Monitoring The Implementation Of No Cigarette Areas (KTR) Policy In Kabanjahe Hospital In 2017

Introduction

The problem of smoking in Indonesia has become a serious issue that has the potential to cause death. According to the World Health Organization (WHO), tobacco use is the leading cause of preventable death worldwide, accounting for more than seven million deaths each year. In Indonesia, the situation is no better, with smoking-related deaths estimated to be around 200,000 per year. In response to this growing concern, the Indonesian government has implemented various policies to reduce smoking, including the establishment of no-smoking areas (KTR) in public places, including hospitals.

Background

Law No. 44 of 2009 concerning Hospitals requires all hospitals in Indonesia to establish all their areas as non-smoking areas (KTR). This policy aims to create a healthier environment for patients, visitors, and hospital staff. However, despite the implementation of this policy, many hospitals in Indonesia, including Kabanjahe Hospital, have struggled to enforce it effectively. This study aims to analyze the implementation of KTR policies in Kabanjahe Hospital and identify the constraints encountered during the process.

Methodology

This study uses a qualitative method with a descriptive analysis approach. The data collection was carried out through in-depth interviews with six informants, including four health workers from the hospital and two patients. Direct observations were also conducted in the hospital environment to gather more information. The analysis technique used is Spradley analysis, which includes domain analysis, taxonomy, and components.

Results

The results of this study show that the implementation of KTR policies in Kabanjahe Hospital has not been successful, despite being in place for eight years. Several factors contribute to this failure, including:

• Lack of commitment from hospital management: Many hospital staff and management still smoke in the hospital area, which sets a bad example for others and undermines the effectiveness of the policy.
• Absence of regional regulations (Perda): The lack of regional regulations governing KTR policies creates confusion and makes it difficult for hospitals to enforce the policy.
• Lack of socialization: The hospital has not conducted effective socialization campaigns to raise awareness about the importance of KTR policies.
• Lack of supporting facilities: The hospital lacks the necessary facilities to support the implementation of KTR policies, such as designated smoking areas for staff.
• Lack of commitment from the Hospital Director: The Hospital Director has not provided adequate sanctions for those who violate the KTR policy.
• Lack of coordination: Coordination between local governments, health offices, and other related organizations has not been effective, making advocacy for KTR policies difficult.

Conclusion

The conclusion of this study confirms that the application of KTR in Kabanjahe Hospital is still not in line with expectations and can be said to have failed. Therefore, it is highly recommended that hospital management improve communication, provide adequate resources, conduct effective advocacy, and strengthen bureaucratic structures to support KTR policies. Additionally, the immediate approval of regional regulations on KTR is expected to increase the effectiveness of this policy and create a healthier hospital environment for all visitors and patients.

Recommendations

Based on the findings of this study, the following recommendations are made:

• Improve communication: Hospital management should improve communication with staff, patients, and visitors to raise awareness about the importance of KTR policies.
• Provide adequate resources: The hospital should provide the necessary facilities and resources to support the implementation of KTR policies.
• Conduct effective advocacy: The hospital should conduct effective advocacy campaigns to raise awareness about the importance of KTR policies and to encourage compliance.
• Strengthen bureaucratic structures: The hospital should strengthen its bureaucratic structures to support the implementation of KTR policies.
• Approve regional regulations: The regional government should approve regulations governing KTR policies to create a clearer framework for hospitals to follow.

Conclusion

Q: What is the purpose of the KTR policy in hospitals?

A: The KTR policy aims to create a healthier environment for patients, visitors, and hospital staff by reducing exposure to second-hand smoke.

Q: Why is the implementation of KTR policies in Kabanjahe Hospital not successful?

A: Several factors contribute to the failure of KTR policies in Kabanjahe Hospital, including lack of commitment from hospital management, absence of regional regulations (Perda), lack of socialization, lack of supporting facilities, lack of commitment from the Hospital Director, and lack of coordination.

Q: What are the consequences of not implementing KTR policies effectively?

A: The consequences of not implementing KTR policies effectively include exposure to second-hand smoke, which can lead to health problems, including respiratory diseases and cancer.

Q: What are the benefits of implementing KTR policies effectively?

A: The benefits of implementing KTR policies effectively include creating a healthier environment for patients, visitors, and hospital staff, reducing exposure to second-hand smoke, and promoting a smoke-free culture.

Q: How can hospital management improve the implementation of KTR policies?

A: Hospital management can improve the implementation of KTR policies by improving communication, providing adequate resources, conducting effective advocacy, and strengthening bureaucratic structures.

Q: What role does the regional government play in implementing KTR policies?

A: The regional government plays a crucial role in implementing KTR policies by approving regulations governing KTR policies, providing support and resources to hospitals, and enforcing the policy.

Q: How can the public support the implementation of KTR policies?

A: The public can support the implementation of KTR policies by raising awareness about the importance of KTR policies, advocating for the policy, and reporting non-compliance.

Q: What are the long-term benefits of implementing KTR policies effectively?

A: The long-term benefits of implementing KTR policies effectively include reducing the negative impact of smoking on public health, promoting a smoke-free culture, and creating a healthier environment for all.

Q: How can Kabanjahe Hospital become an example for other hospitals in implementing effective KTR policies?

A: Kabanjahe Hospital can become an example for other hospitals in implementing effective KTR policies by sharing its experiences, best practices, and lessons learned with other hospitals, and by advocating for the policy at the national level.

Q: What are the next steps for Kabanjahe Hospital in implementing KTR policies?

A: The next steps for Kabanjahe Hospital in implementing KTR policies include improving communication, providing adequate resources, conducting effective advocacy, and strengthening bureaucratic structures, as well as seeking support and resources from the regional government.