Evaluasi Dampak Pelaksanaan Revitalisasi Posyandu di Wilayah Kerja Puskesmas Eromoko Kabupaten Wonogiri Provinsi Jawa Tengah Tahun 2013

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Sri Martini Evaluasi Dampak Pelaksanaan Revitalisasi Posyandu di Wilayah Kerja Puskesmas Eromoko Kabupaten Wonogiri Provinsi Jawa Tengah Tahun 2013 xiv + 91 halaman + 14 tabel + 5 lampiran Salah satu bentuk usaha kesehatan berbasis masyarakat, Posyandu sangat strategis untuk meningkatkan kesehatan masyarakat. Namun pada tahun 2012 mengalami penurunan secara kuantitas maupun kualitas. Penurunan kuantitas dapat dilihat dari jumlah posyandu sebanyak 71 pada tahun 2010 menjadi 65 pada tahun 2012. Sedangkan jumlah kader sebanyak 306 pada tahun 2010 menjadi 264 pada tahun 2012. Menurunnya kualitas posyandu disebabkan beberapa keterbatasan seperti pengetahuan dan keterampilan kader, sarana, dana, dan pendampingan Puskesmas. Dampak dari menurunnya kualitas Posyandu adalah terjadinya beberapa masalah seperti kematian bayi sebanyak 7 orang atau 0,02% (target 0%), kematian balita 12 orang atau 0,037% (target 0%), kematian ibu 1 orang atau 0,003% (target 0%) dan gizi buruk 1,78% (target 1%). Pemerintah melakukan revitalisasi posyandu untuk meningkatkan kualitas posyandu. Untuk mengetahui seberapa jauh dampak revitalisasi, penelitian ini berupaya untuk melakukan evaluasi. Jenis penelitian ini adalah kualitatif dengan menggunakan wawancara mendalam dan observasi langsung Informan utama dalam penelitian ini adalah enam bidan yang telah mengikuti pelatihan fungsi bidan desa yang bekerja di Puskesmas Eromoko Kabupaten Wonogiri. Informan triangulasi petugas gizi, Bidan koordinator, Kepala Puskesmas. Teknik analisis data dengan analisis konten, meliputi wawancara mendalam dengan informan diolah kemudian dilakukan analisis data. Pelaksanaan revitalisasi posyandu di Kecamatan Eromoko menunjukkan bahwa dari sisi input yaitu meningkatnya sarana prasarana, meningkatnya tenaga yang terlatih. Dari sisi proses, meningkatnya frekuensi pelatihan pelatih dan pelatihan kader, dan meningkatnya frekuensi pendampingan dan pembinaan posyandu. Dari sisi output, meningkatnya cakupan bayi dan balita, meningkatnya cakupan ibu hamil dan menyusui, meningkatnya cakupan kasus yang dipantau. Beberapa kendala yang dihadapi dalam posyandu diatasi dengan partisipasi masyarakat dan kader posyandu. Sedangkan untuk meningkatkan kesadaran masyarakat tentang arti penting posyandu dilaksanakan dengan melalui berbagai kesempatan dalam pertemuan secara individu maupun kelompok. Penelitian ini merekomendasikan beberapa saran yaitu bagi kantor PMD agar meningkatkan koordinasi, bagi Dinas Kesehatan agar mengidentifikasi permasalahan masyarakat. Sedangkan saran bagi Puskesmas, diharapkan Puskesmas melaksanakan pelatihan terhadap bidan Pembina posyandu. Kata kunci : evaluasi pelaksanaan revitalisasi posyandu, bidan, kader Referensi : 51 (1990-2010) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2013 ABSTRACT Sri Martini Evaluation on the Impact of Posyandu Revitalization at Eromoko Primary Healthcare Center, Wonogiri District, Central Java, 2013 xiv + 91 pages + 14 tables + 5 enclosures One form of community based health efforts was posyandu (health service post); this posyandu was very strategic to improve community health. Unfortunately, in 2012, quantity and quality of posyandu decreased. Decrease in the quantity was shown by decreasing the number of posyandu from 71 posyandu in 2010 to 65 posyandu in 2012; the number of cadres was 306 in 2010 and 264 cadres in 2012. Decrease in the quality of posyandu was caused by several limitations, such as knowledge and skill of cadres, facilities, funding, and puskesmas (primary healthcare center) accompaniment. Impact of the decrease of posyandu quality was the occurrence of several problems, such as seven infant deaths or 0.02% (target was 0%), 12 deaths of under-five children or 0.037% (target was 0%), one maternal death or 0.003% (target was 0%), and 1.78% severe malnutrition cases (target was 1%). Government has implemented posyandu revitalization to improve posyandu quality. This study was directed to evaluate the impact of posyandu revitalization. This was a qualitative study, and data were collected through in-depth interview and direct observation. Main informants were six midwives who attended in training about function of village midwives, and who worked in puskesmas Eromoko district of Wonogiri. Triangulation informants were nutrition health workers, a coordinator of midwives, and a head of puskesmas. Data were analyzed using content analysis method. Results of implementation of posyandu revitalization in Eromoko sub district showed that, viewed from input side, facilities and skilled workers improved; viewed from process side: frequency of training of trainer and cadre training improved, frequency of posyandu accompaniment and supervision improved; viewed from output side: infant and under-five children coverage increased, coverage of pregnant women and breastfeeding women increased, coverage of monitored cases increased. Several problems faced in the implementation of posyandu were solved by community and posyandu cadre participations. Individual and group meetings were conducted to improve community awareness about the important of posyandu. This study recommends several suggestions: for PMD office is to improve coordination; for district health office is to identify community problems; for puskesmas is to implement training for midwives as posyandu supervisor. Key words : evaluation of the implementation of posyandu revitalization, midwives, cadres Bibliography : 51 (1990-2010)