Nomor FM : FM.11/UKM-IV/R.

UPT PUSKESMAS GRIBIG

JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN TEMPAT PELAKSANA KET

1 KIA-KB Pendataan sasaran Desember Ibu hamil, bersalin, 6 Desa Darini, SSt
nifas bayi, balita,
PUS, WUS, Lansia

2 Pendampingan P4K Jan-Des Semua Ibu Hamil 6 Desa Darini, SSt

3 Kelas Ibu Hamil April, Mei, Juni, Semua Ibu Hamil 6 Desa Darini, SSt
Agustus, September,
Oktober

4 Kelas Ibu Balita Maret, April, Mei, Juni, Semua Ibu Balita 6 Desa Ira Yulistiana, Amd Keb
Juli, Agustus
5 Penyuluhan SDIDTK pada guru Agustus Guru TK/PAUD Aula Puskesmas Ira Yulistiana, Amd Keb
TK/PAUD
6 Sosialisasi dan pelatihan kader Juli Kader Aula Puskesmas Ira Yulistiana, Amd Keb
SDIDTK
7 Kelas Bumil Resti Juli, Agustus Ibu Hamil Resti 6 Desa Darini, SSt
8 Kunjungan rumah ibu nifas Kf1, Kf Jan-Des Bufas 6 Desa Darini, SSt
2,Kf 3
9 Kunjungan rumah Neonatal Kn1, Kn Jan-Des Neonatal 6 Desa Darini, SSt
2, Kn 3
10 Pemantauan pelayanan kesehatan jan-Des Semua Bayi dan 6 Desa Ira Yulistiana, Amd Keb
bayi dan balita di Posyandu Balita

11 Monitoring dan evaluasi Tim Bumil April, Mei, Juni, Juli, Tim Bumil Aula Puskesmas Darini, SSt
Agustus, September,
Oktober

12 Pertemuan Refreshing BPM April Seluruh BPM di Aula Puskesmas Darini, SSt
wilayah Puskesmas

13 Evaluasi tumbuh kembang balita April Semua balita Aula Puskesmas Ira Yulistiana, Amd Keb

14 Supervisi fasilitatif Juli 6 PKD 6 Desa Darini, SSt

15 Penyuluhan PUS dengan ALKI dan Juli, Agustus, Pus 4T, ALKI 6 Desa Dwi Nirmalawati, Amd Keb
4T September
16 Penyuluhan PKPR dan pemeriksaan April, Mei, juni, Juli, Remaja 6 Desa Musaroh, Amd Keb
kesehatan Agustus
17 Pertemuan Refreshing Kader Oktober Kader Remaja Aula Puskesmas Musaroh, Amd Keb
Remaja
18 Sosialisasi Posyandu Remaja Agustus, September Masyarakat 6 Desa Musaroh, Amd Keb
19 Penyuluhan Catin September, Oktober, Catin KUA Dwi Nirmalawati, Amd Keb
Nopember
20 Pertemuan refreshing Dokter April Bdokter praktek Aula Puskesmas Darini, SSt
praktek swasta swasta
21 Kunjungan Hamil s/d Bayi 6 bulan Jan-Des Ibu hamil, Nifas dan 6 Desa Darini, SSt
Bayi

Kunjungan Skrining Hypotiroid Agustus - September Bayi Baru Lahir 6 Desa Ira Yulistiana, Amd Keb
22 Kongenital (SHK)
Gribig,…………………………….
MENGETAHUI
KEPALA PUSKESMAS GRIBIG PENANGGUNG JAWAB UKM
 MOKHAMAD NASIBAN dr SETITI MARGANING RAHAYU
NIP. 197004061990031004 NIP. 198408062009032008
UPT PUSKESMAS GRIBIG
Bulan : Januari 2019
JADWAL PELAKSANAAN KEGIATAN UKM

