International Journal of Environmental Research and Public Health
Secondhand smoke exposure in Indonesia is high, especially compared to other Southeast Asian coun... more Secondhand smoke exposure in Indonesia is high, especially compared to other Southeast Asian countries. Passive smoking leads to negative impacts on health and socio-economic well-being. Therefore, increasing the price of cigarettes and, thereby, increasing barriers to access to cigarettes could be an effective way to reduce smoking prevalence and protect people from second-hand smoke. This study aims to assess passive smokers’ support for cigarette price increases in Indonesia. We perform a quantitative analysis with a cross-sectional design. The data were obtained through phone-based interviews of 1000 respondents aged 18 and older in Indonesia. Only 596 nonsmokers were included to be further analyzed in this study. This study found that 44.1% respondents have at least one family member who smokes. We considered the respondents’ age, gender, education level, employment, and the number of people living in the respondent’s household that are exposed to passive smoking. Our results d...
Background: The capacity of health human resources and the ability of the financial limitation be... more Background: The capacity of health human resources and the ability of the financial limitation become a threat for the sustainability of Posbindu program. The research aimed to analyze the strategy for strengthening Posbindu program for non-communicable diseases (NCD) control in Bogor. Methods: This research used qualitative method based on case study approach. The main informants in this research from Dinkes, Puskesmas, cadres, and community. Results: Posbindu PTM in Bogor had been visited by people from young to old age, but the number of cadres and equipment in each of Posbindu was different, the lack of training of cadres and the funding was still not optimal. Conclusion: The strategy for strengthening the implementation of Posbindu program can be conducted by doing intensive NCD training for cadres from the medical staff, improved the health activities to increase the intensity of the presence of the community to the Posbindu program, and increasing the cross-sector cooperation.
Health spending can lead to decrease the ability of the household financial. Nearly 2.3 million p... more Health spending can lead to decrease the ability of the household financial. Nearly 2.3 million people (1%) each year fall to be poor as a impact of catastrophic health spending of high-cost diseases that are life-threatening complications. The aim of the research is to analyze the determinants of catastrophic health spending of Indonesian households in the first year of implementation of the National Health Insurance program (JKN). This study design is cross sectional using secondary data is data Indonesia Family Life Survey (IFLS) 2014. The methods of analysis used are econometric approach with logit model and instrumental variables probit model. The results of the study significantly shows that households with catastrophic health spending incidence is around 5.38% in the first year of implementing JKN Program. While the determinants that influence catastrophic health spending include level of education, place of residence in the city, health status and economic status. This study recommends to the government to improve and develop the health program that promotes healthy lifestyles and expand the coverage of JKN program to protect the Indonesian households from catastrophic helath spending. Kata Kunci: JKN, Pengeluaran Katastropik, Data IFLS, IV Probit Abstrak Pengeluaran kesehatan dapat memicu ancaman penurunan kemampuan keuangan rumah tangga. Hampir 2.3 juta individu (1%) tiap tahunnya jatuh ke dalam kemiskinan sebagai dampak dari biaya kesehatan katastropik. Tujuan penelitian untuk menganalisis biaya kesehatan katastropik rumah tangga Indonesia setelah implementasi program JKN. Desain penelitian ini adalah cross sectional dengan menggunakan data sekunder yaitu data Indonesia Family Life Survey (IFLS) tahun 2014. Metode analisis menggunakan pendekatan ekonometri analisis model logit dan model regresi instrumental variable probit. Hasil penelitian secara signifikan menunjukkan bahwa di era program JKN, rumah tangga yang mengalami kejadian belanja kesehatan katastropik sebesar 5,38%. Sementara determinan yang mempengaruhi belanja kesehatan katastropik mencakup tingkat pendidikan, tempat tinggal di kota, status kesehatan dan status ekonomi. Penelitian ini menyarankan kepada pemerintah untuk membangun dan meningkatkan program kesehatan yang mengacu pada pola hidup sehat dan memperluas cakupan kepesertaan JKN untuk melindungi rumah tangga dari pengeluaran katastropik.
