Analisis Upaya Pemberdayaan Masyarakat oleh Bidan Desa melalui Pendekatan Positive Deviance pada Perbaikan Gizi Balita di Kabupaten Bojonegoro Tahun 2013

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Maya Primayanti Analisis Upaya Pemberdayaan Masyarakat oleh Bidan Desa melalui Pendekatan Positive Deviance pada Perbaikan Gizi Balita di Kabupaten Bojonegoro Tahun 2013 xvii + 257 halaman + 9 tabel + 4 gambar + 16 lampiran Pada akhir tahun 2012, 56,27% desa di Kabupaten Bojonegoro melakukan pemberdayaan melalui positive deviance (PD). Namun, penurunan presentase balita gizi kurang dan gizi buruk tidak dapat dipertahankan. Tujuan penelitian menganalisis upaya pemberdayaan masyarakat oleh bidan desa melalui pendekatan positive deviance pada perbaikan gizi balita di Kabupaten Bojonegoro. Penelitian dilakukan secara kualitatif. Informan utama 8 bidan desa (4 bidan desa PD kriteria baik dan 4 bidan desa PD kriteria kurang baik) dan informan triangulasi 28 orang (8 kader PD, 8 perangkat desa, 8 ibu balita dan 4 petugas gizi). Data dikumpulkan dengan teknik wawancara mendalam. Pengolahan dan analisis data menggunakan analisis isi. Hasil penelitian menunjukkan upaya pemberdayaan masyarakat oleh bidan desa PD kriteria kurang baik belum optimal dibandingkan PD kriteria baik. Hal ini berkaitan dengan : 1) bidan belum mengupayakan kader meningkatkan partisipasi ibu balita sampai membawa kontribusi bahan makanan dan membantu memasak, 2) pemimpin desa kurang memotivasi dan menggerakkan partisipasi masyarakat, 3) bidan belum memanfaatkan organisasi masyarakat desa sepenuhnya untuk meningkatkan partisipasi masyarakat, 4) bidan belum mengupayakan kader melakukan penyelidikan PD untuk mencari role model sebagai dasar pembuatan menu dan pemberian pesan kesehatan, 5) mobilisasi sumberdaya kurang dalam hal dana swadaya masyarakat atau ADD, serta keaktifan semua kader, 6) kemitraan bidan dengan perangkat desa dan kader belum didukung SK PD dan kesepakatan yang saling menguntungkan, 7) bidan belum mengupayakan kader melakukan evaluasi PD sampai kunjungan rumah, serta tidak ada supervisi rutin dan penilaian/umpan balik pelaksanaan PD dari petugas gizi. Disimpulkan bahwa pelaksanaan PD belum berkelanjutan sesuai harapan. Diperlukan kerjasama semua pihak dalam mewujudkan program tersebut. Disarankan kepada Dinas Kesehatan untuk melakukan pelatihan PD bagi bidan dan kader, serta penempatan tenaga gizi sesuai kompetensi. Disarankan kepada puskesmas untuk meningkatkan komitmen perangkat desa dan pemberian insentif kader. Kata Kunci : Pemberdayaan Masyarakat, Positive Deviance, Perbaikan Gizi Balita Pustaka : 63 (1983-2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Maya Primayanti Effort Analysis of Community Empowerment by Village Midwife through Positive Deviance Approach in Improving Nutrition of Children under Five years old in Bojonegoro District in 2013 xvii + 257 pages + 9 tables + 4 figures + 16 enclosures In the end of 2012, 56.27% of villages in Bojonegoro District had empowered community using positive deviance (PD) approach. However, a decreasing percentage of severely and moderately malnourished children under five years old could not be maintained. The aim of this study was to analyse efforts of community empowerment by village midwife through PD approach in improving nutrition of children under five years old in Bojonegoro District. This was qualitative research. Main informants consisted of eight village midwives (4 midwives with good PD and 4 midwives with bad PD). Meanwhile, 28 persons (8 cadres of PD, 8 village officials, 8 mothers of children under five years old, and 4 nutritionists) were as informants for triangulation purpose. Data were collected using indepth interview method. Furthermore, data were analysed using content analysis. The results of this study showed that efforts of community empowerment conducted by village midwives with bad PD had not been optimal compared to those with good PD. Some reasons for this problem were as follows: 1) midwives had not empowered cadres to increase participation of mothers of children under five years old in order to bring groceries and help cooking; 2) head of villages had not motivated and actuated participation of communities; 3) midwives had not fully utilised villagers’ organisation to increase participation of community; 4) midwives had not empowered cadres to investigate PD for finding role model as a basis of making menu and providing health messages; 5) there was lack of resources mobilisation particularly in terms of self-funding or ADD and activeness of all cadres; 6) partnerships between midwives, village officials, and cadres had not been supported by decree of PD and mutual agreements; and 7) midwives had not empowered cadres in evaluating PD and visiting a house. In addition, there were no regular supervisions and feedback of PD implementation from nutritionists. In conclusion, the implementation of PD had not complied expectation. Therefore, cooperation with other sectors needs to be done to realise its program. District Health Office needs to conduct training of PD for midwives and cadres and place nutritionists in accordance with their competencies. Health centres need to improve commitment of village officials and provide incentive for cadres. Key Words : Community Empowerment, Positive Deviance, Improvement of Nutrition of Children under Five Years Bibliography : 63 (1983-2013)