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Campak dan Rubela merupakan penyakit menular berpotensi wabah yang dapat menimbulkan komplikasi serius bahkan kematian, terutama pada anak-anak. Namun keduanya dapat dicegah melalui pemberian imunisasi. Trend cakupan imunisasi yang menurun, terutama paska pandemi COVID-19, telah menyebabkan peningkatan Kejadian Luar Biasa (KLB) salah satunya Campak-Rubela, sehingga diperlukan respon cepat melalui pemberian imunisasi tambahan berupa Outbreak Response Immunization (ORI). Pelaksanaan ORI di sebagian besar wilayah terdampak KLB masih belum optimal, terutama dari sisi ketepatan waktu respon. Kementerian Kesehatan telah menyediakan alat bantu untuk mendukung proses pra-pelaksanaan ORI, namun penginputan masih bersifat manual dan sistem ini belum terintegrasi dengan sistem informasi lain, serta belum memiliki mekanisme verifikasi dan monitoring oleh tingkat administrasi yang lebih tinggi. Oleh karena itu, dibutuhkan suatu inovasi yang dapat memperbaiki sistem yang ada saat ini. Penelitian ini bertujuan untuk mengembangkan prototipe sistem informasi terintegrasi guna meningkatkan ketepatan waktu pelaksanaan ORI di tingkat puskesmas dalam rangka penanggulangan KLB Campak-Rubela.
Metode yang digunakan adalah Pendekatan Rapid Evolutionary Prototyping yang memungkinkan pengembangan dilakukan bertahap berdasarkan masukan yang diperoleh selama proses implementasi dengan cakupan terbatas. Sistem dikembangkan melalui tahapan analisis kebutuhan, identifikasi masalah, desain (logis serta fisik) dan implementasi. Penelitian ini menghasilkan prototipe yang terintegrasi dengan sistem SKDR dan SMILE dilengkapi beberapa menu utama yaitu notifikasi status, penginputan data kajian epidemiologi, perhitungan kebutuhan vaksin dan pelaporan ORI secara real time. Hasil pengujian yang melibatkan informan dari Dinas Kesehatan Kota Depok, Puskesmas Pengasinan dan Depok Jaya menunjukkan bahwa prototipe Sistem Informasi Outbreak Response Immunization (SIORI) efektif dan efisien dalam mendukung penyelenggaraan ORI. Kesimpulannya, prototipe SIORI memiliki potensi memperbaiki sistem yang ada saat ini dalam meningkatkan ketepatan waktu penyelenggaraan ORI KLB Campak-Rubela.
Measles and Rubella are highly contagious infectious diseases that can lead to serious complications and even death, especially in children. These diseases could cause outbreaks, however, can be prevented through immunization. The declining trend in immunization coverage, particularly after the COVID-19 pandemic, has led to an increase in outbreaks, including Measles-Rubella, thus requiring a prompt response through supplementary immunization activities known as Outbreak Response Immunization (ORI). The implementation of ORI in most outbreak-affected areas remains suboptimal, particularly in terms of response timeliness. Although the Ministry of Health has provided supporting excel based tools to support the pre-implementation process of ORI, data entry is still manual, the system is not yet integrated with other relevant information systems and is not complemented with verification and monitoring mechanisms from higher administrative levels. Therefore, an innovation is needed to improve the current system. This study aims to improve the timeliness of ORI implementation at the primary health care level in response to Measles-Rubella outbreaks through development of an integrated information system prototype. The Rapid Evolutionary Prototyping approach was used as the system development model, which allows for incremental development based on feedback collected during implementation assessment. The system was developed through the stages of needs analysis, problem identification, logical and physical design, and implementation. This study resulted in the development of a prototype information system named SIORI, designed to improve the timeliness of ORI implementation. The system includes several key features including outbreak status notification that is integrated with the Early Warning Alert and Response System (SKDR), input for epidemiological assessment data, vaccine stock data obtained from the Electronic Immunization and Logistics Monitoring System (SMILE), vaccine needs calculation, and reporting functions covering response timeliness and immunization service data input. Implementation test involving informants from Depok City Health Office and selected health centers (Puskesmas Pengasinan and Depok Jaya) showed that SIORI is more effective and efficient in supporting ORI implementation. The conclusion is that prototype SIORI has potentials to improve the current system in to accelerating ORI implementation timeliness.
Kata kunci: Difteri, KLB, Outbreak Response Immunization (ORI)
Diphtheria is contributor of outbreak (KLB) for some regions in Indonesia, included West Java Province. Diphtheria cases recorded increased through 2015 - 2016, cases increased from 59 cases to 153 cases. Depok City became one of the contributors of cases that have fluctuating incidents. Disease trends have declined in 2013-2015, but then increased in 2016 to 8 cases. This study discusses policy implementation, viewed from policy sources, resource arrangements, the characteristics of implementing agencies, bureaucratic structures, communications, the influence of dispositions and socio-economic and political circumstances in control of Diphtheria Outbreak and Outbreak Response Immunization ORI) in Depok City in 2017. This type of research is qualitative research with descriptive design, through in-depth interviews and document review. The results showed that the limited resources, especially human resources, the lack of cross-sectoral concern and social environment factors, like the rejection of some community for vaccination, became a challenge in controlling the Diphtheria Outbreak and Outbreak Response Immunization (ORI) in Depok City. It is expected that policy implementers can commit to working together, and taking into the influential factors in policy implementation, as well as government support in providing halal and safe vaccines and research on bioterrorism can also be done as solving cases of diphtheria fluctuating annually.
