Distribusi dan penggunaan kelambu berinsektisida di Kota Tidore Kepulauan Provinsi Maluku Utara

MASSE, Ambo, Dra. Retna Siwi Padmawati, MA

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Penggunaan kelambu berinsektisida atau kelambu poles, telah direkomendasikan oleh WHO sejak November 2004. Insektisida yang digunakan pada kelambu aman bagi manusia dan telah digunakan oleh banyak negara. Di Indonesia, insektisida dari kelompok piretroid yang dianjurkan dalam program pengendalian malaria adalah permethrin, deltamethrin, dan lambdacyhalothrin. Insektisida yang digunakan pada kelambu yang didistribusikan ke masyarakat Kota Tidore Kepulauan oleh Global Fund dan Dinas Kesehatan adalah Deltametrin dan permethrin. Penggunaan kelambu berinsektisida akan melindungi ibu hamil dari gigitan nyamuk sehingga mengurangi anemia dan kematian ibu, mengurangi BBLR, menurunkan kematian bayi baru lahir, meningkatkan pertumbuhan dan perkembangan selama kehamilan. Sedangkan perbedaan yang spesifik antara kelambu biasa dan kelambu berinsektisida adalah ketahanannya. Tujuan Penelitian: Mempelajari respon dinas kesehatan/puskesmas dan masyarakat penerima kelambu tentang distribusi dan penggunaan kelambu berinsektisida sebagai suatu upaya pencegahan dan pengendalian penyakit malaria di Kota Tidore Kepulauan. Metode Penelitian: Penelitian ini merupakan penelitian deskriptif kualitatif dengan menggunakan rancangan studi kasus. Data primer dikumpulkan melalui wawancara mendalam yang dibantu dengan pedoman wawancara. Informan terdiri dari Kabid PP-PL Dinkes Tikep, Kasi PP Dinkes Tikep, Pengelola Program Malaria Dinkes Tikep, pengelola program Dinkes Provinsi Malut, Pengelola Program malaria Puskesmas Galala, Kepala Puskesmas Galala, Kepala Desa, kader malaria dan masyarakat penerima kelambu serta Project Officer IPM – 5 Global Fund Provinsi Maluku Utara. Hasil Penelitian : Respon dinas kesehatan dan puskesmas hanya sebatas menyiapkan dana sharing untuk pendistribusian, namun pelaksanaan program pendistribusian kelambu berinsektisida masih bersifat mobilisasi sosial (top down intervention). Pada umumnya masyarakat sudah mengerti tentang cara penggunaan kelambu, karena sebagian besar masyarakat sudah menggunakan kelambu biasa/non insektisida. Pelibatan unsur lain belum sepenuhnya berjalan karena pola pendistribusian yang tidak mengikuti kriteria yang sudah ditetapkan oleh GF dan Depkes, akibatnya masih ada masyarakat yang sudah menerima kelambu namun belum menggunakan. Kesimpulan : Program pengendalian malaria diharapkan menggunakan pola bottom up intervention, karena seiring dengan bertambahnya waktu, akan disadari sehingga pola yang dijalankan menjadi lebih baik.

Background: The use of insecticide net has been recommended by WHO since November 2004. Insecticide applied on the net are safe for human and have been used in many countries. In Indonesia, insecticide from piretroid group that have been approved for malaria control programme are permenthrin, deltamethrin, and lambdacyhalothrin. Insecticided nets distributed for people in Tidore Kepulauan were deltamethrin and permethrin. The benefit of using treated net are for protection against mosquito bite for pregnant mother, to reduce the risk of anemia and fatality for mother having low weight on labour, reduce newborn fatality, and to increase their growth and development during pregnancy period. The durability is the specific difference between an ordinary and treated net. Objective: To study the response of Distric Health Officials or community health center staff, and of people who received the treated net on the distribution and uses of the net as a malaria precaution and control efforts in the City of Tidore Kepulauan. Method: This was a descriptive qualitative research using case study design. Primary data were collected through in-depth interviews using interview guide. Informants were Tidore Kepulauan Health Office head of PP-PL Department, head of PP section, and malaria programme manager, North Maluku Health Office programme manager, Galala’s head of Community Health Center and malaria programme manager, heads of village, malaria cadres and people who received the treated net and also IPM-5 Global Fund Project Officer for North Maluku. Result: Health office and community health center’s responses were limited only to preparation of sharing fund for distribution, although the implementation of treated net distribution programme was merely social mobilization in nature. In general, people understand how to use the treated net, because they have use regular or non insecticide net before received the free treated net from government. The involvement of other sectors have not been fully running due to its distribution pattern which did not follow the criterias set by Global Fund and Department of Health. As a result, there were people who already received the net but have not used them. Conclusion: The malaria control programme is expected to use a bottom up intervention pattern, and hopefully in time will be more aware and much better in application.

Kata Kunci : Malaria,Kelambu,Insektisida,Global fund,Distribusi,malaria, net, insecticide, Global Fund, distribution