Evaluasi Pelaksanaan Penanggulangan Kejadian Luar Biasa (KLB) Difteri di Kota Surabaya Tahun 2012

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Ika Mardiyanti Evaluasi Pelaksanaan Penanggulangan Kejadian Luar Biasa (KLB) Difteri di Kota Surabaya Tahun 2012 xv + 135 halaman + 16 tabel + 12 lampiran Difteri merupakan penyakit yang masuk dalam daftar KLB hampir di seluruh Kabupaten/Kota di Jawa Timur salah satunya Surabaya. Dari data tahun 2008-2013 menunjukkan bahwa kasus difteri terus mengalami peningkatan. Berdasarkan survey pendahuluan didapatkan bahwa pelaksanaan penanggulangan KLB difteri belum sesuai standar. Tujuan penelitian ini adalah menjelaskan bagaimana pelaksanaan penanggulangan KLB difteri di Kota Surabaya. Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan cross sectional. Informan penelitian adalah petugas yang menangani KLB baik di Dinas Kesehatan maupun Puskesmas. Sedangkan informan triangulasi adalah Asisten Kesra dan Ketua Komisi D DPRD Kota Surabaya, Ka. Kecamatan, Ka. Kelurahan, Ibu Kader/PKK dan keluarga penderita. Data dikumpulkan dengan wawancara mendalam (indepth interview) dan selanjutnya dilakukan pengolahan data menggunakan metode analisis isi (content analysis). Pelaksanaan penanggulangan difteri di Kota Surabaya menunjukkan bahwa paraturan perundangan untuk penanggulangan KLB belum memadai, SOP belum terdistribusi dengan baik, penelitian belum pernah dilakukan, pencegahan dan mitigasi, peringatan dini serta kesiapsiagaan belum dilakukan secara optimal. Saat tanggap darurat Puskesmas masih bersikap reaktif dan mengandalkan instruksi dari Dinkes Kota Surabaya. Pada saat pemulihan belum ada pengawasan profilaksis dan pemantauan status imunisasi ulang. Penelitian ini merekomendasikan beberapa saran yaitu bagi Dinas Kesehatan agar meningkatkan kerjasama lintas sektor maupun lintas program, mengadakan penilaian secara independen pada Tim Gerak Cepat, dan memastikan pendistribusian SOP KLB difteri hingga tingkat pelaksana di Puskesmas. Sedangkan bagi Puskesmas diharapkan lebih bertindak proaktif, melakukan koordinasi dan komunikasi secara intensif antar tim, pengawasan profilaksis, status imunisasi, dan kondisi pasien saat pemulihan. Kata kunci : Kejadian Luar Biasa Difteri, Surveilans, Imunisasi, Evaluasi Referensi : 36 (1991-2013) 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 Ika Mardiyanti Evaluation of the Implementation of Diphtheria Outbreak Intervention in Surabaya City in 2012 xv + 135 pages + 16 tables + 12 enclosures Diphtheria is one of the diseases on a list of outbreak in most of districts/cities in East Java including Surabaya City. Number of diphtheria cases rose gradually during the period of 2008-2013. The result of preliminary research showed that the implementation of diphtheria outbreak intervention had not met a standard. This research aimed to explain the implementation of diphtheria outbreak intervention in Surabaya City. This was descriptive qualitative research with cross-sectional approach. Informants were health workers who handled outbreak at either City Health Office or Health Center. Furthermore, informants for triangulation purpose were Community Welfare Assistant and Chairperson of Commission D at House of Representative in Surabaya City, Head of Subdistrict, Head of Village, Cadres, and patients’ families. Data were collected using indepth interview and analyzed using content analysis. The result of this research showed that there was no proper regulation to intervene the outbreak, Standard Operating Procedure had not been distributed well and there was no research. In addition, efforts of prevention, mitigation, early warning, and alertness had not been done optimally. In emergency situation, health center was very reactive and just waited for instructions from Surabaya City Health Office. During a recovery time, there was no monitoring activity for prophylaxis and reimmunization status. As a suggestion, City Health Office needs to improve cooperation with cross-sectors and cross-programs, independently assess quick response team, and ensure the distribution of diphtheria outbreak Standard Operating Procedure until level of health center. Additionally, health centers need to be more proactive, make coordination and communication intensively between teams, and monitor prophylaxis, immunization status and patients’ condition during the recovery period. Key Words: Diphtheria Outbreak, Surveillance, Immunization, Evaluation Bibliography: 36 (1991-2013)