Program Eliminasi Tetanus Neonatorum (ETN) merupakan komitmen global hasil Konferensi Tingkat Tinggi Anak tahun 1990 di New York. Tujuan ETN yaitu menekan serendah mungkin angka kesakitan tetanus neonatorum sampai tidak menjadi masalah kesehatan masyarakat lagi. Di perkirakan di seluruh dunia tak kurang dari 350.000 neonatus setiap tahunnya meninggal akibat tetanus neonatorurn.Di Indonesia tetanus neonatorum merupakan penyebab utama ke empat kematian neonatal yaitu sebesar 7,9 %. Angka kejadian tetanus neonatorum tahun 1997- 2000 berkisar 1,6 - 1,8 per 10.000 kelahiran hidup (fenomena gunung es). Jawa Barat merupakan provinsi dengan laporan kasus tetanus neonatorum terbesar di Indonesia, angka kejadian tetanus neonatorum periode 1997-2000 berkisar 1,2 - 1,6 per 10.000 kelahiran hidup dengan CFR berkisar 34,2 % - 47,1 %,Upaya pencapaian eliminasi tetanus neonatorum di lakukan melalui pendekatan risiko secara terpadu, sedikitnya melibatkan tiga program yaitu program imunisasi, KIA dan surveilans. Program imunisasi berperan meningkatkan eakupan imunisasi TT hamil, imunisasi wanita usia subur (WUS). Program KIA berupaya meningkatkan cakupan pelayanan antenatal, cakupan kunjungan neonatus, pembinaan dukun bayi dan meningkatkan pertolongan persalinan oleh tenaga kesehatan. Program surveilans berperan dalam penyelidikan epidemiologi untuk mengidentifikasi faktor risiko dan daerah risiko serta ikut memantau dan menilai keberhasilan dampak program.Meskipun ETN teiah dilaksanakan sejak tahun 1995 namun program surveilans belum mampu memberikan informasi yang harus di tindak lanjuti secara rutin, baik oleh pimpinan maupun oleh program KIA dan imunisasi. Pengolahan data hasil penyelidikan epidemiologi belum didukung oleh suatu sistem informasi yang memadai dan belum mengakomodir keterpaduan program ETN.Dalam melakukan pengembangan sistem informasi surveilans tetanus neonatorum di Dinas Kesehatan Propinsi Jawa Barat, dilakukan observasi dan wawancara dengan petugas. Tujuannya adalah mempelajari permasalahan sistem yang ada saat ini, serta melakukan rancangan sistem informasi yang sesuai dengan kebutuhan program. Permasalahan dalam sistem informasi yang ada saat ini adalah rendahnya kuantitas dan kualitas informasi yang di hasilkan surveilans, belum terstrukturnya pengolahan data surveilans, sebagian proses pengolahan data manual, pengolahan data sangat tergantung kepada petugas tertentu serta belum terpadunya sistem informasi ETN.Pengembangan sistem informasi surveilans tetanus neonatorum terdiri dari rancangan output, rancangan input, rancangan basis data dan rancangan teknologi yang menghasilkan suatu prototipe program aplikasi. Kelebihan dari sistem informasi surveilans tetanus neonatorum adalah proses pengolahan menjadi terstruktur, proses lebih cepat, proses lebih teliti, proses konsisten, mudah di akses dengan tampilan menarik, hasil up to date serta mengakomodir kebutuhan program ETN.Mengingat prototipe aplikasi sistem informasi surveilans tetanus neonatorum secara teknis telah berhasil di ujicoba di laboratorium, dan sumber daya di unit surveilans Dinas Kesehatan Propinsi Jawa Barat memadai, maka perlu kiranya dilakukan implementasi sistem pada kegiatan surveilans yang sebenarnya. Proses implementasi secara manajerial harus di dukung komitmen kuat pimpinan dan pengelola program.Daftar Bacaan : 28 (1981- 2003)

---

The Development of Surveillance Information System on Tetanus Neonatorum in The Health Authority of West Java Province ? 2003The Tetanus Neonatorum Elimination (TNE) Program is a result from global commitment at the Summit Conference for Children in New York in 1999. The aims of the TNE Program is to decreased as low as possible the morbidity of the tetanus neonatorum, until it's not any longer to be the public health problem. It is estimated that there were 350,000 newborns die every year in the world due to tetanus neonatorum.

in Indonesia tetanus neonatorum is the fourth major cause of death on newborn, at 7.9%. Its prevalence in 1997 - 2000 is around 1.6 - 1.8 per 10,000 life birth, but this figure is beliefs to be a tip of the iceberg phenomenon. West Java is a province which reported to be having the highest cases of tetanus neonatorum in Indonesia in 1997 - 2000, as high as 1.2 - 1.6 per I0,000 life birth, with its case fatality rate (CFR) at 34.2 to 47.1%.

An integrated risk approach is accomplished in order to try to eliminate the tetanus neonatorum, which at least involving three programs at the ministry of health (MOH), i.e. the immunization program, the maternal and child health (MCH), and surveillance. The immunization program has a role on increasing the coverage on TT immunization on pregnant mothers, and immunization on women at reproductive age (15 - 39 years old). The MCH program is try to increasing the coverage of antenatal care (ANC) services, coverage on newborn visit by health personnel, train and aide the traditional birth attendant, and increasing the delivery attendant by health personnel. And the surveillance program is responsible on carried out an epidemiology investigation in order to identify any risk factors and risk areas, as well as to monitor and evaluate the impact of a succeed achievement of a program.

Although the TNE program has been conducted since 1995, but so far, its surveillance program is unable to provide information that should be routinely followed up, whether by the decision makers or by MCH or immunization program. Moreover, there is no adequate information system to support the data management of the result of the epidemiology investigation, as well as to accommodate the integrity of TNE program.

in order to develop the surveillance information system of tetanus neonatorum in West Java, an observation and interview toward the officer of the Health Authority of West Java Province is being conducted. The study has an aim on finding out any recent problem that exist on the system, and try to design a proper information system regarded to the need of the program. Some findings on the recent problems on the existing system are: poor information quantity and quality, unstructured data management on the result of surveillance, some data management process is prepared manually, the process is solely depend on particular officer, and the information system of the TNE program has not been integrated yet.

The development of the information system of tetanus neonatorum surveillance is comprises of several stages, which are: an output design, an input design, a data-base design, and a technology design resulting on a prototype of an application program. The advantages of the information system of tetanus neonatorum surveillance are: the management data processing is more organize, faster, more precise, more consistent, easy to access with a good appearance, an up to date result, and put together the main three TNE program organizer.

As laboratory try-out of the prototype of the information system of tetanus neonatorum surveillance is technically succeeded, and its human resources at the surveillance unit of Health Authority of West Java Province is sufficient, it is suggested that the system can be implemented for the factual surveillance activities. And its implementation process should be supported by strong commitment from the decision makers and its program organizer.

Reference: 28 (1981 - 2003)