Kinerja Poryandu dalam pelayanan Program Kesehatan Ibu Anak dan Gizi Keluarga di Kecamatan Kalibawang Kabupaten Kulonprogo

SURIPTO, Dr. Suharko

2006 | Tesis | S2 Sosiologi (Kebijakan dan Kesejahteraan Sosial)

Dalam era otonomi daerah terjadi perubahan pengelolaan pelaksanaan kegiatan pembangunan yang diletakkan pada kemampuan daerah masing-masing sehingga berpengaruh pada lembaga yang menangani kegiatan di bidang kesehatan khususnya dalam melaksanakan kegiatan posyandu. Apabila kita melihat pelaksanaan kegiatan posyandu sebelum era otonomi menunjukkan adanya hasil pembangunan di bidang kesehatan pada umumnya dan posyandu pada khususnya hal ini ditunjukkan adanya kegiatan yang mampu mengatasi berbagai masalah yang dihadapi di bidang kesehatan ini dipengaruhi adanya sistem kegiatan yang masih dapat dikoordinir secara sentralistik, baik mengenai kebijakan, program, anggaran serta pelaksanaannya. Pada era otonomi terjadi desentralisasi kewenangan, pengelolaan dan pelaksanaan pembangunan umumnya dan khususnya bidang kesehatan termasuk pelaksanaan posyandu, dimana sangat berpengaruh terhadap kinerjanya. Hal ini ditunjukkan bahwa tingkat kegiatan posya ndu semakin menurun dengan belum mendapatkan perhatian dari pemerintah daerah, di samping itu dipengaruhi kondisi krisis ekonomi yang semakin komplek. Dari uraian di atas perlu dilihat kinerja Pos Yandu sebelum dan sesudah otonomi serta faktor-faktor yang menyebabkan kinerja tersebut. Penelitian ini menggunakan metode deskriptif kualitatif dan dalam pengumpulan data menggunakan teknik wawancara, focus discussion group (FGD), dan dokumentasi. Berdasarkan hasil penelitian menunjukkan adanya perbedaan kinerja pos yandu sebelum pelaksanaan otonomi daerah dan sesudah otonomi daerah. Hal ini dibuktikan dari hasil wawancara bahwa sebagian besar responden menyatakan adanya perubahan kebijakan dari sentralistik ke desentralistik di kabupaten yang menyebabkan adanya perubahan pengelolaan pembangunan kesehatan di bidang pos yandu. Kondisi ini berpengaruh terhadap kinerja pos yandu menjadi menurun disebabkan berbagai hal seperti keterbatasan anggaran, pengelolaan yang tidak sistematis, sarana dan prasarana yang terbatas. Disamping itu kondisi ini berpengaruh pada rendahnya tingkat partisipasi para kader posyandu serta berdampak munculnya masalah-masalah kesehatan lainnya. Dengan melihat kondisi tersebut di atas perlu dilakukan revitalisasi pos yandu oleh pemerintah daerah yang didukung oleh instansi terkait dan tokoh masyarakat setempat guna mendorong kine rja dan menjamin pelaksanaan pos yandu dalam rangka mencapai tingkat kesehatan yang lebih baik bagi masyarakat.

In the regencial otonomy era, there has been changing in the process of management on the implementation of development that should be depen upon to the capacity of local government. This has also been influencing to the aspect of health development, in the particular the community based self help health program, namely Posyandu (Integrated Health Post). Compared to the previous otonomy era, it could be seen that the progress of health development especially through the Posyandu, had achieved a positive results. Those due to the ability of local government to overcome various health problems which were affected by applying centralistic coordination in all aspects of policy, program, budget, and implementation as well. In the era of otonomy, there has been experiencing decentralization of autority, management and implementation of the whole development programs, included the improvement of community health especially the implementation of Posyandu. This new situation, consequently, influences to performance of Posyandu activities. It can be seen that there is tendency of decreasing the Posyandu activities, due possibly to reduction of attention from the local government and also because of the economy crisis impact in the past time. From those description, therefore, it should be observed the performance of Posyandu before and after otonomy era as well as factors which influence to the declining the Posyandu performance. This research conducted by using descriptive qualitative method, while data collection applying interview tehnique, Focus Group Discussion ( FGD ) and documentation methods. The result of research mentioned that there is difference of Posyandu performance before and after otonomy era. This can be proven from the interview results, that majority of respondents stated that the changing of policy from centralistic to decentralistic system in the regency level bringing transformation in the management of health development of posyandu. This condition effects to the Posyandu performance which tend to decrease due to limited budget, lack of systematic management, restricted of infrastructure and equipments. Likewise, this atmosphere, influences to the decreasing participation of Posyandu cadres, that consequently impacts to appearing other health problems. From those conditions, therefore, it is important to recommend that the Posyandu activities need to be revitalized by the local governmant supported by related offices and community leaders to push its performance and to guaranty the regular implementation to achieve the better condition of community health.

Kata Kunci : Program Kesehatan Masyarakat, Posyandu, regencial otonomy, performance, Integrated Health Post (Posyandu).