N
PROGRAM KEGIATAN WAKTU SASARAN
O
1 KIA/KB Pendampingan P4K Getasrabi; 24, 25. Semua Ibu
Klumpit; 3, 8, 10, 15, Hamil
17, 22, 24. Besito; 2,
8, 12, 14, 28.
Karangmalang; 2,
9,16, 21, 23, 30.
Padurenan; 8, 15,
18, 22, 29. Gribig; 7,
14, 19, 25.
2 KIA/KB Kunjungan rumah ibu nifas Getasrabi; 22, 23, Bufas
Kf1, Kf 2,Kf 3 29, 30. Klumpit; 7, 9,
14, 16, 23, 28.
Besito; 5, 9, 16, 23,
26. Krgmalang; 5,
10, 19, 26, 31.
Padurenan: 4, 11,
19, 25. Gribig: 5, 16,
23, 26, 30

3 KIA/KB Kunjungan rumah Neonatal Getasrabi; 22, 23, Neonatal

Kn1, Kn 2, Kn 3 29, 30. Klumpit; 7, 9,
14, 16, 23, 28.
Besito; 5, 9, 16, 23,
26. Krgmalang; 5,
10, 19, 26, 31.
Padurenan: 4, 11,
19, 25. Gribig: 5, 16,
23, 26, 30
4 KIA/KB Pemantauan pelayanan Getasrabi; 24, 25. Semua Bayi dan
kesehatan bayi dan balita di Klumpit; 3, 8, 10, 15, Balita
Posyandu 17, 22, 24. Besito; 2,
8, 12, 14, 28.
Karangmalang; 2,
9,16, 21, 23, 30.
Padurenan; 8, 15,
18, 22, 29. Gribig; 7,
14, 19, 25.

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0

N UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd
Keb

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
UPT PUSKESMAS GRIBIG
Bulan : Februari 2019
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN

1 KIA KB Pendampingan P4K getasrabi: 1, Semua Ibu
7,8, 14, 21, 22, Hamil
28. Klumpit: 7,
12, 15, 19 21,
26. Besito: 1, 6,
8, 26, 27.
krgmalang: 6,
13, 20,
25,26,27.
Gribig: 4, 7, 11,
16, 18.
2 KIA KB Kunjungan rumah ibu nifas Padurenan:
Getasrabi: 6,4,12, Bufas
Kf1, Kf 2,Kf 3 12,
13, 19,
19, 27,
20, 16
27.
Klumpit: 6, 11,
13, 18, 20, 25.
Besito: 4, 9, 11,
18. Krgmalang:
7, 9, 16, 28.
Gribig: 2,9, 16,
23, 27.
Padurenan: 1,
9, 15, 23.
3 KIA KB Kunjungan rumah Neonatal Getasrabi: 6, 12, Neonatal
Kn1, Kn 2, Kn 3 13, 19, 20, 27.
Klumpit: 6, 11,
13, 18, 20, 25.
Besito: 4, 9, 11,
18. Krgmalang:
7, 9, 16, 28.
Gribig: 2,9, 16,
23, 27.
Padurenan: 1,
9, 15, 23.

4 KIA KB Pemantauan pelayanan getasrabi: 1, Semua Bayi dan

kesehatan bayi dan balita di 7,8, 14, 21, 22, Balita
Posyandu 28. Klumpit: 7,
12, 15, 19 21,
26. Besito: 1, 6,
8, 26, 27.
krgmalang: 6,
13, 20,
25,26,27.
Gribig: 4, 7, 11,
16, 18.
Padurenan: 4,
12, 19, 27, 16
MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
UPT PUSKESMAS GRIBIG
Bulan : Maret
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN

1 KIA/KB Pendampingan P4K ds getasrabi tgl Semua Ibu
1, Hamil
8,14,15,21,22,2
8,29. ds
klumpit : 5,12,
14, 19, 21, 2,.
Ds Gribig:
4,11,16,18. ds
krgmalang:
6,13,20, 27.
Padurenan:
5,12,15,16,19,2
6. Besito: 1, 6,
8, 13, 25.

