Analisis Penyebab Perpindahan Tenaga Kesehatan dari Puskesmas Luar Kota ke Puskesmas Dalam Kota di Kabupaten Kotawaringin Timur Provinsi Kalimantan Tengah

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan 2015 ABSTRAK Hesron Silalahi Analisis Penyebab Perpindahan Tenaga Kesehatan dari Puskesmas Luar Kota ke Puskesmas Dalam Kota di Kabupaten Kotawaringin Timur Provinsi Kalimantan Tengah 161 halaman + 17 tabel + 8 gambar + 10 lampiran Pengadaan dan penempatan tenaga kesehatan menurut UU 36/2009 dilaksanakan untuk memenuhi kebutuhan tenaga kesehatan yang merata bagi masyarakat. Namun di Kab.Kotawaringin Timur masih ada 41 Puskesmas Pembantu tanpa perawat dan 18 poskesdes yang belum ada tenaga bidan akibat banyaknya tenaga kesehatan yang pindah ke Puskesmas dalam kota sehingga pencapaian program kesehatan menurun. Penelitian dilaksanakan untuk mengetahui penyebab perpindahan tenaga kesehatan dari puskesmas luar kota ke puskesmas dalam kota di Kabupaten Kotawaringin Timur. Penelitian deskriptif kualitatif ini menggunakan indept interview untuk menggali informasi dari 8 informan utama dan 7 informan triangulasi. Variabel terdiri dari variabel individu (pengembangan karir dan dukungan keluarga), variabel organisasi (ketersediaan sumber daya, kepemimpinan, imbalan (kompensasi), iklim kerja dan kebijakan pemerintah) serta variabel psikologi (sikap dan motivasi). Data dianalisis dengan content analysis yaitu mengumpulkan, mereduksi, memverifikasi, mendeskripsikan, dan menyimpulkan informasi yang didapatkan. Hasil penelitian menunjukkan penyebab pindah adalah : 1) faktor individual (ingin melanjutkan pendidikan untuk meningkatkan jenjang karier dan dorongan mendekati keluarga); 2) faktor organisasi (kurangnya sumber daya manusia dan sumber daya lain (fasilitas), pimpinan puskesmas tidak mempunyai kewenangan terkait perpindahan pegawai dan penempatan pegawai kurang mempertimbangkan latar belakang sosial budaya, imbalan masih dianggap kurang dan tidak sebanding dengan beban kerja, kebijakan tentang perpindahan belum sesuai dengan aturan; 3) faktor psikologi (sikap tanggung jawab terhadap pekerjaan masih kurang, dan menganggap perpindahan pegawai adalah sesuatu yang wajar, motivasi bekerja masih berorientasi pada materi, orientasi pengabdian masih kurang). Selanjutnya disarankan kepada Kepala Puskesmas untuk membuat analisis beban kerja dan analisis jabatan untuk dasar penataan jenjang karier. Kepala Dinas Kesehatan sebaiknya memberikan reward berupa materi maupun non material secara memadai dan memberikan kewenangan kepada kepala puskesmas terkait dengan perpindahan pegawai sesuai aturan. Agar regulasi dapat dijalankan Pemerintah Daerah sebaiknya lebih tegas menghadapi usul pindah yang tidak prosedural. Perlu rekrutmen tenaga kesehatan dari daerah setempat atau daerah yang berdekatan serta mempertimbangkan sosial budaya. Kata kunci : Tenaga Kesehatan Bidan, Perawat, Puskesmas Kepustakaan : 42 (1985 – 2014) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Administration and Health Policy 2015 ABSTRACT Hesron Silalahi The Causal Analysis of Health Workers Movement from Health Centre located outside the city to Health Centre in the City in East Kotawaringin District in Province of Central Borneo 161 pages + 17 tables + 8 figures + 10 enclosures Recruitment and placement of health workers based on Regulations number 36/2009 were implemented to fulfil the necessity of health workers in a community. However, in East Kotawaringin District, there were any 41 sub health centres which did not have nurses and 18 village health posts which did not have midwives. These conditions were due to movement of health workers to health centres in the city by which achievements of health programs decreased. This study aimed to identify the causes of health workers movement from health centres located outside the city to health centres in the city in East Kotawaringin District. This was descriptive-qualitative research using indepth interview to find out information from 8 main informants and 7 triangulation informants. Variables consisted of individual variables (career development and family support), organisational variables (availability of sources, leadership, reward (compensation), work climate, and government policy), and psychological variables (attitude and motivation). Furthermore, data were analysed using content analysis encompassed collecting, reducing, verifying, describing, and concluding obtained information. The result of this study showed that the causes of movement were as follows: 1) individual factors (health workers wanted continue a study to improve career and to be closer with families); 2) organisational factors (there were lack of human resources and lack of other sources (facilities), there was no authority in a level of head of health centres to move employees, there was no consideration of sociocultural backgrounds regarding placement of employees, accepted rewards were unequal to workload, policy of movement was not in accordance with the regulation); 3) psychological factors (attitude and responsibility towards jobs were low, assumption of workers movement was as a normal thing, work motivation was only to obtain money, and work dedication was low) . Heads of health centres need to analyse workload and position as a basis for managing a career hierarchy. Head of District Health Office needs to provide rewards of either money or non-money sufficiently and provide authority to heads of health centres regarding movement of workers in accordance with the regulation. The regional government needs to implement the regulation strictly regarding a proposal to move a workplace which is not in accordance with a procedure. The locals need to be recruited as health workers as a consideration of sociocultural aspects. Key Words : Health Worker, Midwife, Nurse, Health Centre Bibliography : 42 (1985-2014)