Constraints on the performance of school-based dental program in Yogyakarta, Indonesia: A qualitative study

• Main Authors: Rosa Amalia (Author), Niken Widyanti (Author), Johan W. Groothoff (Author), Rob M.H. Schaub (Author)
• Format: Book
• Published: Universitas Airlangga, 2011-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<p><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Background</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: A high prevalence of caries at ages </em><span style="font-family: SymbolProportionalBT-Regular; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;">≥ <span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>12 in Yogyakarta province (DMFT = 6.5), raises the question of the effectiveness </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of the school-based dental program (SBDP) which, as a national oral health program in schools, is organized by community health centers </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>(CHCs). </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Purpose</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: The aim of this study is to explore the possible constraints on work processes which might affect the performance </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>of SBDPs in controlling caries. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Methods</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: In-depth interviews was conducted in twelve CHCs, covering all five districts both in urban </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>and rural areas. Subjects were 41 dentists and dental nurses working in these CHCs. The interviews were structured according to the </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>following themes: resources and logistics; program planning; target achievement; monitoring and evaluation; and suggestions for </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>possible improvements. The data were analyzed using content analysis. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Results</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: The main constraints identified were limited resources </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>and inflexible regulations for resource allocation in the CHC, and inadequate program planning and program evaluation. Inadequate </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>participation of parents was also identified. Another constraint is thatpolicy at the district level orientates oral health towards curative </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>intervention rather than prevention. Suggestions from interviewees include encouraging a policy for oral health, task delegation, a </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>funding program using school health insurance, and a reorientation towards prevention. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Conclusion</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: The weakness of management </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>processes and the unsupported policy of the SBDP at the local level result in a lack of effectiveness. The constraints identified and </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>suggestions for improvements could constitute a basis for improving program quality.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: SymbolProportionalBT-Regular; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Latar Belakang</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Tingginya prevalensi karies pada usia </em><span style="font-family: SymbolProportionalBT-Regular; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;">≥ <span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>12 tahun (DMFT = 6.5) di Provinsi Daerah Istimewa Yogyakarta </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>(DIY) menimbulkan pertanyaan akan efektifitas
Usaha K
esehatan Gigi Sekolah (UKGS). UKGS adalah salah satu program nasional di </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>bidang kesehatan gigi dan mulut yang dilaksanakan oleh Puskesmas. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Tujuan</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Tujuan dari penelitian ini adalah untuk mengeksplorasi </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>hambatan pada pelaksanaan UKGS yang dapat mempengaruhi kinerja dari UKGS untuk mengontrol karies. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Metode</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Penelitian </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>kualitatif dengan menggunakan in-depth interview dilakukan di 12 Puskesmas, meliputi lima kabupaten di DIY baik di daerah pedesaan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>maupun perkotaan. Subyek terdiri dari 41 dokter gigi dan perawat gigi di Puskesmas. Struktur tema dari wawancara adalah sumber </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>daya dan logistik; perencanaan program; pencapaian target; monitoring dan evaluasi; saran untuk perbaikan program. Data dianalisis </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>menggunakan analisis konten. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Hasil</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Hambatan pada program UKGS yang teridentifikasi adalah sumber daya yang terbatas dan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>regulasi yang tidak fleksibel untuk alokasi sember daya di Puskesmas, perencanaan dan evaluasi program yang tidak memadai dan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>rendahnya peran serta orang tua. Hambatan lain adalah kebijakan pada tingkat kabupaten yang berorientasi pada pelayanan kuratif </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>daripada preventif. Saran yang dikemukakan adalah penguatan kebijakan untuk kesehatan gigi, delegasi tugas, asuransi kesehatan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>sekolah dan reorientasi pelayanan preventif. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Kesimpulan</strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>: Proses manajemen yang lemah dan kurangnya dukungan kebijakan untuk </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>UKGS pada tingkat daerah menjadi salah satu sebab kurang efektifnya program. Hambatan dan saran yang teridentifikasi pada studi </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>ini dapat menjadi dasar untuk meningkatkan mutu program.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>

Item Description

1978-3728
2442-9740
10.20473/j.djmkg.v44.i2.p93-100