2 KIA/KB Kunjungan rumah ibu nifas Getasrabi: 12, Bufas

Kf1, Kf 2,Kf 3 13, 19, 20, 26,
27. Klumpit: 11,
13, 18, 20, 25,
27. Besito: 11,
16, 18, 20, 27.
krgmalang: 2,
14, 23, 30.
Padurenan: 8,
14, 21, 27.
Gribig: 6, 9, 23,
25, 27.
3 KIA/KB Kunjungan rumah Neonatal Getasrabi: 12, Neonatal
Kn1, Kn 2, Kn 3 13, 19, 20, 26,
27. Klumpit: 11,
13, 18, 20, 25,
27. Besito: 11,
16, 18, 20, 27.
krgmalang: 2,
14, 23, 30.
Padurenan: 8,
14, 21, 27.
Gribig: 6, 9, 23,
25, 27.

4 KIA/KB Pemantauan pelayanan ds getasrabi tgl Semua Bayi dan

kesehatan bayi dan balita di 1, Balita
Posyandu 8,14,15,21,22,2
8,29. ds
klumpit : 5,12,
14, 19, 21, 2,.
Ds Gribig:
4,11,16,18. ds
krgmalang:
6,13,20, 27.
Padurenan:
5,12,15,16,19,2
6. Besito: 1, 6,
8, 13, 25.

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
UPT PUSKESMAS GRIBIG
Bulan : April
JADWAL PELAKSANAAN KEGIATAN UKM
APRIL

PROGRAM KEGIATAN WAKTU SASARAN

1 Pendampingan P4K Getasrabi; Semua Ibu
4,5,11,12, 18, Hamil
25, 26. Klumpit;
2, 4, 9, 11, 16,
18, 23. Gribig; 1,
8,15,20, 26.
Krgmalang; 4,
10,15, 18, 23,
24. Padurenan;
2, 9, 16, 23, 26,
27. Besito; 9,
11, 13, 16, 18,
20, 23, 25.

2 Kelas Ibu Hamil 10, 9, 13, 11, Semua Ibu

3 Kelas Ibu Balita 13, 6.
2,4, 15,16 , Hamil
Semua Ibu
18,25 Balita
4 Kunjungan rumah ibu nifas Getasrabi; 9, 10, Bufas
Kf1, Kf 2,Kf 3 16, 22, 23, 24.
Klumpit; 8, 10,
13, 15, 22, 24.
Gribig; 6,10, 13,
22, 24.
Krgmalang; 11,
13, 20, 25, 27.
Padurenan;
5,12,13, 20.
Besito; 6, 8, 13,
15, 20,
5 Kunjungan rumah Neonatal Getasrabi; 9, 10, Neonatal
Kn1, Kn 2, Kn 3 16, 22, 23, 24.
Klumpit; 8, 10,
13, 15, 22, 24.
Gribig; 6,10, 13,
22, 24.
Krgmalang; 11,
13, 20, 25, 27.
Padurenan;
5,12,13, 20.
Besito; 6, 8, 13,
15, 20,

6 Pemantauan pelayanan Getasrabi; Semua Bayi dan

kesehatan bayi dan balita di 4,5,11,12, 18, Balita
Posyandu 25, 26. Klumpit;
2, 4, 9, 11, 16,
18, 23. Gribig; 1,
8,15,20, 26.
Krgmalang; 4,
10,15, 18, 23,
24. Padurenan;
2, 9, 16, 23, 26,
27. Besito; 9,
11, 13, 16, 18,
20, 23, 25.

7 Monitoring dan evaluasi Tim 9 Tim Bumil

Bumil
8 Pertemuan Refreshing BPM 22 Seluruh BPM di
wilayah
Puskesmas
9 Evaluasi tumbuh kembang 13 Semua balita
balita
10 Penyuluhan PKPR dan 2,4,9,10, 11, 23, Remaja
pemeriksaan kesehatan 24, 25, 30
11 Pertemuan refreshing Dokter 16-Apr Bdokter praktek
praktek swasta swasta

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd
Keb
6 Desa Darini, SSt
6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

Aula Darini, SSt

Puskesmas
Aula Darini, SSt
Puskesmas

Aula Ira Yulistiana, Amd

Puskesmas Keb
6 Desa Musaroh, Amd Keb

Aula Darini, SSt

Puskesmas

Gribig,…………………………….

