Otonomi Daerah Dan Akuntabilitas Kinerja Dinas Kesehatan Kabupaten Kulonprogo Di Daerah Istimewa Yogyakarta = Accountability Of Kulonprogo District Health Office In The Context Of District Autonomy

Background: The shifting of the responsibility of the district health office from the ministry health to local government during decetralization policy could mean a positive impact on health status. Since they experience public financed programs and have the capacity to note the difference between what happen in the field what stated in the official report, DPRD and community could have an opportunity to oversee the performance of DOH. If this assumption is true, LAKIP in decentralization era would be more commonsensical and accountable to the program mission and reality. This study evaluates if the practice of performance accountability reporting (LAK1P) in District Health Office has improved after the implementation of district autonomy act. It looks at the evidence for a new vision and mission of the DOH during the decentralization policy, organizational changes in response to them, and local stakeholder participation in local health planning. Method: Main source of information is 2002 and 2003 performance accountability report and relevant government documents. During the field work in November to December 2004, respondents from DOH, DPRD, and community organizations were interviewed. Result: LAKIP reflects more about administrative accountability. No description on the effectiveness of the program available in the report. Several issues related to this matter include time uncertainty of money for program implementation program organization. Importantly, the shift in financial responsibility of local government has no effect on the increase in local resources available for health. The organization vision and mission lack of clarity and district specific intention. Although it is reasonable to share the global and national scope of the Health Department's vision, it is important that local government express its own vision so that create the local driving force to achieve them differently from other district or the national standard. Local stakeholders do not seem to have a room to express their own vision. DPRD and local NGOs have shown a degree of participation health program and planning, however they involved in a few limited events and in an ad hoc basis. Part of this problem is due to the limited personal background of the DPRD member in local health problems, program interventions, and the DOH work practices. Conclusion: LAKIP still reflects administrative procedure in one form of finance public responsibility. Program effectiveness and efficiency remains unnoticed. While it is difficult to judge the performance of DOH for health merely on the basis of LAKIP, it is necessary to open public access to the LAKIP so that local stakeholders could verify the gap between the contents and the public experience. Keywords: Government Performance Report, LAKIP, district autonomy, performance accountability, district health programs, DI