Penerapan perilaku hidup bersih dan sehat pada tatanan rumah tangga di Indonesia pada tahun 2015, baru mencapai 55%. Padahal dari sisi perilaku per indikator idealnya diatas 80%. Faktor risiko timbulnya Penyakit Tidak Menular(PTM) antara lain karena gaya hidup seperti merokok, obesitas, inaktivitas, peminum alcohol dan narkoba. Lemahnya upaya preventif dan promotif dalam upaya kesehatan masyarakat (UKM) disebabkan salah satunya oleh distribusi tenaga promotif preventif di Puskesmas masih belum merata.. Keberadaan tenaga kontrak Promotor Kesehatan di Puskesmas diharapkan mampu menjawab kekurangan tenaga promotif preventif di Kabupaten Indramayu. Namun keberadaan mereka menjadi prokontra sehingga dapat berpengaruh pada kinerja dalam pelayanan promosi kesehatan di Puskesmas.Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi kinerja tenaga kontrak promotor kesehatan dalam pelayanan promosi kesehatan Puskesmas di Kabupaten Indramayu. Jenis penelitian ini menggunakan pendekatan kuantitatif dengan rancangan studi cross sectional. Besar sampel adalah 35 orang. Analisis data secara univariat, bivariat dengan Chi square dan multivariat dengan regresi logistik. Hasil penelitian ini menunjukan bahwa kinerja tenaga kontrak promotor kesehatan dalam pelayanan promosi kesehatan Puskesmas di Kabupaten Indramayu sebagian besar responden berkinerja tinggi (51,4%). Hasil uji statistic menunjukan bahwa terdapat hubungan antara pengetahuan (p=000), kemampuan diri (p=0,000), persepsi beban kerja (p=0,011), motivasi (p=0,010), imbalan (p=0,024) dan sarana prasarana (p=0,001) dengan kinerja tenaga kontrak promotor kesehatan dalam pelayanan promosi kesehatan Puskesmas di Kabupaten Indramayu. Faktor yang memiliki pengaruh paling kuat terhadap kinerja tenaga kontrak promotor kesehatan adalah faktor pengetahuan dengan nilai Odds Ratio (OR=17,84 95% CI=1,99-149,5) dan kemampuan diri (OR=17,36 95% CI=1,4-220). Rekomendasi pada penelitian ini adalah perlu adanya pelatihan e-learning dan in-house training, pembinaan tenaga kontrak, dan penyediaan sarana prasarana promosi kesehatan.
Abstract
The application of clean and healthy life behavior at household order in Indonesia in 2015, had just reached 55%. From the behavior side, where every indicator should be above 80% as the ideal one. The weakness of preventive and promotion effort in accordance with the community health efforts, one of the reasons is because the distribution of the health preventive and promotion agent into the community health centre is not all totally covered yet. The presence of the out-sourcing health promoter agent in the community’s health center is expected to be able to supply the lack of health preventive and promotion agent in Indramayu. However, their presence become pros and cons, which can influence to the performance in theservice of health promotion in community’s health centre. This research aimed to analyze the elements which influence their performance to carry out health promotion service in every community’s health centre in Indramayu. Type of observational study with cross sectional design.The population in this study amounted to 105 people, consisting of 35 contract workers, 35 heads of Puskesmas, and 35 co-workers contract workers.The sampling technique is purposive sampling in total population or saturated sampling, so the same sample size is 105 people. The data are analyzed by univariat, bivariat method with Chi square and multivariate with logistic regression. The results of this study indicate that the performance of health promotion contract workers in health promotion service of Puskesmas in Indramayu Regency most of the respondents are high performers (51.4%). Based on the test of Chi-Square, it shows that the elements related to the out-sourcing health promoter in carrying out the health champagne service at community’s health centre in Indramayu are knowledge (score p=000), self ability (p=0,000), duty perception (p=0,011), motivation (p=0,010), reward (p=0,024), means and infrastructures (0,001). The most influence factors to the performance to the out-sourcing health promoter in carrying out the health champagne service at community’s health centre are knowledge factor (p=0,009) with the OR score=17,84 95% CI=1,99-149,5.Therefore, as the recommendation, the training for the candidates of health promoters, e-learning, in-house training, and also the out-sourcing coaching as well, and providing means and infrastructures of health promotion.
The Impact of Public Health Policy: The Case of Community Health Centers