Implementasi buku KIA pada fasilitas kesehatan di Kabupaten Mimika

WIDANINGRUM, Dedeh, dr. Mubasysyir Hasanbasri, MA

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. dan Manaj. Pe

Latar Belakang: Angka Kematian Ibu untuk daerah-daerah di wilayah Kabupaten Mimika termasuk tinggi, yaitu : 796/100.000 KH di Kecamatan Mapurujaya, 507/100.000 KH di Kecamatan Kokonao dan 167/100.000 KH di Kecamatan Kwamki. Jangkauan pelayanan antenatal di Puskesmas untuk Kabupaten Mimika relatif masih rendah. Dinas Kesehatan Kabupaten Mimika sudah mulai mempergunakan buku KIA sejak tahun 2005. Buku KIA telah didistribusikan ke puskesmas-puskesmas di Kabupaten Mimika, namun belum seluruh puskesmas mendapatkan dan memanfaatkan buku tersebut. Promosi kesehatan serta ketidakmampuan dan kurangnya pengetahuan petugas kesehatan serta minimnya pelatihan dalam memahami implementasi buku KIA juga menghambat kelancaran implementasi buku KIA tersebut. Tujuan: Secara umum penelitian ini bertujuan mengetahui implementasi buku KIA pada fasilitas kesehatan di Kabupaten Mimika. Metode: Metode yang digunakan dalam penelitian ini adalah kualitatif dengan rancangan studi kasus. Sampel yang menjadi sumber informasi adalah Kepala Dinas Kesehatan, Kasubdin Kesga, Kasubdin Yankes, Kasie KIA, Kasie Promkes, 4 orang Kepala Puskesmas serta 4 orang Pengelola Program KIA Puskesmas terpilih. Untuk menjamin validitas data dalam penelitian ini dilakukan teknik triangulasi. Hasil: Buku KIA telah didistribusikan ke puskesmas-puskesmas namun belum seluruh puskesmas di Kabupaten Mimika mendapatkan dan memanfaatkan buku tersebut. Hal ini dikarenakan kurangnya jumlah buku KIA yang harus dibagikan. Pengadaan buku KIA tidak dilaksanakan karena belum adanya dukungan pembiayaan pengadaan dari APBD Kabupaten. Kurangnya promosi kesehatan dalam mendukung implementasi buku KIA berhubungan dengan tidak adanya dana promosi buku KIA. Kesimpulan: Belum seluruh puskesmas di Kabupaten Mimika mendapatkan dan mengimplementasikan buku KIA karena belum adanya dukungan pembiayaan pengadaan dari APBD Kabupaten. Kegiatan promosi kesehatan dalam mendukung implementasi buku KIA sangat jarang dilakukan. Penyuluhan kesehatan tentang implementasi buku KIA yang merupakan bagian dari promosi kesehatan juga belum dilaksanakan secara optimal.

Background: Maternal mortality rate in the areas of Mimika District is relatively high, i.e. 796/100.000 births at subdistrict of Mapurujaya, 507/100,000 births at subdistrict of Kokonao and 167/100,000 births at subdistrict of Kwamki. Antenatal service coverage at the health centers in Mimika District is still relatively low. The Health Office of Mimika District has been using Mother and Child Health Booklet since 2005. The booklet has been distributed to the health centers of Mimika District, however not all centers have got and utilized it. Lack of health promotion and inability and limited knowledge of health staff as well as minimum training in understanding the utilization of the booklet also have hampered the utilization of the booklet. This study studies the implementation of Maternal and Child Health Book ini Mimika District. The study attempts to explain the role district health office and the political context of managing health program during regional autonomy transition. Method: This qualitative study took data in September-December 2006 with the respondents of head of district health office, family and child health program coordinator, and other health pro gram coordinators, Information was also collected from 4 puskesmas maternal and child health coordinator and 4 mothers users of puskesmas. Triangular technique was used to ensure data validity in the study. Result: In contrast to our expectation, health program development in a decentralized administration remain remains dependent to provincial health office and national health ministry. Mimika Health Authority have distributed the MCH-Booklet to health centers since 2005. Unequal distribution of the book among mothers and children under fives was due to the lack of continous supply. Local administrators have not yet own its health program development, including the MCH-Booklet subprogram, due to political transition at the legislative body. Available fund under local expenditure plan were not yet matched to the program designed at the national level. Conclusion: Local administrator has not yet prepared to develop heath program initiative. The implementation of MCH-Booklet shows that local govermnent has the lack of stakeholders that promote local health programs. Provincial and local governments should consider local resources and stakeholders in policy development and program implementation.

Kata Kunci : Layanan Kesehatan,Buku KIA,Fasilitas Kesehatan,MCH Book. implementation, district health office managerial role, political context