BackgroundElectronic syndromic surveillance for early outbreak detection may be a simple, effective tool to rapidly bring reliable and actionable outbreak data to the attention of public health authorities in the developing world.MethodsTwenty-nine signs and symptoms from patients with conditions compatible with infectious diseases are collected from selected Provincial hospitals and analyzed daily. Data is e-mailed on a daily basis to a central data management and analysis center. Automated data analysis may be viewed at the hospital or the Early Warning Outbreak Response System (EWORS) hub at the central level (National Institute of Health Research and Development/NIHRD).ConclusionThe Indonesian Ministry of Health (MoH) has adopted EWORS since 2006 and will use it as a complementary surveillance tool in wider catchment areas throughout the country. Socialization to more users is still being conducted under collaboration of three Directorate Generals (DGs) of the MoH; DG of NIHRD, DG of Medical Services and DG of Communicable Disease Control and Prevention. Currently, EWORS is being adapted to facilitate detecting a potential outbreak of pandemic influenza in the region, and automated procedures for outbreak detection have been added.

Stunting is one of the nutritional problems faced in the world, including Indonesia. To overcome this problem, the government conducted a program to accelerate stunting prevention in 100 priority districts / cities through specific and sensitive nutrition interventions including health and non-health stakeholders. Interventions are carried out in a convergent manner by aligning various resources to achieve the goal of preventing stunting.The convergence is carried out from the planning, budgeting, implementation, to monitoring stages. The purpose of this study is to analyse the challenges of implementing the convergence of stunting prevention programs that have been running since 2018 by local governments in priority districts / cities based on content, context, process, and actors. The research method is operational research with a research design using a qualitative approach design with in-depth interviews in 13 priority districts/cities. The health policy triangle framework is used as an approach in analyzing the results of this study which consists of content, context, process, and actors. In-depth interview sources are policy makers and program managers to accelerate stunting reduction from province to sub-district and village. The results showed that the challenge in implementing convergence was the existence of sectoral egos in each OPD (stakeholders) because of the socialization was not yet optimal so that many stakeholders did not fully understand the stunting prevention program. Information that was late in being obtained, information cut off from socialization, and difficult demographic conditions in the area where one of the causes in certain areas of the obstruction of socialization. The implementation of convergence that has not been optimal is also due to the ansence operational and technical guidelines for implementing program when the research was conducted so that the regions do not know the steps to carry out these activities. Abstrak Masalah anak pendek (stunting) merupakan salah satu permasalahan gizi yang dihadapi di dunia, termasuk Indonesia. Untuk mengatasi permasalahan stunting, pemerintah melakukan program percepatan penanggulangan stunting di 100 kabupaten kota prioritas yang melibatkan sektor kesehatan dan non kesehatan melalui intervensi gizi spesifik dan sensitif. Penyelenggaraan intervensi dilakukan secara konvergen dengan menyelaraskan berbagai sumber daya untuk mencapai tujuan pencegahan stunting. Konvergensi dilakukan mulai dari tahap perencanaan, penganggaran, pelaksanaan, sampai monitoring. Tujuan penelitian ini adalah menganalisis tantangan implementasi konvergensi program pencegahan stunting yang telah berjalan sejak tahun 2018 oleh pemerintah daerah pada Kabupaten prioritas berdasarkan konten, konteks, proses, dan aktor. Metode penelitian merupakan operational research dengan desain penelitian menggunakan pendekatan kualitatif dengan metode wawancara mendalam di 13 kabupaten prioritas. Kerangka segitiga kebijakan kesehatan digunakan sebagai pendekatan dalam menganalisis hasil penelitian ini yang terdiri dari konten, konteks, proses, dan aktor. Informan wawancara mendalam ialah para pengambil kebijakan dan pengelola program percepatan penurunan stunting dari mulai provinsi sampai kecamatan dan desa. Hasil penelitian menunjukkan bahwa tantangan dalam implementasi konvergensi ialah masih adanya ego sektoral pada masingmasing OPD karena masih belum optimalnya sosialisasi sehingga banyak yang belum memahami secara menyeluruh mengenai program pencegahan stunting. Informasi yang terlambat diperoleh, terputusnya informasi dari sosialisasi, serta kondisi demografi wilayah yang sulit menjadi salah satu penyebab pada beberapa daerah tertentu tehadap terhambatnya sosialisasi. Implementasi konvergensi yang belum optimal juga dikarenakan belum diperolehnya juklak dan juknis dalam melaksanakan program saat penelitian dilakukan sehingga daerah belum tahu langkah untuk melakukan kegiatan tersebut.

Integrated health service (Posyandu) is one form of strategic health effort, which provides public health services. One of the posyandu function is as promotion media and growth monitoring of children under five. The purpose of this research was to know the implementation of child growth monitoring at posyandu level in Bandung district. This was an operational studies with qualitative design.Data were collected by depth interview, focus group discussion, and observation. The population of this research were all of the institution that responsible of nutrition surveillance. There were Regencies District Health Office, Primary Health Center (Puskesmas), and Posyandu, in Bandung District, West Java. This research is operational research with qualitatif design. Colected data used with indepth interview, focus group discusion and observasi. Indepth interview used to offices, health workers from two community health centers, and village officials. Group discussions were conducted on cadres and mothers of underfives children. This research show posyandu activities have been going well but have not implemented monitoring function of child growth. Plot weight were not doing well in KMS, interpretation of child growth were still unsuitable, and counseling had not done well. Repositioning of posyandu is needed as a means of growth monitoring children under five years and efforts to increase knowledge about routine growth monitoring for health workers and cadres. AbstrakPos pelayanan terpadu (Posyandu) merupakan salah satu bentuk upaya kesehatan yang strategis, yang menyediakan layanan kesehatan masyarakat. Salah satu fungsi posyandu adalah sebagai media promosi dan pemantauan pertumbuhan anak umur bawah lima tahun (balita). Penelitian ini bertujuan untuk mengetahui pelaksanaan pemantauan pertumbuhan balita di tingkat posyandu di Kabupaten Bandung, Jawa Barat. Penelitian ini merupakan penelitian operasional dengan desain kualitatif. Pengumpulan data melalui wawancara mendalam, diskusi kelompok terarah. Wawancara mendalam dilakukan kepada petugas di dinas kesehatan kabupaten, tenaga kesehatan dari dua pukesmas terpilih, dan aparat desa. Diskusi kelompok dilakukan pada kader dan ibu balita, dan. Hasil penelitian menunjukkan bahwa kegiatan posyandu sudah berjalan baik namun belum melaksanakan fungsi pemantauan pertumbuhan balita. Masih banyak yang tidak melakukan plot hasil penimbangan pada KMS (kartu menuju sehat), interpretasi terhadap perubahan berat badan belum dilakukan dengan benar dan konseling yang belum berjalan baik. Perlu dilakukan reposisi posyandu sebagai sarana pemantauan pertumbuhan balita dan upaya untuk meningkatkan pengetahuan tentang pemantauan pertumbuhan secara rutin bagi tenaga kesehatan dan kader. [Penel Gizi Makan 2018, 41(1):41-54] Kata kunci: pemantauan pertumbuhan, pos pelayanan terpadu, bawah lima tahun (balita)