EVALUASI IMPLEMENTASI PROGRAM IMUNISASI CAMPAK RUBELLA DI KABUPATEN BOYOLALI TAHUN 2024

Fadhlun, Pembimbing 1: Prof. dr. Mei Neni Sitaresmi, Ph.D, Sp.A (K), Pembimbing 2 : dr. Riris Andono Ahmad, MPH., PhD

2025 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang:
Imunisasi Campak Rubella merupakan salah satu upaya kesehatan masyarakat yang terbukti efektif dalam mencegah penyebaran penyakit menular. Di Kabupaten Boyolali, cakupan imunisasi Campak Rubella dosis pertama konsisten mencapai target selama lima tahun terakhir. Namun, cakupan imunisasi lanjutan belum memenuhi target. Penelitian ini bertujuan untuk mengevaluasi implementasi program imunisasi Campak Rubella di Kabupaten Boyolali tahun 2024.

Metode:
Penelitian ini menggunakan metode mix method, dengan desain evaluatif pada sub-studi program dan surveilans, serta cross-sectional pada sub-studi analitik. Evaluasi program menggunakan kerangka EPI Framework, surveilans berdasarkan kerangka WHO, dan analitik menggunakan Health Belief Model. Subjek evaluasi terdiri dari 27 pengelola program dan data, sedangkan sub-studi analitik melibatkan 320 orang tua anak usia 19–24 bulan. Pengumpulan data dilakukan melalui wawancara, kuesioner, dan observasi, dengan analisis kuantitatif (univariat, bivariat, multivariat) dan kualitatif (kuesioner variant).

Hasil:
Penelitian menunjukkan bahwa masih ditemukan kendala program, seperti kekosongan vaksin, kurangnya sosialisasi langsung kepada masyarakat, beban kerja ganda petugas, belum maksimalnya sweeping sasaran, dan pelaporan kejaidan ikutan pasca imunisasi (KIPI) yang belum optimal. Perbedaan data antara sistem pelaporan aplikasi sehat indonesiaku (ASIK) dan pemantauan wilayah setempat (PWS) disebabkan keterlambatan input, kendala teknis aplikasi, dan belum aktifnya pemanfaatan link pengaduan kendala ASIK. Hasil analisis faktor kepatuhan menunjukkan bahwa pemberian imunisasi ganda, pengetahuan, persepsi dan dukungan keluarga dengan kepatuhan orang tua terhadap jadwal imunisasi Campak-Rubella lanjutan.

Kesimpulan:
Pelaksanaan program imunisasi Campak-Rubella di Kabupaten Boyolali berjalan cukup baik, namun masih menghadapi kendala dalam logistik, beban kerja petugas, dan pelaporan. Cakupan MR dosis kedua masih rendah. Kepatuhan orang tua terhadap jadwal imunisasi dipengaruhi secara signifikan oleh usia, tingkat pengetahuan, persepsi positif, dan dukungan keluarga. Upaya peningkatan edukasi dan keterlibatan keluarga perlu diperkuat untuk meningkatkan cakupan imunisasi lanjutan.

Background:
Measles-Rubella (MR) immunization is one of the public health efforts proven effective in preventing the spread of infectious diseases. In Boyolali Regency, the coverage of the first dose of MR immunization has consistently met the target over the past five years. However, the coverage of the follow-up dose has not yet reached the target. This study aims to evaluate the implementation of the MR immunization program in Boyolali Regency in 2024.

Methods:
This study employed a mixed-method approach, using an evaluative design for the program and surveillance sub-studies, and a cross-sectional design for the analytical sub-study. The program evaluation used the EPI Framework, surveillance followed the WHO framework, and the analytical component used the Health Belief Model. The evaluation subjects included 27 program and data managers, while the analytical sub-study involved 320 parents of children aged 19–24 months. Data were collected through interviews, questionnaires, and observations, and analyzed quantitatively (univariate, bivariate, multivariate) and qualitatively (variant questionnaire).

Results:
Research shows that there are still program obstacles, such as vaccine shortages, lack of direct socialization to the community, double workload for officers, suboptimal sweeping of targets, and suboptimal reporting of post- immunization adverse events (KIPI). Differences in data between the ASIK (Healthy Indonesia) reporting system and local area monitoring (PWS) are due to delayed data entry, technical issues with the application, and the lack of utilization of the ASIK complaint reporting link. The results of the compliance factor analysis indicate that double immunization, knowledge, perception, and family support are associated with parental compliance with the measles-rubella vaccination schedule.

Conclusion:
The implementation of the MR immunization program in Boyolali Regency is fairly well conducted but still faces issues in logistics, staff workload, and reporting. The coverage of the second MR dose remains low. Parental compliance with the immunization schedule is significantly influenced by age, level of knowledge, positive perception, and family support. Strengthening education and family involvement is necessary to improve follow-up immunization coverage.

Kata Kunci : Evaluasi program, Sistem surveilans, Imunisasi, Imunisasi campak rubella, Kabupaten Boyolali / Program evaluation, Surveillance system, Immunization, Measles- rubella immunization, Boyolali Distric