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Indonesia teritory geographically is a disaster-prone area. In the event of a disasterthere will usually be certain infectious diseases that arise and have increasedbeyond normal limits in communities affected by the disaster. In the end it can becategorized as a public health emergency. Community is the first to directly dealwith the threat and disaster. Preparedness in community will determines the sizeof the impact of disasters on communities. Indonesia as a developing country haveurban and rural areas that different from the aspect of development, governmentand geography. The potential difference aspects certainly affect the possibility ofdifferences also in terms of community preparedness in the face of public healthemergencies and disasters. The purpose of this study was to determine aboutcommunity preparedness in urban and rural communities in Indonesia, which inthis study took a sample in Kampung Makasar-East Jakarta and Desa Campaka-Cianjur that were selected based on the consideration that the two regions areequally harmful for any problems public health emergencies both in terms ofdisaster as well as an increase in cases of the disease. This study uses acombination of quantitative methods (descriptive analysis data based on anassessment of the preparedness of community that combines elements of DesaSiaga Aktif and Desa Tangguh Bencana) and qualitative methods (in-depthinterviews, review of documents). The results of this study reveal that there areany differences in preparedness in rural and urban communities. In urban areas,the percentage of community preparedness is 62.3%, while in rural areas is 41.3%.Almost all of 20 indicators meet in existence and also vary between rural andurban areas. Points are still lacking is the implementation and performanceindicators were not as expected as it should be. The cause of the most strikingdifference between the results of the structural differences in rural and urbanareas, accessibility, funding and knowledge society. It is necessary for thesupervise of the stakeholders (in this research are health centers, the governmentin rural and urban)Keywords: community preparedness, public health emergency, rural, urban.
ABSTRAK
Tesis ini mengenai kajian Upaya Kesehatan Bersumber Daya Masyarakat( UKBM ) yang ada di Wilayah Kota Administrasi Jakarta Pusat Tahun 2013.Penelitian menggunakan pendekatan kualitatif dengan melakukan wawancaramendalam dan Focus Group Discussion (FGD) pada kelompok pengguna danpengelola UKBM. Pengembangan RW Siaga merupakan pengembangan UKBM,RW Siaga merupakan wadah dimana UKBM berada. Pembiayaan UKBMmendapatkan dukungan dari APBD Provinsi DKI Jakarta. SDM yang terlibatdalam UKBM dalam segi kualitas sudah mencukupi namun dari segi kuantitasmasih kurang. Arah kebijakan penyusunan perencanaan semakin mendukungupaya preventif dan promotif kesehatan dengan mengacu pada Indikator KinerjaProgram (outcome) dan Kegiatan (output). Dari segi manajemen pelaksanaanUKBM dilaksanakan sesuai dengan tugas dan peran masing-masing lembaga yangterlibat dalam UKBM, namun perlu peningkatan koordinasi antar lembaga.Partisipasi masyarakat terhadap pelaksanaan UKBM masih tinggi. Upayakemitraan dan pemberdayaan masyarakat terlaksana dengan baik. Kesimpulannyadengan Program Kartu Jakarta Sehat (KJS) yang memberikan kemudahan bagimasyarakat untuk memperoleh pelayanan kesehatan gratis, namun UKBM sebagaiupaya preventif dan promotif kesehatan masih tetap dilaksanakan dengan baik.
ABSTRACT
This thesis is a study upon Public Health Efforts or known as Upaya KesehatanBersumber Daya Masyarakat (UKBM) in Indonesia. Geographically it focuses onthe condition in the administration of Central Jakarta Region in 2013.The research takes a qualitative approach by conducting in-depth interviews andFocus Group Discussions (FGD) with UKBM users and administrators. Thedevelopment of “RW Siaga” is the expansion of UKBM. RW Siaga is the livingfield form UKBM. UKBM receives it’s funding from the DKI Jakarta ProvincialBudget, or APBD. The human resource involved in UKBM is deemed adequate inquality but insufficient in quantity.The direction of future regulations continue to focus on promoting health, andpreventive health which refers to the Program Performance Indicator, divided intoProgram (outcome) and Activity (Output). UKBM’s management system iscatered to the tasks and role of each body involved, this must be followed bybuilding good coordination among these bodies.Public participation in UKBM is still very high. Partnership chances and publicempowerment is maintained and has been executed well.In conclusion, the Jakarta Health Card or Kartu Jakarta Sehat (KJS) which haseased public health service by providing free healthcare for residents. However, asa program that supports preventive health and promotes health, UKBM is stillconducted well in the society.
