Evaluasi program pemberian kapsul yodium di Kabupaten Magelang Propinsi Jawa Tengah
TITAHELUW, Mouna Emeliana, dr. Kristiani, SU
2003 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: Di Kabupaten Magelang, berdasarkan hasil penelitian yang dilakukan pada tahun 1974, masih dijumpai daerahdaerah yang mengalami Gangguan Akibat Kekurangan Yodium berat,sedang maupun ringan. Di wilayah Kecamatan Srumbung masih ditemukan kretin sebanyak 4 % (Puskesmas Srumbung, 1994). Untuk itu perlu penanganan dalam upaya penanggulangannya terutama program jangka pendek melalui, pemberian kapsul yodium. Penelitian ini bertujuan untuk mengevaluasi program pemberian kapsul yodium di Kabupaten Magelang khususnya pada 3 Kecamatan yang endemik berat dan sedang guna mengetahui permasalahan dalam input dan proses dalam pelaksanaan program pemberian kapsul yodium. Metode Penelitian: Penelitian ini merupakan penelitian non eksperimental dengan rancangan cross sectional, bersifat evaluatif. Lokasi penelitian meliputi 3 Kecamatan yaitu Kecamatan Srumbung, Candimulya dan Salaman, yang dipilih secara purposive berdasarkan kriteria endemik berat dan sedang yang menerima kapsul yodium. Subjek pada penelitian ini adalah terdiri dari petugas gizi puskesmas, guru dan kader serta sasaran penerima kapsul yodium yaitu Wanita Usia Subur (WUS),ibu hamil,ibu menyusui dan anak sekolah dasar yang berjumlah 770 responden. Wawancara mendalam dilakukan terhadap petugas gizi puskesmas, guru UKS dan kader. DKT dilakukan pada kader yang terdiri dari empat kelompok. Hasil: Input : dari 4 puskesmas, hanya 2 puskesmas yang memiliki tenaga gizi dengan latar belakang pendidikan D3 gizi, selain itu sarana penunjang belum dimiliki oleh semua petugas gizi dan dana untuk menunjang kegiatan distribusi sangat kecil yakni tranport petugas gizi per puskesmas Rp. 10.000,- demikian juga transport kader per desa Rp. 10.000,- dari keempat petugas gizi, belum semua petugas memiliki buku pedoman. Pada proses, jumlah kapsul yang diterima tidak berdasarkan perencanaan kabupaten/puskesmas, karena kapsul didrop langsung dari pusat. Sedangkan pelaksanaan distribusi kapsul kepada masyarakat oleh kader dan anak sekolah oleh guru UKS. Metode pendistribusian melalui jalur posyandu, PKK/Dasawisma, pamong/dusun dan SD/LSM yang direncanakan tidak dapat berjalan. Dari hasil yang diperolah ada perbedaan cakupan antara hasil penelitian dan cakupan puskesmas. Dengan hasil penelitian yang didapatkan disarankan untuk dinas kesehatan lebih meningkatkan sosialisasi baik untuk petugas maupun sasaran guna dapat meningkatkan cakupan dan Pemerintah Daerah dapat mengalokasikan biaya operasional yang lebih rasional.
Background: Concern to Magelang district, based on the survey that was held in 1974, they still found many sub districts that have seriously burden by iodine deficiency problem in low, middle and high level. They could find kretin about 4 % (Puskesmas Srumbung,1994). For that reasons it need a certain action as a prevention effort especially short-them prevention effort like iodine capsule distribution program. The objectives of this research are to evaluate iodine capsule distribution program in Magelang district particularly in three-sub district, which comprise as heavy and middle endemic area, to know input and process problems in the implementation of iodine capsule distribution program. Method: This research is evaluative non-experimental research with cross sectional design. It covers three-sub district that consist of Srumbung, Candi Mulya and Salaman districts. They were chosen by purposive sampling method based on the heavy and endemic criteria that was roofed by iodine capsule distribution program. The research subject are Nutrition Officers in Community Health Center, teacher, Nutritious freelancer and also iodine capsule receiver target such as mature women (WUS), pregnant women, lactation mother and elementary school student which number about 770 respondent. This research also interviewed Nutritious Officer in Community Health Center, teacher, and Nutritious freelancer. FGD was done with Nutritious freelancer as a target who was divided into four groups. Result: From the input segment it was showed that from four Community Health Center, only two of them have Nutritious Officers whose degree Nutrition Third Year Diploma. Additionally, not all of them have an adequate amount of money and tools that will support iodine distribution activities. Nutritious officer transportation fee only about Rp. 10.000,- for one Community Health Center and it also happen to Nutritious freelancer who only get Rp. 10.000 transportation fee for one village. All of them don’t have Nutrition Guidance Book. From the process segment it is showed that the quantity of iodine capsule, which was received, didn’t equal with the district plan. It was happened because of the capsule was delivered by Center directly and it was distributed by Nutritious freelancer for community target and teacher for elementary school student target. They also used Posyandu, PKK/Dasawisma, pamong/dusun and Elemanty School/NGO as distribution link, but it didn’t work. From the research result it is showed that there are the coverage differences between research result and Community Health Center coverage. Based on this research we suggest that District Health Office should improve their socialization for the officer and target to increase the coverage. District Government must allocate an adequate amount of operational cost.
Kata Kunci : Layanan Kesehatan Masyarakat,Kapsul Yodium
