Evaluasi program pencegahan gizi buruk melalui promosi dan pemantauan pertumbuhan anak balita di posyandu di Kota Mataram

JULIAWAN, Dudut Eko, Dra. Yayi Suryo Prabandari, M.Si, Ph.D

2009 | Tesis | S2 Magister Perilaku Promosi Kesehatan

Latar belakang: Angka kematian bayi di Provinsi Nusa Tenggara Barat saat ini 77 per 1.000 kelahiran hidup, di atas rata-rata angka nasional 35 per 1.000 kelahiran hidup. Angka kematian ibu 370 per 100.000 kelahiran di atas rata-rata angka nasional 307 per 100.000 kelahiran. Sementara itu angka melek huruf masih di bawah angka nasional. Derajat kesehatan masyarakat di Provinsi Nusa Tenggara Barat yang masih memprihatinkan tersebut diperparah dengan adanya kejadian luar biasa gizi buruk pada tahun 2005 yang lalu. Gizi buruk dapat dicegah melalui kegiatan posyandu. Promosi dan pemantauan pertumbuhan anak balita di posyandu dapat mendeteksi kasus gizi buruk secara dini. Tujuan Penelitian: mengetahui bagaimana pelaksanaan program pencegahan gizi buruk melalui promosi dan pemantauan pertumbuhan anak balita di posyandu di kota Mataram. Metode Penelitian: Penelitian kualitatif dengan 48 orang informan penelitian. Terdiri dari ibu balita sebanyak 14 orang, kader 10 orang, tokoh masyarakat 5 orang, petugas puskesmas 11 orang, tim pokjanal posyandu Kota Mataram 7 orang dan petugas dari provinsi 1 orang. Tempat penelitian di wilayah Kota Mataram. Data diambil secara purposive pada 3 kecamatan, yaitu Ampenan, Cakranegara dan Mataram. Pengumpulan data dengan wawancara mendalam, diskusi kelompok terarah (FGD) dan observasi. Triangulasi metode dan triangulasi sumber dipakai untuk menguji keabsahan data. Analisis data dilakukan dengan transkrip data, koding, penyajian data dan membuat kesimpulan. Hasil dan Pembahasan: Ibu balita yang berpendidikan rendah dan berpenghasilan rendah tidak memahami makna pertumbuhan anak balita, sehingga tidak mampu mencegah gizi buruk. Program promosi dan pemantauan pertumbuhan anak balita di posyandu belum dilaksanakan dengan baik, terutama di meja 3 pencatatan berat badan anak dan meja 4 penyuluhan. Kader belum mampu mendeteksi gizi buruk karena kurang pelatihan. Petugas puskesmas mempunyai beban kerja yang terlalu berat, sehingga tidak bekerja dengan baik di pelayanan posyandu. Kesimpulan: Program promosi dan pemantauan pertumbuhan anak balita di posyandu belum dilaksanakan dengan baik karena kinerja kader masih rendah, kinerja petugas puskesmas masih rendah, kurang dana, kurang peralatan dan kurang pembinaan yang intensif.

Background: Recently, the infant mortality rate in West Nusa Tenggara is remain high which is 77 per 1,000 birth lives. This number is above national rates (35 per 1,000 birth lives). The maternal mortality rate is also high, which is 370 per 100,000 birth, and is above national rates 307 per 100,000 birth. While the literate rate is still under national rate. Degree of community health that has been worse was worsening through outbreak malnutrition in 2005. Malnutrition can be prevented through posyandu activity. Growth monitoring and promotion of children under five years old in posyandu can detect case of malnutrition early. Objective: The study was aimed to know how did execution of programme of growth monitoring and promotion of children under five years old in posyandu in Mataram municipality. Method: This was a qualitative study. Forty eight informants participated in this study. Informants consisted of 14 mother of children under five years, 10 cadres, 5 leaders of community, 11 staff of community health centre (puskesmas), 7 members of Mataram posyandu operational working group (pokjanal posyandu) and 1 staff provincial health office. Location of the study was in Mataram municipality. Data was chosen purposively at three sub district that were Ampenan, Cakranegara and Mataram. Data was collected by in depth interview, focus group discussion and observation. Triangulation on methods and informans/source were used in assessing the trustworthiness of data. Data analysis was carried out through data transcript, open coding, data presentation and making conclusion. Result: Mother of children under five years old with low education and low income did not comprehend meaning growth of child, so that unable to prevent malnutrition. Growth monitoring and promotion of children under five years old has not been carried out well, particulary at desk 3th (weighting measurement) and desk 4th (counseling). Cadre have not had capacity to detect malnutrition, that may caused by lack of training. Staff of puskesmas had burden workload so that they did not work properly in delivery posyandu. Conclusion: Growth monitoring and promotion programme of child under five years old has not been carried out well, low work performance of cadre and puskesmas staff and lack of supervision.

Kata Kunci : gizi buruk,posyandu,pemantauan pertumbuhan,ibu,balita,malnutrition,posyandu,growth monitoring,mother of children under five years old