Analisis Kesiapsiagaan Manajemen Kegawatdaruratan dan Bencana di Puskesmas dalam Penanggulangan Bencana dan Krisis Kesehatan di Kabupaten Banjarnegara

Alda Adiestya Rahmadhani, Prof, dr. Laksono Trisnantoro, M.Sc., Ph.D. (Pembimbing 1); Madelina Ariani, SKM, MPH. (Pembimbing 2)

2025 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar Belakang : Berada di negara dengan risiko tinggi bencana, Puskesmas selalu menjadi fasilitas kesehatan tingkat pertama yang menangani dan didatangi masyarakat terdampak bencana. Kesiapsiagaan bencana Puskesmas sangat penting untuk memastikan pelayanan kesehatan di masyarakat tetap berjalan meski dalam situasi bencana. Kabupaten Banjarnegara merupakan salah satu kabupaten risiko tinggi bencana di Jawa Tengah. Penelitian ini bertujuan menganalisis tingkat kesiapsiagaan bencana Puskesmas dan mengevaluasi instrumen Hospital Safety Index (HSI) untuk Puskesmas. 

Metode : Menggunakan mix method dengan pendekatan sequential explanatory design. Data kuantitatif dikumpulkan melalui self-assesment menggunakan modul 4 HSI, diikuti dengan pengambilan data kualitatif dengan wawancara mendalam, telusur dokumen dan observasi oleh evaluator. Menggunakan teknik total sampling, data dikumpulkan dari 35 orang penanggungjawab bencana di semua Puskesmas di Banjarnegara. Purposive sampling dilanjutkan untuk data kualitatif. Analisis data dilakukan menggunakan kalkulator HSI untuk menentukan tingkat kesiapsiagaan, dan analisis tematik untuk mengidentifikasi hambatan dan rencana tindak lanjut. 

Hasil : Enam belas Puskesmas (46%) berada pada kategori C (tingkat kesiapsiagaan rendah). Hambatan yang dialami yaitu kesalahan memahami definisi tim penanggulangan bencana, ketiadaan prosedur dan dokumen perencanaan, keterbatasan SDM, dan keterbatasan sarana prasarana perawatan pasien saat bencana dan krisis kesehatan. Untuk evaluasi instrumen memperoleh hasil Valid dan Realibilitas baik pada semua item (Kejelasan Bahasa skor P = 75%, ? = 0,985; Relevansi Pertanyaan skor P = 77%, ? = 0,978; Kemudahan Pengisian skor P = 75%, ? = 0,982)

Kesimpulan : Puskesmas masih memerlukan peningkatan kapasitas dalam aspek kesiapsiagaan terhadap ancaman bencana dan krisis kesehatan. 

Background : Located in a country with a high risk of disasters, Public Health Center (Puskesmas) are always the first level of health facilities that treat and are visited by communities affected by disasters. Disaster preparedness at Public Health Center is very important to ensure that health services in the community continue to run even in disaster situations. Banjarnegara Regency is one of the regencies with a high risk of disasters in Central Java. This study aims to analyze the level of disaster preparedness of Public Health Center and evaluate the Hospital Safety Index (HSI) instrument for Public Health Center. 

Method : A mixed-method approach with a sequential explanatory design was used. Quantitative data were collected through self-assesment using the HSI Module 4, followed by qualitative data collection via in-depth interviews, document review, and observation by evaluators. Using total sampling, data were collected from 35 disaster response coordinators at all Public Health Center in Banjarnegara. Purposive sampling was continued for qualitative data. Data analysis was conducted using the HSI calculator to determine the level of preparedness and thematic analysis to identify barriers and action plans. 

Results : Sixteen Public Health Centers (46%) were categorized as C (low level of preparedness). The obstacles encountered were misunderstanding of the definition of disaster managament teams, lack of planning procedures and documents, limited human recources, and limited facilities and infrastructure for patient care during disasters and health crises. For the evaluation of the instrument, the results were found to be valid and reliable across all items (Languange Clarity score P = 75%, ? = 0,985; Relevance of Questions score P = 77%, ? = 0,978; Ease of Completion score P = 75%, ? = 0,982)

Conclusion : Public Health Centers still require capacity building in terms of preparedness for disaster threats and health crises. 

Kata Kunci : kesiapsiagaan bencana, Puskesmas, manajemen kegawatdaruratan dan bencana, Hospital Safety Index