How to cite:
Syaefullah, Arif Darmawan, V Rudi. (2022). Local Government
Innovation in Implementing Mandatory Authorities in the Health
Office Central Lombok District. Journal Eduvest. Vol 2(7): 1.434-
1.442
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2775-3727
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Eduvest – Journal of Universal Studies
Volume 2 Number 7, July, 2022
p- ISSN 2775-3735- e-ISSN 2775-3727
LOCAL GOVERNMENT INNOVATION IN IMPLEMENTING
MANDATORY AUTHORITIES IN THE HEALTH OFFICE
CENTRAL LOMBOK DISTRICT
Syaefullah
1
, Arif Darmawan
2
, V Rudi
3
Universitas Tujuh Belas Agustus Surabaya, Indonesia
Email: [email protected], [email protected], rudih[email protected].id
ABSTRACT
The research objectives are; 1. To see the innovation process
in the health office for health sector affairs 2. To analyze the
models/types of innovation that exist in the health office. 3.
To map the obstacles/barriers in the innovation process at
the agency. 4. To analyze the efforts made in overcoming
these obstacles. This study uses a qualitative approach, data
obtained through interviews, observation, and
documentation with spiral data analysis. Discussion, the
process of innovation in the health department is by
disseminating findings, externalizing findings, combining
findings and internalizing findings. The results of the
innovation process and innovation model at the health office
in the work unit made a breakthrough program that was
applied with the following model: 1. Bajang Tastura
(Ambulance Network Brigade), Rapid Ambulance Assistance
for villagers, 2. P3KM (Infectious Disease P2 Agent),
Recording of infectious diseases in the community, 3. PTM
Posyandu, Monitoring of Non-Communicable Diseases, 4. P3S
(Stunting Acceleration Program), 5. E-PPGBM (Mobile Toddler
Nutrition Growth Monitoring), 6. Integrated Referral for
MCH-ELDERLY and Adolescent-UKS Monitoring Elderly health
in adolescent health, 7. E-Puskesmas, Online -based basic
health services , 8. Quick Quin Blood, UTD implementer.
KEYWORDS
Innovative, Innovative Process, Local Government
This work is licensed under a Creative Commons
Syaefullah, Arif Darmawan, V Rudi
Local Government Innovation in Implementing Mandatory Authorities in the Health
Office Central Lombok District 1.435
Attribution-ShareAlike 4.0 International
INTRODUCTION
The local government as the recipient of the authority for basic services
mandated by Law Number 23 of 2014 concerning Regional Government, which is stated
in article 12 paragraph 1, namely, mandatory government affairs related to basic services
as referred to in article 11 paragraph (2) includes, where one of them mentions in letter
(b) health, then in carrying out that authority of course requires breakthroughs and
innovations in accelerating services in the health sector. Innovation is a step towards
faster progress. Innovation is resistance to establishment which is sometimes not easy to
accept. This is increasingly realized by local governments in providing services to their
people must be faster, more effective and on target.
The problem is that exercising discretion or innovating requires courage,
commitment and clarity of the legal system which ensures that when regional heads make
a breakthrough, they will not be affected by the law if they implement the innovation-
based public service program.
As mandated by Law Number 23 of 2014, where there is a chapter that
specifically regulates regional innovation. In addition, innovation is a path to significant
change and is a must for every public service, especially in this era of disruption that is all
electronic and digital and technological advancements with industry 4.0 and even towards
5.0. is a necessity if an organization does not keep up with developments and changing
times. It is unfortunate if a community organization, in this case a local government, does
not have the characteristics as conveyed by Bean &
Readford (2002:71) saying that an innovative organizational climate has the
following characteristics:
1. Mutual trust ( is trusting );
2. Be open to new ideas and alternative approaches to solving and exploiting
opportunities;
3. An environment that emphasizes adaptability;
4. Emphasize flexibility;
5. Goal -directed with a sense of purpose ;
6. Show concrete evidence that innovation is rewarded;
7. Rewarding innovative achievements.
Based on the characteristics of the organization mentioned above, it should be a
public organization that is given the mandate to carry out the main tasks and functions of
government, namely the implementation of the mandatory authority for basic health
services in accordance with the mandate of Law number 23 of 2014 concerning regional
government. In Article 11 paragraph (2) mandatory government affairs as referred to in
paragraph (1) consist of Government Affairs relating to basic services and government
affairs not related to basic services, then in Article 12 paragraph (1) mandatory
government affairs relating to basic services as referred to in article 11 paragraph (2)
include: in letter b. health. And based on the provisions of Article 386 paragraph (1) in
the context of improving the performance of regional administration, regional
governments can innovate; (2) Innovation as referred to in paragraph (1) is all forms of
reform in the administration of regional government. Then in Article 387, it is stated that
in order to formulate innovation policies, local governments refer to the following
principles: a. Increased efficiency: b. Improved effectiveness; c. improvement of service
quality; d. no conflict of interest: e. oriented to the public interest; f . done openly; g. meet
the values of propriety; and h. can be accounted for the results are not for their own sake.
