PEMBERDAYAAN MASYARAKAT MELALUI MODEL JUMANTIK MANDIRI DENGAN APLIKASI OVITRAP SEBAGAI UPAYA PENGENDALIAN PENYAKIT DEMAM BERDARAH DENGUE (DBD) DI SLEMAN YOGYAKARTA

TRI WAHYUNI SUKESI, dr. Tri Baskoro Tunggul Satotot, M.Sc., Ph.D.; dr. E.Elsa Herdiana Murhandarwati, M.Kes., Ph.D.; Dr. Dra. Retna Siwi Padmawati, MA.

2021 | Disertasi | DOKTOR ILMU KEDOKTERAN DAN KESEHATAN

Latar belakang: Kejadian kasus DBD selalu tinggi khususnya di Kabupaten Sleman. Pelaksanaan program pengendalian DBD belum optimal salah satunya karena peran masyarakat dalam pengendalian DBD masih rendah. Tujuan penelitian untuk menganalisis efektivitas pemberdayaan masyarakat dalam upaya pengendalian DBD melalui kader jumantik rumah mandiri (KJRM) dengan aplikasi ovitrap. Metode:Metode penelitian yang digunakan adalah participatory action research (PAR). Instrumen penelitian yang digunakan adalah kuesioner, panduan wawancara dan check list. Besar sampel untuk data kuantitatif 267 KK di Dusun Patukan (intervensi) dan 219 KK di Dusun Sorogenen 2 (kontrol). Kedua dusun merupakan daerah endemis DBD di Kabupaten Sleman Yogyakarta. Intervensi yang diberikan adalah kader jumantik rumah mandiri (KJRM) dengan aplikasi ovitrap. Data kualitatif digunakan untuk melengkapi data kuantitatif. Subyek penelitian adalah kepala dusun, kader jumantik yang bertugas di dusun dan petugas kesehatan lingkungan puskesmas. Data kuantitatif dianalisis dengan Mann Whitney dan Wilcoxon. Data kualitatif dianalisis berdasarkan isi hasil wawancara. Hasil:Tahapan 1 adalah need assessment menunjukkan bahwa kondisi masyarakat antara daerah intervensi dan kontrol hampir sama, rerata nilai persepsi DBD, persepsi pengendalian DBD, pengetahuan, sikap, perilaku tidak memiliki perbedaan signifikan (p value > 0.05). Rerata nilai modal sosial, kinerja jumantik dan rumah sehat memiliki perbedaan signifikan (p value < 0.05), nilai rerata di daerah kontrol lebih tinggi dibandingkan daerah intervensi. Nilai indeks entomologi HI, CI dan BI di kedua daerah masuk dalam density figure/DF 2 berarti kepadatan populasi nyamuk sedang. Hasil wawancara mendalam menunjukkan bahwa kedua dusun belum memiliki kebijakan pengendalian DBD di tingkat dusun. Tahap kedua adalah intervensi dengan membentuk KJRM yang mengaplikasikan ovitrap dengan didahului dengan rangkaian pelatihan yang wajib diikuti oleh calon KJRM. Tahap ketiga dilakukan untuk mengukur efektivitas pelaksanaan intervensi setelah tiga bulan menunjukkan tingkat kepatuhan menjalankan program 66.91%, tingkat ketepatan menjalankan program 78.65%. Berdasarkan hasil wawancara kepada informan kunci menyatakan bahwa telah terdapat kebijakan pendukung pengendalian DBD yang diterapkan di daerah intervensi. Efektivitas intervensi setelah enam bulan menunjukkan terdapat perbedaan signifikan rerata nilai semua variabel (p value < 0.05) kecuali modal sosial (p value > 0.05). Terjadi penurunan nilai HI, CI dan BI di daerah intervensi menjadi DF 1 yang berarti populasi nyamuk rendah. Penurunan nilai CI berbanding terbalik dengan ovitrap index yang berarti lebih banyak telur nyamuk yang terperangkap dalam ovitrap. Kesimpulan:pemberdayaan masyarakat dengan metode KJRM dengan aplikasi ovitrap efektif dilakukan untuk membantu upaya pengendalian DBD.

Background: The incidence of DHF cases is always high, especially in Sleman Regency.The implementation of the DHF control program has not been optimal, one of which is because the role of the community in controlling DHF is still low. The research objective was to analyze the effectiveness of community empowerment in controlling dengue fever through the independent house Jumantik cadres with the application of Ovitrap. Methods: The research method used is participatory action research (PAR). The research instruments used were questionnaires, interview guides and check lists. The sample size for quantitative data is 267 households in Patukan Hamlet (intervention) and 219 households in Sorogenen 2 Hamlet (control). Both hamlets are DHF endemic area in Sleman Regency, Yogyakarta. The intervention carried out was an independent home jumantik cadre with the ovitrap application. The research subjects for qualitative data were the head of the hamlet, jumantik cadres who served in the hamlet and environmental health officers. Quantitative data were analyzed by Mann Whitney and Wilcoxon. Qualitative data analyzed based on content (content analysis). Results: The first stage is a need assessment following the precede�¢ï¿½ï¿½s flow showed that the conditions of the community in both intervention and control areas were almost the same, like the mean values of DHF perception, their perceptions of DHF control, their knowledge, attitudes, and behavior had no significant differences (p value > 0.05). The mean values of social capital, the performance of jumantik cadres and healthy houses had significant differences (p value <0.05). The mean value in the control area was higher than the intervention area. The entomological index values of HI, CI and BI in both areas were in the density figure/DF 2, meaning that the mosquito population density was moderate. The results of in-depth interviews showed that the two hamlets did not yet have a DHF control policy at the hamlet level. The second stage is intervention by forming independent home jumantik cadres (KJRM) who apply ovitrap preceded by a series of training that must be followed by KJRM candidates. The third stage is carried out to measure the effectiveness of the intervention after three months showed that the level of compliance in running the program was 66.91%, the level of accuracy in running the program was 78.65%. Based on the results of interviews with key informants, it was stated that there were policies supporting DHF control implemented in the intervention areas. After six months, the effectiveness of the intervention showed that there was a significant difference in the mean value of all variables (p value <0.05) except for the social capital (p value> 0.05). There was a decrease in HI, CI and BI values in the intervention area to DF 1, which means that the mosquito population is low. The decrease in CI value was inversely related to the ovitrap index, which means that more mosquito eggs are trapped in the ovitrap. Conclusion: The intervention of independent house jumantik cadres with the application of ovitrap is an effective effort in controlling DHF.

Kata Kunci : DBD, pemberdayaan, kader jumantik, rumah, ovitrap