Dampak Kebijakan Akreditasi Puskesmas dalam Upaya Peningkatan Kualitas Pelayanan Kesehatan

Arief Priyo Nugroho, Irfan Ardani, Diyan Ermawan Effendi

Abstract

Puskesmas/primary health center (PHC) accreditation policy has a relative
impact on improving health services quality. In addition to management and
organizational improvements, PHC accreditation has negative excesses which can
be seen in the implementation process. Namely, the issue of fulfilling citizens’ basic
rights to health. This study aims to explain some of the negative excesses of PHC
accreditation policy to fulfill health care access. A qualitative analysis of various
interviews in roundtable discussions and secondary data collection on the process
and implementation of accreditation in 12 districts/cities. This study shows that the
PHC accreditation policy that was carried out encouraged a shift in the Government’s
values and norms in providing essential health services, from public goods to private
goods. The management logic that tends to be private-like-oriented places the
community as a consumer rather than as a citizen, not yet maximizing the active role
of the community raises the issue of inequity in the country’s efforts to guarantee the
rights of the community as citizens. The Government places basic health services no
longer fully as public goods, which ensures that every people as a citizen can access
them without exception.

 

Abstrak

Kebijakan akreditasi puskesmas relatif memiliki pengaruh pada
peningkatan kualitas pelayanan. Selain terdapat perbaikan manajemen dan
organisasi, akreditasi puskesmas memiliki ekses negatif yang terlihat pada proses
implementasinya, terutama dalam permasalahan pemenuhan hak dasar warga
negara atas kesehatan. Studi ini bertujuan menjelaskan bagaimana kebijakan
akreditasi puskesmas menimbulkan ekses negatif dalam pemenuhan akses
pelayanan kesehatan. Penelitian ini menggunakan pendekatan kualitatif. Data
primer diperoleh melalui wawancara mendalam diskusi meja bundar dan data sekunder dari pengalaman pelaksanaan akreditasi puskesmas di 12 kabupaten/
kota. Studi ini menemukan bahwa kebijakan akreditasi puskesmas yang dilakukan
mendorong pergeseran nilai dan norma pemerintah dalam menyelenggarakan
pelayanan kesehatan dasar, yaitu perubahan dari barang publik menjadi
barang privat. Logika pengelolaan yang lebih cenderung private-like-oriented,
menempatkan masyarakat sebagai konsumen dibanding sebagai warga negara,
belum maksimalnya peran aktif masyarakat memunculkan isu kesenjangan dalam
upaya negara menjamin hak masyarakat sebagai warga negara. Pemerintah
menempatkan pelayanan kesehatan dasar tidak lagi sepenuhnya sebagai barang
publik yang menjamin setiap masyarakat sebagai warga negara mampu mengakses
tanpa terkecuali.

Keywords

akreditasi puskesmas; kesenjangan; pelayanan kesehatan dasar; basic health service; inequity; PHC accreditation

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DOI: https://doi.org/10.46807/aspirasi.v14i1.3039

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