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"Perubahan pada Rencana Strategis Kementerian Kesehatan Tahun 2020-2024 yang sesuai dengan arahan Presiden RI berpengaruh terhadap setiap indikator kinerja, salah satunya pada indikator sasaran strategis FKTP Terakreditasi. Pada tahun 2024 ditargetkan FKTP (puskesmas dan klinik) terakreditasi adalah 100%, tetapi pada semester I tahun 2023 jumlah FKTP Terakreditasi masih sebesar 42,7% dan jumlah puskesmas yang sudah terakreditasi tidak mengalami perubahan sejak tahun 2020. Kementerian Kesehatan lalu menyusun regulasi sebagai dasar pelaksanaan akreditasi puskesmas sehingga pemenuhan target RPJMN dapat tercapai. Regulasi tersebut adalah petunjuk teknis yang berpedoman pada Permenkes Nomor 34 Tahun 2022 Tentang Akreditasi Pusat Kesehatan Masyarakat, Klinik, Laboratorium Kesehatan, Unit Transfusi Darah, Tempat Praktik Mandiri Dokter, dan Tempat Praktik Mandiri Dokter Gigi. Dengan adanya regulasi terbaru terkait program akreditasi puskesmas, penyelenggaraan teknis survei akreditasi juga mengalami perubahan sehingga butuh evaluasi yang bisa menilai efektivitas penyelenggaraan program akreditasi puskesmas tersebut. Penelitian ini menggunakan metode penelitian kualitatif berupa wawancara mendalam dan telaah dokumen dengan pendekatan Input, Proses, dan Output. Hasil penelitian menunjukkan bahwa pada aspek input, SDM yang terlibat adalah Tim Kerja MPK Puskesmas sebagai regulator dan LPA sebagai pelaksana survei akreditasi, anggaran yang digunakan adalah APBN, APBD, dana hibah, dan dana cadangan lain, tidak memerlukan sarana dan prasarana tertentu, adanya regulasi Permenkes Nomor 34 Tahun 2022 dan aturan turunannya berupa Kepmenkes, Kepdirjen, dan SE, serta penggunaan SINAF. Pada aspek proses, Kementerian Kesehatan melaksanakan perancanaan berupa perencanaan kebijakan, anggaran, dan sistem informasi, pengorganisasian tugas dengan membagi PIC provinsi, pelaksanaan survei dilakukan oleh LPA sesuai Kepdirjen Nomor HK.02.02/I/3991/2022, dan pengawasan dilakukan dengan metode Binwas berupa validasi. Output pada indikator FKTP Terakreditasi masih di bawah target, yaitu 68,69% dari target 90%. Sementara itu, per April 2024 masih terdapat 1.672 puskesmas yang belum terkareditasi. Kendala pada input berupa kesulitan memastikan kualitas surveior, anggaran terbatas, penyesuaian kebijakan, dan sulit mengakses sistem informasi; kendala pada proses berupa perencanaan cukup lama, dilema etik, sulit menjamin kualitas survei, dan waktu yang singkat untuk menyelesaikan masalah; serta kendala pada output berupa cakupan persentase akreditasi puskesmas yang masih di bawah target.

