, stored, and transported. If a medicine is not handled properly, it ends up being unfit. Improper disposal of unfit medicines contributes to the appearance of their metabolites in the environment. Methods. A descriptive cross-sectional study was designed to capture quantitative data. The study was conducted in Mwanza region, Tanzania. The study population comprised nongovernmental hospitals and private medicines outlets in the region. The sample size was 111 facilities. This study was conducted between October 2013 and May 2014. The questionnaire was used to assess experience and challenges of dealing with unfit medicines. A review of waste management records was done to capture data of past disposal for unfit medicines. The coded data were analyzed using Statistical Package for Social Sciences (Version 20.0) computer analysis software. Comparison of proportions between groups was performed using Pearson’s chi square. Results. The majority of facilities (41.4%) used methods such as the pouring of unfit medicines into the sink and into the dustbin. About 60.4% of facilities were found with unfit medicines at the time of survey. Majority of unfit medicines found were antibiotics (64.1%). Almost 10% of health facilities maintained a register book for recording unfit medicines. Conclusion. There was improper disposal of unfit medicines in health facilities studied, whereby commonly reported methods of disposal were pouring into the sink and putting into the street dustbin. In private medicines outlets, there was poor storage management practice as some of the unfit medicines were left unpacked into boxes or separated from the usable medicines and not properly labelled.

scholarly journals Examining Health Facility Financing in Kenya in the Context of Devolution

2021 ◽  
Author(s):  
Angela Kairu ◽  
Stacey Orangi ◽  
Boniface Mbuthia ◽  
Joanne Ondera ◽  
Nirmala Ravishankar ◽  
...  
Keyword(s):  
Health System ◽  
Health Facility ◽  
Descriptive Analysis ◽  
Health Facilities ◽  
Public Hospitals ◽  
Health Centers ◽  
User Fees ◽  
Public Facility ◽  
Cross Sectional ◽  
Financial Autonomy

Abstract Background: How health facilities are financed affects their performance and health system goals. We examined how health facilities in the public sector are financed in Kenya, within the context of a devolved health system.Methods: We carried out a cross-sectional study in five purposely selected counties in Kenya, using a mixed methods approach. We collected data using document reviews and in-depth interviews (no=20). In each county, we interviewed county department of health managers and health facility managers from two and one purposely selected public hospitals and health center respectively. We analyzed qualitive data using thematic analysis and conducted descriptive analysis of quantitative data.Results: Planning and budgeting: Planning and budgeting processes by hospitals and health centers were not standardized across counties. Budgets were not transparent and credible, but rather were regarded as “wish lists” since they did not translate to actual resources. Sources of funds: Public hospitals relied on user fees, while health centers relied on donor funds as their main sources of funding. Funding flows: Hospitals in four of the five study counties had no financial autonomy. Health centers in all study counties had financial autonomy. Flow of funds to hospitals and health centers in all study counties was characterized by unpredictability of amounts and timing. Health facility expenditure: Staff salaries accounted for over 80% of health facility expenditure. This crowded out other expenditure and led to frequent stock outs of essential health commodities. Conclusion: The national and county government should consider improving health facility financing in Kenya by 1) standardizing budgeting and planning processes, 2) transitioning public facility financing away from a reliance on user fees and donor funding 3) reforming public finance management laws and carry out political engagement to facilitate direct facility financing and financial autonomy of public hospitals, and 4) assess health facility resource needs to guide appropriate levels resource allocation.

scholarly journals Effect of COVID-19 Pandemic on Provision of Sexual and Reproductive Health Services in Primary Health Facilities in Nigeria: a Cross-sectional Study

2021 ◽  
Author(s):  
Babatunde Adelekan ◽  
Erika Goldson ◽  
Zubaida Abubakar ◽  
Ulla Mueller ◽  
Audu Alayande ◽  
...  
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

Abstract BackgroundNigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive health, maternal and child health, and adolescent health services in primary health care facilities across the Nigerian States.MethodsThis was a cross-sectional study of 307 primary health facilities in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and service provision before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using non-parametric statistics.ResultsThe results show that a large proportion of the primary health facilities in the selected states opened for the provision of essential sexual and reproductive health and rights services during the COVID-19 pandemic lockdown. However, there was a significant reduction in clients’ utilization of services due to challenges experienced in service implementation such as stock-outs, and low demand for services by clients. Although the health facilities reported identifying cases of COVID-19, there was limited provision for primary protective equipment and other special offers that would motivate the health workers to optimize services for clients. ConclusionsWe conclude that efforts made to address these challenges by governments, non-governmental agencies, the private sector, and donor agencies working in low resource settings would reduce the health and social burden posed by COVID-19 in Nigeria.

