Implementasi Higiene Sanitasi pada Satuan Pelayanan Pemenuhan Gizi Program Makan Bergizi Gratis (MBG) di Kabupaten Kuningan Jawa Barat

Diajeng Maulany Shobiroh, Prof. Dr. Ir. Nurliyani, MS., IPM; Dr. Daniel, M.Sc

2026 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Program Makan Bergizi Gratis (MBG) merupakan program strategis nasional yang memerlukan penerapan higiene sanitasi untuk menjamin keamanan pangan bagi kelompok rentan. Meskipun Badan Gizi Nasional telah menetapkan standar higiene sanitasi melalui persyaratan Sertifikat Laik Higiene Sanitasi (SLHS), implementasinya pada Satuan Pelayanan Pemenuhan Gizi (SPPG) belum banyak dievaluasi. Tujuan: Penelitian ini bertujuan menganalisis tingkat implementasi higiene sanitasi pada SPPG Program MBG di Kabupaten Kuningan, mengeksplorasi perilaku pengelola dalam penerapannya, serta mengidentifikasi faktor yang memengaruhi pemenuhan standar higiene sanitasi tersebut. Metode: Penelitian menggunakan metode mixed methods dengan desain sequential explanatory. Tahap kuantitatif menggunakan desain deskriptif evaluatif melalui observasi terhadap 98 SPPG menggunakan Instrumen IKL Jasa Boga Kemenkes RI. Tahap kualitatif menggunakan pendekatan studi kasus melalui wawancara mendalam terhadap enam Kepala SPPG yang dipilih secara purposive berdasarkan tiga skor IKL tertinggi dan tiga skor IKL terendah. Data kualitatif dianalisis menggunakan analisis tematik berdasarkan kerangka Knowledge, Attitude, and Practice (KAP), kemudian diintegrasikan dengan hasil kuantitatif pada tahap pembahasan. Hasil: Sebagian besar SPPG telah memenuhi persyaratan higiene sanitasi, dengan 95 dari 98 unit (96,9%) berstatus memenuhi syarat dan skor rata-rata 88,97%. Meskipun demikian, 82 unit (83,7%) masih memiliki minimal satu skor kritis, menunjukkan bahwa skor total belum sepenuhnya mencerminkan risiko keamanan pangan pada titik-titik yang paling menentukan. Pengelola pada kelompok IKL tinggi maupun rendah menunjukkan pengetahuan yang memadai dan sikap yang positif terhadap higiene sanitasi, namun praktik menjadi dimensi yang paling membedakan capaian keduanya, terutama pada konsistensi penggunaan alat pelindung diri dan pengawasan internal. Implementasi higiene sanitasi lebih banyak dipengaruhi oleh ketersediaan fasilitas, dukungan mitra penyelenggara, dinamika regulasi pusat, dan fungsi pengawasan sanitasi yang belum merata, dibandingkan oleh kapasitas pengetahuan dan sikap pengelola. Kesimpulan: Implementasi higiene sanitasi pada SPPG di Kabupaten Kuningan secara umum telah memenuhi standar, tetapi keberadaan skor kritis pada mayoritas unit menunjukkan perlunya penguatan sistem pemantauan berbasis risiko, bukan hanya penilaian skor kumulatif. Perbedaan implementasi antar-SPPG lebih dipengaruhi oleh faktor sistem pendukung dibandingkan faktor individu, sehingga penguatan higiene sanitasi Program MBG perlu diarahkan pada penyediaan fasilitas, penguatan pengawasan sanitasi, koordinasi kebijakan antara Badan Gizi Nasional dan mitra penyelenggara, serta pengembangan sistem pemantauan dini berbasis titik kritis.

Background: The Free Nutritious Meals Program (Program Makan Bergizi Gratis [MBG]) is a national strategic initiative that requires proper hygiene and sanitation practices to ensure food safety for vulnerable populations. Although the National Nutrition Agency has established hygiene and sanitation standards through the Hygiene and Sanitation Eligibility Certificate (Sertifikat Laik Higiene Sanitasi [SLHS]), their implementation in Nutrition Fulfillment Service Units (Satuan Pelayanan Pemenuhan Gizi [SPPG]) has received limited evaluation. Objective: This study aimed to analyze the level of hygiene and sanitation implementation in MBG SPPGs in Kuningan Regency, explore managers' behaviour in its implementation, and identify factors influencing compliance with hygiene and sanitation standards. Methods: This study employed a mixed methods approach using a sequential explanatory design. The quantitative phase applied a descriptive evaluative design through observation of 98 SPPGs using the Environmental Health Inspection (EHI) Instrument for Catering Services developed by the Indonesian Ministry of Health. The qualitative phase adopted a case study approach through in-depth interviews with six SPPG managers selected purposively based on the three highest and three lowest EHI scores. Qualitative data were analyzed thematically using the Knowledge, Attitude, and Practice (KAP) framework and subsequently integrated with the quantitative findings during the discussion stage. Results: Most SPPGs met the required hygiene and sanitation standards, with 95 of 98 SPPGs (96.9%) classified as compliant and a mean EHI score of 88.97%. However, 82 units (83.7%) still had at least one critical point, indicating that the total score did not fully reflect food safety risk at the most determining points. Managers in both high- and low-scoring SPPGs demonstrated adequate knowledge and positive attitudes toward hygiene and sanitation; however, practice was the dimension that most distinguished the two groups, particularly in the consistent use of personal protective equipment and internal supervision. Implementation was more strongly influenced by facility availability, partner support, central regulatory dynamics, and uneven sanitation supervision than by managers' knowledge or attitudes. Conclusion: Overall, hygiene and sanitation implementation in SPPGs in Kuningan Regency met the established standards; however, the presence of critical points in most units indicates the need to strengthen risk-based monitoring rather than relying solely on cumulative scoring. Differences in implementation across SPPGs were influenced more by supporting system factors than by individual factors. Strengthening hygiene and sanitation implementation in the MBG Program should therefore focus on ensuring adequate facilities, enhancing sanitation supervision, strengthening policy coordination between the National Nutrition Agency and implementing partners, and developing a critical-point-based early monitoring system.

Kata Kunci : higiene sanitasi, keamanan pangan, Program Makan Bergizi Gratis, Satuan Pelayanan Pemenuhan Gizi, mixed methods.