Kode Instrumen : PKM NO KUES :

REPUBLIK INDONESIA
KEMENTERIAN KESEHATAN

INSTRUMEN PERENCANAAN KEBUTUHAN SDM KESEHATAN

TAHUN 2016
PERTANYAAN KEPALA PUSKESMAS
I. IDENTITAS RESPONDEN
1. Nama
...............................................................................
2. Jenis Kelamin 1. Laki-laki 2. Perempuan
3. Jabatan
...............................................................................
4. Status Kepegawaian 1. CPNS/PNS 4. Sukarelawan

2. Honorer/kontrak 5. Lainnya,...................................
3. PTT pusat/daerah
5. Masa Kerja di puskesmas
...........tahun.........bulan
6. No.HP
...............................................................................
7. Alamat E-mail ............................................................................................

II. IDENTITAS PUSKESMAS

1. Provinsi
...............................................................................
2. Kabupaten
...............................................................................
3. Nama Puskesmas
...............................................................................
4. Kode registrasi
puskesmas
........................................

5. Alamat (Jalan, Desa,
Kecamatan, Kode Pos)
............................................................................................

6. Karakteristik puskesmas 1. Perkotaan 3. Terpemcil
2. Perdesaan 4. Sangat Terpencil

7. Tipe Puskesmas 1. Rawat inap 2. Non rawat inap

8. Status Puskesmas 1. BLUD 2. Non BLUD

III. KETERANGAN WAWANCARA

1. Tanggal kunjungan:
tanggal/bulan/tahun
-- s/d--
2. Nama Pewawancara 3. Tanda tangan

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 IV. PERTANYAAN
A. PENGETAHUAN TERKAIT PERENCANAAN KEBUTUHAN SDM KESEHATAN
A01 Apakah saudara mengetahui Pedoman untuk menyusun Perencanaan SDM Kesehatan?
1. Ya, sebutkan......................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
2. Tidak
A02 Apakah Saudara mengetahui adanya peraturan perundang-undangan yang menjadi dasar hukum perencanaan SDM
Kesehatan?
1. Ya, sebutkan......................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
2. Tidak
A03 Menurut Saudara, apakah penting dilakukan rencana kebutuhan SDM Kesehatan di Puskesmas?
1. Ya, jelaskan......................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
2. Tidak, jelaskan......................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
B. IMPLEMENTASI PERENCANAAN SDM KESEHATAN

B01 Apakah di Puskesmas Saudara melakukan perhitungan kebutuhan SDM Kesehatan?

1. Ya

2. Tidak,
jelaskan..................................................................................................................................................................................
...............................................................................................................................................................................................
.........................................................................................................................................................................................

(PERTANYAAN SELESAI)

B02 Sebutkan metode apa yang digunakan untuk menghitung kebutuhan SDM Kesehatan?

........................................................................................................................................................................................................
........................................................................................................................................................................................................
........................................................................................................................................................................................................

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B03 Kapan terakhir kali Puskesmas Saudara menghitung kebutuhan SDM Kesehatan?(sebutkan tahun berapa)

............................

B04 Sebutkan bagian/jabatan yang melakukan perhitungan kebutuhan SDM Kesehatan di Puskesmas Saudara?

........................................................................................................................................................................................................
........................................................................................................................................................................................................
.....................................................................................................................................................................................................

B05 Kemana hasil perhitungan kebutuhan SDM Kesehatan Puskesmas disampaikan?

........................................................................................................................................................................................................
........................................................................................................................................................................................................
.....................................................................................................................................................................................................

B06 Apakah terdapat kendala dan tantangan dalam melakukan perhitungan kebutuhan SDM Kesehatan di Puskesmas?

1. Ya, jelaskan......................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
2. Tidak

B07 Apakah Saudara atau SDM Kesehatan lainnya di Puskesmas pernah mendapatkan pelatihan perencanaan kebutuhan SDM
Kesehatan?

........................................................................................................................................................................................................
........................................................................................................................................................................................................
.....................................................................................................................................................................................................

C. KESESUAIAN PERENCANAAN DENGAN PEMENUHAN SDM KESEHATAN

C01 Apakah hasil perhitungan kebutuhan SDM Kesehatan di Puskesmas Saudara digunakan sebagai acuan dalam pemenuhan
tenaga kesehatan di Puskesmas?
1. Ya, jelaskan...........................................................................................................................................................................
..............................................................................................................................................................................................
..............................................................................................................................................................................................
..............................................................................................................................................................................................
2. Tidak, jelaskan......................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
C02 Apakah secara umum SDM Kesehatan di Puskesmas Saudara melakukan pekerjaan sesuai dengan kompetensi
jabatan/profesi?
.......................................................................................................................................................................................................
.......................................................................................................................................................................................................

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