Implementasi Program Penanggulangan Gizi Buruk di Wilayah Kerja Puskesmas Medan Deli

Abstract

The issue of nutrition in infants and toddlers is still a major problem in the population structure, one of which is malnutrition and malnutrition. Medan Deli Puskesmas is one of the health centers with the most cases of malnutrition in Medan City. Based on the nutrition report at the Medan Deli Public Health Center in 2019, it is known that the number of malnourished children is 8 people. The malnutrition prevention program is a form of activity to minimize nutrition problems in the community. The objective of the research was to find out the implementation of malnutrition improvement program of input, process, output and outcome in the working area of Deli Puskesmas. The research used qualitative research with a phenomenological approach for 10 informants that consisted of the Head of Puskesmas, Nutritionist, Cadre Leaders of Posyandu, Mom of malnourished toddlers and Health Service of Medan. The results showed that the Nutrition Implementers (TPG) were still lacking. In terms of facilities and infrastructure that are classified as minimal, the facilities that are not yet available are the anthropometric kit. The ingredients for PMT, MP-ASI, vitamin A capsules, and Fe tablets are readily available. The infrastructure for the storage building for PMT and MP-ASI has been fulfilled. Operational costs are limited, operational costs come from the BOK in the form of cadre incentives and transportation funds. Health Service of Medan allocates funds for malnutrition prevention programs in the form of PMT-P and MP-ASI to puskesmas.The results showed that the implementation of the malnutrition program through weighing weight and measuring TB, nutrition consultation to families of children with malnutrition was routinely carried out every month at Posyandu and through home visits. Giving vitamin A twice a year to malnourished toddlers, giving iron tablets to pregnant women for 3 consecutive months at the posyandu and puskesmas. Implementation of PMT Recovery has been given on target but there is a shortage of health workers to monitor. The Nutrition Recovery Center (PPG) as a forum for handling malnutrition in toddlers through inpatient care has not been fully utilized by the family. The coverage of malnutrition in toddlers to have not reached the target in providing vitamin A, Fe tablets and PPG. The provision of PMT for recovery had reached the target. The prevalence of malnourished toddlers has decreased but it is not significant, only one malnourished toddler has increased body weight to normal. The conclusion of the research was that malnutrition improvement program in the working area of Medan Deli Puskesmas was not maximal. It is recommended that the Head of the Health Service of Medan complete the facility and infrastructure in order to support the implementation of the activity of malnutrition improvement program. It is also recommended that the management of Puskesmas, Cadre Leaders of Posyandu, adn Mom of toddlers increase commitment in efforts to reduce the prevalence of malnutrition.

Persoalan gizi pada bayi dan balita masih menjadi persoalan utama dalam tatanan kependudukan, salah satunya adalah masalah gizi buruk dan gizi kurang. Puskesmas Medan Deli merupakan salah satu puskesmas dengan kasus gizi buruk terbanyak di Kota Medan. Berdasarkan laporan gizi Puskesmas Medan Deli Tahun 2019 diketahui jumlah balita gizi buruk sebanyak 8 orang. Program penanggulangan gizi buruk merupakan bentuk kegiatan untuk meminimalkan masalah gizi di masyarakat. Penelitian ini bertujuan untuk mengetahui bagaimana implementasi program penanggulangan gizi buruk terdiri dari input, proses, output dan outcome di wilayah kerja Puskesmas Medan Deli. Jenis penelitian adalah penelitian kualitatif dengan pendekatan fenomenologi terhadap sepuluh informan yang terdiri dari Kepala Puskesmas, Tenaga Pelaksana Gizi, Kader Posyandu, Ibu Balita Gizi Buruk dan Dinas Kesehatan Kota Medan. Hasil penelitian menunjukkan bahwa Tenaga Pelaksana Gizi (TPG) masih kurang. Dari segi sarana dan prasarana tergolong minim, sarana yang belum tersedia yaitu antropometri kit. Sarana PMT, MP-ASI, kapsul vitamin A, dan tablet Fe sudah tersedia. Prasarana gedung penyimpanan PMT dan MP-ASI sudah terpenuhi. Biaya operasional terbatas, biaya operasional berasal dari BOK dalam bentuk insentif kader dan dana transportasi. Dinas Kesehatan mengalokasikan dana untuk program penanggulangan gizi buruk dalam bentuk PMT-P dan MP-ASI ke puskesmas. Pelaksanaan program gizi buruk melalui penimbangan BB dan pengukuran TB, konsultasi gizi kepada keluarga balita gizi buruk rutin dilakukan setiap bulan di Posyandu dan melalui kunjungan rumah. Pemberian vitamin A dua kali setahun pada balita gizi buruk, Pemberian tablet Fe pada ibu hamil selama 3 bulan berturut-turut dilakukan di posyandu dan puskesmas. Pelaksanaan PMT Pemulihan sudah diberikan tepat sasaran tetapi kekurangan tenaga kesehatan untuk pemantauan konsumsi. Pusat Pemulihan Gizi (PPG) sebagai wadah dalam penanganan gizi buruk pada balita melalui rawat inap belum dimanfaatkan sepenuhnya. Cakupan program penanggulangan balita gizi buruk belum mencapai target dalam pemberian vitamin A, tablet Fe dan, PPG. Pemberian PMT pemulihan mencapai target. Prevalensi balita gizi buruk mengalami penurunan tetapi tidak signifikan hanya satu orang balita gizi buruk mengalami peningkatkan berat badan menjadi normal. Berdasarkan hasil penelitian dapat disimpulkan bahwa program penanggulangan gizi buruk di wilayah Puskesmas Medan Deli dinyatakan belum maksimal, maka diharapkan kepada Kepala Dinas Kesehatan Kota Medan melengkapi sarana dan prasarana untuk mendukung pelaksanaan kegiatan program penanggulangan gizi buruk. Diharapkan Pihak Puskesmas dan Para Kader Posyandu serta Para Ibu Balita meningkatkan komitmen dalam upaya penurunan prevalensi gizi buruk.