Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Salah satu titik berat pembangunan jangka panjang adalah pembangunan kualitas sumber daya manusia (SDM). Salah satu faktor yang mempengaruhi kualitas SDM adalah tingkat kesehatan yang dipengaruhi oleh status gizi khususnya usia balita (0 - 5 tahun). Kekurangan gizi merupakan salah satu manifestasi dari kemiskinan. Hal ini karena keluarga miskin (gakin) tidak memiliki cukup uang untuk membeli kebutuhannya yang merupakan penyebab rendahnya tingkat konsumsi pangan. Untuk mengatasi masalah gizi khususnya pada balita yang muncul sebagai dampak krisis ekonomi telah dilakukan intervensi perbaikan gizi balita diantaranya melalui pemberian makanan tambahan (PMT). karena dana yang ada dirasakan kurang, sehingga PMT yang diberikan belum mampu menjangkau semua balita gakin dengan gizi buruk. Penelitian ini dilakukan di Dinas Kesehatan Kabupaten Tangerang dengan fokus pada pembiayaan PMT balita gakin gizi buruk. Desain penielitian adalah operasional riset dengan mengumpulkan data alokasi anggaran untuk PMT balita gakin gizi buruk, perhitungan biaya PMT balita gakin gizi buruk, meghitung kesenjangan dan kerugian ekonomi akibat balita gakin gizi buruk dirawat di rumah sakit. Penelitian hanya menghitung biaya yang sifatnya langsung, sedangkan biaya investasi yang besar (seperti gaji, pembangunan gedung) serta biaya pemeliharaan (pemeliharaan gedung) tidak dihitung, karena biaya tersebut sudah selayaknya menjadi beban pemerintah. Dari hasil analisis didapatkan bahwa dana yang tersedia untuk PMT balita gakin gizi buruk yang dikelola oleh Dinas Kesehatan Kabupaten Tangerang tahun 2004 dari berbagai sumber sebesar Rp. 365.908.148,-. Sebagian besar (95%) dari APED Kabupaten Tangerang. Perkiraan biaya yang dibutuhkan sebesar Rp.960.841.337,-, jadi ada kesenjangan pembiayaan sebesar Rp.594.933.189,-. Ditemukan Pula kesenjangan kegiatan sebagai akibat dari kesenjangan pembiayaan. Kesenjangan yang besar adalah pada perencanaan yaitu tidak ada orientasi petugas dan kader serta pemenuhan sarana posyandu berupa timbangan gakin. Kesenjangan pelaksanaan adalah tidak semua gakin gizi buruk mendapatkan PMT, PMT yang diberikan komposisinya masih di bawah kecukupan gizi yang dianjurkan Depkes, tidak ada tranport distribusi dan transport/ insentif kunjungan rumah oleh kader yang diperlukan untuk memastikan bahwa PMT dikonsumsi oleh sasaran serta memberikan konseling kepada keluarga balita. Selain itu monitoring tidak dilaksanakan di semua desa yang ditemukan kasus gizi buruk. Kerugian ekonomi akibat balita gakin gizi buruk dirawat di RS sebesar Rp. 3.954.900,- terdiri dari biaya langsung 77,77%, biaya tidak langsung untuk makan dan transport penunggu balita serta biaya kesempatan 22,23%. Biaya tidak langsung menghabiskan semua penghasilan gakin yang relatif kecil. Selain kerugian terhitung juga ada kerugian yang tidak bisa dihitung dalam nilai uang yaitu rasa sakit, penderitaan dan berkurangnya kemampuan serta kecerdasan balita di masa depan. Melihat besarnya proporsi APBD dalam pembiayaan PMT balita gakin gizi buruk, maka perlu mobilisasi dana dari sumber lain. Memperhatikan kerugian akibat balita gakin gizi buruk dirawat di RS perlu dilakukan berbagai upaya pencegahan munculnya gizi buruk dan perlu ada dana tambahan lain untuk mensubsidi biaya tidak langsung rumah sakit agar gakin tidak menjadi semakin miskin. Daftar Bacaan : 43 (1985 - 2004)

