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.
ABSTRACT The Healthy Indonesia Program with Family Approach (PIS-PK) is an effort to strengthen basic health that began in 2015. To get more comprehensive data and information on the implementation of PIS-PK, in 2017 the Center for Public Health Efforts to carry out a PIS-PK evaluation study in several districts/cities in Indonesia. This study uses a quantitative and qualitative approach, in one puskesmas in Labuan Bajo Regency, North Sumatra Province and Semarang City, Central Java Province. Data collection was carried out by means of in-depth interviews about the implementation of PIS-PK including input indicators (personnel, funds, tools and methods), processes (planning, implementation, supervision), and output. The results of the study show that the implementation of input indicators, such as the limited number of Puskesmas human resources in data collection and data entry, also not yet clear about the sources of funding for implementing PIS-PK. On output (results of family visits), there are differences in the results of the calculation of indicators between the results of data collection conducted by PIS-PK puskesmas officers and study results. When compared between the two puskesmas, Puskesmas H Semarang is more ready for PIS-PK than Puskesmas P in Labuan Batu Regency. It can be concluded that in the implementation of PIS-PK in both puskesmas still encountered problems, both in terms of inputs (personnel, funds, tools and methods), processes (planning, implementation, supervision), and output. As a suggestion, there needs to be more comprehensive planning in implementing PIS-PK. Keywords: PIS-PK, evaluation research, input, process, and output indicator ABSTRAK Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) merupakan program upaya penguatan kesehatan dasar yang mulai dilaksanakan pada tahun 2015. Untuk mendapatkan data dan informasi yang lebih komprehensif tentang pelaksanaan PIS-PK, pada tahun 2017 Puslitbang Upaya Kesehatan Masyarakat melakukan studi evaluasi PIS-PK di beberapa kabupaten/kota di Indonesia. Studi ini menggunakan pendekatan kuantitatif dan kualitatif, di salah satu puskesmas di Kabupaten Labuan Bajo, Provinsi Sumatera Utara dan Kota Semarang, Provinsi Jawa Tengah. Pengumpulan data dilakukan dengan cara wawancara mendalam mengenai pelaksanaan PIS PK meliputi indikator input (tenaga, dana, alat dan metode), proses (perencanaan, pelaksanaan, pengawasan), dan output. Hasil studi menunjukkan bahwa pelaksanaan untuk indikator input, seperti masih terbatasnya SDM puskesmas dalam melakukan pendataan maupun entri data, juga belum jelasnya sumber pembiayaan pelaksanaan PIS-PK. Pada output (hasil kunjungan keluarga) terdapat perbedaan hasil perhitungan indikator antara hasil pendataan yang dilakukan oleh petugas PIS-PK puskesmas dengan hasil studi. Jika dibandingkan diantara ke dua puskesmas, Puskesmas H Kota Semarang lebih siap PIS-PK daripada Puskesmas P Kabupaten Labuan Batu. Dapat disimpulkan bahwa dalam pelaksanaan PIS-PK di kedua puskesmas masih menemui permasalahan, baik dalam hal input (tenaga, dana, alat dan metode), proses (perencanaan, pelaksanaan, pengawasan), maupun output. Sebagai saran, perlu adanya perencanaan yang lebih komprehensif dalam implementasi PIS-PK. Kata kunci: PIS PK, riset evaluasi, Indikator input, proses, dan output
To overcome community health problems, the government has launched the Healthy Indonesia Program through Family Approach (PIS-PK) since 2015. Until early 2018 the progress of this program over regions varies. The aim of this operational research conducted in Semarang in 2018 was to provide assistance for regions in implementing PIS-PK stages based on guidelines in order to produce an intervention model that can be sustainably applied with the commitments of related sectors and community participation. The result showed that Puskesmas Purwoyoso has implemented management of health service program throughout P1, P2, and P3 stages correctly in accordance with the guidelines. Based on healthy family indicators, RW 11 Purwoyoso Village was chosen as a priority area to be intervention model of hypertension prevention. The PIS-PK indicator showed that hypertension sufferers who were regularly treated was small in number. Several models used in handling hypertension cases through community empowerment approach including picking up patients with severe hypertension; blood pressure checking activity during social group gathering, so-called "arisan" (CETAR), and anti-hypertension gardens. The intervention model had been implemented and established in RW 11 of Puskesmas Purwoyoso working area, therefore, other sectors involvement and community participation in hypertension prevention were expected ABSTRAK Sejak tahun 2015 Pemerintah telah meluncurkan Program Indonesia Sehat dengan Pendekatan Keluarga (PIS PK) untuk menangani masalah kesehatan di masyarakat. Hingga awal tahun 2018, kemajuan pelaksanaan PIS PK di beberapa daerah bervariasi. Riset operasional yang dilakukan di Semarang pada tahun 2018 ini bertujuan untuk mendampingi daerah dalam melaksanakan tahapan pelaksanaan program PIS PK yang sesuai dengan pedoman, hingga menghasilkan model intervensi yang dapat diimplementasikan dengan melibatkan lintas sektor dan melibatkan peran serta masyarakat.Hasil pendampingan menunjukkan, Puskesmas Purwoyoso sudah menerapkan manajemen program pelayanan kesehatan Puskesmas melalui tahapan P1, P2, dan P3 sesuai pedoman. Berdasarkan nilai IKS dan cakupan indikator PIS PK yang belum berjalan dengan baik yaitu penderita hipertensi yang berobat teratur, maka dipilih RW 11 Kelurahan Purwoyoso sebagai wilayah prioritas untuk mendapat intervensi model penanggulangan hipertensi. Pemilihan model intervensi hipertensi melalui pendekatan pemberdayaan masyarakat adalah jemput pasien gawat hipertensi, cek tensi saat arisan (CETAR), dan taman hepi (anti hipertensi). Model intervensi telah ditetapkan dan diimplementasikan di RW 11 yang termasuk wilayah kerja Puskesmas Purwoyoso, dan diharapkan keterlibatan lintas sektor serta masyarakat untuk ikut berperan dalam penanggulangan hipertensi. Kata kunci: Model intervensi, hipertensi, PIS-PK
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