Abstrak Pelayanan rawat jalan merupakan salah satu manfaat yang dijamin oleh program Jaminan Kese... more Abstrak Pelayanan rawat jalan merupakan salah satu manfaat yang dijamin oleh program Jaminan Kesehatan Nasional (JKN). Tujuan utama program JKN adalah meningkatkan aksesibiltas masyarakat terhadap pelayanan kesehatan yang sesuai dengan kebutuhan. Pemanfaatan layanan rawat jalan yang semakin baik oleh semua lapisan masyarakat merupakan gambaran ideal dan indikator tercapainya program JKN. Tujuan penelitian ini adalah untuk mengetahui pola pelayanan kesehatan rawat jalan pada fasilitas kesehatan (dokter praktik/klinik, puskesmas, RS pemerintah, dan swasta) di tahun pertama implementasi program JKN. Penelitian ini menggunakan data sekunder dengan menganalisis data Indonesia Family Life Survey (IFLS) 2014 sebagai tahun pertama implementasi program JKN. Teknik analisis dalam penelitian ini menggunakan analisis deskriptif yang diulas secara mendalam. Hasil penelitian menunjukkan bahwa pada rentang satu tahun implementasi program JKN, usia penduduk yang melakukan akses ke pelayanan kesehatan rawat jalan paling banyak pada rentang usia 0–18 tahun,masyarakat daerah perkotaan lebih banyak mengakses pelayanan kesehatan rawat jalan dibandingkan dengan penduduk pedesaan, dan penduduk pada kisaran kuintil 5 (status ekonomi kaya) sebanyak 26,73%. Fasilitas kesehatan yang paling banyak digunakan untuk layanan rawat jalan adalah dokter praktik/klinik sebesar 4,55%. Hasil penelitian ini dapat digunakan sebagai evidence based evaluasi perbaikan akses pelayanan kesehatan untuk lebih memperhatikan masyarakat berstatus ekonomi miskin dan jemput bola peningkatan akses pelayanan kesehatan bagi masyarakat di daerah pedesaan. Kata kunci: rawat jalan, JKN, IFLS 2014, pelayanan kesehatan Abstract Outpatient treatment is one of the benefits guaranteed by the National Health Insurance (JKN) program. The main objective of JKN program is to increase public accessibility to health services that suits their needs. Utilization of outpatient services are getting better by all levels of society is an indicator to the ideal image of the JKN program. The purpose of this study was to determine the pattern of outpatient health care at health facilities (physician practices/clinics, public health center, public and private hospitals) in the first year implementation of JKN program. This study used secondary data to analyze the data of Indonesia Family Life Survey (IFLS) in 2014 as the first year of implementation JKN program. The data in this study using a descriptive analysis which was deeply reviewed.The results showed that in the span of one year of JKN program implementation, the age population who get access to outpatient health care at the most in the range 0-18 years, the people of the urban areas more access outpatient health services compared to rural residences, and the population in the range of quintile (rich economic status) as much as 26.73%. Health facilities are the most widely used for outpatient services is physician practice or clinic amounted to 4.55%. The results of this study can be used as an evidence-based evaluation of the improvement of health care access for the public to pay more attention to the economic status of poor and be a proactive improvement of access to health services for people in rural areas.
