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Minggu, 24 Januari 2010

UPAYA PENINGKATAN PENEMUAN SUSPEK TUBERKULOSIS PARU MELALUI ANALISIS KINERJA TENAGA KESEHATAN PUSKESMAS (Di Balai Pengobatan Puskesmas Kabupaten Jombang)

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UPAYA PENINGKATAN PENEMUAN SUSPEK TUBERKULOSIS PARU MELALUI ANALISIS KINERJA TENAGA KESEHATAN PUSKESMAS (Di Balai Pengobatan Puskesmas Kabupaten Jombang)

Oleh: Dr. Suparyanto, M.Kes

WHO pada tahun 1993 telah mencanangkan bahwa penyakit TB Paru merupakan kedaruratan dunia, karena sepertiga penduduk dunia telah terinfeksi penyakit tersebut termasuk Indonesia. Di Kabupaten Jombang cakupan penemuan suspek TB oleh tenaga kesehatan masih rendah yaitu sebesar 1,19% dari target 10%.

Untuk meningkatkan upaya penemuan suspek TB tersebut diperlukan kinerja tenaga kesehatan yang tinggi. Tujuan penelitian ini adalah menganalisis faktor kinerja (karakteristik individu, karakteristik organisasi dan karakteristik pekerjaan) tenaga kesehatan di BP Puskesmas Kabupaten Jombang dalam upaya peningkatan penemuan suspek TB.

Metode penelitian yang digunakan adalah analitik dengan pendekatan cross sectional. Sampel penelitian adalah semua tenaga kesehatan di BP Puskesmas Kabupaten Jombang sebanyak 95 orang. Pengumpulan data primer dilakukan dengan menggunakan kuesioner, check list dan pemeriksaan laboratorium. Hasil penelitian dianalisis dengan multiple logistic regression.

Hasil penelitian menunjukan bahwa (1) variabel karakteristik individu yang mempunyai pengaruh bermakna terhadap kinerja adalah: pendidikan, pengetahuan dan motivasi; (2) variabel karakteristik organisasi yang mempunyai pengaruh bermakna terhadap kinerja adalah: supervisi, dan pelatihan melalui variabel antara motivasi; (3) variabel karakteristik pekerjaan yang mempunyai pengaruh bermakna terhadap kinerja adalah: beban kerja melalui variabel antara motivasi; sedangkan variabel umur, jenis kelamin, persepsi, sikap, koordinasi, sistem imbalan, umpan balik, dan masa kerja tidak mempunyai pengaruh yang bermakna terhadap kinerja.

Dari hasil penelitian ini diperoleh 7 isu strategis yaitu: belum optimalnya kinerja, pendidikan, pengetahuan, motivasi, supervisi, pelatihan P2TB dan beban kerja tenaga kesehatan di BP Puskesmas. Ketujuh isu strategis tersebut dijadikan bahan kajian Focussed Group Discussion yang melibatkan Dinas Kesehatan dan Puskesmas untuk menyusun upaya peningkatan penemuan suspek TB.

Kesimpulan penelitian ini adalah merekomendasikan upaya peningkatan penemuan suspek TB di BP Puskesmas sebagai berikut:
1. Memberdayakan tenaga kesehatan untuk meningkatkan kinerja mereka dalam menemukan suspek TB melalui:
  • a) Memberi kemudahan ijin belajar, khususnya bagi tenaga kesehatan yang berpendidikan SPK.
  • b) Meningkatkan motivasi tenaga kesehatan melalui pemberian motivator yang diharapkan serta menghindarkan segala sesuatu yang dapat membuat mereka kecewa.
  • c) Supervisi P2TB yang efektif yaitu menggunakan supervisor yang menguasai ketrampilan teknis dan ketrampilan berinteraksi.
  • d) Pembelajaran organisasi agar mereka mempunyai pola pikir dan komitmen yang kuat terhadap program P2TB.
  • e) Mengurangi beban kerja tenaga kesehatan dengan cara pemerataan pembagian tugas program kesehatan.
2. Membangun kemitraan antara Puskesmas dengan sarana pelayanan kesehatan swasta. Sarana pelayanan kesehatan swasta melaksanakan pengobatan penderita TB dengan strategi DOTS, sedangkan obatnya (OAT) disediakan gratis oleh Dinas Kesehatan.