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
UPT PUSKESMAS GRIBIG
Bulan : Mei
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN

1 Pendampingan P4K Getasrabi : 2,3, 9, Semua Ibu Hamil
10, 16, 23, 24
Klumpit : 2, 7,9,
14, 16, 21, 28.
Gribig : 6, 13, 18,
20, 24.
Krgmalang: 6,13,
18,20, 24.
Padurenan : 7,
14, 17, 18, 21,
28. Besito : 9, 11,
14, 16, 18, 21,
23, 28.

2 Kelas Ibu Hamil 15, 4, 11, 16, 11, Semua Ibu Hamil
4.
3 Kelas Ibu Balita 2, 18 Semua Ibu Balita

4 Kunjungan rumah ibu nifas Kf1, Getasrabi 7, 8, Bufas

Kf 2,Kf 3 14, 15, 21, 22.
Klumpit : 6, 8, 13,
15, 20, 22. Gribig
: 8, 11, 15, 22, 25.
Krgmalang: 9, 11,
16, 18, 23.
Padurenan : 10,
11, 24, 25. Besito:
6, 11, 20, 25, 27.
5 Kunjungan rumah Neonatal Kn1, Getasrabi 7, 8, Neonatal
Kn 2, Kn 3 14, 15, 21, 22.
Klumpit : 6, 8, 13,
15, 20, 22. Gribig
: 8, 11, 15, 22, 25.
Krgmalang: 9, 11,
16, 18, 23.
Padurenan : 10,
11, 24, 25. Besito:
6, 11, 20, 25, 27.

6 Pemantauan pelayanan Getasrabi : 2,3, 9, Semua Bayi dan

kesehatan bayi dan balita di 10, 16, 23, 24 Balita
Posyandu Klumpit : 2, 7,9,
14, 16, 21, 28.
Gribig : 6, 13, 18,
20, 24.
Krgmalang: 6,13,
18,20, 24.
Padurenan : 7,
14, 17, 18, 21,
28. Besito : 9, 11,
14, 16, 18, 21,
23, 28.

7 Monitoring dan evaluasi Tim 14, 21 Tim Bumil

Bumil
8 Penyuluhan PKPR dan 2, 7, 8, 9, 14, 15, Remaja
pemeriksaan kesehatan 16, 21, 22, 23.

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd Keb

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd Keb

Aula Puskesmas Darini, SSt

6 Desa Musaroh, Amd Keb

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
UPT PUSKESMAS GRIBIG
Bulan : Juni
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN

1 Pendampingan P4K Getasrabi : 13, Semua Ibu
14, 20, 21, 27, Hamil
28. Klumpit:
11, 13, 18, 20,
25, 27. Gribig :
10, 15, 17, 28.
Krgmalang: 12,
17, 19, 25, 26.
Padurenan : 11,
18, 21, 22, 25.
Besito : 11, 13,
15, 18, 20, 25,
27.

2 Kelas Ibu Hamil 1, 3, 10, 13, 14, Semua Ibu

17 Hamil
3 Kelas Ibu Balita 17, 23, 24 Semua Ibu
Balita
4 Kunjungan rumah ibu nifas Getasrabi: 11, Bufas
Kf1, Kf 2,Kf 3 12, 18, 19, 25,
26 . Klumpit :
10, 12, 17, 19,
24, 26. Gribig :
12, 19, 22, 24,
26. krgmalang:
13,15, 20, 22,
27. Padurenan :
14, 15, 21, 28.
besito : 10, 15,
17, 22, 24.
5 Kunjungan rumah Neonatal Getasrabi: 11, Neonatal
Kn1, Kn 2, Kn 3 12, 18, 19, 25,
26 . Klumpit :
10, 12, 17, 19,
24, 26. Gribig :
12, 19, 22, 24,
26. krgmalang:
13,15, 20, 22,
27. Padurenan :
14, 15, 21, 28.
besito : 10, 15,
17, 22, 24.