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Changes to the Ministry of Health's 2020-2024 Strategic Plan by the direction of the President of the Republic of Indonesia affect every performance indicator, one of which is the strategic target indicator for Accredited Primary Health Care. In 2024, the target for accredited primary health care (community health centers and clinics) is 100%, but in the first semester of 2023 the number of accredited primary health care is still 42.7% and the number of accredited community health centers has not changed since 2020. The Ministry of Health then drafted regulations as a basis for implementing accreditation of community health centers so that fulfillment of RPJMN targets can be achieved. These regulations are technical instructions that are guided by Minister of Health Regulation Number 34 of 2022 concerning Accreditation of Community Health Centers, Clinics, Health Laboratories, Blood Transfusion Units, Doctors' Independent Practices, and Dentists' Independent Practices. With the latest regulations regarding the community health center accreditation program, the technical implementation of the accreditation survey has also changed so that an evaluation is needed that can assess the effectiveness of the implementation of the community health center accreditation program. This research uses qualitative research methods in the form of in-depth interviews and document review with an Input, Process, and Output approach. The results of the research show that in the input aspect, the human resources involved are the Puskesmas Health Service Quality Work Team as the regulator and the LPA as the implementer of the accreditation survey, the budget used is APBN, APBD, grant funds, and other reserve funds, does not require certain facilities and infrastructure, there is regulation of Minister of Health No. 34 of 2022 and its derivative regulations in the form of Kepmenkes, Kepdirjen, and SE, as well as the use of SINAF. In the process aspect, the Ministry of Health carries out planning in the form of planning policies, budgets, and information systems, organizing tasks by dividing provincial PICs, carrying out surveys carried out by LPA by the Director General's Decree Number HK.02.02/I/3991/2022, and supervision is carried out using the monitoring method in the form of validation. The output on the Accredited FKTP indicator is still below the target, namely 68.69% of the target of 90%. Meanwhile, as of April 2024 there are still 1,672 community health centers that have not been accredited. Input constraints include difficulty in ensuring the quality of surveyors, limited budget, policy adjustments, and difficulty accessing information systems; process constraints include long planning, ethical dilemmas, difficulty in ensuring survey quality, and short time to resolve problems; and output constraints include the percentage coverage of puskesmas accreditation that is still below the target."

"Era globalisasi adalah era persaingan terhadap mutu dan kualitas sumber daya manusia. saat ini pemerintah melakukan upaya strategis dalam menjamin mutu lulusan dengan pembinaan dan pengawasan sumber daya manusia kesehatan melalui sertifikasi dan adanya surat tanda registrasi yang sebelumnya harus melalui tahap uji kompetensi. Maka Perguruan tinggi menjadi ujung tombak terhadap standarisasi kualitas lulusan. Salah satu indikator mutu lulusan dapat dilihat dari akreditasi perguruan tinggi. Pada hakekatnya perguruan tinggi harus terus menerus meningkatkan mutu pendidikan dengan dapat melihat peluang, potensi, ancaman agar lebih efektif bertindak dan menghasilkan lulusan yang siap di pasar kerja. Penelitian ini bersifat studi kasus dengan menggunakan data sekunder. Hasil penelitian ini terdapat aspek kepemimpinan dan cara mengelola sumber dana masih rendah. Masih terlihatnya disparitas antara perguruan tinggi yang memiliki status akreditasi A, B, maupun C. Kesimpulan yang didapatkan bahwa menghasilkan lulusan Sarjana Kesehatan Masyarakat sesuai standar nasional dan lulus uji komptensi, diharapkan perguruan tinggi memberikan perhatian yang seimbang bagi 8 delapan komponen uji kompetensi, khususnya aspek kepemimpinan dan dalam rangka menciptakan perguruan tinggi dengan akreditasi A, diharapkan lembaga akreditasi memberikan pembinaan dan pengawasan bagi perguruan tinggi dalam hal peningkatan mutu.

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Globalization is an era of competition to the quality of human resources. This time the goverment established a strategy effort to ensure graduate rsquo s competency by coaching and supervised human resource of public health through sertification and registration letter that have to through the stage of core competency. So the university become the main core to graduates standardization. One of graduate rsquo s quality indicator can be seen by accreditation of the university. Essentially, the university have to increased education rsquo s quality gradually by ability to see the oportunity, potency, and threat to be effective in action and producing compatible graduate that ready to compete at the work field. This case study research was conducted with secondary data.

The result of this research, there are leadership aspect and the way to manage resouce of fund is still low. We still could see the disparity between the university with A accreditation, B, or C. The conclusion that we could take is to produce Public Health gradute that match with national standard and passsed core competency, university is being expeccted to give balanced attention for 8 eight components of core competency, espescially in leadership aspect to create the university with A accredition, accreditation foundation give coaching and monitoring to the university in order of quality escalation."