SUMMARY



THE EFFORT OF SUSPECTED LUNG TUBERCULOSIS CASE FINDING THROUGH HEALTH STAFFS PERFORMANCE ANALYSIS (In BP of Public Health Care Jombang Regency)



In 1993, WHO has already declared that TB become the most deadly disease in all over the world, almost a third of world’s population has been infected by TB diseases, including Indonesia. In Jombang Regency, the spreading of the diseases becomes a serious problem. It is caused by the low recognition of health staffs to detect the number of TB suspected. They were just able to detect 1,19 % from 10 % of target.

In order to improve finding TB suspected efforts, a high qualified health staffs is mostly required. The objective of this research is to analyze the performance factors (individual characteristics, organizational characteristics and work characteristics) of health staffs of BP Puskesmas in Jombang Regency on finding TB suspected efforts.

The method used in this research is an analytic and cross sectional study. The research sample is 95 health staffs of BP Puskesmas Jombang Regency. The primary data was collected by using questionnaire and laboratory examination and the data was analyzed by multiple logistic regression technique.

The results of the research showed that (1) variables for individual characteristics that had a significant influence to health staffs performance were education, knowledge and motivation; (2) variables for organizational characteristics that had a significant influence to health staffs performance were supervision, training, through motivation variable; (3) variables for work characteristics that had a significant influence to health staffs performance was work load through motivation variable; meanwhile variable for ages, sexes, perception, attitudes, coordination, feed back, and work period didn’t have a significant influence to health staffs performance.

Based on the research, we gain 7 strategic issues such us: health staffs performance, education, knowledge, motivation of health staffs, supervision on P2TB, training of P2TB and work load of health staffs weren’t optimum yet. The seven strategic issues were presented as subject matter of Focus Group discussion which involves Dinas Kesehatan and Puskesmas in arranging the finding of Suspected TB efforts.

The conclusions of the study are to recommend the raising TB suspected finding efforts as follow:

1. Empowering the health staffs to improve their performance on finding suspected TB efforts through:
  • a) Giving them the study permission easily, especially for health staffs with SPK’s graduate.
  • b) Raising motivated health staffs by giving them a good motivator and reducing every trouble that make them unsatisfied.
  • c) Effective supervision of P2TB by effective supervisor who have technical skill and motivation skill.
  • d) Learning organization to make them have the same mental model and commitment about P2TB program.
  • e) Reducing health staff’s work load with even distribution of health’s program.
2. Building a good relationship between Puskesmas and some private health care about P2TB program. Private health care implement TB therapy with DOTS strategy, meanwhile oral anti-TB is distributed free by Dinas Kesehatan.



ABSTRACT

THE EFFORT OF SUSPECTED LUNG TUBERCULOSIS CASE FINDING THROUGH HEALTH STAFFS PERFORMANCE ANALYSIS (In BP of Public Health Care Jombang Regency)


The objective of this study was to analyze the health staffs performance factor on raising TB suspected finding efforts. The method of this research is an analytic and cross sectional study. The sample of the research is the whole health staffs of the BP of Public Health Care Jombang Regency.

The first step of the research was collecting some data with questionnaire, used to recognize the number variable of individual characteristics, organizational characteristics, and work characteristics; and check list, laboratory’s examination used to calculate the performance level of health staffs.
The second step of the research was to analyze the recent data by using the multiple logistic regression technique. This way is to recognize the influence of the variable toward the performance level of the health staffs.

The results of the research showed that variables for education, knowledge and motivation, had a significant influence to health staffs performance, meanwhile supervision, training, and work load had a significant influence to health staffs performance through motivation variable.
The third step of the research was to present the result of the study as subject matter for Focus Group Discussion, which involves Dinas Kesehatan dan Puskesmas on raising TB suspected finding efforts in BP of Public Health Care.

The conclusions of the study were to recommend the raising TB suspected finding efforts as follow: empowering health staffs to improve their performance through giving them the study permission easily, raising motivated health staffs, effective supervision of P2TB, learning organization to make them have the same mental model and commitment about P2TB program and building a good relationship between Puskesmas and some private health care about P2TB program.

Keyword: health staffs performance factors, suspected TB case finding

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