6 Pemantauan pelayanan Getasrabi : 13, Semua Bayi dan

kesehatan bayi dan balita di 14, 20, 21, 27, Balita
Posyandu 28. Klumpit:
11, 13, 18, 20,
25, 27. Gribig :
10, 15, 17, 28.
Krgmalang: 12,
17, 19, 25, 26.
Padurenan : 11,
18, 21, 22, 25.
Besito : 11, 13,
15, 18, 20, 25,
27.

7 Monitoring dan evaluasi Tim 18 Juni Tim Bumil

Bumil
8 Penyuluhan PKPR dan 24, 25, 26, 27, Remaja
pemeriksaan kesehatan 28
9 Kunjungan Hamil s/d Bayi 6 15, 22 Ibu hamil, Nifas
bulan dan Bayi

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb
6 Desa Darini, SSt
6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

Aula Darini, SSt

Puskesmas
6 Desa Musaroh, Amd Keb

6 Desa Darini, SSt

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
UPT PUSKESMAS GRIBIG
Bulan : Juli
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN

1 Pendampingan P4K Getassrabi: 4, 5, Semua Ibu
11, 12, 18, 25, Hamil
26. Klumpit: 2,
4, 9, 11, 16, 18,
23. Gribig: 1, 8,
15, 20, 26.
Krgmalang: 3,
10, 15, 17, 23,
24. Padurenan:
2, 9, 16, 19, 20,
23, 30. Besito:
9, 11, 13, 16,
18.

2 Kelas Ibu Balita 2, 9, 16, 18 Semua Ibu

Balita
3 Sosialisasi dan pelatihan 24 Kader
kader SDIDTK
4 Kelas Bumil Resti 5, 6, 6, 13, 17, Ibu Hamil Resti
18
5 Kunjungan rumah ibu nifas Getasrabi: 11, Bufas
Kf1, Kf 2,Kf 3 12, 18, 19, 25,
26. Klumpit : 10,
12, 17, 19, 24,
26. Gribig : 12,
19, 22, 24, 26.
krgmalang: 13,
15, 20, 22, 27.
Padurenan : 14,
15, 21, 28.
besito : 10, 15,
17, 22, 24.
6 Kunjungan rumah Neonatal Getasrabi: 11, Neonatal
Kn1, Kn 2, Kn 3 12, 18, 19, 25,
26. Klumpit : 10,
12, 17, 19, 24,
26. Gribig : 12,
19, 22, 24, 26.
krgmalang: 13,
15, 20, 22, 27.
Padurenan : 14,
15, 21, 28.
besito : 10, 15,
17, 22, 24.

7 Pemantauan pelayanan Getasrabi: 4, 5, Semua Bayi dan

kesehatan bayi dan balita di 11, 12, 18, 25, Balita
Posyandu 26. Klumpit: 2,
4, 9, 11, 16, 18,
23,. Gribig: 1, 8,
15, 20, 26,.
Krgmalang:
3,10, 15, 17, 23,
24. Padurenan:
2, 9, 16, 19, 20,
23, 30. Besito:
9, 11, 13, 16,
18, 20, 23, 25.

8 Monitoring dan evaluasi Tim 9, 16 Tim Bumil

Bumil
9 Supervisi fasilitatif 8, 9, 15, 16, 22, 6 PKD
23
10 Penyuluhan PUS dengan 3, 6, 8, 11, 15, Pus 4T, ALKI
ALKI dan 4T 18
11 Penyuluhan PKPR dan 1, 2, 3, 4, 8, 9, Remaja
pemeriksaan kesehatan 10, 11, 16, 17,
12 Kunjungan Hamil s/d Bayi 6 18 Ibu hamil, Nifas
bulan dan Bayi

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb
Aula Ira Yulistiana, Amd
Puskesmas Keb
6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

Aula Darini, SSt

Puskesmas
6 Desa Darini, SSt

6 Desa Dwi Nirmalawati, Amd

Keb
6 Desa Musaroh, Amd Keb

6 Desa Darini, SSt

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
 JADWAL PELAKSANAAN KEGIATAN UKM

