PENEMUAN TUBERKULOSIS PARU DI PUSKESMAS RIMBO BUJANG KABUPATEN TEBO

SAFRIZAL, dr. Lutfan Lazuardi, M. Kes., Ph.D.

2015 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Tuberkulosis masih menjadi masalah kesehatan masyarakat serius menyebabkan meningkatnya angka kesakitan, kematian serta menjadi perhatian dunia. Meskipun berbagai upaya dilakukan untuk pengendalian TB, namun masih banyak ditemukan masalah di dalam penangannanya. Kabupaten Tebo untuk tiga tahun terakhir masih belum mencapai target minimal dibanding dengan jumlah suspek yang diperkirakan diperiksa. Tahun 2011 pencapaian pemeriksa suspek hanya 44,74%, tahun 2012 pencapaian pemeriksaan suspek 56,28%, dan tahun 2013 terjadi penurunan pencapaian pemeriksan suspek 38,94%. Pengamatan bagaimana penemuan penderita TB paru BTA positif di Puskesmas dilihat dari hambatan koordinasi antar tenaga kesehatan, hambatan koordinasi manajerial, dan hambatan koordinasi antar tenaga kesehatan dan masyarakat, maka penting dilakukan penelitian penemuan TB paru BTA positif di Puskesmas Rimbo Bujang Kabupaten Tebo. Tujuan: Mengidentifikasi bagaimana hambatan koordinasi terhadap penemuan penderita baru TB paru BTA posif di Puskesmas Rimbo Bujang Kabupaten Tebo. Metode: Penelitian deskriptif kualitatif bertujuan untuk menggambarkan secara jelas sesuai kenyataan empiris yang terjadi di lapangan. Adapun desain penelitian menggunakan pendekatan studi kasus. Subyek penelitian pejabat dan staf Dinas Kesehatan Tebo, Kepala Puskesmas serta petugas terkait program TB di puskesmas, teknik pengambilan data melalui wawancara mendalam dan observasi serta telaah dokumen. Hasil: Koordinasi penemuan penderita TB paru BTA positif di Puskesmas Rimbo Bujang sudah berjalan efektif, tetapi ada hambatan dan keterbatasan yang perlu dikelola, di perbaiki pada kualitas dan kuantitas SDM, penganggaran, promosi dan penyuluhan program TB, beban kerja berlebihan, kerjasama praktek dokter swasta serta pencatatan dan pelaporan di tingkat puskesmas. Kegiatan manajerial adalah supervisi yang dilaksanakan Dinas Kesehatan dan puskesmas tidak berjalan optimal, supervisi dilaksanakan secara insidentil dan jadwal supervisi tidak pasti waktunya. Konsekuensi rendahnya cakupan program terutama penemuan TB paru di puskesmas. Kegiatan koordinasi antar petugas dengan masyarakat di Puskesmas Rimbo Bujang dalam penemuan penderita baru TB paru BTA positif sudah berjalan, namun ada hambatan dan keterbatasan yang perlu diperbaiki ke depan seperti promosi aktif dan penyuluhan, kunjungan rumah, kerjasama kader dan dukungan dari PKK. Kata kunci : Tuberkulosis, koordinasi, hambatan penemuan penderita TB paru

Background: Tuberculosis still a serious public health problem that it causes increased morbidity, mortality, and most concern of the world. Tuberculosis has been controlled in many ways but there are still many problems. Tebo district has not yetachieved the minimum target when compared to the number of TB suspects examined in three years. In 2011, inspectors suspected achievement only 44.74%, in 2012 56.28% suspects examination achievement, and in 2013 decreased 38.94% suspects examination achievement. Observation of pulmonary TB BTA positive case detection in health center visits of obstacle coordination among health workers, managerial coordination obstacle, and obstacle coordination among health professionals and cimmunity. Based on this it is important to do research TB Pulmonary BTA positive detection at Rimbo Bujang health center Tebo district. Objective: To identify obstacle of coordination to the detection a new case of pulmonary TB BTA positive Rombo Bujang health center Tebo district. Methods: This study used descriptive qualitative method. This method aims to describe the fact that occur in the field. The study design used a case study approach. Research subject are officials and staff research of Tebo Health District, Head of health center and related personnel TB programs in health centers.Data collection used in-depth interviews, observation and document review. Results: Coordination of case detection of TB pulmonary BTA positive has been effectively in Rimbo Bujang health center but there are obstacle and limitations that need to be managed, improved on the quality and quantity of human resources, budgeting, promotion and counseling of TB programs, over workload, the cooperation of private physician practices and record keeping and reporting at health center level. Managerial activities are not optimal (Health district office conducted supervision and health centers), supervision implemented incidentally and uncertain time schedule. Coordination of new case detection of pulmonary TB BTA positive among health workers and community has been running well in Rimbo Bujang health centerl but there are obstacle and limitations that need to be fixed to the front as the active promotion and counseling, home visits, cooperation and support of the PKK cadres. Keywords: Tuberculosis, coordination, barrier of pulmonary TB case detection

Kata Kunci : Tuberkulosis, koordinasi, hambatan penemuan penderita TB paru; Tuberculosis, coordination, barrier of pulmonary TB case detection