ABSTRAK Penelitian ini bertujuan untuk menganalisis determinan pemilihan metode Keluarga Berencan... more ABSTRAK Penelitian ini bertujuan untuk menganalisis determinan pemilihan metode Keluarga Berencana (KB) pada wanita usia reproduksi. Kerangka analisis penelitian ini merujuk kepada hasil penelitian BKKBN yang menjelaskan bahwa pentingnya memilih metode kontrasepsi jangka panjang dengan menambahkan analisis keluhan efek samping yaitu diare akibat penggunaan KB dan kondisi lingkungan sekitar. Analisis dilaksanakan dengan menggunakan pendekatan ekonometri secara multinomial logit dari data SUSENAS tahun 2012. Hasilnya membuktikan bahwa variabel jumlah anak, usia, dan penolong persalinan dari tenaga kesehatan mempengaruhi pemilihan metode KB wanita usia reproduksi di Indonesia. Implikasi hasil temuan ini, sulitnya menahan laju pertumbuhan penduduk karena metode KB masih lebih banyak digunakan secara hilir. Melalui temuan penelitian ini diharapkan pemerintah meningkatkan gerakan penyuluhan kesehatan kepada wanita usia reproduksi agar bersedia untuk ber KB. Selain itu, meningkatkan upaya promosi pada penggunaan KB steril untuk meningkatkan pengguna kontrasepsi jangka panjang pada wanita usia reproduksi. ABSTRACT This study is aimed to analyze the determinants of the selection method of family planning (FP) in women of reproductive age. The analytical framework of this study refers to the research results from BKKBN that explaining the importance of choosing long-term contraceptive methods by adding analysis complaints of side effects of diarrhea due to the use of family planning and environmental conditions. Analysis was conducted using econometric approach with multinomial logit estimation from data SUSENAS 2012. The results of this study prove that a variable number of children, age, and birth attendants to the health personnel influence the selection of family planning methods in Indonesia especially to women of reproductive age. This condition implies the difficulty restrain the rapid rate of population growth due to family planning methods still begun from downstream. Through the findings, increasing the movement of health counseling from government to the women of reproductive age in order to be willing implementing family planning. In addition, increasing promotion on the use of sterile Family Planning method is needed to improve the long-term contraception in women of reproductive age.
The purpose of this research is to analyze the policy implementation of health coverage for TKI. ... more The purpose of this research is to analyze the policy implementation of health coverage for TKI. This research uses a qualitative method with in-depth interview. The framework of this research consists of the aspect of the advisable policy, the implementation factors, and the schematic representation of the problem by using SWOT. The result of this research is the health insurance owned by TKI comes from TKI insurance, the membership of JKN, and insurance during their employment abroad. TKI insurance policy is the instruction of Law No. 39 of 2004 which regulates the obligation of the ownership of the social security and or insurance policy for TKI. However, TKI insurance has not been involved with the social aspect because the agency commercializes the coverage of TKI and it is not included a social security. The change of consortium may have decreased the ratio of claim's values to the annual premium which is attributable to the decreasing complaint cases from TKI. In the implementation, TKI insurance has been assisted by a lot of agencies. However, the bilateral cooperation related to the coordination of health coverage among countries has not been maximized. This research concludes that the coverage of health insurance for TKI is still lower (curative) and the government's attempt to integrate the social security for TKI is important. The researcher suggests the government should comprehensively implement the health coverage for TKI by incorporating the principle of promotion and prevention. Abstrak. Tujuan penelitian untuk menganalisis implementasi kebijakan jaminan kesehatan bagi TKI. Penelitian ini menggunakan metode kualitatif dengan melakukan wawancara mendalam. Kerangka pikir dasar penelitian terdiri dari aspek kelayakan kebijakan, faktor implementasi, gambaran skema permasalahan dengan analisis SWOT. Hasil penelitian menunjukkan bahwa jaminan kesehatan yang dimiliki oleh TKI berasal dari asuransi TKI, kepesertaan JKN, dan jaminan di negara penempatan. Adanya kebijakan asuransi TKI merupakan amanat UU No.39 Tahun 2004 yang menyebutkan kewajiban kepemilikan jaminan sosial dan atau polis asuransi bagi TKI. Namun, asuransi TKI belum menyentuh aspek sosial seiring badan penyelenggara yang bersifat komersial. Dalam perubahan konsorsium, rasio klaim asuransi TKI tetap lebih kecil dibandingkan dengan premi yang masuk. Dalam implementasinya, terdapat banyak lembaga yang membantu pengaduan TKI. Namun bentuk kerja sama bilateral yang berkaitan dengan koordinasi jaminan kesehatan antar negara belum dimaksimalkan. Penelitian ini menyimpulkan bahwa jaminan kesehatan bagi TKI masih bersifat hilir (kuratif) dan upaya pemerintah untuk mengintegrasikan asuransi TKI dengan jaminan sosial merupakan hal yang penting. Peneliti menyarankan agar menerapkan jaminan kesehatan bagi TKI secara komprehensif dengan memasukkan prinsip preventif dan promotif.
