Analisis Implementasi Integrasi Layanan PPIA HIV ke Layanan Antenatal di Kota Depok 2017

https://doi.org/10.22146/jkki.36396

Mira Miranti Puspitasari(1*), Purnawan Junadi(2)

(1) Health Policy and Administration, Faculty of Public Health, University of Indonesia
(2) Health Policy and Administration, Faculty of Public Health, University of Indonesia
(*) Corresponding Author

Abstract


Pencegahan penularan HIV dari ibu ke anak (PPIA) pada ibu hamil merupakan kegiatan essensial  pada layanan antenatal, sehingga adanya integrasi akan lebih efektif untuk meningkatkan jangkauan ibu hamil melakukan skrining HIV yang bertujuan mencegah penularan secara vertikal dari ibu ke anak. Analisis Implementasi ditujukan untuk melihat pelaksanaan skrining HIV pada ibu hamil terintegrasi dalam layanan antenatal terpadu di Kota Depok 2017. Metode pada penelitian ini adalah kualitatif dengan teknik pegambilan data WM, FGD dan telaah dokumen.Hasil dari penelitian didapatkan aspek komunikasi berupa sosialisasi pedoman pelaksanaan kebijakan belum optimal terutama untuk layanan swasta. Dari sisi dana tidak dilakukannya  alokasi  anggaran spesifik program PPIA mempengaruhi implementasi, kewenangan petugas pelaksana sudah optimal,  belum tersedianya struktur birokrasi yaitu SOP dan fragmentasi untuk layanan terintegrasi, lingkungan sosial berupa dukungan masyarakat, layanan kesehatan swasta yang belum optimal dan masih adanya stigma negatif. Kesimpulan didapatkan bahwa implementasi integrasi layanan PPIA ke layanan antenatal belum optimal hal ini didukung konseling pra-tes dan pasca tes belum efektif, cakupan skrining HIV bumil masih rendah, mekanisme rujukan yang belum berjalan dengan baik dan proses pencatatan dan pelaporan serta monitoring evaluasi yang belum terintegrasi. Direkomendasikan melakukan pemetaan kegiatan yang  sudah dilakukan, membuat regulasi dan roadmap perencanaan kegiatan yang bertujuan untuk perluasan layanan dan dapat menggandeng sektor swasta.

 

 

Prevention of HIV transmission from mother to child (PMTCT) in pregnant women is an activity on antenatal services, the existence of integration would be more effective to increase coverage of pregnant women do HIV screening aimed at preventing contagion vertically from mother to child. Analysis of Implementation aimed to see the implementation of HIV screening of pregnant women integrated to antenatal care in Depok, 2017. Method is qualitative data develop techniques with WM, FGD and review documents. The result is socialization program policies especially for private service not optimal. A special budget allocation of PMTCT has not been made thus affecting the implementation, the Authority managing officers are already optimally, bureaucratic structure which consists of SOP and fragmentation of policy not available, the social environment in the form of community support, private health services that has not been optimized and still the existence of negative stigma. The conclusions obtained that the implementation of the Integration PMTCT to antenatal care has not been optimal this is supported counselling pre-test and post test has not been effective, HIV screening coverage bumil is still low, the referral mechanism has not been going well and the process of recording and reporting as well as monitoring evaluations that have not been integrated. Recommended doing mapping activities already done, making regulation and roadmap planning activities aimed at the expansion of the services and may be working with the private sector.


Keywords


Implementation; PPIA;antenatal care; HIV screening of pregnant women

Full Text:

