Fungsi DInas Kesehatan dalam mendukung Program Kesehatan Ibu dan Anak di Puskesmas Kabupaten Keerom Propinsi Papua

WAKUR, One, dr. Kristiani, SU

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

Latar Belakang. Kabupaten Keerom merupakan kabupaten pemekaran di Propinsi Papua. Angka kematian ibu dan kematian bayi di Kabupaten Keerom masih tinggi serta angka persalinan oleh nakes masih rendah. Hal tersebut menunjukkan bahwa program KIA di Keerom belum berjalan dengan baik. Fungsi Dinas Kesehatan khususnnya Seksi Kesehatan Ibu dan Anak (KIA) mempengaruhi kinerja program KIA di Puskesmas. Tujuan. Untuk mengetahui fungsi Dinas Kesehatan Kabupaten Keerom dalam mendukung program KIA di Puskesmas Metode. Jenis penelitian ini adalah deskriptif dengan rancang an studi kasus dan menggunakan pendekatan kualitatif. Subyek penelitian ini adalah Kepala Dinas Kesehatan, Kasubdin Kesehatan Keluarga dan Masyarakat dan Kepala Seksi KIA Dinas Kesehatan Keerom serta Kepala Puskesmas dan Bidan Penaggungjawab KIA di Puskesmas di Keerom. Instrumen penelitian adalah pedoman wawancara mendalam, diskusi kelompok terarah dan check list. Hasil Penelitian. Faktor input sumber daya manusia (SDM) Dinas Kesehatan Keerom sangat terbatas baik secara kualitas maupun kuantitas, walaupun input dana mencukupi. Keterbatasan SDM di Keerom akibat pemekaran kabupaten. Peran Dinas Kesehatan Keerom dalam mendukung ketersediaan input program KIA di Puskesmas hanya berfungsi mendistribusikan sarana. Penempatan SDM dilakukan Bupati, sehingga berakibat penempatan bidan tidak berdasarkan kebutuhan Puskesmas. Bidan terkonsentrasi di Puskesmas dan jumlah Bidan di desa sangat terbatas. Dinas Kesehatan telah melakukan fungsi pengawasan, pembinaan dan evaluasi pelaksanaan program KIA di Puskesmas, walaupun belum optimal karena keterbatasan kualitas dan kuantitas SDM serta sarana komunikasi antara Dinas Kesehatan dengan Puskesmas. Tupoksi Seksi KIA Dinas Kesehatan yang belum dijalankan adalah penempatan bidan sesuai kebutuhan Puskesmas, pemberlakuan kedisiplinan petugas, menentukan standar penilaian dan analisis kinerja. Cakupan pelayanan KIA Puskesmas Kabupaten Keerom belum mencapai target karena keterbatasan input yang menyebabkan pelaksanaan program KIA di Puskesmas tidak berjalan optimal, terutama di Puskesmas sangat terpencil. Kesimpulan. Fungsi Dinas Kesehatan dalam mendukung program KIA di Puskesmas Kabupaten Keerom belum optimal karena keterbatasan jumlah SDM dan sarana, sehingga cakupan tidak mencapai target yang ditetapkan.

Background: The District of Keerom is a developing district in the Province of Papua, Yet, the maternal and infant mortality rates in this area are still high, besides the low rate of deliveries assisted by health officers. The facts show the mother and child health programs at Keerom District are not yet appropriately-managed. The function of district health office, in this case MCH section influences the performance of MCH program in health centers. Objective: The objective of this research was to get an overview of the function of Keerom District Health Office in supporting MCH programs in health centers. Method: This research was a descriptive research, with case study design, using qualitative method. The subjects of this research were head of district health office, head of family and public health department, head of MCH section, head of health centers, and midwives in charge of MCH programs in health centers at the District of Keerom. The research instruments used in this research were in-depth interview guide, focus group discussion guide, and check list. Result: The input factor, which was the human resources of Keerom District Health Office, was very limited both in quality and in quantity, although it had sufficient financial resource. Limited human resources at Keerom were due to establishment of a new district. In the matter of supporting the MCH programs in health centers, the district of health office only functioned as a distributor of facilities. The placement of human resource was managed by the head of district, not by the MCH section of district health office. Thus, the placement policy of midwives was not based on the needs of health officers for every health center. Midwives were mostly concentrated at health centers and the number of midwives in villages was very limited. The district health office had carried out the function of monitoring, supervision, and evaluation of MCH programs at the health center. Function and responsibilities of MCH section at district health center which had not been carried out were placement of midwives based on the need of the health center, enforcement of discipline among staff, formulation of assessment and performance analysis standard. The coverage of MCH service at the health center of Keerom District had not reached the target because of limited input which led to inoptimum implementation of MCH programs at the center, particularly in isolated areas. Conclusion: The function of Keerom district health office in supporting the MCH programs in health centers at the District of Keerom was not yet optimal because of lack of human resources and facilities. This influenced the coverage of the MCH services, which had not achieved the expected target.

Kata Kunci : Kebijakan Kesehatan,Program Kesehatan Ibu dan Anak,Fungsi Dinas Kesehatan