Electronic Theses and Dissertation

Sistem kesehatan merupakan suatu instrumen kunci yang diciptakan untuk
mendorong pencapaian Sustainable Development Goals, dimana salah satu
tujuannya adalah menjamin kehidupan yang sehat dan mendorong kesejahteraan
bagi semua orang di semua usia, termasuk kelompok ibu dan anak dengan agenda
utama menurunkan angka kematian ibu dan bayi. Secara umum, angka kematian
ibu dan bayi di Indonesia termasuk yang tertinggi di antara negara ASEAN,
demikian juga di Aceh. Penelitian ini bertujuan untuk menganalisis pengaruh tata
kelola, tenaga kesehatan, pembiayaan kesehatan, serta infrastruktur berbasis
teknologi terhadap kinerja sistem kesehatan di Aceh yang berfokus pada
pelayanan kesehatan ibu dan anak dengan mutu pelayanan sebagai variabel
mediasi dan etika kerja Islami sebagai moderasi. Studi dilakukan secara cross-
sectional di fasilitas pelayanan kesehatan yaitu rumah sakit, puskesmas dan klinik
bersalin/ praktik mandiri bidan menggunakan kuesioner terstruktur dengan skala
Likert. Penarikan sampel dilakukan melalui metode multistage random sampling
di 12 kabupaten/ kota terpilih dalam wilayah Provinsi Aceh. Sampel terdiri dari
tenaga kesehatan penyedia layanan kesehatan ibu dan anak yakni dokter, bidan
dan perawat dengan total 384 responden. Data dianalisis menggunakan Structural
Equation Modeling (SEM) yang dioperasikan melalui program Analysis of
Moment Structures (AMOS). Hasil penelitian menunjukkan bahwa terdapat
pengaruh yang signifikan antara tata kelola, tenaga kesehatan, pembiayaan
kesehatan, infrastruktur berbasis teknologi serta mutu pelayanan terhadap kinerja
sistem kesehatan di Aceh. Mutu pelayanan mampu memediasi hubungan antara
tata kelola, tenaga kesehatan, pembiayaan kesehatan dan infrastruktur berbasis
teknologi terhadap kinerja sistem kesehatan, serta etika kerja Islami memperkuat
pengaruh antara mutu pelayanan, tata kelola serta tenaga kesehatan terhadap
kinerja sistem kesehatan di Aceh.

The health system is a key instrument created to encourage the achievement of Sustainable Development Goals (SDGs), whereas one of the goals is to ensure a healthy life and promote prosperity for all people at all ages, including mothers and children with the main agenda of reducing maternal and infant mortality rates. In general, maternal and infant mortality rates in Indonesia are highest among ASEAN, as well as in Aceh. This study aims to analyze the effect of governance, health workforce, health financing, and infrastructure based on technology on health system performance in Aceh. The study focuses on maternal and child healthcare with service quality as a mediating variable and Islamic work ethics as a moderator. The study was conducted crosssectionally in health care facilities, namely hospitals, health centers and maternity clinics using a structured questionnaire with a Likert scale. In this study, sampling was carried out using a multistage random sampling method in 12 selected districts/cities within Aceh Province. The sample consists of health workforce who providing maternal and child health services including doctors, midwives and nurses with a total of 384 respondents. Data were analyzed by using Structural Equation Modeling (SEM) which was operated through the Analysis of Moment Structures (AMOS) Program. The result of research shows that there is a significant influence between governance, health personnel, health financing, infrastructure based on technology and service quality on the health system performance in Aceh. The service quality is able to mediate the relationship between governance, health workforce, health financing and infrastructure based on technology on health system performance, and Islamic work ethic can also strengthen the effect between the service quality, governance and health workforce on health system performance in Aceh