THE IMPLEMENTATION FIDELITY OF FAMILY ASSISTANCE BY FAMILY ASSISTANCE TEAM (TPK) ON CHILDREN 0-6 MONTHS (An Implementation Research Study on Banjarmasin, Indonesia)

Thoriq Abi Pramana, dr. Vicka Oktaria, MPH., Ph.D., FRSPH; Bayu Satria Wiratama, S.Ked., MPH., Ph.D., FRSPH

2025 | Tesis | S2 Ilmu Kesehatan Masyarakat

ABSTRAK

Latar belakang: Stunting masih menjadi tantangan kesehatan masyarakat yang signifikan di Indonesia, didorong oleh gizi yang tidak memadai selama kehamilan dan masa kanak-kanak. Di Banjarmasin, Kalimantan Selatan, Tim Pendamping Keluarga (TPK) memainkan peran penting dalam mengatasi stunting melalui edukasi, rujukan, dan layanan dukungan. Namun, memastikan ketepatan pelaksanaan kegiatan TPK sangat penting bagi keberhasilan program.

Metode: Studi mix-method ini mengevaluasi fidelitas implementasi program bantuan keluarga TPK di Banjarmasin. Data kuantitatif dikumpulkan melalui kuesioner terstruktur dari 236 kader TPK dan 105 ibu dengan anak usia 0–6 bulan. Kuesioner tersebut menilai pengetahuan, sikap, dan perilaku (KAP) kader, kepatuhan terhadap protokol, dan kepuasan pengguna. Data kualitatif dikumpulkan melalui diskusi kelompok terarah (FGD) dan wawancara semi-terstruktur untuk mengeksplorasi hambatan logistik dan implementasi. Statistik deskriptif merangkum data kuantitatif, sementara analisis tematik dan konten diterapkan pada data kualitatif.

Hasil: Kader TPK menunjukkan pengetahuan yang cukup tentang program, dengan 42?rada di kuartil pengetahuan terendah. Sebagian besar kader menunjukkan sikap yang baik dan perilaku yang cukup. Kepatuhan keseluruhan rata-rata 61,01%, dengan kepatuhan konten rendah (48,43%), sementara frekuensi pendampingan (74,22%) dan pencatatan (60,39%) relatif lebih tinggi. Kepuasan pengguna umumnya tinggi, terutama dalam hal edukasi dan rujukan. Namun, tantangan logistik, seperti kurangnya pelatihan, penyediaan formulir manual, dan keterlambatan insentif, menghambat efektivitas program. Hambatan tambahan meliputi masalah administratif, keluarga yang tidak kooperatif, konflik jadwal, masalah teknis aplikasi, dan kesalahan persepsi target.

Kesimpulan:Meskipun kader TPK di Banjarmasin menunjukkan komitmen yang kuat dan kepuasan pengguna yang tinggi, kesenjangan dalam pengetahuan, kepatuhan terhadap konten, dan dukungan logistik membatasi kesetiaan program secara keseluruhan. Memenuhi kebutuhan pelatihan, memperjelas peran kader, dan memperkuat sistem logistik, termasuk insentif, penyediaan atribut dan perangkat program, serta pelaporan yang andal, direkomendasikan untuk meningkatkan kualitas program dan mengurangi stunting secara efektif.

ABSTRACT

 

Background: Stunting remains a significant public health challenge in Indonesia, driven by inadequate nutrition during pregnancy and early childhood. In Banjarmasin, South Kalimantan, the Family Assistance Team (TPK) plays a critical role in addressing stunting through education, referrals, and support services. However, ensuring the implementation fidelity of TPK activities is crucial to program success.

Method: This mixed-methods study evaluated the implementation fidelity of the TPK family assistance program in Banjarmasin. Quantitative data were collected through structured questionnaires from 236 TPK cadres and 105 mothers of children aged 0–6 months. The questionnaires assessed cadres’ knowledge, attitudes, and practices (KAP), adherence to the protocol, and user satisfaction. Qualitative data were gathered through focus group discussions and semi-structured interviews to explore logistical and implementation barriers. Descriptive statistics summarized the quantitative data, while thematic and content analysis were applied to the qualitative data.

Results: TPK cadres showed moderate knowledge of the program, with 42?lling in the lowest knowledge quartile. Most cadres exhibited good attitudes and moderate practices. Overall adherence averaged 61.01%, with content adherence being low (48.43%), while assistance frequency (74.22%) and record-keeping (60.39%) were relatively higher. User satisfaction was generally high, especially in the areas of education and referrals. However, logistical challenges—such as lack of training, manual form provision, and delayed incentives—hindered program effectiveness. Additional barriers included administrative issues, uncooperative families, scheduling conflicts, technical application problems, and target misperceptions.

Conclusion: While TPK cadres in Banjarmasin demonstrated strong commitment and user satisfaction was high, gaps in knowledge, content adherence, and logistical support limited overall program fidelity. Addressing training needs, clarifying cadre roles, and strengthening logistical systems—including incentives, attribute and program toolkit provision, and reliable reporting—are recommended to enhance program quality and reduce stunting effectively.

Kata Kunci : Adherence, Cadre, Family assistance, Fidelity, Implementation research, Stunting, TPK