"Pada sistem pembayaran Kapitasi Berbasis Kinerja (KBK), akan dilakukan perhitungan pencapaian kinerja Fasilitas Kesehatan Tingkat Pertama (FKTP) berdasarkan indikator Angka Kontak, Rasio Rujukan Non Spesialistik, dan  Rasio Peserta Prolanis Terkendali sebagai dasar pembayaran kapitasi. Penelitian ini merupakan penelitian non eksperimental melalui pendekatan kuantitatif, yang bertujuan untuk mengetahui hubungan status pemberlakuan KBK konsekuensi, rasio dokter banding peserta, kelengkapan sarana prasanaran, lingkup pelayanan dan pola pengelolaan keuangan Puskesmas dengan nilai capaian KBK pada Puskesmas di wilayah Provinsi Sumatera Utara Tahun 2023. Dari hasil penelitian ini, nilai capaian KBK Puskesmas di Provinsi Sumatera Utara bulan Desember 2023 sebesar 2,8 atau belum bisa mencapai target nilai capaian KBK maksimal. Rasio dokter banding peserta dan kelengkapan sarana prasarana mempunyai hubungan yang signifikan terhadap nilai capaian KBK. Pemenuhan tenaga medis dokter berdasarkan jumlah peserta terdaftarnya, pemenuhan kebutuhan sarana prasarana sesuai kebutuhan tata laksana jenis penyakit yang dapat dilakukan di FKTP dan pengaturan distribusi peserta terdaftar perlu menjadi perhatian untuk meningkatkan kinerja sesuai ketentuan Kapitasi Berbasis Kinerja.

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In the Performance Based Capitation (KBK) payment system, the performance achievement of First Level Health Facilities (FKTP) will be calculated based on the indicators of Contact Rate, Non-Specialist Referral Ratio, and Controlled Prolanis Participant Ratio as the basis for capitation payments. This research is a non-experimental research using a quantitative approach, which aims to determine the relationship between the status of implementation of KBK consequences, the ratio of doctors to participants, fulfillment of infrastructure, scope of services and financial management patterns of Community Health Centers with the value of KBK achievements at Puskesmas in the North Sumatra Province region in 2023. From the results of this research, the KBK achievement value for Puskesmas in North Sumatra Province in December 2023 is 2.8 or has not yet reached the target maximum. The ratio of doctors to participants and fulfillment of infrastructure have a significant relationship to the KBK achievement score. Fulfillment of doctors based on the number of registered participants, fulfillment of infrastructure and arrangements for the distribution of registered participants need to be paid attention to in order to improve performance in accordance with the provisions of Performance Based Capitation."

"Although research has demonstrated the efficacy of psychological services for ameliorating physical conditions, consumers are often uninformed of the advantages of integrated health care. To begin to address this knowledge gap, the authors developed, offered, and assessed a 2-hr community outreach program."

"Program Pengelolaan Penyakit Kronis (Prolanis) merupakan sistem pelayanan kesehatan terintegrasi yang dilakukan secara proaktif dan terintegrasi melibatkan peserta, fasilitas kesehatan, dan BPJS Kesehatan untuk pemeliharaan kesehatan bagi penderita penyakit kronis, sehingga dapat memiliki kualitas hidup yang lebih baik dengan biaya yang efektif dan efisien. Pemantauan Terapi Obat (PTO) bertujuan untuk memastikan terapi obat yang aman, efektif, dan rasional dengan cara mengkaji pilihan obat, dosis, cara pemberian obat, respons terapi, reaksi obat yang tidak diinginkan (ROTD), dan merekomendasikan perubahan atau alternatif terapi. PTO dilakukan secara berkesinambungan dan dievaluasi secara teratur pada periode tertentu agar keberhasilan atau kegagalan terapi dapat diketahui. Menurut Peraturan Menteri Kesehatan No. 74 tahun 2016 tentang Standar Pelayanan Kefarmasian di Puskesmas, kriteria pasien yang mendapatkan pemantauan terapi obat adalah yang memiliki resep polifarmasi, kompleksitas penyakit, dan penggunaan obat serta respons pasien yang sangat individual yang meningkatkan munculnya masalah terkait obat (Kemenkes, 2016). Penelitian dilakukan di Puskesmas Kecamatan Kalideres pada bulan Maret-April 2023 dengan menggunakan metode studi deskriptif non-analitik. Data penelitian diambil dengan metode purposive sampling dari data rekam medis. Data dianalisis secara univariat dengan menganalisis profil pengobatan pasien sesuai dengan DRPs, kemudian disajikan dalam bentuk persentase yang memuat tabel, angka, dan narasi. Evaluasi dilakukan terhadap penggunaan obat pada pasien Prolanis. Dari hasil analisis pemantauan terapi obat pada pasien A, B, dan C, dapat disimpulkan bahwa terapi pengobatan yang diterima oleh pasien A sudah rasional. Namun, pada pasien B dan C masih terdapat beberapa penggunaan obat yang tidak rasional, khususnya beberapa jenis obat yang kemungkinan besar dapat menimbulkan interaksi satu sama lain apabila digunakan secara bersamaan.

