Dukungan manajemen dalam pelaksanaan manajemen terpadu balita sakit di Puskesmas Kabupaten Jayapura

LIE, Khairul, dr. Mubasysyir Hasanbasri, MA

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebijakan dan Manaj.

Latar belakang: MTBS merupakan suatu pendekatan keterpaduan dalam tatalaksana balita sakit yang datang berobat ke fasilitas rawat jalan pelayanan dasar yang meliputi upaya kuratif terhadap penyakit pneumonia, diare, campak, malaria, infeksi telinga, malnutrisi dan upaya preventif dan promotif meliputi imunisasi, pemberian vitamin A dan konseling pemberian makan yang bertujuan untuk menurunkan AKB dan AKBAL serta menekan morbiditas karena penyakit tersebut. Praktek MTBS bisa berjalan dengan baik apabila ada dukungan manajemen dari dinas kesehatan berupa pelatihan, insentif, supervisi/pembinaan dan sarana/fasilitas yang memadai. Tujuan penelitian ini secara umum ingin memperoleh gambaran praktek MTBS di Puskesmas dengan dukungan manajemen dari Dinas Kesehatan Kabupaten Jayapura. Metode Penelitian: penelitian deskriptif, menggunakan metode kualitatif. Subjek penelitian ini adalah data sekunder berupa laporan tahunan dan formulir pencatatan MTBS di puskesmas yang diambil secara acak, petugas yang dilatih MTBS di Puskesmas, kepala Puskesmas, kepala dinas kesehatan dan kasubdin kesga dan masyarakat serta ibu pengantar balita di Kabupaten Jayapura. Instrumen penelitian berupa pedoman wawancara dan diskusi kelompok terarah, Daftar observasi dan data sekunder. Analisis data sekunder dengan memakai tabel pengumpulan data dan data primer dengan cara menganalisa isi data kemudian kedua data tersebut diinterpretasikan sesuai tujuan penelitian. Hasil penelitian: praktek MTBS berjalan secara rutin di enam Puskesmas yaitu Puskesmas Sentani, Harapan, Dusay, Depapre, Nimbokrang dan Unurum guay sedangkan pada empat Puskesmas lainnya: Demta, Sawoy, Lereh dan Genyem belum berjalan sebagaimana yang diharapkan. Praktek MTBS di Kabupaten Jayapuara bukan hanya di Puskesmas namun telah diperluas jangkauannya sampai ke tingkat Pustu dan bidan desa. Praktek yang seimbang antara upaya Kuratif, Preventif dan Promotif juga terlihat hanya pada enam Puskesmas yang rutin menjalankan MTBS, Pada empat Puskesmas lainnya petugas cenderung kembali menggunakan cara konvensional dalam penanganan anak sakit. Dukungan manajemen berupa pelatihan, insentif, supervisi dan fasilitas yang diberikan oleh dinas kesehatan Kabupaten Jayapura cukup merata pada sepuluh Puskesmas namun pemanfaatan sumber-sumber dukungan manajemen ini kurang maksimal pada empat Puskesmas. Pada enam Puskesmas yang lain cukup maksimal menggunakan dukungan manajemen ini terlihat praktek MTBS berjalan dengan baik. Kesimpulan: MTBS telah berjalan di Kabupaten Jayapura dengan dukungan manajemen dari dinas kesehatan yang cukup merata.

Background: MTBS form of one approach of an integration in management of illness under five which attending to get treatment to outpatient facility of basic service which include curative effort to disease such as pneumonia, diarrhea, measles, malaria, ears infection, malnutrition, and preventive effort and promotive effort include immunization, Vit A provision and counseling about feeding that aimed to lowering infant mortality (AKB) and underfive mortality (AKBAL) as well as suppressing morbidity caused by these disease. MTBS administration could undergoing finely if there are support from management of health office such as training, incentive, supervision/establishment, and adequate infrastructure/facility. Objectives: The objective of the research generally is to obtain the depiction of MTBS administration in Community Health Center which have support from management of Jayapura Regency Health Office. Methods: The research was descriptive research, used qualitative method. The subject of research is secondary data form of annual report and MTBS recording form in Community Health Center which have be pick up randomly, the staff that had MTBS training in Community Health Center, head of Community Health Center, head of Health Office, and head of sub office of family welfare and the public, and the accompanying mother of the underfive in Jayapura Regency. The research instrument consist of interview guidance and Focus Group Discussion, Observation List, and secondary data. Analysis of secondary data was used table of data collecting and primary data by analyzing the content of data, then both of these data be interpreted according to the research’s objective. Results: MTBS administration was go on routinely in six Community Health Centers, that is Sentani, Harapan, Dusay, Depapre, Nimbokrang and Unurumguay Community Health Center, while in four another that is: Demta, Sawoy, Lereh and Genyem Community Health Center not go on yet as be desired. MTBS administration in Jayapura Regency not only in Community Health Center, but have experiencing reaching expanding to the Pustu and Bidan Desa (Village Midwife). Balancing administration between Curative, Preventive, and Promotive effort have also seem only in six Community Health Center which routinely performing MTBS. In four another the staff tend to return using conventional way in management of ill infant. The support from management form of training, incentive, supervision and facility that be provide by Health Office of Jayapura Regency have evenly distributed in ten Community Health Center but the utilizing of this sources of support from management was less maximal in four Community Health Center. In six another was quite maximal in utilizing this support from management that finally seem in good MTBS administration. Conclusions: MTBS in Jayapura Regency was went on with the even support from management of health office.

Kata Kunci : Layanan Kesehatan,Manajemen Layanan,Program MTBS