Kontinuitas pelayanan dalam tatalaksana pengobatan penderita Tuberkulosis OParu di Kabupaten Tanah datar Propinsi Sumatera Barat

FARIETNY, dr. Mubasysyir Hasanbasri, MA

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

Latar Belakang: Program penanggulangan tuberkulosis paru di Indonesia sudah dimulai sejak tahun 1969. Strategi DOTS dilaksanakan mulai tahun 1995. Indonesia penyumbang penyakit TBC terbesar nomor 3 di dunia setelah India dan Cina. Setiap tahun terjadi 9 juta penderita baru TBC, dengan kematian 3 juta orang. Di Indonesia setiap tahun terjadi 583.000 kasus baru dengan kematian 140.000, dan setiap 100.000 penduduk terdapat 130 penderita baru BTA positif yang banyak menyerang usia produktif (15-50 tahun). Diantara 100.000 penduduk, 100 orang akan terinfeksi dan 50 persennya akan menularkan lagi jika tidak mendapatkan tatalaksana pengobatan yang tepat. Masalah yang ditemukan adalah capaian program rendah, kontinuitas pelayanan kurang, hasil pelatihan belum dilaksanakan dengan baik, pengelolaan logistik saran prasarana, ketersediaan pedoman pelaksanaan dan dana kurang serta supervisi belum efektif, maka penulis ingin mengetahui dan memahami hubungan kontinuitas pelayanan dengan manajemen penanggulangan tuberkulosis di Kabupaten Tanah Datar. Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui hubungan antara manajemen penanggulangan tuberkulosis dengan kontinuitas pelayanan ke penderita. Metode Penelitian: Penelitian ini merupakan penelitian analitik dengan rancangan cross sectional, menggunakan metode kuantitatif dan kualitatif. Subjek penelitian petugas tuberkulosis dan petugas labor puskesmas. Data diperoleh menggunakan kuesioner, wawancara mendalam dan observasi dokumen. Hasil Penelitian: Analisis kuantitatif menunjukkan bahwa ada hubungan bermakna antara pelatihan dengan kontinuitas pelayanan, (p=0,025). Ketersediaan logistik sarana prasarana mempunyai hubungan yang bermakna dengan kontinuitas pelayanan, (p=0,038). Ketersediaan buku pedoman dan modul mempengaruhi kontinuitas pelayanan, (p=0,003.) Pelaksanaan supervisi mempunyai hubungan yang bermakna terhadap kontinuitas pelayanan, (p=0,028). Ketersediaan dana sangat berhubungan dengan kontinuitas pelayanan, (p=0,016). Kesimpulan dan Saran: Kegiatan-kegiatan manajerial yang mendukung ke arah kontinuitas pelayanan tuberkulosis paru, baru mendapat perhatian yang kecil. Program penanggulangan tuberkulosis memerlukan komitmen baru yang harus menekankan kepentingan public health daripada pemberian layanan individual pada penderita tuberkulosis. Manajer puskesmas dan dinas kesehatan perlu menempatkan misi publik yang melindungi penularan kuman tuberkulosis oleh penderita yang pengobatannya tidak tuntas. Ketuntasan menjadi unsur utama dalam pelayanan pengobatan penderita tuberkulosis. Kontinuitas pelayanan sangat dipengaruhi oleh manajemen penanggulangan tuberkulosis.

Background: The Tuberculosis handling program in Indonesia have been started by since year 1969. Strategy DOTS executed to start the year 1995. Biggest TBC desease contributor Indonesia of Number 3 in world after India and Chinese. Every year happened by 9 million new patient of Tuberculosis with the death 3 million people. In Indonesia, every year happened by 583.000 new case with the death 140.000 and each; every 100.000 resident of there are 130 new patient of positive BTA which is a lot of groaning age prodektif (15-50 year). Between 100.000 resident, 100 one would infection and 50% will be contagious if do not get the correct tatalaksana medication. found problem, low program performance, kontinuitas service less, result of uncommitted training better, processing of logistics of medium reso, availibility of guidance of execution and fund less and also supervise not yet effective. Hence writer wish to know and comprehend the relation of Continuation of services with with the management of Tuberculosis handling in Tanah Datar District. Objectives: This research aim to to know the relation of between at management of Tuberculosis handling by Continuation of services to patient. Method: This research represent the analytic research with the device of cross sectional, using quantitative method and qualitative. population of Research of worker of tuberculosis and worker of labor puskesmas. Data obtained to use the quesioner, circumstantial interview and document observation. Result: Quantitative analysis indicate that there is relation have a meaning of between training by continuitas service, p=0,025. Availibility of logistics of medium and medium pre have the relation having a meaning by continuitas service, p=0,038. Availibility of book of guidance and module influence the contuinitas service, p=0,003. Execution supervise to have the relation having a meaning to Continuation of services, p=0,028. Availibility of fund very relate to the continuitas service, p=0,016. Conclussion: Continuation of services not yet in priority, focus the training [of] [at] problem tekhnis, supervise not yet effective, fund support still less, and there is relation having a meaning between management of Tuberculosis handling by continuitas service. Suggestion. Continuation of services need in priority so that break the infection link. Lead on duty to be giving support of morale and materil. coach Or facilisator require to improve the communications concept with the patient, Supervise hence checklist and advocasi improved.

Kata Kunci : Layanan Kesehatan,Tatalaksana Pengobatan Tuberkulosis Paru, Continuation of services, Tuberculosis, Health Office of Tanah Datar District