Evaluasi Program Pemberian MP-ASI Bubuk Instan dan Biskuit di Kota Mataram, Kabupaten Lombok Barat, Lombok Timur dan Bengkulu Utara Tahun 2007

ADIYASA, I Nyoman, Prof. dr. Hamam Hadi, MS,Sc

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Peningkatan jumlah keluarga miskin diikuti pula dengan peningkatan prevalensi gizi kurang dan gizi buruk. Prevalensi balita gizi buruk berdasarkan BB/U di Propinsi NTB dan di Propinsi Bengkulu tahun 2005 masih di atas target nasional. Upaya pemerintah menurunkan prevalensi gizi kurang/buruk dengan pemberian MP-ASI pabrikan pada bayi dan anak usia 6-24 bulan dari keluarga miskin. Program ini telah dilaksanakan sejak tahun 2003- 2005 dan banyak ditemukan masalah. Tahun 2007 kembali dilaksanakan program MP-ASI bubuk instan dan biskuit tetapi belum dievaluasi keberhasilannya. Tujuan : Mengetahui tingkat keberhasilan program MP-ASI bubuk instan dan biskuit di Kota Mataram, Kabupaten Lombok Barat, Lombok Timur, dan Bengkulu Utara Tahun 2007. Metode : Jenis penelitian observasional dengan rancangan pre and post test design, menggunakan pendekatan deskriptif, analitik, kuantitatif, kualitatif dan eksploratif. Subyek penelitian yaitu pengelola/pelaksana program MP-ASI di tingkat propinsi, kabupaten/kota, puskesmas, di kelurahan/desa/posyandu dan sasaran program. Variabel input, proses, output, dan outcome diperoleh dengan cara observasi, pengisian kuesioner, wawancara mendalam dan pencatatan data sekunder. Analisis data secara deskriptif, analitik dan kwalitatif. Hasil : Input ; secara kuantitas tenaga cukup tetapi secara kualitas kurang, dana sosialisasi tingkat puskesmas tidak ada, hanya di Kabupaten Lombok Barat dan Lombok Timur yang mempunyai dana monitoring petugas, buku pedoman MPASI tahun 2007 tidak ada di Kabupaten Bengkulu Utara, petunjuk teknis hanya dibuat oleh Kabupaten Lombok Timur, gudang hanya 50% yang memenuhi syarat, paket MP-ASI hanya di Kabupaten Bengkulu Utara yang sesuai dengan jumlah yang diusulkan, metode pendistribusian sesuai dengan buku pedoman, Proses ; perencanaan tidak sesuai dengan buku pedoman, penyimpanan 43,8% sesuai persyaratan, pendistribusian 31,3% sesuai jadwal jumlah jenis, pemantauan sesuai jadwal posyandu, Output ; rata-rata 78,8% tepat sasaran, 32,5% tepat jumlah, 95,6% dapat meningkatkan berat badan dan hasil uji statistik diperoleh p<0,05, Dampak : rata-rata 55,6% dapat menanggulangi dan mencegah terjadinya gizi buruk, gizi kurang dan mempertahankan status gizi baik dan hasil uji statistik Skor Z diperoleh p<0,05. Kesimpulan : Tingkat keberhasilan : Input program di tiga kabupaten/kota termasuk kategori sedang kecuali di Lombok Timur kategori baik. Proses : di Kota Mataram dan Kabupaten Lombok Timur kategori sedang, di Lombok Timur dan Bengkulu Utara kategori kurang. Output di tiga kabupaten/kota termasuk kategori kurang, kecuali di Bengkulu Utara termasuk kategori sedang. Dampak program di semua kabupaten/kota termasuk kategori kurang. Ada perbedaan rata-rata sasaran berat badan sebelum dengan sesudah diberikan MP-ASI. Ada perbedaan rata-rata sasaran Skor Z sebelum dengan sesudah diberikan MP-ASI.

Increasing number of poor families leads to higher prevalence of malnourishment and malnutrition. The prevalence of malnutrition in children under five based on weight/age at the Province of Nusa Tenggara Barat and Bengkulu 2005 was above the national target. An effort made by the government to minimize the prevalence of malnourishment/malnutrition is through the distribution of individual complementary breastfeeding for infants and children of 6-24 months old from poor families. The program had been implemented since 2003-2005 and there were problems of its implementation. In 2007 the program was reimplemented through the program of instant powder and biscuit complementary breastfeeding distribution but its achievement has never been evaluated. To evaluate the achievement of instant powder and biscuit complementary breastfeeding program at Mataram Municipality, District of Lombok Barat, Lombok Timur and Bengkulu Utara 2007. Method: The study was observational with pre and post test design using descriptive, analytical, quantitative, qualitative and explorative approaches. Subject of the study were managers of complementary breastfeeding program at provincial, district/municipal level, health centers, villages/integrated service post and program target. Variables of input, process, output and outcome were obtained through observation, filling in questionnaires, indepth interview and secondary data recording. Data were analyzed descriptively, analytically and qualitatively. Result: Input: human resources were quantitatively adequate and qualitatively inadequate; there was no budget for socialization at the health center; except at District of Lombok Barat and Lombok Timur there was budget for staff monitoring; guidebook for complementary breastfeeding 2007 was unavailable at District of Bengkulu Utara; technical guideline was only available at District of Lombok Timur; only 50% warehouses fulfilled the requirement; complementary breastfeeding packages relevant with the quantity proposed were only available at District of Bengkulu Utara; the distribution method was relevant with the guidebook. Process: planning was irrelevant with the guidebook; storage was 43.8% relevant with the requirement; distribution was 31.3% relevant with the schedule, quantity and types ; monitoring was relevant with the schedule of integrated service post. Output: In average the program was 78.8% relevant with target; 32.5% relevant with quantity; 95.6% could improve gain weight and the result of statistical test showed that p<0.05. Outcome: in average the program could overcome and prevent the prevalence of malnutrition, malnourishment and sustain good nutrition status as much as 55.6% and the result of Z score statistical test was p<0.05. Achievement of instant powder and biscuit complementary breastfeeding program in aspect of input was average at three districts/municipality and good at District of Lombok Timur and poor at District of Bengkulu Utara; in aspect of output was poor at three districts/municipality and average at District of Bengkulu Utara; in aspect of outcome was poor at all districts/municipality. There was difference in average weight target before and after the supply of complementary breastfeeding. There was difference in average Z score target before and after the supply of complementary breastfeeding.

Kata Kunci : Evaluasi Program,Bayi dan Anak Usia 6,24 bulan Gakin,MP,ASI Bubuk Instan dan Biskuit