Analisis Implementasi Program UKGS dalam Pelayanan Promotif dan Preventif di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Semarang Tahun 2011

Abstract

Universitas Dipongeoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Administrasi dan Kebijakan Kesehatan 2011 ABSTRAK Sariyem Analisis Implementasi Program UKGS dalam Pelayanan Promotif dan Preventif di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Semarang Tahun 2011 xiv +115 Halaman + 17 Tabel + 3 Gambar + 12 Lampiran Program Usaha Kesehatan Gigi Sekolah (UKGS) merupakan salah satu bentuk kegiatan untuk melihat kondisi kesehatan gigi dan mulut pada anak sekolah. Kegiatan UKGS meliputi upaya promotif, preventif dan kuratif. Dengan usaha tersebut diharapkan tujuan yang ingin dicapai pada program UKGS dapat tercapai, namun pada kenyataannya program UKGS dalam pelayanan promotif dan preventif belum dilaksanakan semaksimal mungkin, hal ini ditunjukkan dengan hasil cakupan pelayanan promotif dan preventif masih rendah, pelayanan promotif baru mencapai 27% sedangkan preventif 37%, hal tersebut masih jauh dari standar. Tujuan penelitian ini adalah untuk menganalisis implementasi program UKGS dalam pelayanan promotif dan preventif di puskesmas wilayah kerja Dinas Kesehatan Kota Semarang. Jenis penelitian adalah penelitian kualitatif dengan metode observasi dan wawancara mendalam. Informan utama adalah empat dokter gigi dan empat perawat gigi, sedangkan informan triangulasi empat kepala puskesmas dan satu kepala seksi anak dan remaja. Hasil penelitian menunjukkan secara umum komunikasi pada program UKGS dalam pelayanan promotif dan preventif sudah berjalan baik. Pelaksana program belum semua mempunyai komitmen yang sama terhadap tugasnya, sebagian kecil dari pelaksana program mempunyai tanggapan yang negatif terhadap program UKGS dalam promotif dan preventif. Tidak ada SOP dalam pelayanan promotif dan preventif, yang ada pedoman secara umum dari DepKes, pedoman dari DepKes cukup jelas, materi di pedoman jelas dan lengkap, kerjasama lintas program dan lintas sektor sudah berjalan baik terutama dengan UPTD kecamatan, mekanisme pertanggung jawaban selama ini pelaksana program sudah membuat laporan secara rutin ke DKK setiap bulan, pembagian kerja(job discription) antara dokter gigi dan perawat gigi belum membagi tugas secara bergantian, serta pembinaan dari DKK berupa monitoring ke team Pembina UKS kecamatan dan evaluasi rutin setiap bulan, belum semua puskesmas memanfaatkan dana yang ada secara proporsional untuk pelayanan promotif dan preventif, ketersediaan tenaga masih kurang, belum semua puskesmas mempunyai sarana dan prasarana. Kegiatan yang dilakukan hanya sebatas penjaringan kelas I, sikat gigi dan penyuluhan, sasaran program UKGS diutamakan kelas I dan jadwal pelaksanaan program sebagain besar puskesmas sudah membuat awal tahun ajaran baru. Berdasarkan hasil penelitian tersebut disarankan kepada DKK untuk mengevaluasi Job discription petugas, meningkatkan komitmen pelaksana program. Bagi puskesmas agar melengkapi peralatan dan bahan yang belum ada, jenis kegiatan jangan terbatas penjaringan saja, agar kegiatan promotif dan preventif yang lain juga dilaksanakan, memanfaatkan dana untuk kegiatan promotif dan preventif secara proporsional . Kata Kunci : Promotif dan Preventif, Implementasi kebijakan, Puskesmas Jumlah Pustaka : 28 ( 1995 - 2010) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Health Policy Administration 2010 ABSTRACT Sariyem Analysis on the Implementation of School Dental Health Program in Promotive and Preventive at Primary Healthcare Centers in Semarang, 2011 xiv +115 pages + 17 tables + 3 figures + 12 enclosures School Dental Health Service (UKGS) program was one of activity forms to know dental and mouth health condition of school children. The UKGS activities included efforts in promotive, preventive and curative. By implementing that effort, it was expected that the purpose of UKGS program would be attained. In reality, UKGS program in promotive and preventive services has not been implemented maximally. It was shown by the low result of promotive and preventive service coverage. Promotive service coverage was only 27% and preventive coverage was only 37%. These were still far from the target. The objective of this study was to analyze the implementation of UKGS program on promotive and preventive services in puskesmas in the work coverage area of Semarang city health office. This was a qualitative study with observation and in-depth interview. Main informants were 4 dentists and 4 dental nurses. Triangulation informants were 4 head of Puskesmas and 1 chief of children and youth unit. Results of the study showed that communication in UKGS program in the promotive and preventive services was generally good. Not all program workers had the same commitment to their jobs. Few program workers had negative responses to UKGS program especially in the promotive and preventive services. There was no standard operating procedure (SOP) in the promotive and preventive services, only general guideline from the Ministry of Health was used. The guideline from the Ministry of Health was understandable, items in the guideline unequivocal and complete. Cross program and sectoral collaboration were good especially with subdistrict UPTD. In relation to responsibility mechanism, program workers made routine reports to district health office monthly. No alternating schedule for working between dentists and dental nurses was made. Supervision from district health office was in the form of monitoring to subdistrict UKS steering committee and routine monthly evaluation. Not all puskesmas used proportionally the funding for promotive and preventive services. There was insufficient human resource and not all puskesmas had sufficient facilities. UKGS activity was limited only grade 1 students screening. Most of puskesmas had made program time schedule in the early academic calendar year. Based on the study results, it was suggested to the district health office to do workers job description evaluation and to enhance program worker commitment. Puskesmas was suggested to complete instruments and materials needed, to add more UKGS activities and not limited only to screening activity, to implement other promotive and preventive activities, to use promotive and preventive funding proportionally. Key words : Promotive and preventive, policy implementation, puskesmas Bibliography : 28 (1995 – 2010)