scholarly journals Kesesuaian Antara Ketersediaan Antibiotik dan Formularium Nasional Pada Era JKN di Faskes Tingkat Pertama Kota Manado Tahun 2014 - 2017

2020 ◽  
Vol 48 (1) ◽  
Author(s):  
Lukman Prayitno ◽  
Yuyun Yuniar ◽  
Tita Rosita
Keyword(s):  
Drug Use ◽  
Secondary Data ◽  
Antibiotic Use ◽  
Health Facilities ◽  
Health Centers ◽  
National Formulary ◽  
Cross Sectional ◽  
Average Percentage ◽  
The North ◽  
Reward And Punishment

Abstract Benefits of Fornas are guidance in determining drug use, increasing rational drug use, quality control and treatment costs and optimizing services. The use of antibiotics is regulated according to the category of health service facilities. Therefore it is necessary to evaluate the suitability between the availability of antibiotic drugs and national formulary. The study design was cross sectional. This type of research is quantitative followed by qualitative data collection. Quantitative data in the form of secondary data on the availability of antibiotics for the period 2014-2017 at the North Sulawesi Provincial Health Office, Manado City Health Office, and 2 Health Centers in Manado City. The average percentage of suitability of antibiotics with the national formulary from 2014 to 2017 at level 1 health facilities was 61.77% in the Provincial Health Office, 61.59% in the City Health Office, 50.14% in the Puskesmas Bahu, 56.85% in the Tikala Health Center. The low percentage of conformity with fornas in the Provincial Health Office, Manado City Health Office and 2 Health Centers was dominated by the large number of antibiotic use which can only be used for level 2 and 3 health facilities. There needs to be escorting the process of socialization, implementation and supervision. It is necessary to consider forming a particular system, for example reward and punishment for doctors who write prescriptions. Keywords: JKN, Antibiotics, National Formulary, FKTP Abstrak Manfaat Fornas yaitu acuan penetapan penggunaan obat dalam JKN, meningkatkan penggunaan obat rasional, kendali mutu dan biaya pengobatan dan mengoptimalkan pelayanan. Penggunaan antibiotik diatur berdasarkan kategori fasilitas pelayanan kesehatan. Oleh karena itu perlu dilakukan evaluasi kesesuaian antara ketersediaan obat antibiotik dan formularium nasional. Desain penelitian adalah cross sectional. Jenis penelitian ini adalah kuantitatif yang diikuti oleh pengumpulan data kualitatif. Data kuantitatif berupa data sekunder ketersediaan antibiotik selama periode 2014 – 2017 di Dinas Kesehatan Provinsi Sulut, Dinkes Kota Manado, dan 2 Puskesmas di Kota Manado. Rata-rata persentase kesesuaian antibiotik dengan formularium nasional dari tahun 2014 – 2017 pada faskes tingkat 1 adalah 61,77% di Dinkes Provinsi, 61,59% di Dinkes Kota, 50,14% di Puskesmas Bahu, 56,85% di Puskesmas Tikala. Rendahnya persentase kesesuaian dengan fornas di Dinkes Provinsi, Dinkes Kota Manado dan 2 Puskesmas lebih didominasi karena banyaknya penggunaan antibiotik yang hanya boleh digunakan untuk faskes tingkat 2 dan 3. Perlu ada pengawalan terhadap proses sosialisasi, implementasi dan pengawasan. Perlu dipertimbangkan untuk membentuk sistem tertentu, misalnya reward and punishment terhadap dokter yang menulis resep. Kata kunci: JKN, Antibiotik, Formularium Nasional, FKTP

scholarly journals Implementation of respectful maternal care in health facilities in Conakry, Guinea

2021 ◽  
Author(s):  
Soumah Aboubacar Fode Momo1 ◽  
Diallo Mamadou Cellou1 ◽  
Conte Ibrahima1 ◽  
Sylla Ibrahima1 ◽  
Bah Oumou Hawa2 ◽  
...  
Keyword(s):  
Maternal Care ◽  
Good Practice ◽  
Performance Standards ◽  
Daily Practice ◽  
Maternity Hospital ◽  
Lessons Learned ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional

Abstract Objective: Describe the implementation of Respectful Maternal Care in health facilities in the capital and discuss lessons learned. Methods: This was a cross-sectional descriptive study by direct observation of providers from November 29 to December 01, 2020. It consisted of a baseline assessment of pilot sites prior to training in respectful maternal care, followed by the traditional five-day training and an extension to urban health centers, due to their on-site training in SONUB (obstetric and neo-natal care) Basic emergency natals) including the Respectful Maternal Care Training Module (PMF). Random random sampling by random draw, three guards per site, a midwife with a parturiente and their families, providers of health centers in post-training follow-up, were observed through the seven (7) performance standards (Table2) on the skills received. The investigators were clinical synthesis students who were trained in the use of the tool. Results: 199 providers (138 midwives, 49 nurses and 12 doctors) were trained in PMSC in the 24 health facilities in the capital. Post-training follow-up through providers made the following findings in the different areas of PMSCs: The seven (7) standards were observed prior to training in the 6 pilot sites (Center Médical Communal (CMC) of Matam, Minière, Ratoma, Coléah, Bernard Kouchner and the maternity hospital of the National Ignace Deen Hospital) (Fig.1), two were achieved or 0.3 the practice improved compared to the situation of the basic evaluation: in the seven areas of respectful maternal care evaluated and monitored, performance varied by area from 26% to 100% (Fig.2). In health centers, good practice was observed with the observation of skills during post-training follow-up: In the seven areas monitored, performance varied from 50% to 100% (Fig.3) Conclusion: SMR. integration was effective in 25 health facilities in the city of Conakry; training, internal and external regular supervision and provider awareness are essential to sustain PMSCs in daily practice.

scholarly journals Analisis Karakteristik dan Persepsi Pengguna Pelayanan Terhadap Pemanfaatan Puskesmas Sebagai Gatekeeper di Dua Puskesmas Kota Bekasi Tahun 2016

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Fitria Kusumawati Wulandari ◽  
Anhari Achadi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Managed Care ◽  
Health Workers ◽  
Health Facilities ◽  
Health Centers ◽  
Dominant Factor ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Primary Health

AbstrakKonsep pelayanan kesehatan primer pada era Jaminan Kesehatan Nasional (JKN) dikembangkan dengan penguatan pelayanan primer sebagai gatekeeper dengan konsep managed care. Pada konsep managed care, suksesnya sistem gatekeeper salah satunya dinilai dari angka kunjungan dan angka rujukan ke Fasilitas Kesehatan Tingkat Lanjutan (FKTL). Penelitian ini bertujuan untuk mengetahui karakteristik dan persepsi pengguna pelayanan terhadap pemanfaatan Puskesmas sebagai gatekeeper di dua puskesmas Kota Bekasi. Penelitian ini menggunakan desain cross sectional dan pengumpulan data melalui pengisian kuesioner oleh 208 pasien peserta JKN di dua puskesmas Kota Bekasi dengan metode pengambilan sampel secara stratified purposive sampling. Hasil penelitian menunjukkan pekerjaan (nilai p=0,018), persepsi terhadap sikap petugas kesehatan (nilai p=0,000), dan lama berobat (nilai p=0,048) berhubungan dengan pemanfaatan puskesmas sebagai gatekeeper. Persepsi terhadap sikap petugas kesehatan merupakan faktor dominan yang mempengaruhi pemanfaatan Puskesmas sebagai gatekeeper (r=0.720). Penerapan konsep gatekeeper dengan baik dapat meningkatkan pemanfaatan Puskesmas dan menekan angka rujukan ke FKTL. AbstractThe concept of primary health care in the era of National Health Insurance (JKN) is developed by strengthening primary health care as a gatekeeper with the concept of managed care. In this concept of managed care, one og the success story of the gatekeeper system is assessed by the visit and referral rates to the Higher Level of Health Facilities (ALHF/Fasilitas Kesehatan Tingkat Lanjut). This study aimed to determine the characteristics and perception of service users towards utilization of public health centers (PHC/Puskesmas) as gatekeeper in two PHC in City of Bekasi. This study used cross-sectional design and data collection by filling up questionnaires by 208 patients of JKN members in two health centers in Bekasi with stratified purposive sampling methods. The results showed that job(p=0.018), perceptions of the health workers’ attitudes (p=0.000), and treatment duration (p=0.048) were related to the utilization of PHC as a gatekeeper. Perceptions of the health workers’ attitude was the dominant factor affecting the utilization of PHC as a gatekeeper (r=0.720). The health workers’ attitude affected the repeated utilization services in PHC and its utilization as a gatekeeper, especially for continuum care. The proper application of gatekeeper concept should be able to increase the utilization of PHC and reduce the number of referrals to the Advanced Level of Health Facilities (ALHF).

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