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This thesis discusses the factors associated with immunization status of a basic timely on child age 12 months in 16 districts in NTT province in 2007. This research uses cross-sectional design. Results of research have a meaningful relationship between the quality of the examination of the pregnancy status of the basic immunization of children, with a value of OR3,29 (95% CI 1,513 ? 7,153). The need of the intensive counseling to the community about the importance and benefits of providing child immunization. Mothers since the beginning of planning a pregnancy counseling given on "the quality of the examination of pregnancy".
Imunisasi merupakan satu tindakan pemberian kekebalan khusus kepada anak terhadap Penyakit yang Dapat Dicegah Dengan Imunisasi (PD3I), seperti tuberkulosis, difteri, pertusis, tetanus, polio, campak, dan hepatitis B, sebelum berusia satu tahun. Peningkatan cakupan imunisasi mampu menurunkan kematian akibat PD3I dari 23% tahun 1974 menjadi 10% di tahun 2000. Selama tahun 2005, Seksi Pengamatan dan Pencegahan Penyakit, Dinas Kesehatan Propinsi Sumatera Barat melaporkan 2.603 kasus campak klinis, 498 kasus hepatitis, 12 kasus tetanus neonatorum, dan 117 kasus pertusis. Kota Padang melaporkan 959 kasus campak klinis, 65 kasus hepatitis, dan 5 kasus tetanus neonatorum selama tahun 2005. Cakupan imunisasi di Puskesmas Pauh Kota Padang pada tahun 2005, adalah; BCG (89,8%), DPT1 (81,2%), DPT3 (67,8%), Polio 4 (75,8%), Hepatitis (66,6%), dan Campak (84,1%). Imunisasi dasar yang tidak lengkap, hanya memberikan perlindungan sebesar 25-40%. Perkiraan risiko untuk meninggal pada seorang anak balita yang tidak diimunisasi lengkap adalah sebesar 14 kali dibandingkan yang sudah diimunisasi lengkap. Penelitian ini menggunakan disain kasus kontrol, untuk mengetahui faktor-faktor yang berhubungan dengan status imunisasi dasar pada anak. Penelitian dilakukan di wilayah kerja Puskesmas Pauh, dengan pertimbangan jumlah penduduk yang cukup besar, cakupan imunisasi rendah, dan masyarakat yang cukup kooperatif. Kasus adalah anak usia 12 sampai 23 bulan yang tidak mendapatkan salah satu imunisasi sebelum benisia satu tahun, sedangkan sebagai kontrol adalah anak yang sudah mendapatkan imunisasi berupa BCG, DPT1, DPT2, DPT3, Poliol, Polio2, Polio3, Polio4, Campak, serta hepatitis B1, hepatitis B2, dan hepatitis B3 sebelum berusia satu tahun. Kasus dan kontrol dicari dari register imunisasi di puskesmas, dari tanggal 1 Juni 2004 sampai 31 Mei 2005. Responden pada penelitian ini adalah ibu dari kasus rnaupun kontrol yang bertempat tinggal di wilayah kerja Puskesmas Pauh pads waktu penelitian. Penelusuran variable-variabel yang diduga berhubungan dengan status imunisasi dasar dilakukan dengan mengadopsi konsep Green yang melihat faktor predisposisi (umur ibu, pendidikan ibu, pekerjaan ibu, pengetahuan ibu, sikap ibu, jumlah anak, dan pekerjaan suami), faktor pendukung (kepemilikan), dan fakt ar pendorong (anjuran). Hasil penelitian menunjukkan bahwa faktor predisposisi yang berhubungan dengan ketidaklengkapan imunisasi dasar pada anak di Puskesmas Pauh adalah umur ibu 30 tahun dengan OR = 3,10 dengan 95% CI: 1,83-5,26, pendidikan ibu yang rendah dengan OR = 2,01 dengan 95% CI: 1,10-3,69, pengetahuan ibu yang tidak bail( tentang imunisasi dengan OR = 2,16 dengan 95% CI: 1,20-3,90, dan pekerjaan suami pada sektor non formal dengan OR = 3,21 dengan 95% CI: 1,19-8,69. Faktor pendukung (kepemilikan) tidak berhubungan dengan ketidaklengkapan imunisasi dasar pada anak. Faktor pendorong berupa anjuran, berhubungan dengan ketidaklengkapan imunisasi dasar pada anak. Ibu yang tidak pernah mendapatkan anjuran imunisasi mempunyai risiko imunisasi anaknya tidak lengkap sebesar 4,17 kali jika dibandingkan dengan ibu yang mendapat anjuran dari tenaga non kesehatan, dan sebesar 3,86 kali jika dibandingkan dengan-ibu yard mendapat anjuran dari tenaga kesehatan. Anjuran untuk mengikuti program Keluarga Berencana setelah punya dua anak, tidak mempunyai Layi lagi setelah ibu berumur ? 30 tahun, meningkatkan pendidikan ibu, penggalakan kelompok belajar, penyuluhan imunisasi secara berkala dan berkesinambungan, revitalisasi posyandu, dan pelatihan imunisasi leader kesehatan diharapkan dapat ineningkatkan cakupan imunisasi pada masa yang akan datang.