Eduvest – Journal of Universal Studies
Volume 2 Number 7, July 2022
1.436 http://eduvest.greenvest.co.id
Referring to the article above, every regional government is obliged to carry out
innovation in the context of implementing development in the region (Rodríguez-Pose,
2013), it must be carried out in a planned, integrated, integrated and coordinated manner
through the development of science and technology, so that it is necessary to strengthen
the regional innovation system, therefore the community and regional governments that
are innovation plays a very important role in strengthening the carrying capacity, capacity
and competitiveness of the region, so it is necessary to apply science and technology to
all aspects of development in the region.
Based on the description above, the objectives of this research are to see the
innovation process in the health office for health affairs, to analyze the models/types of
innovation that exist in the health office, to find out the obstacles /obstacles in the
innovation process at the agency, to analyze the efforts made in overcoming these
obstacles.
RESEARCH METHOD
The research method used in this study is a qualitative descriptive method. The
type of data used in this study is qualitative data, which is divided into two categories,
namely primary data and secondary data (Onwuegbuzie, Leech, & Collins, 2012).
Sources of data obtained through library research techniques (Library Research), which
refers to sources available online and offline, such as: scientific journals, books, and news
from trusted sources (Metzger, 2007).
These sources are collected based on discussions and links from one information
to another. Data collection techniques used in this study were observation, interviews and
research. Data analysis and drawing conclusions.
RESULT AND DISCUSSION
The application of innovation in government has become a necessity both at the
central government level and for local governments (Hoppe, Graf, Warbroek, Lammers,
& Lepping, 2015). The innovation is intended to facilitate the community in getting more
quality services from the government and the various needs of the community being met
more quickly. The idea of the importance of the government implementing innovation as
put forward (Bekkers, Edelenbos, & Steijn, 2011), which states that:
“Local government's main role to help local communities to learn to make
strategic choices by balancing the costs and benefits of efficiency, effectiveness,
economic growth, quality of life, social justice, participation and legitimacy. This role
one suspects, demand a high level of innovation if local government organizations are to
be effective in their work ”. (The main role of local government is to help local
communities learn to make strategic choices by balancing the costs and benefits of
efficiency, effectiveness, economic growth, quality of life, social justice, participation and
legitimacy. This one role is suspicious, demanding a high level of innovation if local
government organizations want to be effective in their work)”
Innovation should be the core activity of the public sector: helping public
services to improve performance and increase public value, responding to citizen
expectations and adapting to user needs, increasing service efficiency and minimizing
costs (van Ooijen, Ubaldi, & Welby, 2019). Moreover, the public sector has succeeded in
innovation in the past, effective governance and public services depend on successful
innovation – to develop better ways to meet needs, solve problems and use resources and
technology).
Syaefullah, Arif Darmawan, V Rudi
Local Government Innovation in Implementing Mandatory Authorities in the Health
Office Central Lombok District 1.437
Departing from this, comes the meaning of thinking and creative behavior in
order to bring up an innovation. At the government level, as a public servant the direction
is to provide comfort to the people who receive services. A good public service, if the
public servant, namely the local government is good (Szkuta, Pizzicannella, & Osimo,
2014). Innovation development for regional device organizations will be very effective,
when the organization has the ability to innovate. However, if the organization does not
have the potential and ability to innovate, the organization will not be effective in
providing public services.
The process of transforming ideas and knowledge carried out by public
organizations by utilizing the capabilities of their human resources into various forms in
the form of service mechanisms and new systems that provide benefits to the wider
community in the field of basic health services in accordance with the mandate given by
the local government (Wilson & Game, 2011).
Many researches on local government innovations have done it, as has been done
by previous researchers, such as in the research on the pick-up ball innovation process at
Puskesmas II Punggelan, where the innovation is to visit patients at home, namely
pregnant women who are about to give birth, this research is in the form of an effort to
reduce the risk of maternal death by health workers, namely village midwives at the
puskesmas (Yusriani, Alwi, Romalita, & Dewi, 2019).
The form is the same, namely basic health services at the first level, this research
is almost the same as what the author will examine, relating to basic health services, only
the locus is different (Estrada et al., 2012), next is local government innovation in the
administration of authority in the education sector which is carried out in Gowa Regency,
where the results show the ability of the local government in this case because of the
support from the leadership of regional heads and elements of leadership in the legislature
and executive (head of service and staff) (Ledyaev & Chirikova, 2017).
