Implementasi Manajemen Terpadu Balita Sakit (MTBS) dari Aspek Kebijakan Program Studi di Puskesmas Wilayah Kabupaten Pasuruan Tahun 2012 (Studi Kasus pada Puskesmas dengan Cakupan MTBS Tinggi)

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Kosentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Nikmatul Firdaus Implementasi Manajemen Terpadu Balita Sakit (MTBS) dari Aspek Kebijakan Program Studi di Puskesmas Wilayah Kabupaten Pasuruan Tahun 2012 (Studi Kasus pada Puskesmas dengan Cakupan MTBS Tinggi) 161 halaman + 30 tabe l+ 8 gambar +10 lampiran Dari data tahun 2007- 2010, kegiatan MTBS mengalami kenaikan. Akan tetapi hasil cakupan MTBS belum mencapai target yang sudah ditetapkan oleh Dinas Kesehatan Kabupaten Pasuruan yaitu sebesar 80%. Dari studi pendahuluan diperoleh bahwa belum semua balita yang berkunjung tertangani dengan MTBS. Hal ini dikarenakan belum tersedia sarana prasarana program MTBS, supervisi yang tidak terjadwal dan belum adanya umpan balik. Tujuan penelitian ini adalah menjelaskan implementasi program MTBS dari aspek kebijakan di Puskesmas wilayah Kabupaten Pasuruan. Jenis penelitian yang dilakukan adalah observasional kualitatif dengan pendekatan cross sectional berdasarkan populasi seluruh Puskesmas yang melaksanakan MTBS di kabupaten Pasuruan. Informan utama dalam penelitian ini adalah tim MTBS (dokter, bidan, perawat). Informan triangulasi adalah penentu kebijakan (Kepala Puskesmas, Seksi Kesehatan Keluarga) dan masyarakat pengguna. Hasil penelitian menunjukkan bahwa di 4 Puskesmas dengan cakupan MTBS tinggi komunikasi sudah berjalan (sosialisasi dan pemasaran sudah dilakukan) namun tidak ada struktur organisasi khusus (tidak terstruktur). Dari sisi sumber daya, belum semua SDM mendapat pelatihan MTBS, belum semua sarana prasarana MTBS tercukupi, dan tidak ada dana khusus program MTBS. Dalam hal disposisi, seluruh petugas mempunyai sikap positif dalam mendukung program MTBS. Struktur birokrasi belum optimal (sudah tersedia SOP, akan tetapi dalam praktiknya SOP tidak dijalankan secara sempurna. Ada pencatatan dan pelaporan, namun belum ada supervisi rutin dan umpan balik). Berdasarkan penelitian yang dilakukan, disarankan dan direkomendasikan untuk tetap melakukan sosialisasi program MTBS, optimalisasi SDM, mencukupi sarana prasarana, meningkatkan kompetensi petugas dengan pelatihan MTBS, serta melakukan penertiban pencatatan dan pelaporan ke DKK dan peningkatan kualitas supervisi dengan pemberian umpan balik oleh DKK. Kata Kunci : Manajemen Terpadu Balita Sakit, Kebijakan, Puskesmas Kepustakaan : 32 (1997-2010) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2012 ABSTRACT Nikmatul Firdaus Implementation of Integrated Management of Childhood Illness (IMCI) from the Policy Aspect at Pasuruan Primary Healthcare Centers (a Case Study in Primary Healthcare Centers with High IMCI) 161 pages + 30 tables + 8 figures +1 0 enclosures Data in 2007-2010 showed that integrated management of childhood illness (IMCI) activities increased. However, IMCI coverage had not reached the target established by Pasuruan district health office, which was 80%. Preliminary study indicated that not all under-five children who visited health centers received IMCI services. It was caused by no availability of IMCI facilities, unscheduled supervision, and no feedback. The objective of this study was to explain IMCI program implementation from policy aspect in primary healthcare centers in Pasuruan district. This was an observational qualitative study with cross sectional approach. Study population was all primary healthcare centers that performed IMCI in Pasuruan district. Main informants were IMCI team that consisted of physicians, midwives, nurses. Triangulation informants were policy makers such as head of primary healthcare center, head of family health section, and consumers. Results of the study showed that in 4 primary healthcare centers with high IMCI coverage, communication had been performed (socialization and marketing); however, there was no specific organizational structure (unstructured). Viewed from resources side, not all human resource received IMCI training; not all facilities of IMCI were fulfilled; specific funding for IMCI program was not allocated. In relation to disposition, all workers had positive attitude in supporting IMCI program. Bureaucracy structure was not optimal; there was a standard operating procedure, but it was not implemented correctly in practice. There was recording and reporting, but routine supervision and feedback was not performed. Based on the results of study, it was suggested and recommended to keep doing IMCI program socialization, human resource improvement, facility fulfillment, improvement of workers by conducting IMCI training, implementing arrangement for reporting and recording to district health office, improvement in supervision quality by giving feedback to district health office. Key words : Integrated management of childhood illness, policy, primary healthcare center Bibliography : 32 (1997-2010)