International Journal of Environmental Research and Public Health
Secondhand smoke exposure in Indonesia is high, especially compared to other Southeast Asian coun... more Secondhand smoke exposure in Indonesia is high, especially compared to other Southeast Asian countries. Passive smoking leads to negative impacts on health and socio-economic well-being. Therefore, increasing the price of cigarettes and, thereby, increasing barriers to access to cigarettes could be an effective way to reduce smoking prevalence and protect people from second-hand smoke. This study aims to assess passive smokers’ support for cigarette price increases in Indonesia. We perform a quantitative analysis with a cross-sectional design. The data were obtained through phone-based interviews of 1000 respondents aged 18 and older in Indonesia. Only 596 nonsmokers were included to be further analyzed in this study. This study found that 44.1% respondents have at least one family member who smokes. We considered the respondents’ age, gender, education level, employment, and the number of people living in the respondent’s household that are exposed to passive smoking. Our results d...
Background: The capacity of health human resources and the ability of the financial limitation be... more Background: The capacity of health human resources and the ability of the financial limitation become a threat for the sustainability of Posbindu program. The research aimed to analyze the strategy for strengthening Posbindu program for non-communicable diseases (NCD) control in Bogor. Methods: This research used qualitative method based on case study approach. The main informants in this research from Dinkes, Puskesmas, cadres, and community. Results: Posbindu PTM in Bogor had been visited by people from young to old age, but the number of cadres and equipment in each of Posbindu was different, the lack of training of cadres and the funding was still not optimal. Conclusion: The strategy for strengthening the implementation of Posbindu program can be conducted by doing intensive NCD training for cadres from the medical staff, improved the health activities to increase the intensity of the presence of the community to the Posbindu program, and increasing the cross-sector cooperation.
Health spending can lead to decrease the ability of the household financial. Nearly 2.3 million p... more Health spending can lead to decrease the ability of the household financial. Nearly 2.3 million people (1%) each year fall to be poor as a impact of catastrophic health spending of high-cost diseases that are life-threatening complications. The aim of the research is to analyze the determinants of catastrophic health spending of Indonesian households in the first year of implementation of the National Health Insurance program (JKN). This study design is cross sectional using secondary data is data Indonesia Family Life Survey (IFLS) 2014. The methods of analysis used are econometric approach with logit model and instrumental variables probit model. The results of the study significantly shows that households with catastrophic health spending incidence is around 5.38% in the first year of implementing JKN Program. While the determinants that influence catastrophic health spending include level of education, place of residence in the city, health status and economic status. This study recommends to the government to improve and develop the health program that promotes healthy lifestyles and expand the coverage of JKN program to protect the Indonesian households from catastrophic helath spending. Kata Kunci: JKN, Pengeluaran Katastropik, Data IFLS, IV Probit Abstrak Pengeluaran kesehatan dapat memicu ancaman penurunan kemampuan keuangan rumah tangga. Hampir 2.3 juta individu (1%) tiap tahunnya jatuh ke dalam kemiskinan sebagai dampak dari biaya kesehatan katastropik. Tujuan penelitian untuk menganalisis biaya kesehatan katastropik rumah tangga Indonesia setelah implementasi program JKN. Desain penelitian ini adalah cross sectional dengan menggunakan data sekunder yaitu data Indonesia Family Life Survey (IFLS) tahun 2014. Metode analisis menggunakan pendekatan ekonometri analisis model logit dan model regresi instrumental variable probit. Hasil penelitian secara signifikan menunjukkan bahwa di era program JKN, rumah tangga yang mengalami kejadian belanja kesehatan katastropik sebesar 5,38%. Sementara determinan yang mempengaruhi belanja kesehatan katastropik mencakup tingkat pendidikan, tempat tinggal di kota, status kesehatan dan status ekonomi. Penelitian ini menyarankan kepada pemerintah untuk membangun dan meningkatkan program kesehatan yang mengacu pada pola hidup sehat dan memperluas cakupan kepesertaan JKN untuk melindungi rumah tangga dari pengeluaran katastropik.
