DETERMINAN PENGELOLAAN LIMBAH CAIR SARANA KESEHATAN (SARKES) RAWAT INAP DI KABUPATEN BREBES

Abstract

Pemerintah dalam menyejahterakan masyarakatnya adalah dengan membangun yang berwawasan lingkungan, agar lingkungan dan pembangunan tidak saling bertentangan. Pemerintah dalam membangun peningkatan kesehatan memerlukan Sarana Kesehatan (SARKES) rawat inap. SARKES ini disamping bermanfaat juga menimbulkan dampak pencemaran lingkungan. Pencemaran limbah cair adalah paling sulit deteksi. PEMDA Kab. Brebes dalam meningkatkan kesehatan masyarakat memerlukan SARKES rawat inap, yang pembangunannya harus berwawasan lingkungan. Kebijakan pengelolaan lingkungan PEMDA Kab. Brebes sulit dijalankan, karena sebagian besar SARKES rawat inap milik PEMDA Brebes tidak mengelola limbah cairnya secara benar. Demikian juga SARKES rawat inap milik swasta sebagian besar tidak memeliki IPAL. Tentu ada faktor-faktor yang paling berpengaruh dalam pengelolaan limbah cair. Penelitian ini menggunakan metode survei analitik dengan pendekatan cross sectional yaitu, untuk menganalisis faktor-faktor yang berpengaruh terhadap pengelolaan limbah cair SARKES rawat inap di Kabupaten Brebes, yang meliputi rumah sakit, puskesmas rawat inap, klinik rawat inap dan rumah bersalin yang berlokasi di Kabupaten Brebes. Penelitian dilaksanakan pada bulan September sampai November 2012. Populasi dalam penelitian ini adalah seluruh Sarana Kesehatan (SARKES) yang ada di Kabupaten Brebes. Data diperoleh melalui uji laboratorium, wawancara dan observasi dengan menggunakan kuesioner. Hasil uji bivariate dengan korelasi Spearman, didapatkan hasil penelitian antara variabel bebas faktor internal (X1) dan faktor eksternal (X2) menunjukkan adanya hubungan yang positif dan signifikan. Sedang untuk variabel Penanggung jawab (X3) ada dua indikator yang berkorelasi negatif dan tidak signifikan. Pertama, jenis kelamin (X32), kedua, pendidikan (X33). Dapat disimpulkan bahwa baik buruknya Pengolahan Limbah Cair SARKES Rawat Inap (Y) dipengaruhi oleh variabel bebas Internal (X1), Eksternal (X2) dan Penanggung – Jawab (X3). Untuk pengelolaan limbah cair SARKES rawat inap agar memenuhi baku mutu, perlu ditingkatkan manajemen yang baik, pelaksanan hukum yang konsisten dan penanggung jawab SARKES rawat inap yang berperilaku peduli pada kualitas lingkungan. Kata kunci : Sarana Kesehatan, Faktor Internal, Faktor Eksternal, Penanggung Jawab, dan Pengelolaan Limbah Cair Government in saving the community is to build environmentally insight, so that the environment and development are not mutually contradictory. The government in developing health promotion requires Health Institution or Sarana Kesehatan (SARKES) indoor cares. This SARKES is useful also to cause environmental pollution. Liquid waste pollution is the most difficult of detection. Local government of Brebes in improving community’s health requires SARKES of indoor cares that should be environmentally insight. Environmental management policy of Brebes local government is difficult to be carried out, since the most SARKES of indoor cares of Brebes local government do not manage the liquid waste properly . Likewise the most private SARKES of indoor cares do not have Waste Processing Unit/ Installation or Instalasi Pengolahan Air Limbah (IPAL). There are factors certainly that most influence in the management of liquid waste. This research uses analytical survey method with cross sectional approach i.e. analyzing the affecting factors towards the management of fluid waste of Health Institution’s indoor care within Brebes District including Hospital, Community Health Centre (PUSKESMAS), Clinical Indoor Care and Birth-Clinics within Brebes District. This research was done between September to November 2012. The population used in this research were all Health Institutions within Brebes District, therefore the sample covering all population that determined according to inclusive as well as exclusive criteria. Data obtained from laboratory test, interviews and observations using questionnaires. Based on bivariate test with Spearman correlation, the results reveal that there is a positive and significant correlation within independent variables of internal factors (X1) and external factors (X2), however, for independent variable of Health Authority (X3) there are two factors having negative correlation and are not significant i.e. sex category (X32)and education (X33). Multivariate test using logistic regression reveals that the overall research results has shown the overall effects of independent variables toward dependent variables (the management of liquid waste of SARKES Indoor Care), except sub independent variable i.e. sex status (X32) and education (X33). It is concluded that the quality of SARKES Indoor Care Liquid Waste Management (Y) is affected by the Internal (X1), External (X2), and Health Institution (X3) independent variables. It is suggested to regularly monitor, analise and evaluate the management of liquid waste in various Health Institutions especially for that of the lower quality. Furthermore, appropriate, wise and consistence attitudes of the Central as well as Local Governments with their law regulations and law enforcements are needed. Keywords : Health Institution, Internal Factor, External Factor, Health Authority, and Liquid Waste Management System