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Strategic Measurement Method Using Balanced Scorecard Approach at the North Minahasa District Health Office

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Strategic Measurement Method Using Balanced Scorecard Approach at the North Minahasa District Health Office International Journal of Applied Business & International Management, Vol. 4 No. 2 (2019) International Journal of Applied Business & International Management P-ISSN: 2614-7432 ; E-ISSN: 2621-2862 Website: www.ejournal.aibpm.or/IJABIM Research paper, Short communication, and Review Strategic Measurement Method Using Balanced Scorecard Approach at The North Minahasa District Health Office Joice L.M. Katuuk1, Bernhard Tewal2, James Massie3, Victor Lengkong4 Post Graduate Student, Doctoral Program of Management Science, Faculty of Economy and Business, Sam Ratulangi University of Manado, North Sulawesi, Indonesia1 Correspondence Email: [email protected] Dr, Program Human Resource Management of Sam Ratulangi University, Manado2 Dr, Program Marketing Management of Sam Ratulangi University, Manado3 Dr, Program Human Resource Management of Sam Ratulangi University, Manado4 ABSTRACT The purpose of this study is to identify and analyze a series of processes to realize the strategy objectives through strategic measurement using the Balanced Scorecard approach at the North Minahasa District Health Office. The research method used was qualitative with a case study design. The results show that the Balanced Scorecard approach as a strategic management tool can improve the quality of strategy implementation, when it can clarify the size of its strategic performance. This case study contributes to the current state of knowledge and local government regarding the development and implementation of the Balanced Scorecard in the future to local governments that intend to implement it. For further research, the trial of the application of the Balanced Scorecard to local governments is an important strategic issue. Keywords: balanced scorecard, strategic measurement, Local Government INTRODUCTION The challenges of paradigm change in all fields, the challenges of globalization, the demands of bureaucratic reform and various change processes have impacts in all fields and organizations both private and government. The success of each organization is reflected in its performance that is highly dependent on strategy (Sharma, 2009). The ability of the organization to clarify the measure of the success of the effectiveness of the strategy plays a role in improving the quality of the implementation of the strategy (clear measures of strategy effectiveness) (Pella, 2016: 26).The local government in the health sector in North Minahasa District has implemented a strategic management model to improve future organizational performance, but a good strategy has not been successful in overcoming health problems in the region. The initial survey in the North Minahasa District Health Office was informed that it was facing changes in organizational structure downsizing in accordance with the demands of national bureaucratic reform. The fact explains that in North Minahasa District until now according to the regulatory and design framework the organization does not yet have a Regional Health System (Sistem Kesehatan Daerah) that should need to be followed up by the regional government referring to the National Health System (Sistem Kesehatan Nasional). This is influential in the effort to realize and implement health development in the sub-districts and villages in the region, both by the government, the community, the private sector and institutions or other related parties, synergistically, successfully and efficiently, to ensure the success of regional health development. The success of maternal health program efforts, including can be seen from the indicator of Maternal Mortality Rate (MMR). MMR is the number of maternal deaths during pregnancy, childbirth and childbirth caused by pregnancy, childbirth and childbirth or management but not for other reasons such as accidents, falls, etc. in every 100,000 live births indicator is not only able to assess the maternal health program, moreover it is able to assess the health status of the community, because of its sensitivity to improving health services, both in terms of accessibility and quality (Kementerian Kesehatan RI - Profil 2015).This The maternal mortality rate in North Minahasa District is still high. Based on the data, the high maternal mortality rate in 2009 with a proportion of 226.2 (7/3094), in 2011 amounted to 154.7 (5/3231), in 2013 amounted to 136.6 (5/3360).), and in 2016 amounted to 142.37 (5/3512). Copyright © 2019 Authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Figure 1. Maternal Mortality Rate in North Minahasa District 2008 - 2016 (Source: Profil