The evaluation of Nusantara Sehat program using Nusantara Sehat Public Health Index

  • Ida Diana Sari
  • Harimat Hendarwan
  • Rizqiana Halim
Keywords: Program evaluation, Nusantara Sehat, Public Health Index, Indonesia

Abstract

Latar Belakang: Faktor geografi Indonesia yang berupa daratan, lautan, pegunungan, dan pulau-pulau yang tersebar menyebabkan distribusi tenaga kesehatan dan akses pelayanan kesehatan yang tidak optimal. Berdasarkan Peraturan menteri kesehatan yang telah ditetapkan, pemerintah berupaya mendayagunakan secara khusus sumber daya manusia kesehatan dalam kurun waktu tertentu dengan jumlah dan jenis tertentu, agar meningkatkan akses dan mutu pelayanan kesehatan pada fasilitas pelayanan kesehatan khususnya di wilayah Daerah Tertinggal, Perbatasan, dan Kepulauan (DTPK) dan Daerah Bermasalah Kesehatan (DBK) melalui Program Nusantara Sehat (NS).


Metode: Tahun 2015 telah ditugaskan Tim NS Batch 1 dan 2 pada 120 Puskesmas di DTPK dan DBK selama 2 tahun. Kemudian pada tahun 2017 setelah masa tugas berakhir, diadakan evaluasi program yang bertujuan untuk mengetahui dampak program NS terhadap indeks kesehatan masyarakat dengan menggunakan desain Pre and Post-Test Intervention with Control. Evaluasi dilakukan di 15 provinsi, 27 kabupaten, dan 60 Puskesmas pada bulan Februari - Desember 2017.


Hasil: Hasil evaluasi program menunjukkan bahwa pada tahun 2017 terjadi perubahan rata-rata indeks kesehatan masyarakat dibandingkan dengan tahun 2015, baik pada Puskesmas intervensi maupun kontrol (p=0,000). Kemudian hasil uji independen t-test terhadap delta perubahan indeks menunjukkan bahwa peningkatan indeks kesehatan masyarakat pada Puskesmas intervensi lebih besar dibandingkan dengan Puskesmas kontrol (p=0,046).


Kesimpulan: penugasan Tim NS pada Puskesmas telah membawa perbaikan indeks kesehatan masyarakat yang lebih baik. Diperlukan pengamatan lebih jauh terkait sustainabilitas Program NS dan analisis biaya manfaat (cost benefit analysis) terhadap Program NS. 


Kata Kunci: Evaluasi program, Nusantara Sehat, Indeks Kesehatan Masyarakat, Indonesia.

 

Abstract


Backgrounds: Indonesia’s geographical factors in the form of land, oceans, mountains, and scattered islands have caused the distribution of health workforce and access to health services are not optimal. Based on the Minister of Health regulation, the government seeks to utilize health human resources specifically for a certain period, with certain number and types, in order to improve access and quality of health service to health service facilities, especially in remote area through the Nusantara Sehat Program (Health Indonesia Program-NS).


Methods: In 2015, NS Team Batch 1 and 2 were assigned to 120 primary health care center (Puskesmas) in remote areas for 2 years. Then in 2017 after the term ends, NS program evaluation were conducted in 15 provinces, 27 districts, and 60 Puskesmas from Feb to Dec 2017.


Results: This evaluation aims to analyze the impact of NS program on public health index using Pre and Post Test Intervention with Control Design. The results of program evaluation showed that in 2017 there was a change in the average public health index compared to 2015, both in intervention and control Puskesmas (p = 0,000). The independent t-test result on the delta of index change indicated that public health index improvement at intervention Puskesmas is greater than the control (p = 0,046).


Conclusion: The assignment of NS Team at the Puskesmas has brought improvement of public health index. Further observations are needed regarding the sustainability and the cost benefit analysis of NS Program. 


Keywords: Program evaluation, Nusantara Sehat, Public Health Index, Indonesia.

