EVALUASI PELAKSANAAN MANAJEMEN TERPADU BALITA SAKIT (MTBS) PADA PETUGAS KESEHATAN DALAM TATALAKSANA PNEUMONIA PADA BALITA DI KABUPATEN ACEH BESAR

Dewi Sartika Adnan, dr. Mei Neni Sitaresmi, SpA(K), Ph.D.

2013 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Pneumonia merupakan salah satu masalah kesehatan dan penyebab terbesar kematian anak di seluruh dunia, di Indonesia menyumbang 6 juta kasus pertahun dan termasuk kedalam 6 negara yang terbesar kejadian pneumonia pada balita. Jumlah kematian karena pneumonia 609 balita dari 480.033 kasus. Angka penemuan dini pneumonia sangat rendah di Indonesia yaitu 20% jauh dari target pemerintah 80%. Keadaan ini dapat meningkatkan angka kematian balita. Pelayanan MTBS sudah dilaksanakan sejak tahun 1997. Tatalaksanaan balita dengan pneumonia didukung sumber daya manusia dari petugas kesehatan, pendanaan, sarana, dan prasarana. Tujuan Penelitian: Diketahui bahwa pelatihan MTBS berguna untuk meningkatkan keterampilan petugas kesehatan dalam tatalaksana pneumonia yang komprehensif. Metode Penelitian: Penelitian ini merupakan studi observasional dengan rancangan cross sectional, subjek penelitian adalah semua petugas yang memberikan pelayananan MTBS di Puskesmas wilayah kerja Kabupaten Aceh Besar dan penelitian ini mengikutsertakan balita yang melakukan konsultasi kesehatan dengan keluhan batuk. Analisis data meliputi dari analisis univariabel, two-sample t-test with unequal variances, korelasi pearson product moment serta multivariable menggunakan uji regresi linier Hasil: Keterampilan tatalaksana pneumonia pada petugas kesehatan yang telah dilatih lebih baik dari pada petugas kesehatan yang tidak dilatih dengan perbedaan rerata 14,3% (95% CI 11.7-16.9), dengan nilai perbandingannya 127%. Tingkat pengetahuan berpengaruh terhadap keterampilan tatalaksana pneumonia p<0,05), sedangkan pendidikan, masa kerja, sarana, supervisi tidak berhubungan dengan keterampilan tatalaksana pneumonia p>0,05. Pelatihan berkontribusi paling dominan 63,6% mempengaruhi keterampilan tatalaksana pneumonia. Kesimpulan: Keterampilan petugas yang telah dilatih lebih baik dibandingkan keterampilan petugas yang tidak dilatih. Pengetahuan berhubungan dengan keterampilan petugas dalam tatalaksana pneumonia. Sedangkan pendidikan, masa kerja, sarana, supervisi tidak berhubungan dengan keterampilan petugas dalam tatalaksana pneumonia.

Background: Pneumonia was one of the biggest health problems and the causes of children death around the world. In Indonesia pneumonia accounted for 6 million cases per year and be one of the 6 countries with the largest incidence of pneumonia in infants. The number of death due to pneumonia was 609 infants of 480.033 cases. Early detection rate of pneumonia was very low in Indonesia, which is 20 % away from the government target of 80%. This situation could increase the mortality rate. IMCI services have been implemented since 1997. For the management of infants with pneumonia which was supported by human resources from health professionals, funding, facilities, and infrastructure. Objective: It is known that IMCI training is useful to improve the skills of health workers in the management of a comprehensive pneumonia. Methods: This study was an observational study with cross-sectional design. The research subjects were all workers who provide services of IMCI at community health centers of Aceh Besar district area and the study involving infants who did medical consultations with cough complaint. Data analysis included univariable analysis, two-sample t -test with unequal variances, Pearson product moment correlation and multivariable using multiple linear regression test. Results: Skills management of pneumonia at health workers who have been trained better than the health care workers who were not trained with the mean difference 14.3% (95% CI 11.7-16.9), with value changes 26%.The skill level of knowledge influenced the management of pneumonia (p< 0.05), where as education, years of service, facilities, supervision was not related to the treatment of pneumonia skills p > 0.05. The training contributed most dominant 63.6 % affects the treatment of pneumonia skills. Conclusion: The skills of health workers who have been trained better than the skills of health workers who are not trained. The knowledge related to the skills of workers in the management of pneumonia. While education, years of service, facilities, supervision were not related to the health workers skills in the managements of pneumonia.

Kata Kunci : Pelatihan MTBS, Keterampilan petugas, tata laksana pneumonia; IMCI training, skills, management pneumonia