STUDI KUALITATIF MOTIVASI KERJA TENAGA PELAKSANA PROGRAM TB PARU TERHADAP PELAKSANAAN STRATEGI DOTS DI PUSKESMAS RUJUKAN MIKROSKOPIS (PRM) KABUPATEN KAPUAS PROPINSI KALIMANTAN TENGAH

Abstract

According to WHO report (1995), Tuberculosis ('IBC) is a very serious and crucial health problem on public. In Indonesia TBC is the third killer disease after cardiovascular, it is predicted that there are about 500.000 TBC patients every year with the mortality rate of 500 persons every day. The solving system method to radicated is DOTS (Directly Observed Treatment Short Course) strategic which is was recommended by WHO in 1995/1996 and has been done through five components. The lung TB program performer is the worker who absolutely determines the achievement of lung IB program in Kapuas Regency. One of the achievement factors is working motivation from the related performer itself. In 1998/1999 until 2000/2001, the conversion number and the recovery number were still low. The purpose of this study is to explain the availability of measurement and devices, which , covered the availability of microscope, reagent and medicines, and the explanation of lung TB program performer motivation toward the DOTS strategic performance in PRM in Kapuas Regency. It is included fulfillment factors, achievement, appreciation, responsibility and development. This study is a qualitative study on the lung IB of program performer in five PRM Kapuas Regency along with ten respondents (total of population), which use two methods that are Objective Group Discussion and indepth Interview. These two methods were held on April 11-20,2002. The result of this study shows that the performer has twofold jobs for leprosy program, immunization, and rabies . This lung TB program does not have decree ( Surat Keputusan or SIC). What motivates the respondents is the status as the PNS (Civil Government Employee), so they will get a pension. The performer lokks forward to receiving the training education are they can understand the development of this program and also can get new information. Additionally, they are intending to get working appreciation, special incentive for the lung TB program, requiring to get the advancement throughout the supervision either from the delegated supervisor of regency or the principal of the community health centre and finally the availability of good working relation, well maintained communication between the superior and inferior. Program performer does not have decree, and they have not got the advancement program either from delegated supervisor of regency or the principal of the Community Health Center, therefore they do not get special incentive. As a result, SK is needed as the legitimation, provide training for the performer who has not got training, equipping the measurement facilities in PRM and if there are any brokrn equipment, it needs to be replaced soon. Menurut WHO (1995) penyakit Tuberkulosis (TBC) merupakan masalah kesehatan masyarakat yang penting dan serius. Di Indonesia TBC merupakan pembunuh ketiga setelah penyakit kardiovaskular,setiap tahun diperkirakan 500.000 penderita penyakit TBC, dengan jumlah kematian 500 orang setiap hari. Tahun 1995/1996 sistem penenggulangan dengan strategi DOTS yang direkomendasikan WHO dengan 5 komponen. Tenaga pelaksana program TB paru merupakan tenaga yang sangat menentukan keberhasilan program TB Paru di Kabupaten Kapuas. Salah satu faktor keberhasilan tersebut adalah motivasi kerja dari tenaga yang bersangkutan. Masih rendahnya angka konversi dan kesembuhan yang dicapai mulai tahun 1998/1999 sampai dengan 2000/2001. Tujuan penelitian ini adalah untuk menjelaskan ketersediaan sarana dan prasarana yang meliputi ketersediaan mikroskop, reagensia dan obat-obatan, menjelaskan motivasi tenaga pelaksana program TB Paru terhadap pelaksanaan strategi DOTS di PRM Kabupaten Kapuas yang meliputi faktor pemuas ; prestasi, penghargaan, pekerjaan, tanggung jawab dan pengembangan Penelitian ini melalui pendekatan studi kualitatif pada tenaga pelaksana program TB Paru di 5 PRM Kabupaten Kapuas dengan jumlah responden 10 orang (total populasi), menggunakan dua metode yaitu Diskusi Kelompok Terarah dan Wawancara Mendalam yang dilaksanakan dari tanggal 11-20 April 2002. Hasil penelitian menunjukan bahwa tenaga pelaksana mempunyai tugas rangkap untuk program kusta, imunisasi, rabies. Untuk program TB Paru tidak mempunyai Surat Keputusan (SK). Yang memotivasi responden bekerja karena status sebagai PNS, ada pensiun. Tenaga pelaksana mempunyai harapan terhadap diklat agar dapat mengetahui perkembangan program dan dapat infonnasi baru, menginginkan adanya penghargaan kerja, insentif khusus program TB Paru , memerlukan pembinaan melalui supervisi baik oleh wasor kabupaten maupun pimpinan puskesmas dan adanya hubungan kerj a yang baik, komunikasi dan keterbulcaan antara atasan dengan bawahan. Tenaga pelaksana program tidak mempunyai SK, belum ada pembinaan oleh wasor maupun pimpinan puskesmas, tidak ada insentif. Oleh karena itu disarankan adanya SK sebagai legitimasi, tersedia insentif, m engikutsertakan petugas yang belum mendapat pelatihan, melengkapi fasilatas sarana di PRM dan jika ada peralatan yang rusak segera diganti.