PEMANFAATAN PELAYANAN SKRINING KANKER LEHER RAHIM DI RUMAH SAKIT UMUM DAERAH DR. ZAINOEL ABIDIN BANDA ACEH

Adri IDiana, dr. Ova Emilia, SpOG (K)., M.M.Ed., Ph.D.

2012 | Tesis | S2 Kesehatan Masyarakat/KIA

Latar belakang: Program pencegahan kanker leher rahim di negara maju telah efektif dalam mengurangi kesakitan dan kematian karena penyakit ini. Insiden kanker leher rahim di negara berkembang 61/100.000 perempuan sedangkan di negara maju 11/100.000 perempuan. Salah satu upaya yang dilakukan untuk pencegahan adalah dengan melakukan skrining kanker leher rahim. Skrining kanker leher rahim dapat mendeteksi sedini mungkin perubahan dari sel rahim sehingga dapat mencegah penyakit berkembang kearah yang lebih serius. Namun pemanfaatan skrining kanker leher rahim di Negara Berkembang masih sangat rendah disebabkan oleh banyak faktor diantaranya ketersediaan fasilitas pelayanan dan sumber daya manusia. Tujuan penelitian: Mengetahui gambaran pemanfaatan pelayanan skrining kanker leher rahim. Metode penelitian: Jenis penelitian kualitatif dengan rancangan studi kasus. Pengambilan sampel menggunakan purposive sampling. Informan utama yaitu wanita yang memanfaatkan dan yang tidak memanfaatkan pelayanan pap smear, petugas kesehatan dan pengambil kebijakan. Pengumpulan data melalui Diskusi Kelompok Terarah (DKT), wawancara mendalam dan observasi. Analisis data menggunakan deskriptif analitik. Hasil Penelitian: Fasilitas pelayanan pap smear dan laboratorium penunjang telah tersedia. Pelayanan skrining kanker leher rahim yang diberikan oleh petugas sudah sesuai dengan aturan yang berlaku. Wanita memanfaatkan pelayanan pap smear karena didorong akan kebutuhan atas kesehatannya bukan karena informasi yang diterima dari petugas. Petugas belum melakukan promosi dan pemberian informasi kesehatan secara proaktif. Alasan wanita yang belum memanfaatkan pelayanan pap smear adalah takut dan malu karena belum tahu prosedur pemeriksaan, tidak ada keluhan, biaya mahal. Kesimpulan: Adanya fasilitas pap smear di RSUDZA memberikan kemudahan kepada klien yang membutuhkan pelayanan ini. Namun promosi belum dilakukan secara aktif dari instansi maupun petugas kesehatan sehingga pemanfaatannya masih rendah. Untuk meningkatkan pemanfaatan pelayanan pap smear selanjutnya diharapkan rumah sakit dapat mengambil kebijakan lain yang bersifat proaktif seperti kegiatan pap smear gratis saat ulang tahun dan melakukan sosialisasi tentang tindakan pap smear melalui poster, leaflet dan kegiatan promosi lainnya.

Background: Cervical cancer prevention programs in developed countries have been effective in reducing morbidity and mortality caused by this cancer. The incidence of cervical cancer in developing countries is 61/100,000 women while in developed countries it reaches only 11/100,000 women. One effort made to the cancer prevention is to perform cervical cancer screening. This screening can detect early changes of cervical cells that can prevent the disease’s serious progresses. However, the utilization of cervical cancer screening in developing countries is still very low due to many factors, including the availability of service facilities and human resources. Objective: To determine the overview of cervical cancer screening services utilization. Methods: This was a qualitative research with a case study design. Samples were taken using a purposive sampling. The main informants were women who utilized and did not utilized the pap smear services, health officers and decision-makers. The data was collected through Focus Group Discussions (FGDs), in-depth interviews and observation. The data analysis used a descriptive analytic method. Result: Facilities of pap smear services and supporting laboratory had been available. Cervical cancer screening services provided by the officers had met the existing rules. The women utilized the pap semar services driven by their need to health not by the information received from the officers. The officers had not been proactively given the health promotion and information. In addition, some reasons for women who had not utilized the pap smear services yet were that they were afraid and embarrased due to their lack of information about examination procedure; however, there was no complaint about the high cost of the services. Conclusion: Pap smear facility in RSUDZA had already given an easy access to provide services to women in need of this service. However, the promotion had not actively been done by the related institution or health officers so that the utilization was still low. To enhance the utilization of pap smear services in the future, the hospital is expected to provide another policy which is proactive such as giving free pap smear services for any women who celebrate their birth days and conducting disseminations about pap smear services through poster, leaflet, and other promotional activities.

Kata Kunci : kualitatif, pemanfaatan pelayanan skrining kanker leher rahim, pap smear