Dalam Peraturan Presiden nomor 7 tahun 2005 tentang Rencana Pembangunan Jangka Menengah Nasional (RPJMN) tahun 2004?2009 yang memuat 10 program, yang diamanatkan kepada Departemen Kesehatan salah satunya adalah program lingkungan sehat yang dalam pelaksanaannya telah disusun Rencana strategis Departemen Kesehatan tahun 2005?2009 termasuk indikatornya (Depkes RI, 2007). Salah satu kegiatan Program lingkungan sehat adalah penyediaan air bersih dan sanitasi dasar. Program penyehatan air bersih dilaksanakan untuk pemenuhan akses masyarakat terhadap air bersih, tidak hanya untuk pemenuhan segi jumlah/debit, namun kualitas/mutu air bersih yang dikonsumsi oleh masyarakat juga harus menjadi prioritas. Untuk itu diperlukan kerja keras dari pemegang program penyehatan air, khususnya sanitarian puskesmas sebagai ujung tombak pelaksanaan progran tersebut di tingkat puskesmas. Penelitian ini dilakukan dari bulan Maret sampai Mei 2007 di Kabupaten Solok. Tujuan dari penelitian ini adalah didapatkannya gambaran kinerja petugas Sanitasi Puskesmas dan faktor-faktor yang berperan pada kinerja petugas sanitasi puskesmas dalam pelaksanaan program penyehatan air di Kabupaten Solok Tahun 2007. Penelitian ini menggunakan pendekatan kualitatif melalui wawancara mendalam, Diskusi Kelompok Terarah dan observasi, dengan informan Sanitarian puskesmas dilanjutkan triangulasi sumber dengan Kepala Puskesmas dan Kepala Bidang PL & PKM Dinas Kesehatan Kabupaten Solok. Rendahnya kinerja sanitarian puskesmas dalam pelaksanaan program penyehatan air bersih dilihat dari Cakupan IS rendah, Penyuluhan Kurang, Pembinaan Pokmair Kurang, Pengawasan air Kurang , Sistem informasi program tidak jalan. Faktor yang berperan dalam kinerja sanitarian tersebut adalah; kemampuan dan keterampilan sanitarian yang kurang terasah, supervisi baik dari Kabupaten maupun Kapala Puskesmas kurang; pelatihan sanitarian frekwensi yang kurang serta tidak sesuai kebutuhan, motivasi sanitarian yang rendah, imbalan dan dana operasional kurang, adanya beban kerja tambahan, sarana dan prasarana tidak memadai, kurang prioritas program oleh Kepala Puskesmas, akses sebagian wilayah kerja yang tidak lancar terutama untuk kecamatan terisolir, serta kebijakan Dinas Kesehatan terutama kebijakan anggaran yang belum memprioritaskan anggaran program kesehatan lingkungan atau program air bersih. Saran yang dapat diberikan dari penelitian ini adalah agar kebijakan Dinas Kesehatan Kabupaten Solok pada program penyehatan air pelaksanaanya diintegrasikan dengan kegiatan puskesmas luar gedung dengan didukung tersedianya sarana dan prasarana, alokasi dana opersional sesuai dengan kebutuhan; Pengembangan Sistem Informasi Kesehatan; Pelaksanaan supervisi yang berkesinambungan, Pelatihan sanitarian sesuai dengan kebutuhan kerja di lapangan, pembuatan petunjuk pelaksanaan dan petunjuk teknis program sesuai kebutuhan sanitarian, pelatihan untuk meningkatkan kemampuan dan keterampilan, pengadaan sarana dan prasaran sanitarian, merancang program pemberian reward bagi sanitarian teladan.

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President Regulation No 7 in 2005 concerning National Development Planning at Middle Period (RPJMN) of 2004-2009 which conclude 10 programs that are instructed to Health Department. One of them is health environment program which its accomplishment arranged a strategic planning of Health Department at period of 2005- 2009 including its indicator (Health Department of Indonesian Republic, 2007). One of health environment program activity is preparing hygienic water and basic sanitation. Healthy program of hygienic water is accomplished to fulfill public access to hygienic water, not only a quantity supplied, but quality of hygienic water which is consumed by public must become a priority. Therefore, it needs a hard work from water healthy program holder, especially for sanitation officer at primary health care as leader of this program accomplishment at primary health care level.

This study was conducted from March until May 2007 at district of Solok. This study aim is to get describing of sanitation officer performance at primary health care and the factors which related to sanitation officer performance at primary health care on accomplishment of water healthy program at district of Solok in 2007. This study used a qualitative method by in depth interview, directed group discussion and observation, informant is sanitation officer at primary health care, and then source triangulation with a leader of primary health care and leader of PL and PKM of Health Service Department at district of Solok.

Low performance of sanitation officer at primary health care on accomplishment healthy program of hygienic water if it was seen from low IS coverage, less counseling, less training of Pokmair, less monitoring of water, information system program is not functioned. The factors which are important on sanitation officer performance such as : less ability and skill of sanitation officer, less supervision of district and primary health care leader, less training frequency of sanitation officer and the need is not available, low motivation of sanitation officer, less reward and operational fund, many extra jobs, facility and basic facility are not adequate, less program priority by leader of primary health care, work area access is not good especially for isolated district, and Health Service Department policy especially for budget policy which does not prioritized budget of development health program or hygienic water program.

It was suggested to Health Service Department policy at district of Solok on water healthy program in order its accomplishment is integrated with primary health care activity out of building by supporting of available facility and basic facility, operational fund allocation is available with the need, health information system development, accomplishment of continuity supervision, sanitation officer training is available with job need at work area, making of accomplishment guide and program technique guide are available with sanitation officer need, training to improve ability and skill, levying facility and basic facility of sanitation officer, arranging reward program for expert sanitation officer.