Key words: Diphteria, Outbreak, Outbreak Response Immunization (ORI)
Kesehatan reproduksi adalah “keadaan sejahtera fisik, mental dan sosial secara utuh (tidak semata-mata bebas dari penyakit atau kecacatan) dalam semua hal yang berkaitan dengan sistem reproduksi, serta fungsi dan prosesnya”. Masa remaja menjadi sangat penting dalam kesehatan reproduksi karena masa remaja (10-19 tahun) merupakan saat dimana organ reproduksi manusia mengalami pematangan atau pubertas, terjadi perubahan fisik secara cepat yang tidak seimbang dengan perubahan kejiwaan. Jika perubahan-perubahan ini tidak disertai dengan perhatian dan bimbingan yang tepat pada remaja maka akan membawa pada masalah-masalah yang dapat merugikan masa depan remaja sendiri. Masalah-masalah tersebut seperti hubungan seks pra nikah, kehamilan tidak diinginkan, PMS, anemia. Penelitian di Sumatera Selatan, Jawa Barat bagian timur, Kalimantan Barat, dan Nusa Tenggara Timur menunjukkan bahwa sebesar 4,7% remaja laki-laki pernah melakukan hubungan seks sebelum menikah dan pada remaja perempuan sebesar 3,2%. Prilaku beresiko lainnya seperti merokok, minum alkohol, dan penggunaan obat terlarang. Masalah kesehatan reproduksi seperti yang telah diuraikan diatas dapat disebabkan oleh beberapa hal diantaranya kurangnya pengetahuan remaja tentang masalah tersebut yang disebabkan oleh kurangnya informasi tentang kesehatan reproduksi remaja. Salah satu pemberian informasi kepada remaja dapat dilakukan melalui internet. Internet merupakan media elektronik yang sudah memasyarakat yang dapat digunakan dan penting dalam bertukar informasi salah satunya informasi kesehatan. Minat remaja untuk mencari informasi lewat situs yang menyajikan informasi mengenai dunia remaja cukup tinggi. Namun situs-situs yang menyediakan informasi bagi remaja khususnya kesehatan reproduksi masih kurang dibandingkan dengan situs-situs lainnya, karena itu perlu dibangun suatu jaringan terintegrasi yang memberikan informasi kesehatan reproduksi remaja melalui internet. Membangun jaringan terintegrasi untuk informasi kesehatan reproduksi remaja ini dilakukan di Dinas Kesehatan Kota Bogor dengan ruang lingkup pada pelaksanaan program Kesehatan Reproduksi Remaja di Klinik Konsultasi Remaja Puskesmas Bogor Timur serta pemanfaatan internet sebagai media informasi kesehatan reproduksi remaja. Metode yang digunakan dalam membangun jaringan terintegrasi tentang Kesehatan Reproduksi Remaja ini adalah dengan metode incremental dengan tahaptahap analisis, perancangan, pengkodean dan uji coba prototipe. Jaringan terintegrasi yang terbentuk adalah website Informasi Kesehatan Reproduksi Remaja yang memberikan informasi kesehatan reproduksi remaja yang mencakup proses reproduksi sehat yang bertanggung jawab, organ reproduksi dan fungsinya, menstruasi, kehamilan, metode kontrasepsi, penyakit menular seksual termasuk HIV/AIDS, dan gizi remaja. Daftar Pustaka : 52 (1999 – 2007)
Reproductive health is “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes”. Meanwhile, adolescence is known as a crucial period of time on its reproductive health. Since adolescence (10-19 years old) is also the time when human reproductive system is going to be matured (puberty) and the development of rapid changes physically (growth spurt), are occurred. In which sometimes the changes are imbalance with its psychological changes. When the changes are not properly led and guided, it can be lead to problems that can ruin their own futures, such as pre-marital sex, unwanted pregnancy, STD, and anemia. Data shows that 4.7% of boys and 3.2% of girls in Sumatera Selatan, Jawa Barat bagian timur, Kalimantan Barat, dan Nusa Tenggara Timur has have experience in pre-marital sex. Another risk behavior which adolescents used to engage are smoking, drinking, and drug abuses. Problems in reproductive health that have mentioned above are mostly due to lack of knowledge regarding to reproductive matters because they have less or no exposures on the information of adolescent reproductive health. One of approaches of information to reach the adolescent is through internet. Since is have known that internet is an electronic media that broadly known and used well for searching and exchanging information, as well as information on health. There is a quite high figure on adolescent who looking for the sites providing information about youth matters. However, there are only few internet sites which provides information on adolescent reproductive health compare to other information. Therefore, there is a need to develop an integrated networking on providing information on reproductive health toward adolescent through the internet. The Health Authority Office of Kota Bogor is carrying out the developing of the integrated networking as part of the implementation of the program on the adolescent reproductive health at the Consultation Clinic for Adolescent of Puskesmas Bogor Timur with its internet utilization as the media of the information on the adolescent reproductive health. The incremental method is used in developing the networking which has the stages on analysis, designing, coding, and prototype testing. The integrated networking that established is a website on the Information of the Adolescent Reproductive Health that provide any information regarding to the adolescent reproductive health, namely reproductive organs and function, menstruation, pregnancy process, contraception, sexually transmitted diseases include HIV/AIDS, and nutrition problems in youth.. Reference: 52 (1999-2007)
