EVALUASI PROGRAM PENCEGAHAN DAN PENANGGULANGAN FAKTOR RISIKO MALARIA DAN PENINGKATAN SDM DALAM UPAYA ELIMINASI MALARIA DI KABUPATEN KULON PROGO TAHUN 2016

HUSNI, Prof. dr. Supargiyono, DTM & H.,SU., PhD., Sp.ParK;drg. Th. Baning Rahayujati, M.Kes

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latarbelakang: Kabupaten Kulon Progo telah melaksanakan berbagai kegiatan pencegahan dan pengendalian faktor risiko dan peningkatan SDM. Berbagai upaya telah dilakukan namun kasus penularan setempat masih terjadi. Salah satu faktor yang menyebabkan belum efektifnya pelaksanaan program karena belum optimalnya sistem penyelenggaraan program tersebut. Tujuan penelitian ini untuk mengevaluasi program pencegahan dan penanggulangan faktor risiko dan peningkatan SDM menuju eliminasi malaria di Kabupaten Kulon Progo tahun 2016 berdasarkan pendekatan sistem. Metode: Jenis penelitian ini adalah Evaluasi Program dengan menggunakan metode Mixed Methods (Sequential Explanatory Design). Pengumpulan data dilakukan di 7 puskesmas fokus aktif malaria dan dinas kesehatan kabupaten. Responden adalah petugas pengelola program dan kepala puskesmas, pengelola program kabupaten, kepala seksi pengendalian dan pemberantasan penyakit menular, dan kepala dinas kesehatan kabupaten. Instrumen yang digunakan adalah kuesioner terstruktur dan pedoman wawancara mendalam. Analisis data kuantitatif secara deskriptif dan data kualitatif menggunakan model Miles dan Huberman. Hasil: Pencegahan dan penanggulangan faktor risiko dari aspek masukan, hanya pengelola program yang memenuhi standar ketenagaan, alokasi dana hanya untuk kegiatan IRS dari BOK kabupaten, ketersediaan sarana cukup dan kondisi baik. Perencanaan jenis pengendalian vektor tidak berdasarkan data entomologi. Pelaksananaan distribusi kelambu berinsektisida dan IRS telah memenuhi ketentuan. Cakupan distribusi kelambu dan cakupan IRS memenuhi target. Kegiatan peningkatan SDM dari aspek masukan, petugas yang memenuhi standar adalah mikroskopis, pengelola program, dan dokter sedangkan perawat dan bidan tidak memenuhi standar. Hanya kegiatan re-orientasi program menuju tahap eliminasi yang masuk dalam pendanaan kabupaten. Semua kegiatan peningkatan SDM telah terlaksana. Cakupan petugas kesehatan yang mengikuti kegiatan re-orientasi program menuju tahap eliminasi dan pelatihan tata laksana termasuk rendah. Kesimpulan: Semua kegiatan pencegahan dan penanggulangan faktor risiko terlaksana tapi tidak berdasar pada data entomologi dan semua peningkatan SDM terlaksana. Dinas kesehatan kabupaten sebaiknya merekrut tenaga entomolog untuk mendukung kegiatan pengendalian vektor.

Background: Kulon Progo District has implemented various activities of prevention and control for malaria risk factors and improvement of human resources. Various efforts have been made but indigenous cases still occur. One of the factors causing the effectiveness of the program implementation because the program has not been optimally implemented.This research to evaluate program of prevention and control for malaria risk factors and improvement of human resources to eliminate malaria in Kulon Progo District in 2016 based on system approach. Methods: This research was Evaluation Program used Mixed Methods (Sequential Explanatory Design). Data collected from 7 public health center of active focus malaria and district health office. Respondents were program managers and head of public health center, district program managers, head of control and eradication of communicable diseases, and head of district health offices. The instruments used structured questionnaires and in-depth interview guides. Quantitative data analysis was descriptive and qualitative data used Miles and Huberman model. Results: Prevention and control of risk factors program from the input aspect, only program managers who meet labor standards, the allocation of funds is only for IRS activities from BOK districts, the availability of adequate facilities and good conditions. Vector control planning was not based on entomological data. The implementation of distribution of LLINs and IRS has fulfilled the requirements. The coverage of LLINs and IRS coverage meets the targets. Improvement of Human Resouces (HR) program from input aspect, officers who meet the standards are microscopic, program managers, and doctors while nurses and midwives were not meet the standards. Only re-orientation activities of the program towards the elimination phase are included in district funding. All improvement of HR activities have been implemented. Coverage of health workers who follow the re-orientation activities of the program towards the elimination stage and training of the management was low. Conclusions: Prevention and control program for malaria risk factors has implemented but was not based on entomological data and all HR improvements has implemented. District health offices should recruit entomologist to support vector control activities.

Kata Kunci : eliminasi malaria, evaluasi program, pengendalian vektor, peningkatan SDM