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Co-Production Dalam Pelayanan Publik: Studi pada pelayanan deteksi penyakit jantung melalui Program SMARThealth di 10 Desa di Kabupaten Malang
Salsabilla, Sekar Aqila, Program Magister Administrasi Publik, Fakultas Ilmu Administrasi Universitas Brawijaya. 2023. Co-Production Dalam Pelayanan Publik (Studi Pada Pelayanan Deteksi Penyakit Jantung Melalui Program SMARThealth di 10 Desa di Kabupaten Malang); Ketua Komisi Pembimbing: Dr. Choirul Saleh, M.Si., Anggota Komisi Pembimbing: Sujarwoto, S.IP., M.Si., Ph.D.
Pelayanan kesehatan merupakan hak seluruh warga negara Indonesia. Namun, pelayanan kesehatan di tingkat desa di Indonesia masih belum dapat dirasakan oleh masyarakat dan belum mencapai kondisi yang diharapkan. Hal tersebut disebabkan oleh sumber daya manusia di desa yang terbatas maka dari itu tenaga kesehatan desa diperbantukan oleh Kader. Akan tetapi, pelayanan deteksi penyakit jantung masih belum mencapai target hal ini disebabkan oleh keterlibatan kader dan masyarakat yang belum berkolaborasi secara aktif. Program SMARThealth merupakan sebuah inovasi yang dikembangkan dalam rangka untuk memberikan deteksi dini dan pencegahan terhadap penyakit jantung dengan memanfaatkan teknologi informasi dan pemberian layanan kesehatan yang berkolaborasi dengan masyarakat di Desa di Kabupaten Malang melalui Co-Production. Konsep co-production yang melibatkan masyarakat dengan sangat aktif dapat menciptakan inovasi dan solusi baru yang lebih mengakomodir kebutuhan dan keinginan masyarakat. Atas dasar hal tersebut maka penelitian ini bertujuan untuk menjelaskan proses Co-Production pada 10 Desa di Kabupaten Malang serta faktor pendorong dan penghambatnya dan bagaimana proses tersebut dapat meningkatkan akses, mutu, dan keberlanjutan pelayanan deteksi penyakit jantung.
Penelitian ini menggunakan penelitian deskriptif dengan pendekatan kualitatif sehingga dapat mendeskripsikan dengan lebih detail proses co-production yang dilakukan dan bagaimana hal tersebut dapat meningkatkan akses, mutu, dan keberlanjutan pelayanan deteksi penyakit jantung pada 10 desa di Kabupaten Malang. Jumlah narasumber dalam penelitian ini adalah 190 narasumber yang meliputi Dokter, Apoteker, Perawat Desa, Perangkat Desa, Kader, dan Masyarakat atau Pasien. Indikator yang digunakan dalam penelitian ini adalah proses co-production yang meliputi co-assess, co-decide, co-design, co-deliver dan layanan kesehatan yang bernilai tinggi yang dilihat melalui akses, mutu, dan keberlanjutan. Sumber data penelitian terdiri dari dari data primer dan sekunder. Teknik pengumpulan data dilakukan dengan wawancara, observasi, dan dokumentasi. Instrumen penelitian adalah peneliti, pedoman wawancara, dan perangkat penunjang penelitian. Data yang diperoleh selanjutnya dianalisis dengan model analisis data oleh Creswell 2014.
Hasil penelitian ini menunjukan bahwa co-production dapat meningkatkan pelayanan deteksi penyakit jantung pada 10 desa di Kabupaten Malang. Hal tersebut dapat terjadi dengan adanya pelibatan masyarakat dan Kader secara lebih aktif dan bersama-sama dengan Dokter, Apoteker, Perawat, dan Perangkat Desa untuk membuat keputusan yang mendorong pada penciptaan inovasi dan strategi baru yang lebih mengakomodir kebutuhan dan keinginan masyarakat. Adapun proses Co-Production dapat dilihat melalui 4 (empat) tahap, yaitu, (1) co-assess merupakan tahap penilaian maka masyarakat dilibatkan secara aktif untuk melakukan penilaian terhadap penyelenggaraan pelayanan deteksi penyakit jantung. Identifikasi masalah dilakukan dengan pengumpulan tanggapan dari masyarakat melalui Perawat dan Kader yang selanjutnya akan didiskusikan bersama seluruh pemangku kepentingan; (2) co-decide merupakan tahap dimana permasalahan yang sudah diidentifikasi akan dikaji dan secara bersama-sama mencari solusi atas permasalahan tersebut; (3) co-design merupakan tahap penyusunan strategi yang melibatkan Perawat dan Kader secara aktif dalam setiap prosesnya dan strategi yang sudah disusun akan melalui tahap evaluasi dan perbaikan yang selanjutnya akan disepaki bersama-sama; (4) co-deliver, merupakan tahap penyelenggaraan pelayanan berdasarkan strategi yang ada pada tahap co-design dengan melibatkan seluruh pihak untuk berkontribusi dan berperan aktif serta saling memberikan dukungan dan bekerjasama sehingga dapat meningkatkan kualitas pelayanan yang diberikan. penerapan proses Co-Production yang dilakukan pada 10 Desa di Kabupaten Malang dipengaruhi oleh beberapa faktor. Dimana faktor pendukung proses Co-Production adalah, (1) Kader diberikan kepercayaan untuk dilibatkan dalam setiap proses; (2) peran aktif dari seluruh pihak terlibat sesuai dengan kompetensi dan kapabilitas masing-masing; (3) koordinasiantar pihak baik secara daring mupun luring; dan (4) keterbukaan informasi dan perekamaan data yang terintegrasi melalui aplikasi SMARThealth. Sedangkan faktor penghambat proses Co-Production yaitu; (1) perbedaan persepsi yang menimbulkan rasa ketidakpercayaan; (2) Pemerintah Desa, Pendamping Wilayah, dan Petugas Apoteker tidak berkontribusi sesuai dengan kompetensi dan kapabilitasnya; (3) tidak terdapat ruang berdialog; dan (4) aplikasi SMARThealth sering mengalami kelumpuhan sistem. Melalui proses Co-Production tersebut dapat meningkatkan akses, mutu, dan keberlanjutan pelayanan deteksi penyakit jantung pada 10 (sepuluh) Desa di Kabupaten Malang.