UPT PUSKESMAS GRIBIG

Bulan : Agustus
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN TEMPAT PELAKSANA KET

1 KIA/KB Pendampingan P4K Getasrabi: 1, 2, 8, 9, 15, Semua Ibu Hamil 6 Desa Darini, SSt
22, 23. Klumpit: 1, 6, 8,
13, 15, 20, 27. Gribig: 5,
12, 17, 19, 23.
Krgmalang: 7, 14, 19, 21,
27, 28. Padurenan: 6, 13,
16, 17, 19, 21, 22, 27.
Besito: 10, 13, 15, 17, 20,
22, 27, 29.

2 KIA/KB Kelas Ibu Hamil 14, 1, 3, 10, 13, 14, 17 Semua Ibu Hamil 6 Desa Darini, SSt

3 KIA/KB Kelas Ibu Balita 12, 16 Semua Ibu Balita 6 Desa Ira Yulistiana, Amd
Keb
4 KIA/KB Penyuluhan SDIDTK pada 20 Guru TK/PAUD Aula Ira Yulistiana, Amd
guru TK/PAUD Puskesmas Keb

5 KIA/KB Kelas Bumil Resti 2, 9, 10, 10, 14, 15 Ibu Hamil Resti 6 Desa Darini, SSt
6 KIA/KB Kunjungan rumah ibu nifas Getassrabi: 7, 13, 14, 20, Bufas 6 Desa Darini, SSt
Kf1, Kf 2,Kf 3 21, 27. Klumpit: 7, 12, 14,
19,21, 26. Gribig: 7, 10,
14, 21, 24. Krgmalang: 8,
10, 15, 17, 22.
Padurenan: 9, 10, 16, 23.
Besito: 7, 12, 14, 19, 21.

7 KIA/KB Kunjungan rumah Getassrabi: 7, 13, 14, 20, Neonatal 6 Desa Darini, SSt
Neonatal Kn1, Kn 2, Kn 3 21, 27. Klumpit: 7, 12, 14,
19,21, 26. Gribig: 7, 10,
14, 21, 24. Krgmalang: 8,
10, 15, 17, 22.
Padurenan: 9, 10, 16, 23.
Besito: 7, 12, 14, 19, 21.

8 KIA/KB Pemantauan pelayanan Getasrabi: 1, 2, 8, 9, 15, Semua Bayi dan 6 Desa Ira Yulistiana, Amd
kesehatan bayi dan balita 22, 23. Klumpit: 1, 6, 8, Balita Keb
di Posyandu 13, 15, 20, 27. Gribig: 5,
12, 17, 19, 23.
Krgmalang: 7, 14, 19, 21,
27, 28. Padurenan: 6, 13,
16, 17, 19, 21, 22, 27.
Besito: 10, 13, 15, 17, 20,
22, 27, 29.

9 KIA/KB Monitoring dan evaluasi 13 Tim Bumil Aula Darini, SSt

Tim Bumil Puskesmas

10 KIA/KB Penyuluhan PUS dengan 5, 6, 7, 12, 15, 19 Pus 4T, ALKI 6 Desa Dwi Nirmalawati,
ALKI dan 4T Amd Keb
11 KIA/KB Penyuluhan PKPR dan 1, 2, 3, 6 Remaja 6 Desa Musaroh, Amd Keb
pemeriksaan kesehatan
12 KIA/KB Sosialisasi Posyandu 7, 8, 13, 14, 15 Masyarakat 6 Desa Musaroh, Amd Keb
Remaja
13 KIA/KB Kunjungan Hamil s/d Bayi Ibu hamil, Nifas 6 Desa Darini, SSt
6 bulan dan Bayi
13 KIA/KB Kunjungan Skrining 19, 20, 21, 22, 23, 24 Bayi Baru Lahir 6 Desa Ira Yulistiana, Amd
Hypotiroid Kongenital Keb
(SHK)

