Krisis ekonomi yang terjadi di Indonesia sejak tahun 1997 dan dampak kekeringan yang berkepanjangan telah membawa masalah baru berupa penurunan daya beli dan penurunan konsumsi pangan terutama pada keluarga miskin sehingga mempengaruhi kesehatan dan status gizi masyarakat. Anak usia dibawah lima tahun (balita) adalah golongan usia yang rentan terhadap masalah kesehatan dan gizi, terutama masalah Kurang Energi Protein (KEP) dan hal ini merupakan salah satu masalah gizi utama di Indonesia yang perlu ditanggulangi karena dapat mempengaruhi kecerdasan melalui kerusakan otak yang akan bersifat permanen. Ibu kota propinsi Riau adalah kota Pekanbaru, memiliki 8 kecamatan dan merupakan pusat aktivitas perekonomian, pemerintahan maupun sosial kemasyarakatan. dimana berdasarkan hasil pemantauan status gizi (PSG) balita tahun 2001 didapatkan 5 (lima) kecamatan masih memiliki prevalensi gizi buruk lebih dari atau lama dengan 1% (>1%), sehingga untuk menghindari agar status gizi balita tidak jatuh kepada keadaan yang lebih buruk, dilakukan penelitian terhadap sistem tata laksana kurang energi protein (KEP) balita. Penelitian dilakukan di kota Pekanbaru terhadap kecamatan yang memiliki balita dengan status gizi sedang dimana berdasarkan batasan kritis kesehatan masyarakat dengan berat badan menurut umur (BB/U)adalah lebih dari 15% (<-2SD). Penelitian dilakukan dengan menggunakan metode kualitatif, yang dilaksanakan pada bulan februari 2003. Pengumpulan data dilaksanakan dengan menggunakan teknik wawancara mendalam (in depth Interview), observasi dan telaah dokumen terhadap variabel pengetahuan petugas, dana, sarana dan prasarana, metode, perencanaan, pengorganisasian. penggerakan, pengawasan, cakupan program dan tindak lanjut penanganan masalah. Informan dalam penelitian ini adalah pejabat pengambil keputusan, penanggung jawab operasional program gizi dan masyarakat pengguna dalam hal ini kader dan ibu balita dengan status gizi sedang. Berdasarkan hasil penelilian terhadap penemuan Kurang Energi Protein menunjukkan bahwa kurang lengkapnya pengetahuan petugas lapangan, masih rendahnva kemampuan advokasi Dinas Kesehatan Kota kepada pihak pemerintah Kota dalam hal penyediaan dana bagi penemuan Kurang Energi Protein balita, lemahnya sistim pencatatan dan pelaporan dalam ketersediaan sarana, belum dilaksanakannya penggunaan metode penanggulangan Kurang Energi Protein balita secara optimal, masih lemahnya data dan informasi dalam penyusunan perencanaan dan evaluasi, tidak aktifnya koordinasi lintas sektoral, belum berjalannya fungsi penggerakan secara maksimal di tingkat puskesmas, belum dilaksanakannya fungsi pengawasan secara menyeluruh meliputi komponen input, proses, dan out put, dan belum terkoordinasinya sistim rujukan antara Rumah sakit dan puskesmas maka manajemen penemuan Kurang Energi Protein (KEP) di Dinas Kesehatan Kota Pekanbaru perlu diperkuat. Dalam upaya penemuan Kurang Energi Protein (KEP) di Dinas kesehatan kota Pekanbaru disarankan agar pihak Dinas kesehatan bekerja sama dengan Puskesmas lebih meningkatkan perhatiannva pada kegiatan peningkatan pengetahuan petugas lapangan, advokasi yang efektif kepada pemerintah kota dan DPRD, peningkatan hubungan kerja sama lintas sektoral, peningkatan sistem manajemen data dan informasi terutama pencatatan, pelaporan dan pengolahan data, serta meningkatkan fungsi pengawasan meliputi komponen input, proses dan out put.
An Analysis of Protein Energy Malnutrition (PEM) Management System for Children Under-Five in District Health Office of Pekanbaru in 2002Economic crisis, which has started since 1997, and the effect of long dry season in Indonesia have brought about some new problems, such as the decrease of public purchasing power and food consumption especially for the poverty family. This decrease may influence public health and nutritional status. The group of children under five is susceptible to health and nutritional problems, especially to the problem of Protein Energy Malnutrition (PEM), and this is a main nutrient problem in Indonesia that is necessary to prevent due to its bad effect to one's intelligence through permanent brain decay. The capital city of Riau Province is Pekanbaru. It is a center of economic activities, government administration and social activities and has 8 sub districts. Data of Nutritional Assessment (NA) of children under five in 2001 show that 5 (five) sub districts remained to have bad nutrient prevalence, which is more or equivalent to 1% (> 1%). To prevent the bad nutritional status of children under five is not becoming worse, it is necessary to carry out a research about Protein Energy Malnutrition (PEM) management system for children under five. This research was conducted in Pekanbaru City in five sub districts that have medium nutritional status, vbere its public health critical limit to the body mass based on age is more than 15% (< -2SD). The research was conducted by using qualitative method, which is conducted in February 2003. The data were collected by using in-depth interview, observation and documents review for the variables of personnel's knowledge, fund, structure and super-structure, methods, planning, organization, movement, supervision, program coverage, and follow up of problem treatment. The informants of the research were policy makers, operational coordinator of nutritional program, and communities: mother candidates or mothers of children under five with medium nutritional status. According to the result the study of finding management system of protein energy malnutrition, there are less completeness of field personnel?s' knowledge, lack ness of City of Health Office's advocacy ability to the City Government to provide sufficient fund for protein energy malnutrition for children under five, weaknesses in recording and reporting system due to facilities availability: not optimum of using protein malnutrition energy finding method, weaknesses of data and information in plan arrangement and evaluation, inactiveness of cross sectoral coordination, not maximum of moving function in the level of Public health center, not carrying out of overall supervision function, which consists input, process, and output component, and no coordination of reference system between Hospital and Public Health Center. Therefore, Protein Energy Malnutrition (PEM) management system for children under five in the Health Office of Pekanbaru is necessary to be strengthened. In the effort of Protein Energy Malnutrition (PEM) management system in City Health Office of Pekanbaru, it is suggested to Health Office to work together with Public Health Centers to increase their attention to the programs of field personnel's' knowledge development, to make effective advocacy to the City Government and Local House Representative, to increase cross-sectoral coordination, to improve data and information systems especially in recording, reporting, and data processing, also to increase supervision function, which consists input, process, and output component. |
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