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Chronic Disease Management Program (Prolanis) is an integrated healthcare service system proactively involving participants, healthcare facilities, and BPJS to maintain the health of chronic disease patients, thus improving their quality of life cost-effectively and efficiently. Therapeutic Drug Monitoring (TDM) aims to ensure safe, effective, and rational drug therapy by assessing drug selection, dosage, administration method, therapy response, adverse drug reactions (ADRs), and recommending therapy changes or alternatives. According to the Minister of Health Regulation No. 74 of 2016 regarding Pharmaceutical Service Standards at Community Health Centers, patients eligible for medication therapy monitoring are those with polypharmacy, disease complexity, and individual patient responses that increase the occurrence of drug-related problems (Ministry of Health, 2016). The research was conducted at Puskesmas Kecamatan Kalideres in March-April 2023 using a non-analytical descriptive study method. Research data were collected using purposive sampling method from medical record data. The data were analyzed univariately by analyzing the patient's medication profile according to DRPs then presented in the form of percentages containing tables, figures, and narratives. The evaluation was conducted on the use of drugs in Prolanis patients. From the analysis results of medication therapy monitoring in patients A, B, and C, it can be concluded that the treatment received by patient A is rational. However, in patients B and C, there are still some irrational drug uses, especially several types of drugs that are likely to interact with each other if used together."

"Pelayanan Obstetri dan Neonatal Emergensi Dasar (PONED) merupakan salah satu pelayanan Puskesmas yang diharapkan dapat memberikan kontribusi untuk penurunan AKI dan AKB. Angka Kematian Ibu (AKI), Angka Kematian Bayi (AKB) dan Angka Kematian Balita (AKABA) di Indonesia tertinggi dibandingkan negara-negara ASEAN lainnya. Kabupaten Administrasi Kepulauan Seribu memiliki 2 Puskesmas Kecamatan yang memiliki rawat inap yang berfungsi PONED dan 4 Puskesmas Kelurahan yang mempunyai perawatan 24 jam. Namun demikian indikator pelayanan Program PONED masih belum mencapai target, salah satunya angka Kematian Bayi dan Rujukan Ibu Melahirkan yang masih sangat tinggi. Penelitian ini merupakan penelitian analitik kualitatif. Informan ditentukan dengan menggunakan purposive sampling. Informan penelitian antara lain masyarakat, Pemerintah Daerah, Tim PONED Puskesmas, Para Kepala Puskesmas PONED, penanggung jawab program PONED Sudinkes Pulau Seribu, dan Penanggung Jawab SDM Kesehatan Sudinkes Kepulauan Seribu. Data yang dikumpulkan berupa data primer dan data sekunder berupa hasil wawancara mendalam dan telaah dokumen. Hasil penelitian diperoleh data bahwa pada standar dan ukuran kebijakan telah dipahami oleh pelaksana kebijakan. Pemahaman ini didukung komunikasi yang jelas dan berkelanjutan antara Dinas Kesehatan, puskesmas dan stakeholder, kejelasan informasi dan konsistensi informasi. Ketersediaan anggaran, sarana dan prasarana sudah mencukupi tetapi terkendala masalah pemeliharaan alat karena faktor air asin yang menyebabkan peralatan mudah berkarat dan rusak. Struktur birokrasi sudah terdapat Keputusan Bupati mengenai tim PONED, namun belum ada struktur khusus PONED di Suku Dinas Kesehatan Kepulauan Seribu Disposisi ditunjukan dengan sikap positif berupa komitmen bersama Pemerintah Daerah dan Puskesmas dalam penanganan ibu hamil, penanganan kasus rujukan ibu melahirkan dengan penyulit. Peran serta masyarakat dalam pelaksanaan PONED sudah ditunjukan dengan pemanfaatan Puskesmas PONED dalam pemeriksaan kehamilan dan proses melahirkan, Output pelaksanaan program PONED sudah dilakukan pencatatan dan pelaporan capaian program kepada penanggung jawab di Sudinkes, belum ada format pelaporan khusus PONED dan belum dilakukan analisa pelaporan PONED serta feedbacak pelaporan belum dilaksanakan. Implementasi pelayanan PONED di Puskesmas Kepulauan Seribu Selatan dan Puskesmas Pulau Seribu Utara sudah berjalan tapi belum optimal dengan adanya hambatan dan kendala di komponen input, proses maupun output yang harus diatasi sehingga pelayana PONED di Kepulauan Seribu bisa berjalan dengan baik.