Kesehatan Kabupaten Minahasa Utara 2017) The fact that infectious and non-infectious disease control efforts explain that Indonesia currently includes North Minahasa District faces a burden of disease called the "Double Burden Disease and Double Burden of Nutrition Problem" related to "Undernutrition" nutritional problems (lack of nutrition, short / Stunting, skinny) and "Overnutrition" (the problem of obesity or obesity). Indonesia also faces the burden of three diseases or "Triple Burden of Disease", which is related to the problem of shifting infectious diseases towards increasing infectious diseases (heart disease, kidney failure, diabetes, cancer, etc.), emerging threats of infectious diseases new (Avian Flu, Ebola, drug resistant Tuberculosis) and the public are faced with the problem of unfinished infectious diseases (Dengue Fever, Tuberculosis, Malaria, Human Immunodeficiency Virus/Acquired Immune Deficiency Sundrome, Filariasis and Worm). The other facts obtained at the Minahasa Utara District Health Office regarding the ability of community resources to carry out technical development in the health sector were lacking, so many did not follow up on the results of coaching such as providing feedback and solving solutions problem. Health financing in North Minahasa District is still low, especially the budget through the General Allocation Fund (Dana Alokasi Umum), if the percentage is averaged this condition is still far from the mandate of Undang-Undang Nomor 39 Tahun 2009 concerning Health, which is 10% of the Regional Budget per year outside employee expenditure (Kementerian Kesehatan RI, Rencana Strategi, 2015- 2019, Dinas Kesehatan Kabupaten Minahasa Utara, Rencana Strategi 2016-2020) Based on various problems, challenges and obstacles, local governments with all the existing units, including the Regional Work Units, especially the North Minahasa District Health Office should follow up on changes and developments that occur through strengthening management to adapt to the Balanced Scorecard management tools / methods. The purpose of this study is to identify and analyze a series of processes to realize the strategy objectives through strategic measurement using the Balanced Scorecard approach at the North Minahasa District Health Office. LITERATURE REVIEW The balanced scorecard was originally designed to measure multidimensional performance, this concept has evolved into an organizing framework for strategic management systems (Hoque, 2012; West et al, 2009). Empirical evidence from the literature confirms that the implementation of the balanced scorecard in the public sector is very important as a result of certain characteristics of modern organizations (Kaplan & Norton, 1992, 1996). Kaplan and Norton: as performance measurement tools (1992), as a link between performance metrics and strategy (1993:135), as a performance management system (1996), as a strategic performance management system (1996), as implementation guidelines (1996), as a focus tool on strategy mapping (2000), as a strategic management system and control (2000), as a strategy alignment tool (2004); Kaplan and Norton make a distinction between diagnostic measurements and strategic measurements. Diagnostic measurements monitor whether something is in control. A statistical process control chart with upper and lower limits is a good example of a diagnostic type system that can be used for controlling a process. Strategic measurements define a strategy for competitive excellence and future success. The balanced scorecard is a strategic measurement system. The objective is to balance the measurements associated with each perspective, all focused on a single strategy. These measurements should reinforce each other. Most of the measurements are both leading (drivers) and lagging (outcomes). Kaplan and Norton also emphasize that "the balanced scorecard should be used as a communication, informing, and learning system, not as a controlling system." Mapping strategies using the balanced scorecard concept can focus on organizational strategies 66 to eliminate barriers to success (Sudirman, 2012). Balanced scorecard as a performance management tool (Gomes and Liddle, 2010; Sudirman, 2012). The balanced scorecard is an important mechanism for improving performance (Ramadhan and Borgonovi (2015). The Balanced Scorecard provides the foundation for a new strategic management system. This allows organizations to introduce new governance and process renewal that focuses on strategy (Isoraite, 2008). the implementation of a strategic system of performance management, based on the balanced scorecard: improved organizational management (Bacala, 2014) .The balanced scorecard is widely accepted as a performance measurement system and strategic management system (Kazi et al, 2010); Balanced Scorecard-
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