Perbedaan manajerial distribusi tablet Fe ibu hamil Puskesmas Cakupan Tinggi dan Puskesmas Cakupan Rendah di Kabupaten Bengkulu Selatan Propinsi Bengkulu tahun 2003

SURAHMAN, Prof.dr. Hamam Hadi, MS.ScD

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang. Prevalensi anemia di Indonesia sebesar 50,9 % yang sebagian besar disebabkan defisiensi Fe. Akibat yang ditimbulkan oleh defisiensi Fe pada masa kehamilan yaitu membawa resiko terhadap sumber daya manusia baik terhadap ibu maupun bayi yang akan dilahirkan menjadi tidak cukup sehat bahkan membawa kematian bagi ibu dan bayinya. Defisiensi Fe ini dapat dicegah dan diobati dengan pemberian zat besi melalui Puskesmas, Puskesmas Pembantu serta Bidan di Desa dan Posyandu. Sementara di Kabupaten Bengkulu Selatan cakupan Fe1 sebesar 43,6% dan cakupan Fe3 sebesar 44,7%.Tujuan dari penelitian ini adalah untuk mengetahui perbedaan yang ada dalam input, dan proses sehingga dapat dicari pemecahan yang dapat meningkatkan cakupan program pemberian tablet besi kepada wanita hamil di Kabupaten Bengkulu Selatan. Metodologi. Penelitian ini menggunakan metode penelitian Kualitataif diskriptif yang dilakukan secara belah lintang. Populasi adalah sebanyak 10 Puskesmas sedangkan sampel di ambil sebanyak 6 Puskesmas yang terdiri dari 3 Puskesmas cakuapan Fe terendah dan 3 Puskesmas cakupan Fe tertinggi. Subjek Penelitian adalah Kepala Puskesmas, Petugas Gizi Puskesmas, Petugas KIA dan Kasi Gizi Kabupaten Bengkulu Selatan. Hasil. Ada perbedaan perencanaan antara Puskesmas cakupan tinggi dengan Puskesmas cakupan rendah. Perencanaan di Puskesmas cakupan tinggi telah dibuat berdasarkan data yang lengkap hanya Puskesmas Lubuk Tapi yang belum membuat perencanaan. Puskesmas dengan cakupan rendah semuanya belum membuat perencanaan. Tidak ada perbedaan jalur distribusi antara Puskesmas cakupan tinggi dengan Puskesmas cakupan rendah. Jalur distribusi tablet besi di semua Puskesmas yang diteliti, baik cakupan tinggi maupun cakupan rendah masih sebatas pada pelayanan kesehatan. Ada perbedaan pelaksanaan antara Puskesmas cakupan tinggi dengan Puskesmas cakupan rendah. Pelaksanaan pemberian tablet besi di Puskesmas cakupan tinggi sudah sesuai dengan buku pedoman dan koordinasi antara petugas gizi dan KIA sudah berjalan dengan baik. Sedangkan Puskesmas cakupan rendah belum sesuai dengan buku pedoman dan koordinasi antara petugas gizi dan KIA belum berjalan dengan baik. Kesimpulan. Semakin baik kerjasama antara petugas gizi dan KIA, semakin baik pengelolaan program pemberian tablet besi ibu hamil.

Background : The prevalence of anemia in Indonesia that averages 50.9% is mostly caused by iron deficiency. Iron deficiency during pregnancy can be harmful to both the mother and the infant, even it may lead to mortality. An effort to prevent and treat such case is by having iron supplementation through primary health care, mid-wife and Posyandu. In South Bengkulu, the coverage of Fe1 averages 43.6% while the coverage of Fe3 is 44.7%. Objective : The objectives of this research was to determine the differences included in input and process so that ways that may improve and increase the coverage of iron supplementation programme among pregnant women in South Bengkulu could be found out. Study Design : This was descriptive qualitative study with longitudinal design. The population were 10 primary health care while samples were 6 primary health care consisted 3 primary health care with the lowest Fe coverage and other 3 with the highest Fe coverage. Subjects were head of primary health care, nutritionist, mother and infant health officer, and head of nutritionist. Results : There were differences of planning between primary health care with high and low Fe coverage. Primary health care with high Fe coverage have made planning based on accurate data except Lubuk Tapi while none of primary health care with low Fe coverage made them. There were no differences of distribution between primary health care with high and low Fe coverage. The distribution of of iron supplementation, both in low and high Fe coverage, still worked only in the line of health service. There were implementation differences of Fe supplementation between primary health care with high and low Fe coverage. Iron supplementation in primary health care with high coverage had worked appropriately based on guiding book and the coordination between nutritionist and mother and infant health officer were good. While in primary health care with lowe Fe coverage, the programme had not worked appropriate and the coordination between nutritionist and mother and infant health officer were poor. Conclusion : The better the coordination between nutritionist and mother and infant health officer, the better the programme of iron supplementation among pregnant women.

Kata Kunci : Gizi Masyarakat,Distribusi Tablet Fe,Puskesmas, coverage, nutrition, anemia, pregnant women