PDF


References

Turan JM, Onono M, Steinfeld RL, Shade SB, Owuor K, Washington S, et al. Effects of antenatal care and HIV treatment integration on elements of the PMTCT cascade: Results from the SHAIP cluster-randomized controlled trial in Kenya 2015. doi:10.1097/QAI.0000000000000678. [2] K L Gunn J, O Asaolu I, E Center K, J Gibson S, Wightman P, E Ezeanolue E, et al. Antenatal care and uptake of HIV testing among pregnant women in sub-Saharan Africa: a cross-sectional study. J Int AIDS Soc 2016;19. doi:10.7448/IAS.19.1.20605. [3] Lincetto O, Mothebesoane-Anoh S, Gomez P, Munjanja S. Antenatal Care 2013. [4] Kak L, Chitsike I, Luo C, Rollins N. Opportunities for Africa’s Newborns 113 Prevention of mother-to-child transmission of HIV/AIDS programmes III 2005. [5] Chou R, Cantor A, Bougatsos C, Zakher B. Screening for HIV in Pregnant Women: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation. Agency for Healthcare Research and Quality (US); 2012. [6] Lindsay L keenan. No. 185-HIV Screening in Pregnancy. J Obstet Gynaecol Canada 2017;39:e54–8. doi:10.1016/J.JOGC.2017.04.009. [7] WHO. WHO | Number of women living with HIV. WHO 2016. [8] Kementerian Kesehatan. Rencana Aksi Nasional Pencegahan Penularan HIV Dari Ibu Ke Anak (PPIA) Indonesia 2013-2017. Kementeri Kesehat 2013:1–36. [9] Didik Budijanto drh, Hardhana B, Yudianto M, drg Titi Soenardi Ms, Dalam Negeri K, Pusat Statistik B, et al. Profil Kesehatan Indonesia tahun 2016. Yoeyoen Aryantin Indrayani SDs; B B Sigit; Sinin 2017. [10] Kementerian Kesehatan R. Peraturan Menteri Kesehatan Nomor 51 Tahun 2013 tentang Pedoman Pencegahan Penularan HIV dari Ibu ke Anak 2013. [11] Kementerian Kesehatan. Peraturan Kementerian Kesehatan Nomor 97 Tahun 2014 tentang Pelayanan Kesehatan Masa Sebelum Hamil, Masa Hamil, Persalinan, Dan Masa Sesudah Melahirkan, Penyelenggaraan Pelayanan Kontrasepsi, Serta Pelayanan Kesehatan Seksual 2014. [12] Kementerian Kesehatan. Peraturan Menteri Kesehatan RI Nomor 43 Tahun 2016 tentang Standar Pelayanan Minimal (SPM) Bidang Kesehatan 2016. [13] P2M DK. Analisis situasi Program HIV/AIDS Kota Depok Tahun 2017. 2017. [14] Dinas Kesehatan Kota Depok. Profil Dinas Keehatan 2016. [15] Dinas Kesehatan Kota Depok. Profil Kesehatan Kota Depok Tahun 2017 2017. [16] Nugroho R. Public policy : Dinamika Kebijakan - Analisis Kebijakan - Manajemen Kebijakan. PT Elex Media Komputindo; 2011. [17] Winarno B. Kebijakan Publik : Teori dan Proses. 1st ed. Yogyakarta: Media Pressindo.; 2007. [18] Ghoma‑linguissi LS, Ebourombi DF, Sidibe A, Kivouele TS, Vouvoungui JC, Poulain P, et al. Factors influencing acceptability of voluntary HIV testing among pregnant women in Gamboma, Republic of Congo. BMC Res Notes 2015;8. doi:10.1186/s13104‑015‑1651‑5. [19] Ladner J, Besson M-H, Rodrigues M, Saba J, Audureau E. Performance of HIV Prevention of Mother- To-Child Transmission Programs in Sub- Saharan Africa: Longitudinal Assessment of 64 Nevirapine-Based Programs Implemented in 25 Countries 2015. doi:10.1371/journal.pone.0130103. [20] Balitbangkes KK. Pokok - Pokok Hasil Survey Indikator Kesehatan Nasional (SIRKESNAS). 2016. [21] Mathingau FA. Factors Influencing Acceptance Of Routine Hiv Testing And Counseling Among Pregnant Women In Kibera Informal Settlement, Nairobi, Kenya A Research Thesis Submitted In Partial Fulfillment Of The Requirment Of Degree Of Master Of Public Health In The School 2013. [22] Suharni M, Perwira I. Tinjauan Historis Kebijakan dan Program Penanggulangan HIV/AIDS di Indonesia. Integr Upaya Penanggulangan HIV Dan AIDS Ke Dalam Sist Kesehat 2015:21. [23] Trisnawati L. Peran Sistem Kesehatan dalam Program Pencegahan Penularan HIV dari Ibu ke Anak di Kabupaten Jaya Wijaya 2014. [24] Pace W, Faules D. Komunikasi Organisasi : Strategi Meningkatkan Kinerja Perusahaan. 9th ed. PT Remaja Rosdakarya; 2015. [25] Ishikawa N, Dalal S, Johnson C, Hogan DR, Shimbo T, Shaffer N, et al. Should HIV testing for all pregnant women continue? Cost- effectiveness of universal antenatal testing compared to focused approaches across high to very low HIV prevalence settings 2016. doi:10.7448/IAS.19.1.21212. [26] Luoma, Marc, Ravinskar N, et all. Using Nonfinancial Incentives To Improve Performance And Retention Among Health Workers: Results From An Impact Evaluation In Swaziland. 2011. [27] Edwards III CG, Shaharkansy I. The Policy Predicarment : Making and Implementing Public Policy. 1980. [28] Agustino L. Dasar-Dasar Kebijakan Publik. Bandung: Alfabeta; 2006. [29] Baker U, Okuga M, Waiswa P, Manzi F, Peterson S, Hanson C. Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda. Int J Gynecol Obstet 130 2015:S43–S50. [30] Ogden J, Nyblade L. Common at its Core: HIV-Related Stigma Across Contexts 2005.



DOI: https://doi.org/10.22146/jkki.36396

Article Metrics

Abstract views : 392 | views : 1584

Refbacks

  • There are currently no refbacks.


Copyright (c) 2018 Jurnal Kebijakan Kesehatan Indonesia : JKKI

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

The Jurnal Kebijakan Kesehatan Indonesia : JKKI [ISSN 2089 2624 (print); ISSN 2620 4703 (online)] is published by Center for Health Policy and Management (CHPM). This website is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Built on the Public Knowledge Project's OJS 2.4.8.1.
 Web
Analytics View My Stats