Peran Pemerintah Daerah dalam Penguatan Sistem Posyandu (Studi Kasus di Kabupaten Ngawi)

ADAM UMBARA, Dr. dr. Mubasysyir Hasanbasri, M.A

2020 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Penguatan health system merupakan peningkatan dari semua system building block dan pengelolaan interaksi dari semua hal tersebut guna mencapai peningkatan keadilan dan keberlanjutan diseluruh pelayanan kesehatan dan outcomes dari Kesehatan. Posyandu adalah salah satu layanan kesehatan yang dekat untuk diakses masyarakat guna mendapatkan informasi terkait kesehatan. Setiap tahun, jumlah dan strata posyandu mengalami peningkatan. Jumlah Posyandu Kabupaten Ngawi per tahun 2017, 2018, dan 2019 adalah 1.202 posyandu dengan 967 aktif, 1208 posyandu dengan 973 aktif, dan 1214 posyandu dengan 1044 aktif. Faktor keberhasilan dari peningkatan jumlah dan strata posyandu di Kabupaten Ngawi melibatkan berbagai stakeholder. Stakeholder tersebut terdiri dari perangkat daerah, pemerintah desa, Puskesmas, bidan desa, dan Tim Penggerak PKK. Beberapa hal tersebut yang melatarbelakangi penulis ingin mengetahui peran pemerintah daerah dalam penguatan sistem posyandu. Tujuan: Penelitian ini bertujuan untuk menganalisis peran pemerintah daerah dalam penguatan sistem posyandu di Kabupaten Ngawi. Metode: Jenis penelitian ini adalah deskriptif dengan metode kualitatif dan rancangan studi kasus. Penelitian ini ingin melihat peran pemerintah daerah dalam penguatan sistem posyandu. Hasil: Peran pemerintah daerah dalam penguatan sistem Posyandu sangat penting. Peran pemerintah daerah dalam penguatan posyandu di Kabupaten Ngawi diwujudkan dalam dukungan leadership/governance, financing, dan workforce. Leadership/governance dalam penguatan posyandu diwujudkan dengan dukungan regulasi, dan tata kelola. Dukungan financing dalam penguatan posyandu melalui penganggaran dari APBD, Dana Desa, dan BOK. Kader sebagai front line yang bertugas sebagai ujung tombak pelayanan di posyandu. Workforce diwujudkan dengan adanya pelatihan dan pembinaan kader posyandu oleh pemerintah daerah melalui kegiatan refreshing kader. Peran administratif pemerintah daerah diwujudkan dengan terbentuknya pokjanal posyandu, regulasi, kolaborasi lintas sektoral dan insentif untuk kader. Continuous learning dilakukan secara berkala agar kemampuan dan keterampilan kader posyandu selalu diperbarui. Job description kader posyandu tidak hanya di Posyandu, tetapi juga kunjungan rumah, kader PPKBD, dan kader KPM. Penguatan manajerial posyandu dapat dilakukan dengan membentuk manajer program posyandu. Kesimpulan: Peran leadership/governance dalam penguatan sistem posyandu sudah optimal. Peran financing pemerintah daerah dalam penguatan sistem posyandu sudah optimal, honor insentif kader, PMT Balita, pengadaan sarana prasarana sudah baik. Peran workforce pemerintah daerah dalam penguatan sistem posyandu perlu ditingkatkan pada aspek pelatihan kader posyandu agar kemampuan dan pengetahuan kader tetap optimal. Kata Kunci: Pemerintah Daerah, Sistem Kesehatan, Posyandu, Pemberdayaan Masyarakat, Kader Posyandu

Background: Strengthening the health system is an improvement of all system building blocks and managing interaction of all of these things in order to achieve an increase in fairness and sustainability in all health services and health outcomes. Posyandu is one of the close health services for the public to access to get information related to health. Every year, the number and strata of posyandu have increased. The number of Posyandu for Ngawi District in 2017, 2018 and 2019 is 1,202 posyandu with 967 active, 1208 posyandu with 973 active, and 1214 posyandu with 1044 active. The success factor of increasing the number and strata of posyandu in Ngawi District involved various stakeholders. The stakeholders consist of regional apparatus, village government, Puskesmas, village midwives, and PKK Teams. Some of these are the author's background who want to know the role of local governments in strengthening the posyandu system. Objective: This study aims to analyze the role of local government in strengthening the posyandu system in Ngawi District. Method: This type of research is descriptive with qualitative methods and case studies approaches. This research wants to see the role of local governments in strengthening the Posyandu system. Results: The role of local government in strengthening the Posyandu system is very important. The role of local governments in strengthening posyandu in Ngawi Regency is manifested in leadership/governance support, financing, and workforce. Leadership/governance in strengthening posyandu is realized with the support of regulations and governance. Financing support in strengthening posyandu through budgeting from the APBD, Village Fund, and BOK. Cadres as the front line who serve as the spearhead of posyandu services. Workforce is realized through the training and coaching of posyandu cadres by the local government through cadre refreshing activities. The administrative role of local governments is realized by the formation of pokjanal posyandu, regulations, cross-sectoral collaboration and incentives for cadres. Continuous learning is carried out regularly so that the posyandu cadres' abilities and skills are always updated. Job description posyandu cadres not only at Posyandu, but also home visits, PPKBD cadres, and KPM cadres. Posyandu managerial strengthening can be done by establishing a posyandu program manager. Conclusion: The role of leadership / governance in strengthening the posyandu system is optimal. The role of local government financing in strengthening the posyandu system has been optimal, the incentive fees for cadres, PMT for toddlers, and provision of infrastructure are good. The role of the local government workforce in strengthening the posyandu system needs to be improved in the aspect of posyandu cadre training so that the skills and knowledge of cadres remain optimal. Keywords: Local Government, Health Systems, Health Integrated Post (Posyandu), Community Empowerment, Cadres

Kata Kunci : Pemerintah Daerah, Sistem Kesehatan, Posyandu, Pemberdayaan Masyarakat, Kader Posyandu