ABSTRAK Peran kader kesehatan sebagai ujung tombak di bidang kesehatan sudah mulai menurun ditandai dengan pemanfaatan posyandu hanya sebesar 13% dan 14% kategori posyandu Purnama dan Mandiri . Sehingga dilakukan penelitian untuk analisis hubungan peran kader pada UKBM di posyandu berdasarkan 2 (dua) kriteria yakni kriteria kontekstual kelurahan dan kriteria Malcolm Baldrige, untuk mendapatkan dari sisi mana dari keduanya yang dapat mempercepat peningkatan peran kader kesehatan. Penelitian dengan 159 kader dari 32 posyandu. Uji yang digunakan dengan Chi Square untuk melihat hubungan yang ada pada 7 (tujuh) kriteria kontekstual kelurahan dan 7 (tujuh) kriteria Malcolm Baldrige. Kemudian Analisis Regresi Linier Ganda digunakan untuk melihat hubungan antara satu variabel dengan beberapa variabel terkait sesuai dengan tujuan dan kerangka konsep. Hasilnya, dari beberapa uji hubungan antara tingkat partisipasi masyarakat dengan tingkat kematangan masyarakat, tingkat kematangan dengan tingkat kendali masyarakat, tingkat kendali masyarakat dengan kader sebagai agent of changes, kader sebagai agent of changes dengan motif keberdayaan, motif keberdayaan dengan kepemilikan masyarakat dalam upaya pembangunan, kesemuanya memiliki hubungan yang signifikan antara kedua variabel. Sedangkan variabel keterlibatan berbagai stakeholders memiliki hubungan yang signifikan atas tingkat partisipasi, peran kader sebagai agent of changes, kepemilikan masyarakat dalam upaya pembangunan, dan tingkat kematangan keberdayaan. Pada kriteria Malcolm Baldrige ada hubungan yang signifikan antara kepemimpinan dengan rencana strategis dan desain program sesuai kebutuhan. Ada hubungan yang signifikan antara Kepemimpinan, desain program sesuai kebutuhan, manajemen pelayanan dan kapasitas SDM dengan fokus pada hasil. Peningkatan peran kader pada UKBM dalam program gizi dan KIA diperlukan pembenahan Pokja (kelompok Kerja) yang telah dibentuk untuk lebih mempertegas kembali tugas pokok dan fungsi lintas sektor terkait, sehingga dapat terlaksana dengan baik peran kader kesehatan dalam program gizi dan KIA.
ABSTRACT The role of health as a vanguard cadre of health has begun to decline marked by posyandu utilization of only 13% and 14% posyandu Purnama and Mandiri categories. So the research on the analysis of the role of volunteers in UKBM in posyandu by 2 (two) criteria and the criteria of contextual urban Malcolm Baldrige criteria, to get from which side of the two that can accelerate the increase in the role of health cadres. Study with 159 volunteers from 32 posyandu. Test used by Chi Square to see the relationships that exist in the 7 (seven) villages contextual criteria and 7 (seven) Malcolm Baldrige criteria. Multiple Linear Regression Analysis then used to examine the relationship between the variables associated with some variables in accordance with the objectives and conceptual framework. The result, of some of the test the relationship between the level of community participation with the maturity level, the level of maturity to the level of community control, level control society as an agent of changes cadres, cadres as the motive agent of changes to the empowerment, empowerment motif with local ownership in development, all of which have a significant relationship between the two variables. While the involvement of various stakeholders variables have a significant relationship on the level of participation, the role of volunteers as agents of changes, the ownership of development efforts, and the maturity level of empowerment. In the Malcolm Baldrige criteria no significant relationship between leadership and strategic planning and program design as needed. There is a significant relationship between leadership, program design as needed, service management and capacity building with a focus on results. Enhancing the role of volunteers in UKBM nutrition and MCH programs needed revamping Working Group (working group) which has been formed to further reaffirm the basic tasks and functions across relevant sectors, so that they can perform well in the role of health cadres nutrition and MCH programs.
Hasil analisis kuantitaf dari faktor predisposisi (predisposing factors)menunjukkan bahwa umur (p=0.38), pendidikan (p=0.301), pengetahuan (p=0.201),pekerjaan (p=0.68), kondisi ekonomi (p=0.592), sikap (p=0.452) dan faktor sosialbudaya tidak mempunyai hubungan yang bermakna dengan pemanfaatan RTK diManggarai Barat. Faktor ketersediaan sarana dan tenaga kesehatan mempunyaihubungan bermakna (p=0.038) serta ketersediaan sarana transportasi juga bermakna(P=0.04). Faktor ketersediaan kendaraaan dijelaskan oleh faktor jarak dan faktorgeografis. Faktor-faktor penguat (reinforcing factors) seperti keluarga (p=0.201), masyarakat (p=1), tenaga kesehatan (p=0.26) dan pemerintah (p=0.345) tidak bermakna terhadap pemanfaatan RTK di Manggarai Barat tahun 2016.
Bad goegraphic condition and bad access to health facility still remain to bethe big problem in effectivity of maternity care in NTT Province, Indonesia. The badaccess to the facility causes the problems of 3 Lates (Tiga Terlambat) and still highof MMR and IMR. One of the wayouts of the problems is the revoluiton of Motherdan Infant Health care in NTT since 2009 with providing maternity waiting houses(MWH) near facility of health care.The aim of the study is to determine the effectivity of using maternity waitinghouses in district of Manggarai Barat, Province of NTT, in 2016. The use of MWHlink to the factors of: predisposing factors, enabling factors and reinforcing factors.This research uses Mixed Method Research with explanatory design. Totalsurvey samples are 100 respondents using multistage random sampling method andtotal indepth interview samples are 29 respondents. The analisys of data using thesoft ware program of Statistical Product and Service Solutions (SPSS) and Nvivo 11Plus.The result of the survey is 19% pregnant women used MWH in ManggaraiBarat in 2016. Indepth Interview shows the fact that the use of MWH have a positiveimpact for many pregnant women from the villages with bad geographic conditionsand the pregnant women with high risk maternity. The quantitative analysis showingthe result that the predisposing factors: age (p=0.38), education (p=0.301),knowledge (p=0.201), work (p=0.68), socio-economic condition (p=0.592), attitude(p=0.452) and socio-cultural factors had no significant relation with the use of MWHin Manggarai Barat in 2016. The factors of heath facility and healt care provider(p=0.038) and the presence of transportation facility (car or vehicles) (p=0.04) havesignificat relation with the use of MWH. The reinforcing factors: family (p=0.201),public figures (p=1), health care provider (p=0.26) and government (p=0.345) had nosignificant relationship with the use of MWH in Manggarai Barat, 2016.
