Di Indonesia masih banyak terdapat usaha informal yang belum memilliki akses mendapatkan pelayanan kesehatan kerja. Permasalahan program kesehatan kerja seringkali terjadi dikarenakan pergantian dokter puskesmas, kurangnya pengetahuan dari petugas dan kader kesehatan kerja. Di Kabupaten Pesawaran Propinsi Lampung terdapat empat puskesmas yang menjadi percontohan program upaya kesehatan kerja dimana sudah diberikan pelatihan kepada dokter dan pemegang program tentang kesehatan kerja serta sudah pernah dilakukan bimbingan teknis serta monitoring. Akan tetapi, program upaya kesehatan kerja di puskesmas belum berjalan. Penelitian ini bertujuan mengetahui kendala apa saja yang ada dalam implementasi program upaya kesehatan kerja pada tahap perencanaan, pelaksanaan dan juga evaluasi. Penelitian ini bersifat kualitatif dengan menggunakan fungsi manajemen menggunakan metode wawancara mendalam dan telaah dokumen. Informan dalam penelitian ini adalah Kepala Dinas Kesehatan Kabupaten Pesawaran, Kepala Seksi Kesehatan Khusus dan Matra, Kepala Puskesmas, Pemegang program dan perwakilan dari sasaran. Hasil dari penelitian ini yaitu program upaya kesehatan kerja belum menjadi prioritas dikarenakan bukan merupakan program pokok di puskesmas namun ada juga yang mengemukakan bahwa tidak ada perbedaan antara program prioritas dan program pengembangan. Masih kurangnya pengetahuan, jumlah sumber daya manusia yang terlibat dalam program upaya kesehatan kerja. Dari segi anggaran, program upaya kesehatnan kerja memiliki alokasi anggaran baik sehingga program upaya kesehatan kerja masih terintegrasi dengan program kesehatan lain. Selain itu, program upaya kesehatan kerja juga tidak didukung oleh peralatan yang memadai serta tidak ada rencana kerja. Dan juga keterlibatan sasaran yang kurang aktif serta kondisi lingkungan yang tidak mendukung dari sisi keamanan. Penelitian ini menyimpulkan bahwa program upaya kesehatan kerja di Kabupaten Pesawaran belum menjadi prioritas dikarenakan masuk kedalam program pengembangan dan belum diukung adanya sumber daya manusia yang memadai, tidak ada alokasi anggaran, tidak ada peralatan serta rencana kerja, keterlibatan masyarakat masih kurang aktif serta lingkungan yang kurang mendukung. Oleh karena itu, program upaya kesehatan kerja perlu dimasukkan dalam rencana kerja baik itu di dinas kesehatan dan puskesmas. serta adanya alokasi anggaran untuk program serta peningkatan kualitas sumber daya manusia dan juga peralatan yang menunjang program serta di butuhkan kerjasama lintas sektor untuk lebih memaksimalkan implementasi program upaya kesehatan kerja di puskesmas.

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In indonesia there are still many informal businesses who have not have access occupational health services. Occupational health problems program often occurred due to the doctor puskesmas, the lack of knowledge of officers and kader occupational health. In Pesawaran District, there are the four be pilot programs health effort work where already provided training to medical doctors and holder programme about occupational health and is has been done technical training and monitoring.But, program health effort work at puskesmas not run. This study aims to identify the constraints all that is for the implementation of program health effort work in the planning stages, the implementation and also evaluating.

This research qualitative by using function management uses the method in-depth interviews and review of documentation. Informants in this research was head of district health pesawaran, head of specific health and matra, the head of puskesmas, holders the program and representatives of the target. The result of this research namely the program health effort work had not been priority because not is a program basic puskesmas but some are suggested that there is no difference between priority programs and development program. There is a lack of knowledge, the number of human resources involved in the program health effort work. On the budgeting side, program efforts kesehatnan work are budget allocation good and the health effort work still integrated with other health program.

In addition, health effort program work also are not supported by proper equipment and had no work plan. And also the involvement of a target that is less active as well as environmental conditions that not in favor of security side. This research concluded that the program working health effort in kabupaten pesawaran had not been a priority because entered into a program to develop and has not diukung the presence of human resources sufficient, there was no budget allocation, there is no equipment and the work plan, the involvement of the community is still less active as well as the environment less supportive.

In addition, health effort program work also are not supported by proper equipment and had no work plan. And also the involvement of a target that is less active as well as environmental conditions that not in favor of security side. This research concluded that the program working health effort in kabupaten pesawaran had not been a priority because entered into a program to develop and has not diukung the presence of human resources sufficient, there was no budget allocation, there is no equipment and the work plan, the involvement of the community is still less active as well as the environment less supportive. Hence, health effort program work will need to be included in the work plan whether it is in health department and public health center. And the existence of the budget allocation for the program as well as improving the quality of human resources and also that support equipment of the program and need cooperation cross-sectors to be more maximize the implementation of health effort program work in public health.