Implementasi supervisi terpadu terhadap kinerja program KIA (kesehatan ibu dan anak) di Kabupaten Kediri Jawa Timur
HERAWATI, Diana, dr. Lutfan Lazuardi, M.Kes., Ph.D
2009 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: Dinkes kabupaten Kediri merupakan salah satu Dinas tekhnis daerah yang berada di bawah pemerintahan Kabupaten Kediri dan mempunyai tugas pokok melaksanakan kewenangan dalam bidang kesehatan otonomi daerah dalam berbagai peran pemerintah. Elemen yang penting dari manajemen suatu program adalah supervisi. Tanpa adanya supervisi sangat sulit kiranya obyektif suatu program dapat dicapai secara efisien dan efektif. Pengetahuan dan keterampilan petugas dipegaruhi oleh pembinaan dan bimbingan yang tentunya banyak faktor yang mempengaruhinya, diantaranya adalah pelaksanaan supervisi yang dilakukan Dinkes dan puskesmas. Untuk menyamakan persepsi tentang supervisi serta meningkatkan kualitas pelayanan dan pencapaian program maka Kebijakan Kepala Dinas Kesehatan Kabupaten Kediri untuk menjalankan kembali supervisi terpadu. Tujuan Penelitian: Mendapatkan informasi tentang pelaksanaan supervisi terpadu, efisiensi perencanaan dan pelaksanaan pada kinerja program KIA di Dinas Kesehatan Kabupaten Kediri Metode: Penelitian ini yaitu metode deskriptif kualitatif dengan rancangan studi kasus. Penelitian ini dilakukan di Dinkes dan 4 puskesmas, sebagai unit analisis Kadinkes, kasubdin KMR, kasi KIA, Kepala Puskesmas, bidan koordinator puskesmas dan bidan di desa. Instumen penelitian peneliti sendiri dengan panduan wawancara mendalam, kuesioner dan cek dokumentasi Hasil Penelitian: Kesiapan SDM seksi KIA Dinas kesehatan Kabupaten Kediri masih bervariasi belum ada kriteria supervisor. Pendanaan supervisi terpadu belum ada dukungan dari Pemda karena masih uji coba dana berasal dari shering semua subdin dan seksi. Pedoman dan pelaksanaan melibatkan semua program yang ada di Dinkes dan Puskesmas. Komitmen kehadiran Kasubdin, kasi, pemegang program Dinkes untuk turun bersama-sama ke Puskesmas memecahkan masalah di lapangan masih kurang dan karena jabatan banyak yang kosong dan merangkap. Pencatatan dan laporan di seksi kesga & repro belum di arsip khusus dan tidak teratur di Puskesmas di arsip khusus dan teratur. Pengorganisasian ada panitia khusus tim supervisi terpadu. Follow up belum ada pertemuan khusus tentang supervisi terpadu evaluasi di gabungkan dengan pertemuan kepala Puskesmas dan bidan koordinator setiap bulan supervisi terpadu di lanjutkan dengan supervisi program dan fasilitatif. Kesimpulan: Implementasi supervisi terpadu terhadap kinerja program KIA lebih efisien dari supervisi program tapi belum efektif karena output supervisi terpadu belum kelihatan pada peningkatan cakupan program KIA.
Background: District Health Office of Kediri is one of regional technical offices under the district government of Kediri and had the main task in implementing the authority of health field autonomy in various government roles. An important element from management of a program is supervision. Without supervision, it is very difficult for a program to be accomplished effectively and efficiently. Knowledge and skill of the health care provider was influenced by supervision and guidance that had many influenced factors such as supervision implementation that was implemented by health office and primary health care. In order to adjust the meaning of supervision as well as to improve the quality service and program achievement, it is the policy of the head of district health office of Kediri to reimplement the comprehensive. Objective: This research was aimed to obtain information on comprehensive supervision, planning efficiency, and the implementation of maternal and perinatal health (KIA) program in the district health office of Kediri. Method: This was a descriptive qualitative case study. The study was conducted in district health office and 4 primary health cares. The subject of the study was the head of health office, head of sub division of KMR, head division of KIA, head of primary health care, coordinator midwife of primary health care, and village midwife. The used instrument was interview guidance, questioner and check list. Result: The preparedness of human resources in KIA division was varied and yet there was no supervision criteria. There was no funding support of comprehensive supervision from regional government as there was still funding try out and sharing from divisions and sections. Implementation and guidance involved all programs in the health office and primary health care. There was still lack of commitment of head division’s attendance, program implementator of health office to solve the problem in the field because there were many empty positions and double duties. Report and registration of family welfare division and reproduction have not been well recorded in primary health care. There was a special team to organize the comprehensive supervision. In addition, there was no special meeting for comprehensive supervision. Evaluation was combined in the meeting of head of primary health care and coordinator midwife every month. Comprehensive supervision was followed with program supervision and facilitation. Conclusion: The implementation of comprehensive supervision in KIA was more efficient than program supervision although it was not yet effective as the output was not yet exist in the improvement of KIA program coverage.
Kata Kunci : Implementasi supervisi terpadu,Kinerja program KIA, implementation of comprehensive supervision, performance of KIA program
