Evaluasi Implementasi Kebijakan Posyandu di Kota Tegal
SUPENO, Agus, dr. Kristiani, SU
2008 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang : Keberadaan posyandu dalam era otonomi daerah tetap dipertahankan. Posyandu di Kota Tegal berjumlah 191 tersebar di 4 kecamatan. Pada tahun 2006, data kunjungan Balita ke posyandu di Kota Tegal yang ditunjukkan dengan indikator D/S hanya 52,85% berarti masih jauh di bawah target Standar pelayanan minimal untuk Provinsi Jawa Tengah sebesar 80%. Penelitian ini bertujuan untuk mengevaluasi implementasi Kebijakan tentang posyandu di Kota Tegal. Metode Penelitian : Jenis penelitian deskriptif dengan metode kualitatif, menggunakan rancangan studi kasus. Variabel penelitian adalah kebijakan, input dan proses tindakan kebijakan, output sebagai hasil kebijakan. Pengambilan data dengan cara wawancara, observasi lapangan, dan telaah arsip/dokumen dengan sumber antara lain data Dinas Kesehatan, Informasi dari Ketua, Sekretaris dan Anggota Pokjanal posyandu Kota Tegal, secara keseluruhan berjumlah 31 informan. Hasil Penelitian : Kebijakan posyandu di Kota Tegal mengikuti kebijakan dari pusat dan provinsi seperti kebijakan revitalisasi posyandu dengan memberikan uang transport kader dan dana PMT Penyuluhan. Input dana yang terkait posyandu cenderung naik dari tahun 2004 sebesar Rp.59.005.000,00 dan terakhir tahun 2007 sebesar Rp.257.250.000,00. Sekitar 50% Posyandu hanya dihadiri 1 tenaga kesehatan dengan tersedianya sarana esensial seperti Fe sebesar 50%, dan oralit sebesar 63%. Proses kegiatan posyandu tidak berjalan baik karena tidak tercukupinya input tenaga dan sarana/prasarana. Output indikator posyandu di Kota Tegal pada tahun 2007 adalah K/S 93,1%, D/S 58,1%, N/D 61,4%, N/S 35,6%. Pada perkembangannya dari tahun 2003 s.d. 2007 cenderung stagnan dan bahkan beberapa indikator mengalami penurunan. Koordinasi lintas program dan lintas sektoral di Kota Tegal sudah berjalan tetapi belum optimal. Dana yang bersumber dari partisipasi masyarakat, swasta, dan LSM menunjukkan perkembangan yang positif. Perkembangan selanjutnya adalah adanya upaya pihak swasta memberi bantuan tenaga kesehatan. Kesimpulan : Meskipun kebijakan posyandu di Tegal mengikuti kebijakan pusat dan provinsi, diperlukan dukungan input dari Pemda serta dikembangkannya mitra dari swasta dan LSM.
Background : The existence of posyandu (the integrated health service post) in local autonomy era remains existed. There are 191 posyandus in Tegal City, spreaded in four sub-districts. In 2006, only 52.85% of under five year-old children visited posyandu on Tegal city. It was still below standard minimum service target for Central Java Province, which was 80%. This research goal was to evaluate policy implementation of posyandu in Tegal City. Methods : Descriptive study type with qualitative method using case study was applied. Variables were policy, input and policy action process, and output as a result of policy. Data were collected by interview, field observation, file/document studies from health service data, information of leader, secretary and members of the operational working team of posyandu in Tegal City, with as much as 31 informants. Results : The policy of posyandu in Tegal City has followed central and provincial policy, such as, policy of posyandu revitalization with provision of cadre transport and additional fund for nutrition education. Budget input for posyandu tended to rise from 2004 as much as Rp.59,005,000.00 and Rp.257,250,000.00 in the end of 2007. Posyandu activity process did not work well because input of personnel and instruments/infrastructures were inadequate. Output of posyandu indicators in Tegal City in 2007 were 93.1% of K/S, 58.1% of D/S, 61.4% of N/D, 35.6% of N/S; its development from 2003 to 2007 tended to be stagnant and, even, some indicators were decreasing. Inter-program and inter-sector coordination in Tegal City had worked but not optimal. Data of society participation, individuals, and non government organization (NGO) showed positive progress. Other development was the effort of private parties to provide health personnel assistance. Conclusion : Although the policy of posyandu in Tegal has been in line with the central and government policy on posyandu, input supports from the local goverment and partnership with private sector and NGOs are needed.
Kata Kunci : Evaluasi Kebijakan,Input,Proses,Output, policy, input, process, output