Salsabilla, Sekar Aqila, Master of Public Administration Program, Faculty of Administrative Science Brawijaya University. 2023. Co-Production in Public Service (Study on Early Detection of Cardiovascular Disease Through SMARThealth Program at 10 villages in Malang Regency); Chairman of the commission supervising: Dr. Choirul Saleh, M.Si., Member of the commission supervising: Sujarwoto, S.IP., M.Si., Ph.D.
Health services are the rights of all Indonesian citizens. However, health services at the village level in Indonesia still cannot be felt by the community and have not reached the expected condition. This is due to limited human resources in the village, therefore village health workers are seconded by cadres. However, heart disease detection services have not yet reached the target, this is due to the involvement of cadres and the community who have not actively collaborated. The SMARThealth program is an innovation developed in order to provide early detection and prevention of heart disease by utilizing information technology and providing health services in collaboration with communities in villages in Malang Regency through Co-Production. The concept of co-production which involves the community very actively can create new innovations and solutions that better accommodate the needs and desires of the community. On this basis, this study aims to explain the Co-Production process in 10 villages in Malang Regency as well as the driving and inhibiting factors and how this process can improve access, quality, and sustainability of heart disease detection services.
This research uses descriptive research with a qualitative approach so that it can describe in more detail the co-production process that is being carried out and how it can improve access, quality, and sustainability of heart disease detection services in 10 villages in Malang Regency. The number of informants in this study were 190 informants which included doctors, pharmacists, village nurses, village officials, Kader, and the community or patients. The indicators used in this study are the co-production process which includes co-assessment, co-decide, co-design, co-deliver and high-value health services as seen through access, quality and sustainability. Sources of research data consist of primary and secondary data. Data collection techniques were carried out by interviews, observation, and documentation. Research instrument. The research instruments were researchers, interview guides, and research support tools. The data obtained was then analyzed using the data analysis model by Creswell 2014.
The findings of this study suggest that collaboration can enhance services for heart disease detection in 10 villages in Malang Regency. This can be accomplished through actively including the community and Kader in decision-making, as well as working with physicians, pharmacists, nurses, and village officials to develop new innovations and methods that better meet the requirements and preferences of the community. The four (four) stages of the co-production process are as follows: (1) co-assessment, which involves the community in the evaluation of the implementation of services for cardiovascular screening. Problems are identified by gathering community feedback through nurses and Kader, which is then discussed with all stakeholders; (2) co-decide is the stage where the problems that have been identified will be studied and jointly seek solutions to these problems; (3) co-design is a strategy formulation stage that actively involves nurses and Kader in each process and the strategy that has been developed will go through an evaluation and improvement stage which will then be agreed upon together; (4) co-deliver, is the stage of service delivery based on the existing strategy at the co-design stage by involving all parties to contribute and play an active role as well as provide mutual support and work together so as to improve the quality of services provided. the implementation of the Co-Production process carried out in 10 villages in Malang Regency was influenced by several factors. Where the supporting factors for the Co-Production process are, (1) Kader are given the trust to be involved in every process; (2) the active role of all parties involved in accordance with their respective competencies and capabilities; (3) coordination between parties, both online and offline; and (4) information disclosure and integrated data recording through the SMARThealth application. Meanwhile, the inhibiting factors for the Co-Production process are; (1) differences in perceptions that create a feeling of distrust; (2) The Village Government, Area Holders, and Pharmacist Officers do not contribute according to their competence and capability; (3) there is no space for dialogue; and (4) the SMARThealth application often experiences system crashes. Through the Co-Production process, access, quality and continuity of heart disease detection services can be improved in 10 (ten) villages in Malang Regency.
2023109 | TES 352.63 SAL c 2023 k.1 | Fadel Muhammad Resource Center (Ilmu Sosial) | Tersedia |
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