Compared to the research that the author will examine, is the difference in
authority, namely basic services in the field of education (McDonald & Ruiters, 2012), on
innovation through the Licensing Service Clinic (KLIPPER) which successfully helps the
organization's daily tasks and provides benefits to the community ( M. Rizky, 2016) .
KLIPPER is a licensing consultation program for investors who will make complex
buildings so that the licensing process is faster, cheaper and does not violate regulations.
The service innovation carried out by the Yogyakarta City Health Office through
the Elderly Health Home in improving services for the elderly , the research locus on
advanced health services at the Elderly Hospital, compared to research that researchers
will do the difference in the locus, namely service basic health level I, health innovations
whose locus is the implementation of the Home Care program in the city of Makassar are
still not fully implemented in accordance with the best practice criteria. The similarity of
the research that the researchers will do is that the legality of the resulting innovation
program has not been legalized, so it will be weak in the sustainability of the home care
program. Smart Card as Innovation Government Areas in the City Makassar by analyzing
the attributes of innovation used in assessing the implementation of innovation
(Wulandari & Munawaroh, 2020) .
This research was carried out in the the city of Mak Assar as a place of
implementation smart card program as a support for the creation of a smart city in the city
of Makassar so that it becomes the main focus of research, exploring an innovation in
public services in the health and emergency fields, namely the Public Safety Center
(PSC) 119 Bantul Regency, the research conducted is one of the innovations that
researchers get at the Central Lombok Health Office. but research on regional innovations
Eduvest – Journal of Universal Studies
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in the implementation of the mandatory authority for basic health services no one has
done it yet.
The process of innovation at the district health office
According to Nonaka (1995) innovation is a thought process, so the innovation
process can be explained with the SECI example of Management Knowledge. The SECI
model consists of Socialization, Externalization, Combination, and Internalization, so that
government innovation can run effectively, it is better to go through the discovery process
using the SECI example, namely discovery socialization, discovery externalization,
discovery combination and discovery internalization. With the spiralization from the
SECI Nonaka model, the government's innovation process will run effectively and
sustainably. This condition led the writer to conduct an in-depth study of the concept of
the process of finding government in the realm of local government, based on the theory
of the SECI model that the researcher used, namely: starting from the process of
socialization, externalization, combination and internalization, namely:
1. Bajang Tastura (Ambulance Network Brigade)
This is a model of standby delivery service carried out at the village level, namely the
polindes, where each village is given a village ambulance whose budget is from village
funds, this is done to prevent a high risk of pregnant women who will give birth when
assisted at the polindes level, the health workers cannot because the patient's condition is
at risk if giving birth at the polindes, then an immediate referral is made to a higher health
facility, namely, to the nearest RSU that has BPJS services.
2. Quick Quin Blood
Is a model of providing blood bags for patients during childbirth/pregnant women
who are about to give birth, which is a form of saving/providing blood from family
members of pregnant women who are registered at the time of delivery, in this way it is
intended to make it easier for patients if there is a risk of severe bleeding and need Blood
will be given immediately, because the patient's family had anticipated it from the start.
3. P3KM (P2 Infectious Disease Agent)
Is a model of monitoring the types of infectious diseases that occur in the community
by involving data collection agents or health cadres who voluntarily want to become
monitoring officers and recorders of diseases that often arise in the community.
4. PTM Posyandu
This is the opposite of P3KM, which is monitoring the types of non-communicable
diseases to be recorded and submitted to the puskesmas officers.
5. E-PPGBM (Mobile Toddler Nutrition Growth Monitoring)
In the context of preventing and resolving cases of stunting or undernourished
toddlers, a nutrition monitoring application was formed which is a continuation of the
program that has been manually recorded, to be immediately reported to the health
department and the process of handling it quickly, and can be monitored by other
institutions that have cooperation, such as social services etc.
6. Integrated Reference for KIA-ELDERLY and Adolescent-UKS
Is a program of activities carried out by the Maternal and Child Health section, which
is community-based by empowering and optimizing the role of health cadres in recording
and providing education to elderly groups at the neighborhood or hamlet level, as well as
guidance and education to school-age youth based on the school environment in the
working area of the puskesmas and village villages by posyandu cadres.
7. E-Puskesmas
Is a basic health service program at the puskesmas level, which is carried out based
on the internet or in a network, making it easier for the community to register and get fast
service when they go to the Puskesmas for treatment.