Abstrak Pelayanan rawat jalan merupakan salah satu manfaat yang dijamin oleh program Jaminan Kese... more Abstrak Pelayanan rawat jalan merupakan salah satu manfaat yang dijamin oleh program Jaminan Kesehatan Nasional (JKN). Tujuan utama program JKN adalah meningkatkan aksesibiltas masyarakat terhadap pelayanan kesehatan yang sesuai dengan kebutuhan. Pemanfaatan layanan rawat jalan yang semakin baik oleh semua lapisan masyarakat merupakan gambaran ideal dan indikator tercapainya program JKN. Tujuan penelitian ini adalah untuk mengetahui pola pelayanan kesehatan rawat jalan pada fasilitas kesehatan (dokter praktik/klinik, puskesmas, RS pemerintah, dan swasta) di tahun pertama implementasi program JKN. Penelitian ini menggunakan data sekunder dengan menganalisis data Indonesia Family Life Survey (IFLS) 2014 sebagai tahun pertama implementasi program JKN. Teknik analisis dalam penelitian ini menggunakan analisis deskriptif yang diulas secara mendalam. Hasil penelitian menunjukkan bahwa pada rentang satu tahun implementasi program JKN, usia penduduk yang melakukan akses ke pelayanan kesehatan rawat jalan paling banyak pada rentang usia 0–18 tahun,masyarakat daerah perkotaan lebih banyak mengakses pelayanan kesehatan rawat jalan dibandingkan dengan penduduk pedesaan, dan penduduk pada kisaran kuintil 5 (status ekonomi kaya) sebanyak 26,73%. Fasilitas kesehatan yang paling banyak digunakan untuk layanan rawat jalan adalah dokter praktik/klinik sebesar 4,55%. Hasil penelitian ini dapat digunakan sebagai evidence based evaluasi perbaikan akses pelayanan kesehatan untuk lebih memperhatikan masyarakat berstatus ekonomi miskin dan jemput bola peningkatan akses pelayanan kesehatan bagi masyarakat di daerah pedesaan. Kata kunci: rawat jalan, JKN, IFLS 2014, pelayanan kesehatan Abstract Outpatient treatment is one of the benefits guaranteed by the National Health Insurance (JKN) program. The main objective of JKN program is to increase public accessibility to health services that suits their needs. Utilization of outpatient services are getting better by all levels of society is an indicator to the ideal image of the JKN program. The purpose of this study was to determine the pattern of outpatient health care at health facilities (physician practices/clinics, public health center, public and private hospitals) in the first year implementation of JKN program. This study used secondary data to analyze the data of Indonesia Family Life Survey (IFLS) in 2014 as the first year of implementation JKN program. The data in this study using a descriptive analysis which was deeply reviewed.The results showed that in the span of one year of JKN program implementation, the age population who get access to outpatient health care at the most in the range 0-18 years, the people of the urban areas more access outpatient health services compared to rural residences, and the population in the range of quintile (rich economic status) as much as 26.73%. Health facilities are the most widely used for outpatient services is physician practice or clinic amounted to 4.55%. The results of this study can be used as an evidence-based evaluation of the improvement of health care access for the public to pay more attention to the economic status of poor and be a proactive improvement of access to health services for people in rural areas.
