Analisis Pemanfaatan Bantuan Operasional Kesehatan dalam Upaya Peningkatan Kesehatan Ibu dan Anak di Puskesmas Wilayah Kerja Dinas Kesehatan Kabupaten Kudus

Abstract

Bantuan Operasional Kesehatan (BOK) telah dimanfaatkan untuk penyelenggaraan upaya
promotif dan preventif termasuk peningkatan kesehatan ibu dan anak (KIA) di Puskesmas
wilayah kerja Dinas Kesehatan Kabupaten Kudus, namun kasus kematian ibu dan anak di
Kabupaten Kudus cenderung meningkat. Penelitian ini bertujuan untuk menjelaskan
pemanfaatan BOK dalam upaya peningkatan KIA di Puskesmas wilayah kerja Dinas
Kesehatan Kabupaten Kudus tahun 2011. Penelitian ini menggunakan metode kualitatif
dengan membandingkan antara Puskesmas serapan tinggi yang berhasil menekan kasus
kematian ibu dan bayi dengan Puskesmas serapan rendah dan kurang berhasil dalam menekan
kasus kematian ibu dan bayi. Pengambilan data dengan wawancara mendalam terhadap
informan utama Kepala Puskesmas serta informan triangulasi bidan koordinator KIA dan
Dinas Kesehatan Kabupaten Kudus. Analisis data menggunakan metode analisis isi.
Hasil penelitian menunjukkan pada Puskesmas dengan serapan tinggi dan berhasil menekan
kasus, pemahaman tentang juknis BOK jelas, pelaksanaan kegiatan sesuai dengan laporan dan
dilaksanakan secara tim, ada keterlibatan pelaksana dalam penyusunan Plan of Action (POA)
serta ada evaluasi pelaksanaan kegiatan. Selain itu pada Puskesmas yang berhasil, pelaksana
kegiatan juga menyusun kelengkapan data pendukung sehingga pembuatan laporan tidak
hanya dibebankan kepada Tim Pengelola BOK Puskesmas. Demi keberhasilan implementasi
kebijakan pemanfaatan BOK untuk peningkatan kesehatan ibu dan anak, perlu penerapan
fungsi manajemen yang benar di Puskesmas yang meliputi perencanaan, pelaksanaan, dan
evaluasi.

Health Operational Aid (BOK) had been utilized for the implementation of promotive and
preventive services. This included maternal and child health improvement in the primary
healthcare centers of Kudus district health office work area. However, maternal and child
mortality in Kudus district tended to increase. The study objective was to explain the
utilization of Health Operational Aid in the maternal and child health improvement efforts in
the primary healthcare centers of Kudus health office. This was a qualitative study. This study
compared utilization of BOK in high absorbing primary healthcare centers that succeeded in
32minimizing maternal and infant mortality cases and in low absorbing primary healthcare
centers that did not succeed in minimizing maternal and infant mortality cases. Data were
collected through in-depth interview to main informants namely the head of primary
healthcare centers, and triangulation informants namely maternal and child health
coordinator midwives and head of Kudus district health office. Content analysis was applied
in the data analysis.
Results of the study showed that in the high absorbing primary
healthcare centers that succeeded in minimizing cases: understanding about health
operational aid technical guideline was clear; implementation of activities was according to
the reports; executors were involved in a plan of action formulation; and there was an
evaluation on the activity implementation. In addition, in the success primary healthcare
centers, it was found that executors of the activities arranged the completeness of supporting
data; therefore, report making was not done only by the management team of primary
healthcare center’ health operational aid. To be successful in the health operational aid
utilization for maternal and child health, application of a right management function in the
primary healthcare center is needed. This management function includes planning,
implementation and evaluation