Immunization is a procedure on giving a special protection on children, before one year of age, from diseases that can be prevented by immunization, such as tuberculosis, diphtheria, pertuses, tetanus, polio, measles, and Hepatitis B. The escalation on the immunization coverage has reduced the mortality, caused by the diseases that can be prevented by immunization, from 23% in 1974 to 10% in 2000. During 2005, the province of West Sumatra has reported cases on 2,603 clinical measles, 498 Hepatitis, 12 tetanus neonatorum, and 117 aertuses. Meanwhile, Kota Padang has reported 959 cases of clinical measles, 65 cases of Hepatitis, and 5 cases of tetanus neonatorum. The immunization coverage at Puskesmas Pauh of Kota Padang in 2005 is: BCG (89.8%), DPT i (81.2%), DPT3 (67.8%), Polio4 (75.7%), Hepatitis (66.6%), and measles (84.1%). Uncompleted basic immunization is only giving 25-40% of protection. An estimation on risk of death for children under five who have uncompleted immunization is fourteen times compare to those who have completed immunization. The design of the study is case-control in order to find out the factors related to the child status on basic immunization. The study is carried out in the working area of Puskesmas Pauh was chosen based on total among the population approximately, the low coveragi immunization as well as the cooperative behavior of the community. The case is children age 12 to 23 months who has uncompleted one of basic immunization before one year of age. Meanwhile, the control is children who have completed basic immunization before one year of age. The completed immunization should consist of immunization on ECG, DPT1, DPT2, DPT3, Polio], Polio2, Polio3, Polio4, Measles, HepatitisB-l, HepatitisB-2, and HepatitisB-3. The case and the control are found out from puskesmas' immunization registration, during 151 June 2004 to 315` May 2005. Respondents of the study are mothers of the case and the control who lives in the working area of puskesmas. Exploration on variables that assumed to have relationship with the status of basic immunization is accomplished by applying 'the concept of Green, which is looking at the predisposing factors (age, education, occupation, knowledge, attitude, number of children, and husband's occupation), the enabling factors (ownership) and the reinforcing factors (advice). The result of the study showed that predisposing factors have relationship with incompleteness of basic immunization status of children. The predisposing factors the are relationship also between the predisposing factors with status on basic immunization are: age > 30 years (OR: 3.19 with 95% CI at 1.83 - 5.26), low education (OR: 2.01 with 95% CI at 1.10 --- 3.69), poor knowledge on immunization (OR: 2.16 with CI 95% at 1.20 - 3.90), and husband's occupation at non-formal sectors (OR: 3.21 with CI 95% at 1.19 - 8.69). There is no relationship between enabling factor (ownership) with the incompleteness of basic immunization of the children. The reinforcing factor, in this case is the advice, is correlated with the incompleteness of basic immunization of the children. The risk of mother have never had an advice about child immunization have a risk 4.17 times to have incompleteness on child immunization compare to mothers who receive the advice from non-health personnel. While the risk is lower 3.86 times if compared to mother who receive the advice from health personnel. Suggestions are addressed the mothers to: participate on family planning program after having two children, not to be pregnant after 30 years of age, to increase the level of mother education, educational package programme for the mother to foolow sustainability of IEC immunization program. Posyandu revitalization, and immunization training for should voluntary health worker about immunization. Hopely by accomplish all the suggestion the immunization coverage will bw increase in the future time.