MENGETAHUI
KEPALA PUSKESMAS GRIBIG PENANGGUNG JAWAB UKM

MOKHAMAD NASIBAN dr SETITI MARGANING RAHAYU

NIP. 197004061990031004 NIP. 198408062009032008
 JADWAL PELAKSANAAN KEGIATAN UKM

UPT PUSKESMAS GRIBIG

Bulan : September
JADWAL PELAKSANAAN KEGIATAN UKM

N
PROGRAM KEGIATAN WAKTU SASARAN
O
1 Pendampingan P4K Getassrabi 5, 6, Semua Ibu
12, 13, 19, 26, Hamil
27. Klumpit: 3,
5, 10, 12, 17,
19, 24. Gribig: 2,
9, 16, 21, 27.
Krgmalang: 4,
11, 16, 18, 24,
25. Padurenan:
3, 10, 17, 20,
21, 24. Besito:
10, 12, 17, 19,
21, 24, 26.

2 Kelas Ibu Hamil 5, 7, 10, 11, 14, Semua Ibu

15. Hamil
3 Kunjungan rumah ibu nifas getassrabi: 10, Bufas
Kf1, Kf 2,Kf 3 11, 17, 18, 24,
25. Klumpit: 9,
11, 16, 18, 23,
25. Gribig: 7, 11,
14, 18, 25.
krgmalang: 7,
12, 14, 19, 21.
Padurenan: 13,
14, 20, 27.
Besito: 9, 11,
16, 18, 23, 25.
4 Kunjungan rumah Neonatal getassrabi: 10, Neonatal
Kn1, Kn 2, Kn 3 11, 17, 18, 24,
25. Klumpit: 9,
11, 16, 18, 23,
25. Gribig: 7, 11,
14, 18, 25.
krgmalang: 7,
12, 14, 19, 21.
Padurenan: 13,
14, 20, 27.
Besito: 9, 11,
16, 18, 23, 25.

5 Pemantauan pelayanan Getassrabi 5, 6, Semua Bayi dan

kesehatan bayi dan balita di 12, 13, 19, 26, Balita
Posyandu 27. Klumpit: 3,
5, 10, 12, 17,
19, 24. Gribig: 2,
9, 16, 21, 27.
Krgmalang: 4,
11, 16, 18, 24,
25. Padurenan:
3, 10, 17, 20,
21, 24. Besito:
10, 12, 17, 19,
21, 24, 26.

6 Monitoring dan evaluasi Tim 10,17 Tim Bumil

Bumil
7 Sosialisasi Posyandu Remaja 2, 3, 10, 11, 12, Masyarakat
17, 18, 19
8 Kunjungan Hamil s/d Bayi 6 Ibu hamil, Nifas
bulan dan Bayi
9 Penyuluhan catin 11, 16 Catin
10 Kunjungan Skrining Hypotiroid 16, 17, 18, 19, Bayi Baru Lahir
Kongenital (SHK) 20, 21

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0
EGIATAN UKM

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

Aula Darini, SSt

Puskesmas
6 Desa Musaroh, Amd Keb

6 Desa Darini, SSt

Kantor KUA Dwi Nirmalawati

6 Desa Ira Yulistiana, Amd Keb

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
 JADWAL PELAKSANAAN KEGIATAN UKM

UPT PUSKESMAS GRIBIG

Bulan : Oktober
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN

1 Pendampingan P4K Getassrabi: 3, 4, Semua Ibu
10, 11, 17, 24, Hamil
25. Klumpit: 1,
3, 8, 10, 15, 17,
22. Gribig: 7, 14,
19, 21, 25.
Krgmalang: 2, 9,
16, 21, 22, 23.
Padurenan: 1,
8, 15, 22, 29.
Besito: 8, 10,
12, 15, 17, 19,
22, 24, 29.