References

Global Health Workforce Alliance & WHO. A universal truth: no health without a workforce. 2013. Available from: https://www.who.int/ workforcealliance/knowledge/resources/GHWA-a_ universal_truth_report.pdf

Tandi TE, Cho YM, Akam AJ, Afoh CO, Ryu SH, Choi MS, et al. Cameroon public health sector: shortage and inequalities in geographic distribution of health personnel. International journal for equity in health. 2015. DOI:10.1186/s12939-015-0172-0

Kanchanachitra C, Lindelow M, Johnston T, Hanvoravongchai P, Lorenzo FM, Huong NL, et al. Human resources for health in Southeast Asia: shortages, distributional challenges, and international trade in health services. The Lancet. 2011;377:769-81. DOI:10.1016/S0140-6736(10)62035-1

Zhu A. Attraction and retention of rural Primary Health Care workers in Asia Pacific region. Durham: Duke Global Health Institute, Duke University. 2017. ProQuest Number: 10258185

Sa-angchai. Geographical distribution of health workforces in LAO PDR. South Asian Journal of Tropical Medicine and Public Health. 2016;47(4):868–79

Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Nomor 110 Tahun 2015 tentang Penetapan 48 Kabupaten dan 124 Puskesmas Sasaran Program Prioritas Nasional Pelayanan Kesehatan di Daerah Perbatasan Tahun 2015-2019. Jakarta: www.kemkes.go.id. 2015. Indonesian.

WHO. WHO Report 2008: Primary Health Care - now more than ever. 2008. https://www.who.int/whr/2008/en/

Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 36 Tahun 2015 tentang Tenaga Kesehatan. Jakarta: www.hukor.depkes.go.id. 2015. Indonesian.

Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Nomor HK.02.02/Menkes/52/2015 tentang Rencana Strategis Kementerian Kesehatan Tahun 2015-2019. Jakarta: www.kemkes.go.id. 2015. Indonesian.

Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 23 Tahun 2015 tentang Penugasan Khusus Tenaga Kesehatan Berbasis Tim (Team Based) Dalam Mendukung Program Nusantara Sehat. Jakarta: www.hukor.depkes.go.id. 2015. Indonesian.

Triwinarto A, Hendarwan H, Rosita. Laporan hasil penelitian Riset Khusus Nusantara Sehat (Team Based) Tahun 2015. Jakarta: Pusat Teknologi Intervensi Kesehatan Masyarakat Balitbangkes Kemenkes RI; 2015. Indonesian.

Badan Litbangkes Kementerian Kesehatan. Indeks Pembangunan Kesehatan Masyarakat. Jakarta: www. litbang.depkes.go.id. 2014. Indonesian.

Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan RI No. 16 Tahun 2017 tentang Penugasan Tenaga Kesehatan dalam Program Nusantara Sehat. Jakarta: www.kemkes.go.id. 2017. Indonesian.

UNDP. Sustainable Development Goals (SDGs) Goal 3: Good Health And Well-Being. New York: www.id.undp.org. 2018.

Hussein R. A review of realizing the Universal Health Coverage (UHC) goals by 2030: Part 2 - what is the role of e-health and technology. Journal of Medical Systems. 2015. DOI:https://doi.org/10.1007/s10916-015-0255-x

Etches V, Frank J, Ruggiero ED, Manuel D Measuring population health: a review indicators. Annual Review of Public Health. 2006;27:29-55. DOI:10.1146/annurev.publhealth.27.021405.102141.

Younger DS, Moon-Howard J. Assessing the public’s health. Neurologic Clinics. 2016;34:1057- 70. DOI:http://dx.doi.org/10.1016/j.ncl.2016.06.007

Zuniga MA, Carrillo-Zuniga G, Seol YH, Fos PJ. Multi-criteria assessment of county public health capability disparities. Journal of Health and Human Services Administration. 2009;32:238-58.

Freitas A, Santana P, Oliveira MD, Almendra R, Costa JB, Costa CB. Indicators for evaluating European Population Health: a Delphi selection process. BMC Public Health. 2018;18:557. DOI:https://doi. org/10.1186/s12889-018-5463-0

Published
2019-07-26
How to Cite
Sari, I., Hendarwan, H., & Halim, R. (2019). The evaluation of Nusantara Sehat program using Nusantara Sehat Public Health Index. Health Science Journal of Indonesia, 10(1), 41-50. https://doi.org/10.22435/hsji.v10i1.1265
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Articles