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Basic Emergency Obstetric and Neonatal Care (PONED) is one of the Primary Health Care services that is expected to contribute to the reduction of MMR and IMR. Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR) and Toddler Mortality Rate in Indonesia are the highest compared to other ASEAN countries. The Seribu Islands Administrative Regency has 2 sub-district health centers that have PONED inpatient care and 4 sub-district health centers that have 24-hour care. However, the service indicators of the PONED program have not yet reached the target, one of which is the very high infant mortality rate and maternal referral. This study was a qualitative analytic study. Informants were determined using purposive sampling. The research informants included the community, local government, Primary Health Care PONED team, Heads of Primary Health Care PONED, the person in charge of the Thousand Island sub-district PONED program, and the person in charge of the Thousand Islands sub-district health human resources. The research results show that the policy standards and measures have been understood by implementers. This understanding is supported by clear and continuous communication between the Health Service, community health centers and stakeholders, clarity of information and consistency of information. The availability of budget, facilities and infrastructure is sufficient but is hampered by equipment maintenance problems due to the salt water factor which causes the equipment to rust easily and cause damage. The bureaucratic structure already has a Regent's Decree regarding the poned team, but there is no special PONED structure in the Seribu Islands Health Sub-Department. The disposition is shown by a positive attitude in the form of a joint commitment between the Regional Government and the Community Health Center in handling pregnant women, handling referral cases of mothers giving birth with complications. Community participation in the implementation of PONED has been demonstrated by the use of PONED Community Health Centers in pregnancy checks and the birthing process. The output of the implementation of the PONED program has been recorded and reported on program achievements to the person in charge at the Health Sub-Department. reporting has not been implemented. The implementation of PONED services at the South Seribu Islands Community Health Center and North Thousand Islands Health Center is already underway but is not yet optimal due to the existence of barriers and obstacles in the input, process and output components that must be overcome so that PONED services in the Thousand Islands can run well."

"Puskesmas sebagai fasilitas kesehatan tingkat pertama, bertanggung jawab dalam kegiatan pelayanan kesehatan secara menyeluruh, terpadu, dan berkesinambungan. Dalam rangka melaksanakan program JKN dan memenuhi himbauan dari Kepala Dinas Kesehatan DKI Jakarta terkait akreditasi, Puskesmas Kecamatan Ciracas telah menyusun pedoman berupa Formularium Puskesmas. Pemilihan obat untuk Formularium Puskesmas mengacu pada daftar Obat Esensial Nasional (DOEN) dan Formularium Nasional (Fornas). Formularium tersebut digunakan sebagai acuan oleh Puskesmas Kecamatan Ciracas dalam menjamin ketersediaan obat yang berkhasiat, bermutu, aman, dan terjangkau. Tujuan dari laporan PKPA ini adalah untuk memahami alur penyusunan formularium puskesmas serta mengevaluasi kesesuaian daftar obat di formularium puskesmas dengan formularium nasional. Laporan ini didasarkan dari penelusuran literatur dan observasi data formularium puskesmas serta wawancara dengan apoteker yang terlibat dalam penyusunan formularium puskesmas. Berdasarkan analisis, alur penyusunan formularium telah sesuai dengan prosedur yang berlaku dan dilakukan evaluasi satu tahun sekali. Daftar obat di formularium puskesmas secara keseluruhan telah sesuai dengan formularium nasional yang berlaku. Namun, terdapat beberapa obat kategori fasilitas kesehatan tingkat 2 dan/atau 3 yang tetap dimasukkan ke Formularium Puskesmas Kecamatan Ciracas Tahun 2023 didasarkan atas hasil rapat dan disertai kajian/justifikasi dari dokter yang mengusulkan.