Syaefullah, Arif Darmawan, V Rudi
Local Government Innovation in Implementing Mandatory Authorities in the Health
Office Central Lombok District 1.439
Obstacles in the Innovation Process:
1) Internal Barriers
a. Organizational structure
Judging from the organizational structure, where there are levels in the division of
tasks and functions for each employee in the organizational environment, it can be an
obstacle in the innovation process, namely every employee who has an idea or concept,
then the person concerned must report to the coordinator or leader. above, for example at
the staff level, the staff will report the results of their work to the higher-level leadership,
namely the lower-level leader or the so-called section head, and so on, from the section
head to the head of the field, and the head of the field to the head of his service.
b. Organizational culture
Organizational culture is an inhibiting factor because of the work pattern and attitude
of employees who always wait for instructions or directions from their superiors, thus
limiting the ideas or concepts that a staff wants to do, must get direction or approval from
their leaders based on SOPs in the organization, bureaucratization,
c. Organizational Resources
The number of health workers in Central Lombok district is currently sufficient, both
medical and paramedical and non-medical personnel, namely the adequacy of the number
of general practitioners and specialists and midwifery, nursing and other supporting
health workers, this can be seen from the ratio of the number of medical personnel and
paramedics. medical services spread across 12 sub-districts within the working area of the
Central Lombok district health office, as follows:
Table 1 Number of Health Workers (PNS/ASN) in 2020
Medical
personnel
Nursing
Personnel
Midwifery
Pharmacy
Staff
Other Health
Workers
5.00
55.00
22.00
6.00
16.00
4.00
30.00
20.00
3.00
8.00
5.00
59,00
49.00
6.00
19.00
2.00
47,00
28.00
9.00
9.00
4.00
49.00
16.00
4.00
15.00
5.00
67,00
34.00
5.00
21.00
5.00
70.00
60.00
5.00
18.00
4.00
57,00
35.00
6.00
19.00
6.00
87.00
53.00
7.00
23.00
4.00
42.00
45.00
5.00
17,00
3.00
41.00
31.00
4.00
16.00
3.00
31.00
19.00
2.00
8.00
50.00
635.00
412.00
62.00
189.00
External Barriers
Social structure of society
Central Lombok society has a social structure based on categories:
1) Social Class
Which is divided into aristocratic groups, Kyai groups, and commoners. This social
class greatly affects the success of the official work program, because without the
Eduvest – Journal of Universal Studies
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support of the above social classes the program cannot run optimally as planned, namely
the higher-level group and the kyai group will play a very important role, when
socialization is carried out to the common people group.
2) Education Level
Divided into higher education, namely starting from Diploma, Bachelor, Postgraduate
to Doctoral strata, moderate education with high school level and low education, starting
from elementary school to junior high school. The level of education also affects the
success of the official work program because there will be stagnation if the target of the
work program is more targeted at the low level of education it will be difficult to run the
work program.
3) Economic Level
Divided into elite, middle and low classes, where the target of this work program will
usually be aimed more at people with a low economic level or income/income level in the
category of underprivileged/poor, this has implications for the success of the official work
program. health is not optimal as expected.
Efforts to Overcome Obstacles
Internal
1. Policy Sync
This policy synchronization means that each work unit handles work programs to
make an innovative study and program on access to services to the community (Soldani
& Manzalini, 2015).
2. Activity Program Socialization
It is carried out in the form of sharpening the activities of each work unit according to
the program and activity plans that have been made in the RKA, as well as providing
(Hakim, Saputra, & Saleh, 2021).
3. Activity Program Budget Support
Priority is given to program activities that support the mission and work programs of
the office that are novelty or digital innovation of public services (Mergel, 2018).
Social Class
Actively and continuously involved through socialization and consolidation with
2 groups, namely the aristocratic group and the clerics group, because by involving these
two groups the common people will listen and want to be invited to carry out official
program activities because of their character as community leaders and religious leaders.
Education Level
Involving these high and medium educated groups, through socialization and
consolidation of official work programs to become examples for people with low
education, because by looking at groups with high and middle education they are willing
to participate in official program activities.
Economic level
Involving the elite and middle class directly through the socialization and
consolidation of the official work program for this lower class group, where these two
groups help share or are involved in providing assistance to this lower class/poor group to
reduce costs if the poor community group needs it.
CONCLUSION
The innovation process at the health office runs according to the characteristics of
an innovative organization and the mandate of Law 23/2014, Constraints faced are the
lack of available funds, Efforts are being made to increase funds, cross-sectoral
Syaefullah, Arif Darmawan, V Rudi
Local Government Innovation in Implementing Mandatory Authorities in the Health
Office Central Lombok District 1.441
collaboration with village and sub-district governments. In order for the innovation
process to run well, the head of the health office is asked to provide support and
assistance as well as an adequate budget, in order for innovation to be sustainable, local
governments are asked to legalize or make regional head regulations the results of
innovations that have been produced by the Regional Work Unit (health office) to
strengthen their network. To strengthen cross-sectoral coordination through institutional
strengthening of the results of these innovations.
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