ABSTRAK
Tabur gizi, sebuah fortilikasi yang mengandung vitamin dan mineral berbentuk serbuk untuk diberikan di rumah, telab terbukti berhasil mengobati dan mencegab anemia hingga 49-91%. Di Indonesia, program tabur gizi akan dijadikan program nasional seperti halnya pada negara-negara Asia lainnya. Untuk menciptakan suatu program nasional yang efektif dan efisien, diperlukan suatu strategi sistem distribusi yang benar sehingga cak:upan program yang tinggi dan merata akan tercapai dan terpelihara. Tujuan umum penelitian in adalah untuk mengkaji implementasi dari sistem distribusi program tabur gizi yang serlang berjalan di Praya Tengah, kabupaten Lombok Tengah. Sebuah penelitian cross sectional dilaksanakan dengan melaknkan interview pada 240 ibufpengasuh yang memiliki anak usia 12- 59 bulan, 48 kader Posyandu dan petugas kcsehatan yang bertanggungjawab atas program tabur gizi di Puskesmas, Dinas Kesehatan (Dinkes) dan UNICEF. Metode lain yang digunakan adalab interview mendalam, observasi dan telaah dokumen. Semua data di analisa secara deskriptif. Tidak ada mekanisme sistem permintaan dari Posyandu ke Dinkes. Distribusi tabur gizi juga berjalan tanpa catatan logistik dari Dinkes hingga ke Posyandu. Posyandu sebagai saluran distrihusi utama tabur gizi mudah dijangkau oleh hampir semua kader (95.8%) dan ibufpangasuh (78.3%). Perencanaan dan manajemen di Puskesmas buruk dan kurang akan supervisi yang efektif terhadap Posyandu, maupun supervisi dari Dinkes ke Puskesmas. Pelatihan untuk kader hanya berlangsung dua kali yang berpangaruh terhadap rendabnya pangetabuan kader terlatih tentang program tabur gizi Hanya sekitar 30.2% kader yang peruab mengikuti pelatihan program tabur gizi. Sebanyak 79.2% Posyandu telab memasukkan laporan distribusi tabur gizi ke Puskesmas, Sebagi~m besar Posyandu (85.4%) mengalami kelebihan persediaan tabur gizi dan sebagian besar oleh karena distribusi dari persediaan yang berlebih dari Puskesmas. Partipasi masyarakat terutama kepala dusun tidak begitu berperan: Cakupan distribusi yang menerima 60 bungkus tabur gizi pada enam bulan terakhir hanya sekitar 37.9%. Hampir semua komponen esensial pada sistem distribusi tabur gizi tidak berfungsi dengan baik. Setiap komponen saling berkaitan dengan komponen lainnya, sehingga malfungsi dari suatu komponen akan juga berpengaruh pada komponen lainnya, yang pada akhirya akan berpengaruh pada rendahnya cakupan distribusi tabur gizi.
ABSTRACT
Multiple micronutrients powder (MNP), a home fortification contains of vitamins and minerals in a form of powder have been showed successful in treating and preventing anemia with a cure rate of 49-91%. Scaling-up the :MNP program nationally is addressed to Asian countries including Indonesia. One of the requirements of establishing effective and efficient scale-up program is to define the proper delivery strategy or distribution system, hence high and equitable program coverage will be obtained and well maintained. The general objective of this study was to review the implementation of existing distribution system of MNP program in relation to coverage in Praya Tengah, Central Lombok District. A cross sectional study was conducted by interviewing 240 children aged 12-59 months, 48 Posyandu cadres and health service providers responsible person for MNP program of Puskesmas, District Health Office (DHO) and UNICEF. To reveal the existing distribution system, indepth interview, observation, record checking or document review were also executed. All data were descriptively analyzed. There was no mechanism of requesting system from Posyandu to DHO. The frequency of distribution was inconsistent with no records of MNP logistic from DHO level to Posyandu. Posyandu as the main site of MNP distribution was accessible by most cadres (95.8%) and mother/caregivers (78.3%). Planning and management in Puskesmas was poor~ with lacks of effective supervision either to Posyandu or from DHO. Training for cadres only conducted two times during the last three years, resulting in poor knowledge of trained cadre. Daly 30.2% cadre were ever trained on MNP program. About 79.2% Posyandu submitted last report of MNP distribution to Puskesmas. Most Posyandu (85.4%) had experienced MNP over stocking, mostly due to over dropping by Puskesmas. Community participation on MNP distribution especially community leader was insufficient Only 37.9% of targeted children received 60 sachets in the last six months, considered a low coverage of MNP distribution. Almost all especial components ofMNP distribution system were mostly deficient. As they interrelated to each other, any deficiency might give impact to others; consequently, coverage of MNP distribution was low. |
