Evaluasi Layanan Konseling Upaya Berhenti Merokok (UBM) di Puskesmas Kraton Kota Yogyakarta

Dwi Okta Pangestika, Dr. Dra. Retna Siwi Padmawati, MA; dr. Bagas Suryo Bintoro, Ph.D

2024 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Indonesia merupakan negara ketiga dengan jumlah perokok usia
?15 tahun tertinggi di dunia pada tahun 2019 sebesar 51,5 juta dan negara di
ASEAN dengan prevalensi penduduk yang merokok dewasa dan remaja tertinggi
dibandingkan dengan negara lain di ASEAN yaitu sebesar 28,9?n 19,2%.
Proporsi merokok pada penduduk umur ? 15 tahun pada tahun 2018-2021
mengalami peningkatan yaitu sebesar 28,9% menjadi 33,5%. Asap rokok dapat
mengakibatkan berbagai permasalahan bagi kesehatan. Salah satu strategi
menurunkan prevalensi perokok melalui perluasan layanan konseling upaya
berhenti merokok (UBM). Puskesmas Kraton merupakan puskesmas yang telah
menjalankan layanan konseling UBM dan satu-satunya puskesmas yang ada
wilayah Dinas Kesehatan Kota Yogyakarta yang melaporkan rekapitulasi pasien
layanan konseling UBM.
Tujuan: mengeksplorasi input, process, output, dan outcome layanan konseling
upaya berhenti merokok (UBM) di Puskesmas Kraton Kota Yogyakarta.
Metode: Penelitian kualitatif dengan rancangan studi kasus. Teknik pengambilan
sampling teknik purposive sampling dengan criterion sampling. Kriteria informan
dalam penelitian adalah informan yang mengetahui pelaksanaan, terlibat, dan
menggunakan layanan konseling UBM. Jumlah informan sebanyak 20 orang terdiri
dari penanggung jawab UBM puskesmas, konselor, kepala puskesmas, penanggung
jawab promosi kesehatan puskesmas 2 orang, petugas pendaftaran, bidan,
penanggung jawab UBM dinas kesehatan, kasi promosi kesehatan dinas kesehatan,
kecamatan, kelurahan, dan kader kesehatan. Cara pengumpulan data menggunakan
wawancara mendalam, observasi, dan dokumentasi (telaah dokumen). Keabsahan
data yang dilakukan adalah triangulasi sumber data, triangulasi metode, member
checking, dan peer debriefing.
Hasil: Aspek input yang tersedia yaitu terdapat tenaga kesehatan terlatih, sarana
dan prasarana, anggaran. Aspek process yang belum terlaksana yaitu promosi
belum dilakukan kepada semua masyarakat, langkah Tindak Lanjut belum
dilakukan secara konsisten, skrining merokok dan rujukan ke konseling UBM
belum dilakukan oleh semua tenaga kesehatan. Aspek output pasien konseling 2
belum menunjukkan perubahan perilaku kurangnya kesadaran masyarakat bahaya
merokok. Aspek outcome hambatan dalam pelaksanaan layanan konseling UBM
adalah layanan konseling UBM bukan masalah atau layanan prioritas.
Kesimpulan: Pelaksanaan layanan konseling UBM di Puskesmas Kraton sudah
berjalan dan belum sesuai dengan petunjuk teknis layanan konseling UBM di
Indonesia sehingga diperlukan peningkatan pelaksanaan layanan konseling UBM
di Puskesmas Kraton.

Background: In 2019, Indonesia was the third country in the world with the highest
number of smokers aged ?15 years, totaling 51.5 million. It also had the highest
prevalence of adult and teenage smokers in ASEAN countries, at 28.9% and 19.2%,
respectively. The proportion of smokers aged ?15 years increased from 28.9% to
33.5?tween 2018 and 2021. Cigarette smoke can cause various health problems.
One strategy to reduce the prevalence of smokers is by expanding smoking
cessation effort (SCE) counseling service. Kraton primary health center is a primary
health center that has implemented SCE counseling service and is the only health
center in the Yogyakarta City Health Department area reporting a summary of SCE
counseling patients.
Objective: To explore the input, process, output, and outcome of smoking cessation
effort (SCE) counseling service at Kraton Primary Health Center, Yogyakarta City.
Method: This qualitative research employs a case study design. The sampling
technique used is purposive sampling with criterion sampling. The criteria for
informants in this research are those who are knowledgeable about the
implementation, involved in, and users of the SCE counseling service. The
informants include 20 individuals consisting of the SCE program coordinator at the
health center, counselor, the head of the health center, two health promotion
coordinators, registration officer, midwive, the SCE coordinator from the health
department, health promotion section head of the health department, district and
village officials, and health cadres. Data were collected through in-depth
interviews, observations, and documentation (document review). Data validity was
ensured through data source triangulation, method triangulation, member checking,
and peer debriefing.
Results: The input aspects are available trained healthcare workers, facilities and
infrastructure, and budget. The process aspects that have not been implemented are
promotions that have not been conducted for the entire community, the steps of
Follow-up have not been carried out consistently, and not all healthcare workers
conduct smoking screenings and referrals to counseling. The output aspect is that
patients counseling 2 have not shown behavioral changes due to the lack awareness
about the dangers of smoking. The outcome aspect is that the obstacle in
implementing SCE counseling services is that SCE counseling is not considered a
priority issue or service.
Conclusion: The implementation of SCE counseling services at Puskesmas Kraton
has been carried out but does not yet comply with the technical guidelines for UBM
counseling services in Indonesia, necessitating improvements in the
implementation of SCE counseling services at Puskesmas Kraton.

Kata Kunci : Kata kunci: Evaluasi, Layanan Konseling, Upaya Berhenti Merokok, Puskesmas, Logic model