---

Cost Need Analysis of Food Supplementation Program for Underfive Children of Poor Families in Tangerang District Year 2004One emphasis of long run development is the development of human resource quality. Important factor that influence the human resource quality is health status which in turn is influenced by nutritional status, especially during the first five years of life. Under nutrition is a manifestation of poverty. This is mainly caused by insufficient amount of money owned by poor families to afford their needs and thus causing low food consumption level. To overcome under nutrition problem among underfives that was caused by economic crises, several nutrition interventions have been implemented including food supplementation. Due to lack of funding, this program could not reach all severely malnourished underfives from poor families . This study was conducted in Tangerang District Health Office focused on costing of Food Supplementation Program. Design of this study was operational research by collecting data on budget allocation for food supplementation program, calculating the cost of food supplementation program, calculating the gap between cost need and real allocation as well as the economic loss as implication of hospital care of severely malnourished children. This study only calculated direct cost, and did not calculate large investment such as salaries, building, and maintenance costs considering those as to be fully funded by government. The analysis showed that available fund for food supplementation program in the year 2004 from various sources was Rp. 365.908.148,-. Most of the funding (95%) came from Local Development Budget (APED) Tangerang District. Predicted cost need was Rp.960.841.337,-, therefore there was Rp.594.933.189,- gap. Gap in activity due to this funding gap was also found. One particular large gap was found in planning where no clear orientation among health workers and cadres and insufficient amount of necessary equipment such as weighing scales to be located in integrated health post (posyandu). Gap in program implementation was reflected by the facts that not all target children received food supplement, insufficient nutrients contained in food supplement, no money for transport, distribution, and home visits by cadres. Monitoring was not conducted in all villages. The economic loss due to hospital care of severely malnourished children was Rp. 3.954.900,- consisted of 77,77% direct cost, 22,23% indirect costs for food and transport of person who accompanied the child in hospital, and opportunity cost. This indirect costs absorbed the whole income of poor families. There were also losses which could not be valued by money including pain, suffers, and decreasing ability and intelligence of the children. Considering the large proportion of APBD in the costing of food supplementation program, there was a need to mobilize other sources of funding. To prevent unnecessary cost to be spent by poor families of hospitalized child, there wish an urgent need to prevent severely malnourished cases by various means and interventions, as well as extra fund to subsidize indirect cost to prevent further impoverishment of the poor. References: 43 (1985-2004)

Abstrak :
A cross-sectional study was conducted in eight villages of Paninggahan Puskesmas catchment area in Solok district, West Sumatra province during March 1996. Its main objective was to investigate the relationship between iodine supplementation and IDD status among school age children in endemic goiter area. A total of 238 children aged between 8 - 10 years from 8 public elementary schools were recruited into the study. Methods of assessment were palpation of thyroid gland, measurement of UIE level, determination of iodine level in salt and drinking water, weight and height, and interviews to determine the actual iodized oil capsule coverage. In addition, samples of environmental water was collected to assess its iodine content. The survey area was categorized as mild 1DD area based on goiter rate, i.e. 19% (all were in grade 1). Median UIE level indicated that the subjects had been in iodine-replete condition (13.1 pg/dl). Iodine in salt was 14.4 t 9 ppm and iodine in drinking water was 11.7 t 8.2 pg/L. Mean of iodine level in the environmental water (river, well, and lake) was relatively high (12.2 t 4.7 pgfL). Iodized oil capsule coverage was 61%, and 55% of those children received their latest capsule less than one year at the time of the study. The surveyed children had low nutritional status based on anthropometric measurement, which was shown by the -high prevalence of stunting (36%), underweight (31%), and wasting (5%). There was no association between anthropometric indices and goiter. The three types of iodine supplementation, i.e.: iodized oil capsule, iodized salt, and iodinated water were not associated with goiter rate, while iodine level in salt - although below the recommended level - was significantly associated-with -UiE level, suggesting that efforts to -attain the universal-salt iodization should be encouraged. The relatively high iodine level in environmental water implied sufficient iodine sources in the area, therefore factors other than iodine deficiency might play an important role in the 1DD status of the surveyed population.