Evaluasi program eliminasi tetanus neonaturum di Kabupaten Bengkulu Selatan

SAHIDAN, dr. Tjahjono Kuntjoro, MPH.,Dr.PH

2001 | Tesis | S2 Ilmu Kesehatan Masyarakat

Penyakit tetanus neonatorum masih merupakan salah satu penyebab kematian pada mas neonatus. Sejak tahun 1990 telah dilakukan program eliminasi tetanus neonatorum dengan tujuan menurunkan angka kejadian tetanus neonatorum menjadi 1 / 10.000 kelahiran hldup. Di Indonesia angka kesalutan dan kematian akibat tetanus neoanatorum bervariasi, menurut hasil survey kesehatan rumah tangga 1992 memperkirakan 30.000 kematian bayi disebabkan tetanus neonatorum. Kabupaten Bengkulu Selatan angka kejadian dan kematian tetanus neoantorum masih relatif tinggi. Pada tahun 1998 terjadi 9,7 per 10.000 kelahiran hidup dengan Case fatality rate(CFR) 67,5%, tahun 1999 terjadi 3,86/ 10,000 kelahiran hidup dengan angka CFR 100 %, tahun 2000 dengan kejadian 2,291 10.000 kelahiran hidup dengan CFR 100%. Penelitian ini bertujuan untuk mengevaluasi pelaksanaan program eliminasi tetanus neonatoruin , pencapaian cakupan, dan faktor yang mendukung dan menghambat program pada puskesmas kantong dan bukan kantong di kabupaten Bengkulu Selatan. Jenis penelitian adalah penelitian evaluatif dengan pendekatan kualitatif menggunakan alat penelitian dafiar tilik, wawancara mendalam dan diskusi kelompok terarah.terhadap input ( tenaga, sarana,dan dana), proses ( Perencanaan(P 1 ), Penggerakakan Pelaksaiiaan (P2) dan Pengawasan, pengendalian dan penilaian (P3). Hasil penelitian didapatkan keadaan input baik tenaga, sarana, dan dana puskesmas kantong dan bukan kantong tetanus neoantonim dalain kondisi cukup, Proses peiencanaan( P 1 ) , Penggerakkan pelaksanaan (P2),dan Pengawasan, Pengendalian dan Penilaian(P3) baik pada puskesmas kantong dan bukan kantong tetanus neonatorum sudah memadai. Namun ada puskesmas pada daerah kantong yang beluin meinbuat perencanaan dan belum optimalnya supervisi. Cakupan program puskesmas kantong belum mementh target, sedangkan pada puskesmas bukan kantong telah mencapai target yang ditetapkan Faktor pendukung program adanya bidan desa dan imunisasi calon penganten dan faktor penghambat adalah tempat tinggal penduduk yang jauh dari desa, tingkat pengetahuan inasyarakat akan tetanus neonatorum inasih rendah. Diharapkan puskesmas dapat ineningkatkan penyuluhan , pelatihan pada petugas, mencapai target cakupan , dan meningkatkan supervisi dan bimbingan teknis

Neonatal tetanus is one of mortality factors in neonatal stage. Since 1990 there has been neonatal tetanus elimination program to decrease the number of neonatal tetanus cases up to 1 per 10,000 life births, In Indonesia the rate of mortality and disease as result of neonatal tetanus is varied. Household health survey in 1992 predicted that 30,000 infant mortality was caused by neonatal tetanus. In South Bengkulu the neonatal tetanus cases and mortality were still relatively high. Zn 1998, there were 9.7 cases per 10,000 life births with 67.5% case fatality rate, in 1999 there were 3.86 cases per 10,000 life birtlis with 100?/’0 case fatality rate. In 2000, there were 2.29 cases per 10,000 life births with 100% case fatality rate. This study was aimed at evaluating the neonatal tetanus elimination program, its coverage and factors supporting and threatening the program at pocket and non pocket areas health centre in South Bengkulu. This was an evaluation study using qualitative approach, using check list, in depth interviews, focus group discussion on inputs (human resources, equipment and budget), process (planning), actuating and implementation, supervision, controlling and evaluation. The result of study showed that condition of input, namely human resources, facilities, and budget at pocket areas health centre was adequate Planning(Pl), Implementation drive(P2), supervision,control, and evaluation(T3), at pocket areas and non-pocket areas health centre was adequate. However there was health centre at pocket areas that had not made planning and its supervision was not optimal. The coverage of program at pocket areas health centre had not reached target, While non pocket area health centre achieve the established target. The supporting program factor were availbility of midwife and pre married immunization. Inhibiting factor included inhibition residence bieng far from village area, the level of awarness of community member on neonatal tetanus was low. It was Expected health centre was able to improve health extension, staff tanning, full filing coverage target aiid promoting supervision and technical guidance.

Kata Kunci : Manajemen Kesehatan Masyarakat,Program Eliminasi Tetanus Neonaturum,Kabupaten Bengkulu Selatan, Program evaluation, Neonatal tetni elimination, pocket an non pocket areas health centre