Analisis Implementasi Program Penanggulangan Gizi Buruk Di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Sorong Provinsi Papua Barat

*Zaenab Ismail -  Poltekkes Kemenkes Sorong Prodi D3 Kebidanan Sorong, Indonesia
Martha Irene Kartasurya -  Fakultas Kesehatan Masyarakat, Universitas Diponegoro, Semarang, Indonesia
Atik Mawarni -  Fakultas Kesehatan Masyarakat, Universitas Diponegoro, Semarang, Indonesia
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Abstract

Prevalensi balita gizi buruk di kota Sorong pada tahun 2008, 2009 dan 2010 berturut-turut adalah 3,59%;1.1%;1,9%. Implementasi suatu program dapat dipengaruhi oleh berbagai faktor antara lain faktor komunikasi, sumber daya, disposisi dan struktur birokrasi. Penelitian ini bertujuan untuk mengetahui implementasi program penanggulangan gizi buruk di puskesmas wilayah kerja Dinas Kesehatan kota Sorong Papua Barat Tahun 2011. Jenis penelitian adalah kualitatif dengan pendekatan cross sectional. Pengumpulan data dilakukan melalui wawancara mendalam, menggunakan pedoman wawancara. Ada 5 puskesmas yang diteliti, informan utama adalah pelaksana program gizi di Puskesmas. Informan triangulasinya adalah keluarga/orang tua balita gizi buruk, Kepala puskesmas dan Kepala.seksi.Gizi Dinas Kesehatan Kota Sorong Provinsi Papua Barat. Hasil Penelitian menunjukkan implementasi program belum berjalan sesuai standar pelaksanaan dari Depkes, dikarenakan komunikasi yang dilakukan Dinas Kesehatan kota Sorong melalui sosialisasi program belum optimal. Ketersediaan sumber daya yang meliputi sumber daya tenaga pelaksana belum memadai karena hanya petugas dengan latar belakang pendidikan gizi yang menjalankan program sedangkan tenaga lain tidak terlibat. Belum ada tim asuhan gizi di semua puskesmas, selain itu sebagian besar tenaga belum mendapatkan pelatihan. Pengelolaan dana program tidak sesuai dengan unit cost. Sarana dan prasarana tidak memadai dan masih ada puskesmas yang tidak layak. Petugas pelaksana sangat mendukung program namun kurangnya transparansi dan sosialisasi mengakibatkan kurangnya komitmen. Tidak ada kewenangan maupun SOP yang diberikan dari Dinas Kesehatan Kota Sorong kepada Puskesmas. Selain itu tidak ada supervisi terhadap pelaksana program gizi. Disimpulkan bahwa implementasi program penanggulangan gizi buruk di Puskesmas wilayah kerja Dinas Kesehatan Kota Sorong tahun 2011 belum optimal. Disarankan kepada Dinas Kesehatan Kota Sorong untuk meningkatkan sosialisasi program penanggulangan gizi buruk keseluruh pelaksana program termasuk kepala Puskesmas yang berada di wilayah kerja DKK Sorong, membentuk tim asuhan gizi dan pelatihan untuk tim tersebut. Pengalokasian dana dilakukan tepat sasaran dan sarana prasarana untuk kemudahan pelayanan dilengkapi. Supervisi, monitoring dan evalusai dilakukan secara berkesinambungan.

The prevalence of under-five children with severe malnutrition in Sorong city West Papua in 2008, 2009 and 2010 consecutively was 3.59%, 1.1% and 1.9%. Implementation of a program could be influenced by many factors such as communication, resources, disposition and bureaucracy factors. The objective of this study was to know the implementation of severe malnutrition control program at primary healthcare centers (puskesmas) in the working area of Sorong city health office West Papua in 2010. This was a qualitative study with cross sectional approach. Data was collected through in-depth interview using interview guideline. There were 5 primary healthcare centers studied with program executors as main informants. Triangulation informants were family or parents of under-five children with severe malnutrition, head of puskesmas and head of nutrition section of Sorong city health office West Papua province. Results of the study showed implementation of the program had not run according to the standard of implementation from the Ministry of Health. It was caused by not optimal communication that was done by Sorong city health office through program socialization. The availability of resources such as human resource to implement the program was insufficient. Only those who had nutrition educational background implemented the program and other workers were not involved in the program. There was no nutrition care team in all puskesmas. Additionally, the majority of the workers had not received training yet. Management of program funding was not according to the unit cost. Facilities were inappropriate and there was still improper puskesmas. The executor workers were needed for implementing the program; unfortunately due to less transparency and socialization, commitment was also low. No authority or standard operating procedure (SOP) given by Sorong city health office to puskesmas. In addition there was no supervision to the nutrition program workers. It was concluded that the implementation of severe malnutrition control program in Puskesmas in the working area of Sorong city health office West Papua province was not optimal. It was suggested to Sorong city health office to improve socialization about severe malnutrition control program to all program executors including heads of puskesmas in the working area of Sorong city health office; to create nutrition care and training teams. Funding allocation should be given to the right target and facilities should be completed.   Supervision, monitoring and evaluation were done continuously.

Keywords
Penanggulangan Gizi Buruk; Puskesmas; Implementasi Program; Severe Malnutrition; Public Health Centre; Program Implementation

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  1. Hartanto, R.Jarot, Kodim. Pengaruh Status Gizi Anak Usia Bawah Lima Tahun Terhadap Nilai Belajar Verbal Dan Nmerik. Jurnal Kesehatan Masyarakat Nasional. 2009; Vol.3 No 4.
  2. Mulia M. Gizi Masyarakat Berkualitas dan Pencapaian Tujuan MDGs, 2007. Download 22 Juni 2008 www.icrp-online.org
  3. Depkes. RI. Rencana Aksi Nasional Pencegahan Dan Penanggulangan Gizi Buruk 2005-2009. Jakarta: 2005.
  4. Kementerian Kesehatan. Rencana Aksi Pembinaan Gizi Masyarakat. Jakarta: 2010.
  5. Depkes. RI. Pedoman Penyelenggaraan Pelatihan Tatalaksana Anak Gizi Buruk Bagi Tenaga Kesehatan. Jakarta: 2007
  6. ___________. Laporan Hasil Riset Kesehatan Dasar (RISKESDAS) Indonesia. Jakarta: 2007
  7. Kementrian Kesehatan RI. Riset Kesehatan Dasar. Badan Penelitian dan Pengembangan Kesehatan; 2010.
  8. Dinas Kesehatan Kota Sorong. Profil Dinas Kesehatan Kota Sorong. Provinsi Papua Barat; 2008.
  9. Depkes. RI. Buku Pemantauan Tatalaksana Anak Gizi Buruk. Jakarta: 2009
  10. ————————. Buku Bagan Tatalaksana Gizi Buruk, Buku I. Jakarta: 2006
  11. ————————. Pedoman Penyelenggaraan Pelatihan Tatalaksana Anak Gizi Buruk Bagi Tenaga Kesehatan. Jakarta: 2007.
  12. Agustino,L. Dasar-Dasar Kebijakan Publik. Bandung: Alfabeta;2008