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Puskesmas, as the first-level health facility, is responsible for comprehensive, integrated, and sustainable health service activities. In order to implement the JKN program and comply with the appeal from the Head of the DKI Jakarta Health Office regarding accreditation, the ciracas subdistrict health center has developed guidelines in the form of a Puskesmas Formulary. The selection of drugs for the Puskesmas Formulary refers to the National Essential Medicines List and the National Formulary. The formulary is used as a reference by the ciracas subdistrict health center to ensure the availability of efficacious, quality, safe, and affordable medicines. The purpose of this PKPA report is to understand the flow of the formulation of the puskesmas formulary and to evaluate the conformity of the drug lists in the puskesmas formulary with the national formulary. This report is based on a literature search and observation of puskesmas formulary data, as well as interviews with pharmacists who were involved in preparing the puskesmas formulary. Based on the analysis, the flow of the formulation of the formulary is in accordance with the applicable procedures and is evaluated once a year. The list of medicines in the Pukkesmas formulary as a whole is in accordance with the applicable national formulary. However, there are several level 2 and/or 3 health facility category drugs that are still included in the ciracas subdistrict health center formulary based on the results of the meeting and accompanied by a review or justification from the doctor who proposed it."

"Written in an accessible, user-friendly, and practical style, this text provides a focused and highly engaging introduction to community health nursing. It focuses on health care for people in their homes and where they live with an overriding emphasis on care of the client in the community, and the business and politics of community health nursing. This book is accompanied by a robust Companion Website full of online activities to enhance the student learning experiences."

"Puskesmas berperan sebagai penyedia pelayanan kesehatan tingkat pertama di Indonesia dengan program-program seperti Upaya Kesehatan Masyarakat dan Upaya Kesehatan Perorangan, termasuk Program Pengelolaan Penyakit Kronis (PROLANIS) yang melibatkan peserta, fasilitas kesehatan, dan BPJS Kesehatan untuk memelihara kesehatan peserta BPJS Kesehatan dengan penyakit kronis. Penelitian ini mengevaluasi data resep pasien Poli PTM di Puskesmas Kecamatan Kalideres selama Januari dan Februari 2023 untuk memperoleh pola penggunaan obat dan pemenuhan obat pada pasien PROLANIS, dengan fokus pada pasien lanjut usia dan polifarmasi. Evaluasi menunjukkan penurunan penggunaan obat dan tekanan darah yang menandakan perbaikan kondisi pasien, serta tingkat kepatuhan pasien terhadap pengobatan dianggap memuaskan.

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The Public Health Center (Puskesmas) is a primary healthcare provider system in Indonesia, offering comprehensive healthcare services and government-mandated health programs such as Public Health Efforts and Individual Health Efforts. One of its managed programs is the Chronic Disease Management Program (PROLANIS), aimed at maintaining the health of BPJS Kesehatan participants with chronic diseases to achieve optimal quality of life while ensuring effectiveness and efficiency in healthcare service expenditures. This study evaluates prescription data from the Non-Communicable Disease (PTM) Clinic at Kalideres District Health Center during January and February 2023 to analyze medication usage patterns and compliance among PROLANIS patients, focusing on elderly patients and polypharmacy. The evaluation reveals a decrease in medication usage and blood pressure, indicating patient improvement, with satisfactory medication adherence observed among patients at Kalideres Public Health Center."