ABSTRAK Penelitian ini bertujuan untuk menganalisis determinan pemilihan metode Keluarga Berencan... more ABSTRAK Penelitian ini bertujuan untuk menganalisis determinan pemilihan metode Keluarga Berencana (KB) pada wanita usia reproduksi. Kerangka analisis penelitian ini merujuk kepada hasil penelitian BKKBN yang menjelaskan bahwa pentingnya memilih metode kontrasepsi jangka panjang dengan menambahkan analisis keluhan efek samping yaitu diare akibat penggunaan KB dan kondisi lingkungan sekitar. Analisis dilaksanakan dengan menggunakan pendekatan ekonometri secara multinomial logit dari data SUSENAS tahun 2012. Hasilnya membuktikan bahwa variabel jumlah anak, usia, dan penolong persalinan dari tenaga kesehatan mempengaruhi pemilihan metode KB wanita usia reproduksi di Indonesia. Implikasi hasil temuan ini, sulitnya menahan laju pertumbuhan penduduk karena metode KB masih lebih banyak digunakan secara hilir. Melalui temuan penelitian ini diharapkan pemerintah meningkatkan gerakan penyuluhan kesehatan kepada wanita usia reproduksi agar bersedia untuk ber KB. Selain itu, meningkatkan upaya promosi pada penggunaan KB steril untuk meningkatkan pengguna kontrasepsi jangka panjang pada wanita usia reproduksi. ABSTRACT This study is aimed to analyze the determinants of the selection method of family planning (FP) in women of reproductive age. The analytical framework of this study refers to the research results from BKKBN that explaining the importance of choosing long-term contraceptive methods by adding analysis complaints of side effects of diarrhea due to the use of family planning and environmental conditions. Analysis was conducted using econometric approach with multinomial logit estimation from data SUSENAS 2012. The results of this study prove that a variable number of children, age, and birth attendants to the health personnel influence the selection of family planning methods in Indonesia especially to women of reproductive age. This condition implies the difficulty restrain the rapid rate of population growth due to family planning methods still begun from downstream. Through the findings, increasing the movement of health counseling from government to the women of reproductive age in order to be willing implementing family planning. In addition, increasing promotion on the use of sterile Family Planning method is needed to improve the long-term contraception in women of reproductive age.
The purpose of this research is to analyze the policy implementation of health coverage for TKI. ... more The purpose of this research is to analyze the policy implementation of health coverage for TKI. This research uses a qualitative method with in-depth interview. The framework of this research consists of the aspect of the advisable policy, the implementation factors, and the schematic representation of the problem by using SWOT. The result of this research is the health insurance owned by TKI comes from TKI insurance, the membership of JKN, and insurance during their employment abroad. TKI insurance policy is the instruction of Law No. 39 of 2004 which regulates the obligation of the ownership of the social security and or insurance policy for TKI. However, TKI insurance has not been involved with the social aspect because the agency commercializes the coverage of TKI and it is not included a social security. The change of consortium may have decreased the ratio of claim's values to the annual premium which is attributable to the decreasing complaint cases from TKI. In the implementation, TKI insurance has been assisted by a lot of agencies. However, the bilateral cooperation related to the coordination of health coverage among countries has not been maximized. This research concludes that the coverage of health insurance for TKI is still lower (curative) and the government's attempt to integrate the social security for TKI is important. The researcher suggests the government should comprehensively implement the health coverage for TKI by incorporating the principle of promotion and prevention. Abstrak. Tujuan penelitian untuk menganalisis implementasi kebijakan jaminan kesehatan bagi TKI. Penelitian ini menggunakan metode kualitatif dengan melakukan wawancara mendalam. Kerangka pikir dasar penelitian terdiri dari aspek kelayakan kebijakan, faktor implementasi, gambaran skema permasalahan dengan analisis SWOT. Hasil penelitian menunjukkan bahwa jaminan kesehatan yang dimiliki oleh TKI berasal dari asuransi TKI, kepesertaan JKN, dan jaminan di negara penempatan. Adanya kebijakan asuransi TKI merupakan amanat UU No.39 Tahun 2004 yang menyebutkan kewajiban kepemilikan jaminan sosial dan atau polis asuransi bagi TKI. Namun, asuransi TKI belum menyentuh aspek sosial seiring badan penyelenggara yang bersifat komersial. Dalam perubahan konsorsium, rasio klaim asuransi TKI tetap lebih kecil dibandingkan dengan premi yang masuk. Dalam implementasinya, terdapat banyak lembaga yang membantu pengaduan TKI. Namun bentuk kerja sama bilateral yang berkaitan dengan koordinasi jaminan kesehatan antar negara belum dimaksimalkan. Penelitian ini menyimpulkan bahwa jaminan kesehatan bagi TKI masih bersifat hilir (kuratif) dan upaya pemerintah untuk mengintegrasikan asuransi TKI dengan jaminan sosial merupakan hal yang penting. Peneliti menyarankan agar menerapkan jaminan kesehatan bagi TKI secara komprehensif dengan memasukkan prinsip preventif dan promotif.
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