Kinerja posyandu di distrik Arso Kabupaten Keerom Provinsi Papua

TORIKI, Evi, dr. Kristiani, SU

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang. Keberadaan posyandu merupakan wujud peranserta masyarakat dan merupakan upaya kesehatan bersumber daya masyarakat (UKBM) dengan program prioritas keluarga berencana, kesehatan ibu dan anak, gizi, imunisasi dan penaggulangan diare. Jumlah kader aktif di Kabupaten Keerom terdapat sebanyak 354 (80%), akan tetapi tidak diikuti capaian D/S dan N/D yang nampak masih rendah (53,64%) terutama di distrik Arso,capaian D/S justru mengalami penurunan yaitu 66,14% pada tahun 2005, sedangkan tahun 2006 sebesar 58,78%. Status kesehatan masyarakat di Kabupaten Keerom masih memprihatinkan terlihat pada masih tingginya angka kematian ibu (778,8/100000 kelahiran hidup) dan angka kematian bayi (31,8/1000 kelahiran hidup). Tujuan Penelitian. Secara umum penelitian ini bertujuan untuk mengetahui kinerja Posyandu di Distrik Arso Kabupaten Keerom. Metode Penelitian. Penelitian ini merupakan penelitian deskriptif dengan metode kualitatif menggunakan rancangan studi kasus. Unit analisis adalah posyandu dengan subjek penelitian kader posyandu, tokoh masyarakat/tokoh agama, LSM/swasta, dan aparat pemerintah daerah. Kinerja posyandu diukur dengan K/S, D/K, D/S, N/D dan N/S. Pengambilan data dilakukan dengan metode penyabaran kuisioner, wawancara mendalam dan observasi lapangan. Secara keseluruhan informan berjumlah 132 orang. Hasil Penelitian. Kinerja Posyandu di Distrik Arso Kabupaten Keerom belum optimal, yang dapat dilihat pada capaian indikator kinerja posyandu tahun 2008 yaitu D/S = 60,40 %; N/D = 47,95; N/S = 32,38%; D/K = 61,85 dan K/S=97,64%. Capaian ini tidak banyak mengalami perubahan secara signifikan dibanding 3 tahun sebelumnya. Kondisi sarana dan prasarana fisik belum memadai dan kader yang aktif cukup tinggi tapi kualitasnya belum memadai. Peran ibu balita sebagai pengguna posyandu masih rendah, begitupun peran aparat desa, tokoh masyarakat/tokoh agama. Lembaga swadaya masyarakat/swasta cukup berperan aktif dalam mendukung kegiatan posyandu yang diberikan dalam bentuk pelatihan dan pembelajaran kader, rehab tempat pelayanan posyandu, serta pengadaan sarana dan prasana posyandu. Peran puskesmas belum optimal karena lemahnya manajemen SDM dan sarana prasarana juga karena koordinasi lintas sektor yang tidak berjalan baik. Di Kabupaten Keerom belum ada peraturan dan kebijakan lokal tentang posyandu termasuk pokjanal posyandu, baik di tingkat kabupaten maupun distrik. Kebijakan tentang posyandu hanya mengacu pada peraturan dari pemerintah pusat dan provinsi. Dukungan pemerintah daerah pada posyandu masih sebatas pada dukungan dana serta sarana dan prasarana. Kesimpulan. Kinerja posyandu di distrik Arso Kabupaten Keerom belum optimal, karena kurangnya dukungan manajemen SDM, dana dan sarana prasarana yang baik dari puskesmas dan dinas kesehatan, belum adanya dukungan kebijakan lokal dari pemerintah daerah serta masih rendahnya peran serta masyarakat.

Background: the existence of Integrated Service Post, briefly mentioned as Posyandu, is an evidence of community participation. This is one of the efforts which has local community as its human resources (UKBM) and has top priority in family planning, maternal and child health, nutrition, immunization, and diarrhea control program. The numbers of active cadres in district Keerom are 354 or about 80 %, however the coverage of D/S and N/D is still very low (which achieves only 53,64%) especially in sub district Arso. In Arso, the coverage of D/S declines into 66,14% and 58,78% in the year of 2005 and 2006 respectively. Maternal and infant mortality rates, 778,8/100.000 live birth and 31,8/1000 live birth respectively, which are still high show that the community health status of district Keerom is still in low level. Research Objectives: this research was aimed to find out and understand work-performance of Posyandu in Arso, district Keerom. Research Method: this research is a descriptive research using qualitative method with case study approach. The analysis unit is Posyandu and the research subjects are its cadres, public figures, NGO, private sectors, and local government officials. K/S, D/K, D/S, N/D, and N/S are used to measure workperformance of posyandu. Data was collected by questioners, in-depth interviews, and observation. The numbers of the informants were 130 persons. The result: work-performance of posyandu in Arso was still poor. The achievement of its work-performance indicators in the year of 2008 was showed by D/S, N/D, N/S, D/K, K/S which have value 60,40%; 47,95%; 32,38%; 61,85%; 97,64 respectively. There were no significant changes on these values compared the value achieved 3 years before. The fact showed that the amount of active cadres was high but its quality was still poor. The maternal participation was still very low. The lack of participations was emerged from local government (village level) and public figures. The role of Community Health Center (Puskesmas) was still limited. Puskesmas did not actively assist the cadres or support the budget. Contrarily, the role of NGO or private sectors was much better in supporting posyandu. They conducted training for cadres and support the facilities of posyandu. The policy about posyandu was just referred to central or province government. The role of local government (district level) was still limited which were only in supporting budget and tools provision. There is no rules and policy about posyandu in district level also showed the lack of local government role. Conclusion: work-performance of posyandu in Arso, district Keerom, was still poor due to the lack of human resource management, technical and financial support from both of Puskesmas and district health office, and policy about posyandu made by district government. Besides, community participation (including cadres, village level government, and public figures) is still low.

Kata Kunci : Kinerja posyandu,Manajemen puskesmas,Kebijakan pemerintah daerah,Peran serta masyarakat, Work-performance of Posyandu, Community Participation, The Role of Puskesmas, Policy of Local Government.