Evaluasi pelaksanaan fogging dalam penanggulangan demam berdarah dengue di Kota Denpasar

SUARTA, Gede, Dra. Retna Siwi Padmawati, MA

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang. Perkembangan kasus DBD di Kota Denpasar selama empat tahun terakhir terus mengalami peningkatan. Angka kematian tertinggi terjadi pada tahun 2006 dengan jumlah kasus 3017 orang (CFR: 0,73%), dengan jumlah kematian sebanyak 22 orang (IR:505,1 per 100.000 penduduk). Dengan kebijakan Kota Denpasar untuk mencegah peningkatan kasus dan KLB maka banjar diberikan mesin fogging sebagai upaya untuk menekan populasi nyamuk sehingga penyebaran penyakit DBD dapat dicegah. Kegiatan program fogging ini belum pernah dievaluasi, seiring dengan terjadinya peningkatan kasus dan terjadi kematian sehingga sangat diperlukan suatu kegiatan evaluasi dengan pendekatan sistem input, proses dan output. Tujuan Penelitian. Mengevaluasi pelaksanaan fogging yang dilaksanakan oleh petugas banjar, keterlibatan banjar dalam penanganan kasus DBD dan permasalahan dalam pelaksanaannya Metode. Penelitian kualitatif dengan rancangan RAP. Jumlah seluruh informan sebanyak 34, berasal dari petugas fogging 12 orang, petugas kesehatan enam orang dan tokoh masyarakat dari klian banjar 16 orang. Pengumpulan data dilakukan dengan wawancara mendalam, diskusi kelompok terarah, studi dokumen dan observasi. Analisis data menggunakan analisis tema. Hasil Penelitian. Penanggulangan DBD dengan melakukan fogging fokus oleh tenaga banjar belum dilaksanakan secara optimal. Terutama alokasi dana belum sesuai dengan jumlah kasus DBD yang terjadi di masingmasing puskesmas. Kemudian sumber daya manusia petugas fogging masih ada yang belum diberikan pelatihan termasuk tenaga pengawas. Terlambatnya laporan kasus diterima puskesmas dan pelaksanaan kegiatan fogging fokus yang belum sesuai dengan pedoman/petunjuk teknis serta kurangnya fungsi pengawasan dari pemerintah dan puskesmas terutama kegiatan fogging fokus yang bersumber dari swadaya masyarakat. Kesimpulan. Keterlambatan laporan kasus yang diterima puskesmas serta kurangnya pengawasan dari pemerintah terhadap pelaksanaan fogging fokus menyebabkan kasus DBD masih tetap tinggi. Agar keterlambatan bisa diatasi koordinasi dengan sarana kesehatan dan kinerja surveilans puskesmas maupun dinas kesehatan perlu ditingkatkan.

Background: The number of DHF cases in Denpasar Municipality during the past four years has been increasing. The highest mortality rate occurred in 2006 with 3017 cases (CFR=0.73%) and 22 people died (IR=505.1 per 100,000 population). Through a policy of Denpasar Municipality in preventing the increase of cases and outbreaks, each Banjar has been given a fogging machine as an effort to reduce mosquito population and prevent the spreading of DHF disease. Activities of fogging program have never been evaluated whereas cases and deaths are increasing. Therefore, an evaluation using input, process and output approaches is urgently needed. Objective: To evaluate fogging carried out by Banjar officials, and understand the involvement of Banjar in managing DHF cases and the problem of its implementation. Method: This was a qualitative study with Rapid Assessment Procedures (RAP) design. There were 34 informants consisting of 12 fogging officials, 6 health staff and 16 leading members of Klian Banjar. Data were obtained through indepth interview, focus group discussion, document examination and observation. Data were analyzed using thematic approach. Result: DHF control through fogging by Banjar officials had not been well implemented, particularly the allocation of fund was still irrelevant with number of DHF cases occuring at each health center. Human resources, both fogging officials and supervisors had not been trained. Reports of cases to the health center were delayed; the implementation of fogging activities was not yet relevant with the technical guideline; and monitoring of the government and the health center particularly on fogging activities which were self- financed by the community was minimum. Conclusion: Delayed reporting of cases to the health center and limited monitoring of the government on the implementation of fogging have caused DHF cases remained high. In order to overcome the situation, improvement had to be made on coordination, provision of health facilities, performance of surveillance staff at the health center, and performance of health office.

Kata Kunci : Evaluasi fogging,Program demam berdarah dengue,evaluation, fogging, dengue hemorrhagic fever