Analisis efektivitas biaya operasional program kesehatan ibu dan anak terkait penurunan angka kematian ibu di Kabupaten Muaro Jambi

RAMBE, Muhammad Darwis, Agastya, SE., MBA., MPM

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Salah satu permasalahan kesehatan yang harus diselesaikan seperti yang tertuang di dalam komitmen global bagi negara berkembang yakni Millenium Develompment Goals (MDGs) adalah penurunan Angka Kematian Ibu (AKI). Jika dilihat dari aspek pembiayaan kesehatan maupun sumber daya manusia kesehatan dan sarana kesehatan yang ada maka upaya peningkatan cakupan program kesehatan dan ibu dan anak dalam rangka penurunan angka kematian ibu di Kabupaten Muaro Jambi seharusnya tidak mengalami kendala yang cukup berarti tetapi kenyataannya hampir semua target indikator yang telah ditetapkan setiap tahunnya belum tercapai dan kasus kematian ibu semakin meningkat. Hal ini dimungkinkan bahwa biaya operasional program KIA yang telah dianggarkan setiap tahunnya terkait penurunan angka kematian ibu belum berjalan efektif. Metode Penelitian: Metode kualitatif dengan rancangan penelitian study eksploratif yang bertujuan untuk mengetahui efektivitas biaya operasional program kesehatan ibu dan anak terkait penurunan angka kematian ibu di Kabupaten Muaro Jambi. Hasil: Kasus kematian ibu di Kabupaten Muaro Jambi hampir sebagian besar disebabkan kasus komplikasi yakni pendarahan dan eklamsia. Meskipun alokasi biaya operasional program KIA mengalami peningkatan dari tahun 2005 - 2007. Tetapi dilihat dari proporsionalnya yang didasarkan pada kegiatan pokok KIA terkait penuruanan angka kematian ibu dan penerapan strategi MPS ternyata pengalokasiannya kurang proporsional terutama biaya operasional untuk aktivitas peningkatan pelayanan kegawatdaruratan sangat kecil sekali dan semakin menurun setiap tahunnya. Kesimpulan: Alokasi biaya operasional program KIA terkait penurunan angka kematian ibu di Kabupaten Muaro Jambi mengalami peningkatan. Tetapi aktivitas yang dilakukan belum sepenuhnya diarahkan untuk mengatasi penyebab kasus kematian ibu yang lebih didominasi oleh kasus pendarahan dan eklamsia. Oleh karena itu, agar pemanfaatan biaya operasional program KIA lebih efektif maka aktivitas yang harus dilaksanakan lebih fokus pada aktivitas penambah nilai yang mengatasi kedua penyebab kematian ibu tersebut yakni peningkatan kualitas pelayanan antenatal care dan peningkatan kualitas pelayanan kegawatdaruratan.

Background: One of the health problems that should be overcomed as stated in global commitment for developing country Millenium Development Goals (MDGs) was the decreasing of maternal mortality rate (AKI). If it is seen from the aspects of health financing or human resources in health and the existing of health facility; the improvement effort of health program coverage, maternal and perinatal health in decreasing maternal mortality rate in Muaro district of Jambi should not experienced obstacles. However, almost all of the stated indicator targets was not yet achieved and maternal mortality case was still keep improved. This might be caused by the operational cost of maternal and perinatal health program which have been budgeted every year that was related with the decreasing of maternal mortality rate that was not effective. Method: This was a qualitative research that used explorative study design that was aimed to find out the effectiveness of operational cost of maternal and perinatal health that was related with the decreasing of maternal mortality rate in Muaro district of Jambi. Result: Most of maternal mortality rate in Muaro district of Jambi was caused by complication case that was bleeding and eclampsia. The operational cost allocation of maternal and perinatal health (KIA) was improved in the year of 2005 -2007. Nevertheless, if it is seen proportionally based on the main activity of KIA that was related with the decreasing of maternal mortality rate and MPS strategy application, the allocation was not proportional especially in operational cost for emergency service improvement activity that was decreased gradually annually. Conclusion: The operational cost allocation of maternal and perinatal health that was related with the decreasing of maternal mortality rate in Muaro district of Jambi was improved. However, activities conducted were not directed to solve the cause of maternal mortality case that was dominated by bleeding and eclampsia. Therefore, in order to make the utilization of operational cost of KIA program could be more effective , the activity should be more focused on the activity of value added which could solve the causes of maternal mortality that was quality improvement of antenatal care service and quality improvement of emergency service.

Kata Kunci : Program kesehatan ibu dan anak,Biaya operasional,Aktivitas penambah nilai,Efektivitas biaya,Maternal mortality, maternal and perinatal health program, operational cost, value added activity, cost effectiveness