Introduction
Edited by dr. Rani Tiyas Budiyanti, Dr. Dra. Ayun Sriatmi & Dr.dr.Sutopo Patria Jati, this book was prepared as a guide for students of public health to learn about logistics management in health services. Health policy is a collection of decisions made by government related to health. Health policy aims to improve the level of optimal in public health. Core policies regarding National health is formulated from Law Number 36 of 2009 concerning Health and Presidential Regulation Number 72 of 2012 concerning the Health System National. This policy outlines the direction, objectives, policies and foundations regarding efforts to administer all health efforts in Indonesia. If you look at the form and hierarchy, health policy is part of public policy. Meanwhile public policy is part of the overall policy which is part of the policy as a whole general. In preparing a policy, there is a health policy cycle divided into 5 stages, namely agenda setting, policy formulation, policy adoption, policy implementation and policy evaluation. After policy evaluation, the results of the evaluation can become problems that become the next agenda setting so that it becomes a continuous and continuous cycle.
Agenda setting is determining the focus of the issues to be discussed or develop policies. Agenda setting is a meeting of 3 pillars namely the problem, possible solutions to the problem and political circumstances. The existence of a public issue is the beginning of policy formulation in the policy cycle. For example, during the corona pandemic there is a problem of the spread of corona through movement/interaction between people. If the problem presented allows for a solution, then policies will be developed such as the Social Restrictions policy in Large Scale during the corona pandemic is a government policy solution. Policy is very closely related to political conditions. Support from the political environment necessary for the policy to be
implemented. Issues that have pros and cons for example, it will be difficult to develop into public policy. Products in policy formulation such as academic texts, regulatory drafts, drafts policies and so on. Ratification of policies or adoption of policies constitutes important stage because at this stage a policy will come into effect. In enactment then the consequences of the policy also begin applies. Implementation is an important stage to carry out. As good as whatever a policy is, if it is not implemented it will not serve its purpose from the formation of the policy. Implementation involves all actors, organization, procedures and technical aspects to achieve policy or program objectives. Good policy programs can fail when implemented in one area, while in other areas the policy is succeed implemented. In implementing this policy there will be many influential factors. Implementation of health policies has an important role in the cycle or stages of health policy.
According to Dunn (2003) policy implementation is the implementation or control of policy actions over a period of certain time. In the implementation of policies, there are two possibilities, namely the policy is successfully implemented or vice versa failure in implementing the policy. According to Hann (2007), there are two alternatives in implementing policies, namely implement it in the form of a program or create derivative policies. Readiness to implement policies greatly influences effectiveness and success of a policy. Formulating policies based on data and evidence greatly influences the success or failure of policy implementation. Therefore, the existence of the main actors in analyzing readiness in implementing policies is very important. These actors include the Agency's Executive Committee Policy Formulation, Health/Medical Research Council, Ministry of Health, Ministry of Education and Culture, as well as university consortiums. It would be better if the analysis results these are combined into one, apart from that it requires the role and involvement of researchers, academics, professional organizations, certain medical expertise associations and so on. Failure in policy implementation is caused by gaps implementation. This can be due to bad policies, poor implementation (bad implementation), or lacking policies to get attention (bad luck). Examples of policies that are not getting enough attention is a mental health policy. Various policies and funding have been implemented disbursed in the implementation of mental health programs, but in implementation is still not optimal because the policy is considered not populist so it gets less attention. Bad policy can occur in policies that are developed without basis evidence based so policies are often not on target, or even appropriate with targets, the effectiveness of the implemented policies is felt to be lacking. The implementation of a policy is also influenced by politics, economic conditions, geographical conditions and cultural conditions in an area. In implementation that is influenced by geographical conditions, for example policies regarding equitable distribution of health services are influenced by geographical factors. Moreover, Indonesia consists of various mountains, straits, seas and rivers which make it difficult to access health services equally. This will also affect the implementation of the referral process health that requires immediate treatment. Policy implementation is also influenced by the process of formulating a policy either top down or bottom up. Policy formulation using the top model down such as elite models, process models and incremental models, in their implementation influenced by variables such as implementers, policy targets and the environment policy. Policy formulation model with a bottom-up approach such as Institutions and groups can be effectively implemented if they are implemented from the start target groups are involved in policy making.
