Analisis Faktor -€” Faktor Organisasi Yang Berhubungan Dengan Cakupan Imunisasi Puskesmas di Kabupaten Batang (Analysis of Organizational Factors That Influence The Coverage of Immunization at The Health Center in District of Batang)

Abstract

A goal of immunization program is to decrease infant mortality rate caused by diseases that could be prevented by immunization. The success of immunization program is measured by coverage of immunization and depended on the work performance of the immunization officer at the Health Center. The work performance of the immunization officer is influenced by individual factor, psychological factor, and organizational factor that comprise leadership, supervising, resource, compensation, structure, and job design. The aim of this research was to get information about the organizational factors that influence the coverage of immunization at the Health Center in District of Batang. This was Observational research using survey method and cross sectional approach. Research instrument used questionnaires. Number of respondent was 48 persons. They were the immunization officers at the Health Center in District of Batang. Data was analyzed by univariate, bivariate, and multivariate method using Chi Square test and Logistic Regression with Enter method and significant level on 0.05. Result of this research shows that the factors which have significant relationship with the coverage immunization the Health Center in District of Batang are as follows: clear guidance (p value = 0.001), involvement of the Head In staff meeting (p value = 0.000), and responsiveness of the Head (p value = 0.015). Beside that, capability of supervisor (p value = 0.0001), advice from supervisor (p value = 0.002), feed back of supervision result (p value = 0.000), incentive (p value = 0.012), opportunity of scientific activities (p value = 0.006), opportunity of continuing study (p value = 0.0001), availability of equipment (p value = 0.001), and availability of transportation (p value = 0.0001). Inappropriate of immunization equipment could predict the coverage immunization equal to 12,698 times. Inappropriate of continuing study could predict the coverage immunization equal to 6,835 times. It needs to give clear guidance, to make Standard Operating Procedure, to make job aid, to do the routine meeting, to supervise periodically, to use checklist, to give incentive based on the work performance (index point), to plan training, and to provide equipment and transportation. Tujuan program imunisasi adalah menurunkan angka kematian bayi akibat Penyakit yang Dapat Dicegah Dengan Imunisasi ( PD3I ). Keberhasilan program imunisasi diukur dengan pencapaian target cakupan imunisasi. Keberhasilan tersebut tergantung pada kinerja tenaga pelaksana imunisasi di Puskesmas sementara kinerja tenaga pelaksana imunisasi dipengaruhi oleh faktor individu, faktor psikologi dan faktor organisasi yang terdiri dari kepemimpinan, supervise, sumber daya, kompensasi, struktur dan desain pekerjaan. Penelitian ini bertujuan untuk Memperoleh informasi tentang faktor¬faktor organisasi yang berhubungan dengan cakupan imunisasi Puskesmas di Kabupaten Batang. Jenis penelitian observasional dengan metode survei dan pendekatan cross sectional. Instrumen penelitian menggunakan kuesioner pada 48 orang pelaksana imunisasi di Puskesmas Kabupaten Batang. Data primer maupun sekunder diolah dan dianalisa dengan cara kuantitatif melalui analisis univariat, bivariat dan multivariat. Analisis bivariat menggunakan uji chi square dan analisis multivariat menggunakan uji regresi Logistik binary. Signifikansi ditentukan dengan nilai p < 0,05. Hasil penelitian menunjukkan bahwa faktor organisasi yang berhubungan dengan cakupan imunisasi Puskesmas di Kabupaten Batang adalah kejelasan pengarahan tugas petugas (nilai p : 0,001), keterlibatan pimpinan dalam rapat staf Puskesmas (nilai p : 0,000), tanggapan pimpinan terhadap kesulitan petugas dalam pelaksanaan imunisasi (nilai p : 0,015), kesesuaian kemampuan supervisor dengan kegiatan imunisasi (nilai p : 0,0001), pemberian masukkan oleh supervisor pada saat supervisi (nilai p : 0,002), pemberian umpan balik hasil supervisi (nilai p : 0,000), insentif (nilai p : 0,012), kesempatan mengikuti kegiatan ilmiah (nilai p : 0,006), kesempatan melanjutkan pendidikan (nilai p : 0,0001), ketersediaan alat (nilai p : 0,001) dan ketersediaan transportasi (nilai p : 0,0001). Petugas yang mempersepsikan ketersediaan alat imunisasi tidak sesuai memiliki resiko terjadinya kinerja rendah sebesar 12,698 kali serta petugas yang mempersepsikan kesempatan melanjutkan pendidikan tidak sesuai memiliki resiko terjadinya kinerja rendah sebesar 6,835 kali. Perlu pengarahan tugas yang jelas, pembuatan standard operating procedur, pembuatan job aid , rapat rutin, supervisi secara berkala menggunakan check list , insentif di hitung berdasarkan kinerja staf (indeks point), merencanakan pelatihan, pengadaan alat dan transportasi.