Evaluasi pelaksanaan sistem kewaspadaan dini kejadian luar biasa (SKD-KLBN) gizi buruk di Kabupaten Lombok Barat tahun 2006-2009

ROSMAYADI, Dr. ner.nat.dr. BJ. Istiti Kandarina

2010 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Gangguan pertumbuhan pada balita di Kabupaten Lombok Barat mengalami peningkatan dalam 4 tahun terakhir. Prevalensi gizi buruk masih tinggi dan terjadi peningkatan Case Fatality Rate. Kejadian gizi buruk perlu dideteksi dini melalui intensifikasi pemantauan pertumbuhan. Sistem Kewaspadaan Dini Kejadian Luar Biasa sebagai penyedia informasi penting dalam mencegah dan menanggulangi terjadinya gizi buruk. Tujuan Penelitian: Mengetahui pelaksanaan SKD KLB gizi buruk dan korelasinya dengan jumlah kasus gizi buruk di Kabupaten Lombok Barat tahun 2006-2009. Metode Penelitian: Penelitian ini adalah penelitian observasional dengan rancangan cross sectional study. Analisis secara kuantitatif dan kualitatif. Subyek penelitian ditentukan dengan sampling purposive, terdiri dari kepala puskesmas, tenaga pelaksana gizi, bidan desa dan kader posyandu aktif. Data dikumpulkan dengan wawancara dan observasi dokumen. Unit analisis di puskesmas Kabupaten Lombok Barat. Hasil Penelitian: Pelaksanaan SKD KLB buruk masih ada kegiatan yang belum dilaksanakan di puskesmas. Ada hubungan signifikan dan kuat dengan arah positif, yaitu semakin baik kajian epidemiologi rutin maka semakin banyak jumlah kasus gizi buruk, semakin baik peningkatan kewaspadaan dan kesiapsiagaan KLB gizi buruk maka semakin banyak jumlah kasus gizi buruk dan semakin baik kajian epidemiologi rutin maka semakin baik peningkatan kewaspadaan dan kesiapsiagaan KLB gizi buruk. Tidak ada hubungan yang signifikan yaitu antara peringatan kewaspadaan dini KLB gizi buruk dengan jumlah kasus gizi buruk, antara kajian epidemiologi rutin dengan peringatan kewaspadaan dini KLB gizi buruk dan antara peringatan kewaspadaan dini KLB gizi buruk dengan peningkatan kewaspadaan dan kesiapsiagaan KLB gizi buruk. Hasil analisis jalur variabel secara keseluruhan berpengaruh terhadap jumlah kasus gizi buruk dengan nilai R² sebesar 0,384. Kesimpulan dan saran: Pelaksanaan SKD KLB gizi buruk belum sesuai Pedoman SKD KLB Gizi Buruk. Uji statistik menunjukkan ada variabel yang berhubungan signifikan dan kuat dengan arah positif dengan jumlah kasus gizi buruk. Kegiatan kajian epidemologi rutin dan peningkatan kewaspadaan & kesiapsiagan KLB gizi buruk mempengaruhi jumlah kasus gizi buruk sebesar 38,4%. Diharapkan dinas kesehatan kabupaten melakukan pelatihan SKD KLB gizi buruk bagi petugas gizi puskesmas, melakukan evaluasi dan pembinaan. Puskesmas melakukan pelaporan, umpan balik, menganggarkan dana untuk keguatan SKD KLB gizi buruk, mengurangi tugas rangkap petugas gizi dan memanfaatkan kegiatan minilokakarya secara rutin sebagai bentuk pengawasan, pembinaan dan evaluasi pelaksanaan SKD KLB gizi buruk.

Background: Growth disorder in underfives at District of Lombok Barat has been increasing within the last four years. The prevalence of malnutrition is still relatively high and there is increase of case fatality rate. The prevalence of malnutrition needs early detection through intensification of growth monitoring. Outbreak alert system as information provider has important role to prevent and control the prevalence of malnutrition. Objective: To identify the implementation of malnutrition outbreak alert system and its correlation with cases of malnutrition at District of Lombok Barat 2006-2009. Method: This observational study used cross sectional study design and quantitative as well as qualitative analysis, Subject were purposively selected, consisting of head of health center, nutrition staff, village midwives and active integrated service post (Posyandu) cadres. Data were obtained through indepth interview and document study. Analysis unit were health centers at District of Lombok Barat. Result: Some activities related to malnutrition outbreak alert system had not been implemented at health centers. There was significant and strong association at positive direction, i.e. better routine epidemiologic studies meant more cases of malnutrition, better routine epidemiologic studies meant better nutrition outbreak alert and preparedness. There was no significant association between malnutrition outbreak alert warning and number of malnutrition cases, between routine epidemiologic studies and malnutrition outbreak alert warning and between malnutrition outbreak alert warning and increase of malnutrition outbreak alert and preparedness. Variable affecting number of malnutrition cases was routine epidemiologic studies and increase of malnutrition outbreak alert and preparedness (R2=0.384). Conclusion & Suggestion: The implementation of malnutrition outbreak alert system was not yet relevant with guideline of malnutrition outbreak alert system. The result of statistical analysis showed there was variable significantly and strongly associated at positive direction with number of malnutrition cases. Activities of routine epidemiologic studies and increase of malnutrition outbreak alert and preparedness could affect number of malnutrition cases as much as 38.4%. District health office should conduct training on malnutrition outbreak alert system for nutrition staff at health centers, evaluation and supervision. Health centers should make reporting, feedback, allocate budget for malnutrition outbreak alert system activities, minimize dual jobs of nutrition staff and utilize activities of mini workshops periodically as a form of monitoring, supervision and evaluation of malnutrition outbreak alert system implementation.

Kata Kunci : SKD KLB gizi buruk, Gizi buruk