EVALUASI PEMANFAATAN EARLY WARNING ALERT AND RESPONSE SYSTEM (EWARS) DI KABUPATEN BOYOLALI

SRI YATMI MEI K, Prof. dr. Hari Kusnanto, Dr.PH.

2015 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Kabupaten Boyolali telah menerapkan Early Warning Alert and Response System (EWARS) dalam upaya kewaspadaan dini dan respon terhadap penyakit – penyakit potensial Kejadian Luar Biasa (KLB). Meskipun telah menerapkan EWARS dengan ketepatan waktu dan kelengkapan laporan yang cukup baik, namun KLB masih banyak terjadi di Kabupaten Boyolali. Ada peningkatan jenis KLB setelah penerapan EWARS. Tujuan: Mengevaluasi pengelolaan dan pemanfaatan informasi sistem kewaspadaan dini dan respons KLB ―EWARS‖ dalam kegiatan surveilans di Kabupaten Boyolali Jawa Tengah. Metode: Penelitian ini merupakan penelitian kualitatif dengan rancangan studi kasus eksploratoris. Subjek dalam penelitian ini adalah 1 orang Petugas Surveilans Kabupaten (District Surveilans Officer/DSO), 29 orang Petugas Surveilans Puskesmas, 1 orang Kepala Seksi Pencegahan dan Surveilans Dinas Kesehatan, 1 orang Kepala Bidang P3PL dan 1 orang Kepala Dinas. Unit analisis pada penelitian ini adalah Sistem Kewaspadaan Dini dan Respon KLB ―EWARS‖ Dinas Kesehatan Kabupaten Boyolali. Data dikumpulkan dengan cara wawancara mendalam, Focus Group Discusion (FGD), observasi langsung dan observasi partisipan dengan menggunakan panduan wawancara dan checklist observasi. Analisa data dilakukan dengan penjodohan pola. Hasil: Ketepatan waktu laporan rendah (43%) dan cenderung menurun. Kelengkapan laporan sudah mencapai target (81%) namun ada kecenderungan menurun.Input data EWARS berasal dari bidan desa, pustu, PKD dan kunjungan puskesmas. Data kunjungan ke klinik swasta, BPS maupun DPS tidak tercover. Pengolahan data EWARS belum dilakukan baik di tingkat Kabupaten maupun puskesmas. Output EWARS tidak disajikan. Analisis dan interpretasi data EWARS dilakukan secara insidentil. Umpan balik laporan disampaikan tiga bulan sekali. Pengambilan keputusan bukan berdasarkan data yang dikumpulkan melalui EWARS namun berdasarkan informasi dari puskesmas atau RS jika kasus sudah positif. Kesimpulan: Kegiatan surveilans epidemiologi dengan menggunakan EWARS di Kabupaten Boyolali belum maksimal karena ada beberapa tahapan dari kegiatan surveilans yang tidak dilakukan. Informasi dari EWARS tidak bisa disajikan sehingga tidak dapat digunakan untuk pengambilan keputusan dalam pengendalian KLB. Kata kunci: Evaluasi, Pemanfaatan, Sistem Kewaspadaan Dini dan Respons

Background: Boyolali District have been already implementing Early Warning Alert and Response System (EWARS) in their effort to early wary on and respond to a disease that potentially being an outbreak. There was an increasing ttype of outbreak after the implementation of EWARS. Objectives: To evaluate the management and utilization of early warning alert and response system ―EWARS‖ in surveillance activities in Boyolali District, Central Java. Methods: This was qualitative study by exploratory case study design. The subject in this study were; 1 surveillance officier of the district (District Surveillance Officer/DSO), 29 surveillance officier of the Public Health Center (PHC), 1 chief of Prevention and Surveillance Section of Health Office, 1 chef of P3PL section and 1 chief of Office. Analysis unit in this study was ―EWARS‖ of Health Office of Boyolali District. Data was collected by in depth interview, Focus Group Discusion (FGD), direct observation and participant observation by using interview guielines and observation checklist. Data analysis was performed by pattern matching. Results: The on time scheduling was low (43%) and tend to decrease. The reporting completeness already achieved the target (81%) but there was decreasing trend. Data for entry in EWARS was originated from village midwife, auxillary Public Health Center, village health post and Public Health Center visiting. Data on private clinic visiting, private midwife and physician was not covered. EWARS data processing was not performed finely yet in both district level and subdistrict level. EWARS output was not presented. Analysis and intepretation of EWARS data was performed incidentally. Reporting feedback was presented in each tree months. Decision making was not based on data that was collected by EWARS but based on information from the public, PHC or hospital. Conclusion: Epidemiological surveillance activities using EWARS in Boyolali District does not maximum yet because there are several stages of the surveillance activities that is not perform. Information from EWARS can not be presents therefore can not be use for decision making in outbreak control /management. Keywords: Evaluation, utilization, Early Warning Alert and Response System

Kata Kunci : Evaluasi, Pemanfaatan, Sistem Kewaspadaan Dini dan Respons; Evaluation, utilization, Early Warning Alert and Response System