Peningkatan penampilan monitor dan promosi pertumbuhan melalui gugus kendali mutu

WIJAYANTO, Oktora Wahyu, dr. Endy Paryanto, MPH.,Sp.AK

2005 | Tesis | PPDS I Ilmu Kesehatan Anak

Kegiatan penimbangan balita yang diintegrasikan dalam kegiatan posyandu adalah salah satu kegiatan Usaha Perbaikan Gizi Keluarga (UPGK) yang dilaksanakan satu bulan sekali. Pelaksanaan penimbangan yang dilakukan bertujuan memonitor grafik berat badan balita apakah naik atau tidak. Kegiatan monitor dan promosi pertumbuhan telah diterapkan sebagai komponen inti program kesehatan dan nutrisi di beberapa negara berkembang sejak tahun 1985 hingga sekarang. Di Indonesia program ini dikenal sebagai pos penimbangan di Posyandu. Saat ini pelaksanaan penimbangan belum seperti yang diharapkan dalam tujuan program Promosi dan Monitor Pertumbuhan. Tujuan penelitian ini adalah untuk mengetahui apakah gugus kendali mutu dalam kegiatan posyandu akan meningkatkan penampilan Monitor dan Promosi Pertumbuhan (MPP) berdasarkan persentase kehadiran balita, persentase yang membawa KMS, persentase balita yang ditimbang, persentase KMS yang ditandai, persentase KMS yang tergambar grafik, persentase ibu yg mendapat penyuluhan dan pujian. Penelitian ini menggunakan rancang bangun eksperimental semu dalam kerangka Operational Research. Subyek penelitian sebanyak 75 posyandu yang tersebar di empat kecamatan yaitu Tegalrejo, Godean, Kasihan dan Kotagede. Proses penelitian ini memakan waktu 6 bulan. Hasil pengukuran tampilan MPP posyandu dipergunakan sebagai dasar untuk menyusun rencana tindak lanjut bulan berikutnya, yang terangkum dalam gugus kendali mutu. Data hasil pengukuran tersebut akan ditransformasikan ke dalam nilai indeks yang kemudian dilakukan uji t. Dalam penelitian ini terbukti gugus kendali mutu yang dilakukan selama 3 bulan ini dapat meningkatkan tampilan MPP di posyandu kelompok intervensi secara umum. Pada awal didapatkan nilai 0,47 + 0,12 vs 0,42 + 0,17, p: 0,302, kemudian pada monitor bulan II: 0,58 + 0,07 vs 0,42 + 0,16, p: <0,001, dan monitor bulan III: 0,63 + 0,18 vs 0,45 + 0,17, p:<0,001. Akan tetapi untuk indeks ibu (persentase kehadiran balita, persentase yang membawa KMS) tidak terjadi perubahan yang signifikan. Gugus kendali mutu dapat meningkatkan penampilan posyandu secara umum akan tetapi tidak mempengaruhi indeks ibu.

The weighing of children under five is one of the Usaha Perbaikan Gizi Keluarga (UPGK) activities which was integrated in monthly Posyandu activities. The aim of this activity is to observe child weighing by monitoring from KMS (Kartu Menuju Sehat/growth charts) weight graphic. Growth, monitoring and promotion (GMP) has been used as a main component of the health and nutritional programme in several developing countries since 1985. GMP in Indonesia is known as a child weighing activity in Posyandu. Unfortunately, this activity has not run as the GMP programme has expected. The objective of this study was to understand how the quality assurance/ total quality management (QA/ TQM) influenced the performance of the GMP based on the percentage of the attendance of children under five, mothers who brought KMS at weighing session, children under five weighing, KMS which was noted, KMS which was drawn, and mothers who got counseling and reward. The method of the study was Operational Research. The subjects were 76 Posyandu in four subdistricts (Tegalrejo, Godean, Kasihan and Kotagede). The study took 6 months. The results of the Posyandu’s GMP score performance were used as a basic to improve the performance for the next consecutive months with QA system. The data were transformed as a score index. t- test was used to analyze the data. In this study we found that quality assurance could increase the performance of GMP in general, which was done in Posyandu intervention group for 3 consecutive months. The baseline score for both groups were 0,47±0,12 vs 0,42±0,17. p: 0,302, at the second month monitoring: 0,58±0,07 vs 0,42 ±0,16, for the intervention group p: < 0,001. The mothers’ index (percentage of the children under five attendance and mothers who brought KMS at weighing session), however, did not significantly change. Total quality management increased the performance of Posyandu in general significantly, but the programme could not influence the mothers’ index.

Kata Kunci : Posyandu, Monitor dan Promosi Pertumbuhan, Gugus Kendali Mutu, growth monitoring and promotion, quality assurance, quasi-experimental,