Hambatan pelaksanaan program klinik sanitasi di Kabupaten Kulon Progo

RUSTAPA, Prof.Dr.dr. Soebijanto

2006 | Tesis | S2 Ilmu Kesehatan Kerja

Kabupaten Kulon Progo merupakan salah satu kabupaten di Propinsi Daerah Istimewa Yogyakarta, klinik sanitasi merupakan salah satu program yang diharapkan mampu menurunkan kasus penyakit berbasis lingkungan. Pada tahun 1998 program klinik sanitasi mulai disosialisaikan dan tahun 2005 diadakan penyegaran kembali kepada koordinator kesehatan lingkungan. Namun hingga tahun 2005 hanya 4 puskesmas (20%) yang telah melaksanakan program klinik sanitasi. Tujuan penelitian ini untuk mengetahu faktor-faktor yang menjadi hambatan penyelenggaraan program klinik sanitasi di Kulon Progo. Penelitian ini merupakan penelitian studi kasus. Populasi pada penelitian ini adalah puskesmas yang belum melaksanakan program klinik sanitasi di Kabupaten Kulon Progo. Sebagai subyek penelitian adalah penanggung jawab program, penanggung jawab kegiatan dan pelaksana kegiatan. Pengumpulan data dilakukan dengan wawancara dan observasi lapangan. Hambatan pelaksanaan program klinik sanitasi puskesmas di Kabupaten Kulon Progo terjadi pada beberapa faktor Faktor masukan pada unsur dana 14 puskesmas (100%) tidak ada dana khusus untuk program klinik sanitasi, unsur sarana 14 puskesmas (100%) tidak memiliki peralatan, ruangan dan formulir pencatatan. Faktor proses, unsur unformasi sulit dilaksanakan karena tidak adanya dukungan dana dan sarana pada 14 puskesmas (100%).Sedangkan pada unsure kebijakan sebanyak 14 puskesmas (100%) menyatakan tidak adanya peraturan daerah atau petunjuk dari Propinsi dan Kabupaten, struktur organisasi di Dinas Kesehatan Kabupaten Kulon Progo tidak sesuai dengan tugas pokok fungsinya, unsur manajemen 14 puskesmas (100%) tidak membuat rencana khusus pelaksanaan program klinik sanitasi. Belum dilaksanakannya program klinik sanitasi puskesmas di Kabupaten Kulon Progo, dari analisis scoring diperoleh hasil berdasarkan tingkat hambatan yang terbesar adalah dana, sarana, kebijakan, manajemen, konseling, rujukan, informasi dan tenaga.

Sanitation clinic is one of programs which is meant to reduce cases of environmentally based diseases. In 1998 sanitation clinic program was socialized/publicized and in 2000 program refreshing was done to environmental health coordinators. However, in 2005 there were only 4 community health centers (20%) at Kulon Progo District which carried out sanitation clinic program. The study was aimed at identifying factors hindering the implementation of sanitation clinic program at Kulon Progo District. This was a case study. Population were community health centers which had not carried out sanitation clinic program at Kulon Progo District. Subject of the study were program coordinator, people in charge of activities and those who carried out the activities. Data were obtained through interview and field observation. Constraints in the implementation of sanitation clinic program of community health center at Kulon Progo District consisted of the following. Input factors: as many as 14 community health centers (100%) did not have fund for sanitation clinic program, 14 community health centers (100%) did not have facilities, rooms and records. Process factor: 14 community health centers (100%) did not have media of information. Environment factor: 14 community health centers (100%) did not have local regulation or guide from the government at district or provincial levels, the structure of organization of the health office at Kulon Progo District was irrelevant with its main function. Management factor: 14 community health centers (100%) did not have certain action plan for the implementation of sanitation clinic program. The result of the analysis showed that intervention based on problem priorities in order that sanitation clinic program at community health center could be implemented at Kulon Progo District fund, means, policies, organization, management , counseling, information and fund consisted of staff.

Kata Kunci : Kesehatan Lingkungan,Program Klinik Sanitasi,Hambatan