Analisis Keberadaan Tenaga Kesehatan Non-PNS Di Puskesmas Indonesia

Abstract

Abstrak Permasalahan ketidakmerataan tenaga kesehatan dalam jumlah dan jenis serta sebarannya masih dialami puskesmas di Indonesia. Upaya pemenuhan tenaga kesehatan yang dilakukan pemerintah melalui pengangkatan tenaga kesehatan non-PNS menyebabkan adanya berbagai status kepegawaian yang tidak sejalan dengan Undang-Undang Aparatur Sipil Negara. Tujuan penulisan ini untuk mengetahui jenis kepegawaian tenaga non-PNS dan menganalisis kebijakan terkait regulasi tenaga kesehatan non-PNS di puskesmas Indonesia. Kajian ini dilakukan dengan menelaah dokumen laporan hasil Rifaskes 2011 dan Risnakes tahun 2017 terkait status ketenagaan dan peraturan perundang-undangan. Hasil menunjukkan terjadinya peningkatan persentase tenaga kesehatan non-PNS yang signifikan dalam periode 2011 sampai dengan 2017. Persentase tenaga kesehatan non-PNS pada Rifaskes 2011 sebesar 25,74%, sedangkan hasil Risnakes 2017 sebesar 47,41%. Jenis kepegawaian tenaga kesehatan non-PNS di puskesmas antara lain tenaga sukarela, tenaga kontrak BLUD, tenaga PTT/honorer, tenaga Tugsus/NS, dan tenaga kontrak BOK. Kebijakan penempatan tenaga non-PNS mengikuti regulasi yang dikeluarkan kementerian teknis pada awal kebijakan tersebut dikeluarkan, kecuali untuk tenaga sukarela. Dengan keluarnya UU ASN dan PP nomor 49/20a18, regulasi yang mendasari kebijakan pengangkatan/ penempatan tenaga kesehatan non-PNS tidak disesuaikan (tidak sinkron) sehingga menimbulkan policy conflict/konflik kebijakan. Disarankan untuk dilakukan sinkronisasi/harmonisasi regulasi lintas kementerian dan pemerintah daerah yang mengatur ketenagaan non-PNS di bidang kesehatan. Perlunya perencanaan kebutuhan tenaga kesehatan berdasarkan analisis jabatan dan analisis beban kerja masing-masing puskesmas dengan mempertimbangkan jumlah pegawai non-PNS yang sudah bekerja dan lama mengabdi di puskesmas. Kata kunci: puskesmas, analisis,kebijakan, tenaga kesehatan, non-PNS Abstract The problem of inequality of health workers in the number and type and distribution is still experienced by public health centers in Indonesia. The government’s efforts to fulfill health workers through the appointment of non-PNS health workers have resulted in various employment statuses that are not in line with the State Civil Apparatus Law. The purpose of this paper is to determine the types of staffing for non-PNS health workers and to analyze policies related to the regulation of non-government employees in Indonesian Health Centers. This study examines the Rifaskes 2011 and Risnakes 2017 reports related to workforce status and laws and regulations. The result of the study shows that there has been a significant increase in the percentage of non-government employees from 2011 to 2017. The percentage of non-government employees in Rifaskes 2011 was 25,74%, while the results of the Risnakes 2017 were 47,41%. The types of staffing for non-government employees at the Health Center including volunteers, BLUD contract workers, PTT/honorary staff, Tugsus/NS personnel, and BOK contract workers. The policy for the appointment of non-government employees follows the regulation issued by the technical ministry at the beginning of the policy, except for volunteer workers. Following the issuance of the ASN Law and PP 49/2018, those underlying line ministries’ regulations are not adjusted which then causes policy conflicts. It is recommended to synchronize and harmonize among line ministries regulations as well as local government regulations about non-government employee health workers. Planning of health workers is needed based on a job analysis and workload analysis of each health center by taking into account the number of non-government employees who have worked and long served at the health centers. Keywords: health center – policy analysis - health worker – non-government employee