Implementasi pemberdayaan masyarakat bidang kesehatan di Puskesmas Arso Barat Kabupaten Keerom

SALIM, Agus, dr. Mubasysyir Hasanbasri, MA

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. dan Manaj. Pe

Latar Belakang. Agar keterbatasan sumber daya manusia dan kendala geografi tidak menjadi kendala dalam pelayanan kesehatan pada penduduk yang menyebar luas, maka upaya mendorong kemandirian masyarakat agar mampu menolong dirinya sendiri harus menjadi kebijakan utama Primary Health Care. Upaya untuk memberdayakan masyarakat dengan mendirikan posyandu dan memfasilitasi kemandirian kader bisa bertumbuh atau tidak. Tujuan. Mengetahui implementasi pemberdayaan masyarakat bidang kesehatan dan faktor-faktor yang terkait dengannya. Metode. Cross sectional, rancangan studi kasus, tehnik pengambilan data dengan metode kualitatif. Unit analisis adalah puskesmas dan wilayah kerjanya. Subjek penelitian: penanggungjawab program promosi kesehatan, juru imunisasi, petugas gizi, penanggungjawab program kesehatan ibu dan anak dan puskesmas pembantu. Data primer diperoleh dengan kuesioner, wawancara, telaah dokumen dan observasi. Hasil. Hasil penelitian ini membuktikan bahwa kader telah mandiri dalam membuat perencanan sederhana dan berkemampuan mengembangkan organisasi, berkoordinasi, menanggulangi hambatan dan mampu bekerja sama dalam tim. Mereka telah mandiri dalam mengangkat kader baru dan mengembangkan kemampuannya. Ketua kader telah memiliki jiwa kepemimpinan, mampu berkomunikasi serta mengetahui cara memotivasi anggotanya. Mereka juga sudah terbiasa melakukan pengawasan dan evaluasi sederhana. Terimplemetasikannya pemberdayaan masyarakat di atas terkait dengan pelaksana yang berkapasitas. Namun implementation gap masih dijumpai karena: jadwal posyandu masih ditentukan oleh puskesmas, program makanan tambahan pemulihan sebagian masih dikelola oleh bidan, pemberdayaan kader dukun bayi tidak disesuaikan dengan potensinya, semakin sedikit kader yang termotivasi melakukan penyuluhan. Adanya implementation gap di atas terkait dengan komunikasi yang tidak berjalan dan persediaan dana masih dibawah batas anggaran minimal. Kesimpulan. Meskipun terdapat jurang-jurang dalam implementasinya, namun program pemberdayaan masyarakat di Puskesmas Arso Barat Kabupaten Keerom telah mampu menumbuhkan kemandirian pelaksanaan posyandu melalui penguatan potensi kader dari kontribusi tenaga puskesmas. Penelitian ini menyarankan penguatan pemberdayaan kader yang lebih tepat sesuai dengan potensinya.

Background. In order that the human resource limitations and the geographical problems create no obstacles in the delivery of health services to wide-spread population, efforts to encourage community self-reliance to help themselves should become the main policy of the Primary Health Care. These efforts include the establishment of Integrated Health Service Posts (IHSPs) and facilitating the IHSP cadres. Objectives. To find out the implementation of community empowerment in health and the factors that are related to the empowerment.Methods. It was a qualitative study using the cross-sectional design. The units of analysis were the primary health care and the areas of its operation. The subjects of study consisted of coordinators of health promotion program, immunization personnel, nutritional personnel, coordinators of mother and child health program, and secondary health cares. The primary data were obtained from questionnaires, interviews, document reviews, and observations. Results. The results of study indicated that the cadres had been self-reliant in preparing simple programs and were able to develop their organization, establish coordination, resolve obstacles, and work in team. They had demonstrated self-reliance in recruiting new cadres and developing their capability. The cadre leaders possessed leadership skills, were able to communicate and to find out ways to motivate their members. They had also been familiar with simple supervision and evaluation activities. Such implementation of the community empowerment was related to its implementing agents. However, implementation gaps still existed due to several reasons, including the schedule of IHSP activities were still determined by the primary health care, additional food program was still organized by midwives, empowerment of traditional midwives was not carried out according to their capacity, and the decreasing number of motivated cadres who were willing to provide health information to the public. These implementation gaps were related to the lack of communication and the availability fund which was still below the limit of minimum budget. Conclusion. In spite of the gaps in its implementation, the community empowerment program in the primary health care of West Arso in Keerom district was able to increase self-reliance in the implementation of IHSP activities through the strengthening of cadre capacity by primary health care personnel. This study recommends the strengthening of cadre empowerment in appropriate ways according to their capacity.

Kata Kunci : Layanan Kesehatan,Pemberdayaan Masyarakat,Posyandu,empowerment, implementation gap, personnel capacity, communication