Hasil laporan Sub Direktorat Imunisasi Depkes RI bersama WHO tentang studi pengukuran keamanan penyuntikan di empat porpinsi di Indonesia (1999) menunjukkan bahwa 37,5% syringe tidak steril, 22,5% bagian jarum tidak steril ketika akan digunakan dan 28,5% bagian jarum dan syringe yang steril tersentuh waktu pemakaian. Di samping itu Laporan Tahunan Imunisasi 1998/1999 menunjukkan bahwa berdasarkan hasil survei Badan Litbangkes Depkes RI menunjukkan bahwa 40-50% praktek imunisasi tidak aman termasuk pelaksanaan Bulan Imunisasi Anak Sekolah (BIAS). Hal ini menyangkut kepatuhan petugas pelaksana pelayanan imunisasi. Tujuan penelitian ini adalah diperolehnya informasi tentang tingkat kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi dan faktor-faktor yang berhubungan dengan kepatuhan petugas tersebut di puskesmas Kota Pontianak Propinsi Kalimantan Barat Tahun 2000. Desain penelitian ini menggunakan pendekatan kuantitatif dengan rancangan potong lintang (cross sectional). Pengamatan dilakukan di 20 Puskesmas di Kota Pontianak sebanyak 100 orang petugas pelaksana pelayanan imunisasi di Puskesmas atau di Posyandu. Pengumpulan data dilaksanakan dengan menggunakan daftar tilik untuk pengamatan kepatuhan petugas, setiap petugas diamati sebanyak tiga kali. Setelah selesai pengamatan dilakukan wawancara tentang hal yang berkaitan dengan faktor-faktor yang berhubungan dengan kepatuhan petugas. Hasil analisis univariat kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi nilai total menunjukkan yang patuh sebesar 53,0 %. Pengamatan kepatuhan dilakukan pada tiga komponen kegiatan yang hasilnya menunjukkan bahwa petugas yang patuh terhadap proses pencatatan 81,0%, proses penyuntikan 79,0%, tetapi yang patuh pada proses penyuluhan 8,0%. Petugas dengan tingkat pengetahuan baik lebih sedikit dari yang tingkat pengetahuannya kurang, sebagian besar berpengetahuan baik tentang jadwal imunisasi, sebaliknya sebagian besar berpengatuhan kurang tentang cara imunisasi. Hasil analisis bivariat menunjukkan adanya hubungan yang bermakna antara pengetahuan dengan kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi. Petugas yang berpengetahuan baik yang patuh sebanyak 68,1% dan yang pengetahuan kurang yang patuh 39,6%. Variabel pengetahuan menunjukkan faktor yang paling dominan berhubungan dengan kepatuhan petugas terhadap pedoman pelaksanaan pelayanan imunisasi. Saran, perlu adanya upaya peningkatan kepatuhan petugas dengan peningkatan pengetahuan tentang pelaksanaan pelayanan imunisasi melalui pelatihan, pertemuan maupun supervisi.

---

Report of Immunization Sub Directorate of the Ministry of Health Republic of Indonesia in a joint project with WHO (World Health Organization) concerning study on measurement of injection safety in four provinces in Indonesia (1999) shows that 37.5% of syringe were not sterile, 22.5% of the needles to use were not sterile and 28.5 % of sterile needles and syringe were touched during their use. In addition, the Immunization Annual Report 1998/1999, based on a survey conducted by National Institute of Health Research and Development of the Ministry of Health Republic of Indonesia, reveals that 4U°/o-50% of the immunization practice were not safe, including the implementation of Bulan lmunisasi Anak Sekolah (BIAS) or School Immunization Program. This finding correlates with the staff compliance in delivering immunization service.

This study was aimed at gathering information regarding level of staff compliance to the implementation guidelines of immunization service and factors that correlate with such staff compliance at all Puskesmas (community health centers) in Pontianak City, West Kalimantan Province, Year 2000.

The study design employed a qualitative approach with a cross sectional method. Observation was conducted at 20 Puskesmas in Pontianak City over 100 operatives or staffs of immunization service at Puskesmas or Posyandu (Integrated-Service Shelter). Data collection was conducted by using checklist to observe the staffs? compliance. Each staff was observed for three times. Following the observation, interviews were set to dig information on factors that correlate with the staffs? compliance to the guidelines.

Result of univariat analysis of the staffs compliance to the guideline shows that 53.0% of the staffs compliance to the guidelines. The observation over the staffs compliance was focused on three components of activities, The results describes that 81.0% of the staffs compliance to recording process, 79.0% of the staffs compliance to injection procedures, and only 8.0% of them compliance to the program dissemination session. The number of knowledgeable staff was far littler that the opposite staff, a lot of the staffs acknowledged the immunization schedule, while most of them were less informed about appropriate immunization procedures.

The bivarians analysis result shows that there is a significant correlation between knowledge level of the staffs and their compliance to the implementation guidelines of the immunization service. 68.1% of the knowledgeable staff's compliance to the guidelines while 39.6% of the less knowledgeable staff-'s compliance to the guidelines. Knowledge variable proved to be the most dominant factor that correlated with the staffs compliance to the implementation guidelines of immunization service. As recommendations, there should be improvement of the staffs? compliance to the guidelines by increasing their knowledge of the guidelines through regular training, meetings or supervisions.