EVALUASI PROGRAM PEMBERIAN TABLET TAMBAH DARAH (TTD) PADA REMAJA PUTRI DI WILAYAH KERJA PUSKESMAS RUMBIA KABUPATEN BOMBANA

HURFIATI, Dr. rer. nat. dr. BJ Istiti Kandarina.; Dr. Siti Helmyati, DCN., M.Kes.

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Anemia remaja putri di Indonesia masih cukup tinggi. Data Riskesdas 2013 menunjukkan bahwa prevalensi anemia remaja putri 22,7% sedangkan prevalensi anemia perempuan usia >=15 tahun di Sulawesi tenggara sebesar 38%. Program pemberian Tablet Tambah Darah (TTD) pada remaja putri di Kabupaten Bombana baru berjalan dua tahun. Progam ini dianggap penting karena periode remaja merupakan periode yang menentukan seribu hari pertama kehidupan dan generasi berikutnya. Program suplementasi besi tidak selalu dapat berjalan dengan baik, selain penyebab langsung yang menyebabkan masalah anamia terdapat faktor lain terkait yaitu suplai, distribusi TTD, dan karakteristik konsumen, yang akan menentukan cakupan dan kepatuhan konsumsi TTD, sehingga akan berdampak terhadap penurunan anemia. Tujuan: Mengevaluasi program pemberian TTD pada siswi remaja putri di wilayah kerja Puskesmas Rumbia Kabupaten Bombana. Metode: Penelitian ini merupakan penelitian deskriptif analitik dengan rancangan mix method kualitatif dan kuantitatif. Penelitian kualitatif dilakukan pada perencana program pemberian TTD di Dinas Kesehatan dan pelaksana program pemberian TTD di Puskesmas Rumbia serta guru Usaha Kesehatan Sekolah (UKS). Sedangkan penelitian kuantitatif dilakukan pada remaja putri SMP dan SMA dengan melihat kepatuhan konsumsi TTD dan status anemia. Analisis kualitatif adalah content analysis sedangkan analisis data kuantitatif dengan distribusi frekuensi. Hasil: Indikator input meliputi dana, tenaga, sarana belum mencukupi kebutuhan program sedangkan ketersediaan TTD sudah mencukupi. Indikator proses meliputi perencanaan kebutuhan, distribusi, cara pemberian, pencatatan, pelaporan dan pemantauan program pemberian TTD belum sesuai dengan petunjuk teknis program pemberian TTD yang dirancang oleh Kementerian Kesehatan. Begitupun dengan sosialisasi yang dilakukan oleh petugas kesehatan masih sangat minim. Sedangkan cara penyimpanan TTD sudah sesuai dengan standar penyimpanan obat. Indikator output meliputi cakupan TTD tahun 2017 cukup tinggi yaitu 98,8%, namun kepatuhan remaja putri dalam mengkonsumsi TTD masih rendah yaitu 20%. Dampak ditemukan 12% remaja putri mengalami anemia dan 18% remaja putri anemia mikrositik hipokromik . Kesimpulan: Tidak semua indikator input, proses sesuai dengan kebutuhan program dan petunjuk teknis yang dirancang oleh Kementerian Kesehatan. Indikator output belum mencapai target yang harapkan. Dan dari segi dampak prevalensi anemia masih menjadi masalah kesehatan masyarakat.

Background: The anemia of female adolescents in Indonesia is still quite high. Riskesdas 2013 data showed that the prevalence of anemia in adolescent girls was 22.7% while the prevalence of anemia in women aged <=15 years in Southeast Sulawesi was 38%. The program of iron and folic acid supplementation tablet distribution on female adolescents in Bombana had been run for the past two years. The program was considered as crucial as adolescence was a period that determined the first 1,000 days of life and future generation. The program of iron and folic acid supplementation tablet distribution did not always run smoothly, directly caused by anemia causes and other relevant factors as supply, distributions of iron and folic acid tablet supplementation, and consumer characters that would determine the range and compliance with the consumption of iron and folic acid supplementation, hence decreasing anemia occurrences. Objectives: This research aimed to evaluate the program of iron and folic acid supplementation distribution to female adolescent students in the working area of Puskesmas Rumbia Bombana. Methods: The research was descriptive-analytical research applying the mixedmethods of qualitative and quantitative designs. The qualitative research was conducted to those planning the program of iron and folic acid supplementation distribution in Puskesmas Rumbia and teachers of school medical room.Moreover, the quantitative research was done to both junior and senior high female adolescents by investigating their compliance with the consumption of iron and folic acid supplementation and anemia status. Qualitative data analysis was performed by applying a content analysis; while quantitative analysis was conducted by observing the frequency distribution. Result: In the input indicators, it was figured out that fund, human resources, and facilitations were insufficient; while availability of iron and folic acid supplementation tablets was. In the process stage, designing the needs, distribution, distribution methods, recording, reporting, and monitoring of iron and folic acid supplementation tablet distribution program were not in accordance with technical instructions designed by the Ministry of Health. Furthermore, the socialization done was still minimum. Storage methods of iron and folic acid supplementation tablets had referred to the standards of drug storage. Output indicators covering coverage in 2017 was quite high at 98.8%, but the adherence of supplementation consumption was still low at 20%. A total of 12% of female adolescent had anemia and 18% of adolescent girls had hypochromic microcytic anemia. Conclusion: Not all input a nd process indicators meet the program requirements and technical guidelines designed by the Ministry of Health. Output indicators have not reached the expected target. And in terms of impact, the prevalence of anemia remains a public health problem.

Kata Kunci : Evaluasi program, Tablet Tambah Darah (TTD), Remaja Putri, Program Evaluation, Iron and Folic Acid Supplementation, Female Adolescent