2 Kelas Ibu Hamil 3, 5, 12, 14, 16, Semua Ibu

19 Hamil
3 Kunjungan rumah ibu nifas Getassrabi : 8, Bufas
Kf1, Kf 2,Kf 3 9, 15, 16, 22,
23. Klumpit: 7,
9, 14, 16, 21,
23. Gribig: 9, 12,
16, 23, 26.
Krgmalang: 5,
10, 17, 19, 24.
Padurenan: 4,
11, 18, 25.
Besito: 7, 9, 14,
16, 21.
4 Kunjungan rumah Neonatal Getassrabi : 8, Neonatal
Kn1, Kn 2, Kn 3 9, 15, 16, 22,
23. Klumpit: 7,
9, 14, 16, 21,
23. Gribig: 9, 12,
16, 23, 26.
Krgmalang: 5,
10, 17, 19, 24.
Padurenan: 4,
11, 18, 25.
Besito: 7, 9, 14,
16, 21.

5 Pemantauan pelayanan Getassrabi: 3, 4, Semua Bayi dan

kesehatan bayi dan balita di 10, 11, 17, 24, Balita
Posyandu 25. Klumpit: 1,
3, 8, 10, 15, 17,
22. Gribig: 7, 14,
19, 21, 25.
Krgmalang: 2, 9,
16, 21, 22, 23.
Padurenan: 1,
8, 15, 22, 29.
Besito: 8, 10,
12, 15, 17, 19,
22, 24, 29.

6 Monitoring dan evaluasi Tim 8 Tim Bumil

Bumil
7 Pertemuan Refreshing Kader 10 Kader Remaja
Remaja
8 Kunjungan Hamil s/d Bayi 6 Ibu hamil, Nifas
bulan dan Bayi
Penyuluhan Catin 9, 15 Catin

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0
EGIATAN UKM

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

Aula Darini, SSt

Puskesmas
Aula Musaroh, Amd Keb
Puskesmas
6 Desa Darini, SSt

Kantor KUA Dwi Nirmalawati

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
 JADWAL PELAKSANAAN KEGIATAN UKM

UPT PUSKESMAS GRIBIG

Bulan : Nopember
JADWAL PELAKSANAAN KEGIATAN UKM

NO PROGRAM KEGIATAN WAKTU SASARAN

1 Pendampingan P4K Getassrabi : 1, Semua Ibu
7, 8, 14, 21, 22, Hamil
28. Klumpit: 5,
7, 12, 14, 19,
21, 26. Gribig: 4,
11, 16, 18, 22.
Krgmalang: 6,
13, 18, 20, 26,
27. Padurenan:
5, 12, 16, 19,
26. Besito: 12,
14, 19, 21,.

2 Kunjungan rumah ibu nifas Getassrabi : 5, Bufas

Kf1, Kf 2,Kf 3 6, 12, 13, 19,
20. Klumpit: 11,
13, 18, 20, 25,
27. Gribig: 6, 8,
13, 20, 23.
Krgmalang: 7, 8,
14, 16, 21.
Padurenan: 8,
15, 22, 29.
Besito: 6, 11,
13, 18, 20
3 Kunjungan rumah Neonatal Getassrabi : 5, Neonatal
Kn1, Kn 2, Kn 3 6, 12, 13, 19,
20. Klumpit: 11,
13, 18, 20, 25,
27. Gribig: 6, 8,
13, 20, 23.
Krgmalang: 7, 8,
14, 16, 21.
Padurenan: 8,
15, 22, 29.
Besito: 6, 11,
13, 18, 20

4 Pemantauan pelayanan Getassrabi : 1, Semua Bayi dan

kesehatan bayi dan balita di 7, 8, 14, 21, 22, Balita
Posyandu 28. Klumpit: 5,
7, 12, 14, 19,
21, 26. Gribig: 4,
11, 16, 18, 22.
Krgmalang: 6,
13, 18, 20, 26,
27. Padurenan:
5, 12, 16, 19,
26. Besito: 12,
14, 19, 21,.

5 Penyuluhan Catin 6, 13 Catin

6 Kunjungan Hamil s/d Bayi 6 Ibu hamil, Nifas

bulan dan Bayi

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0
EGIATAN UKM

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

KUA Dwi Nirmalawati, Amd

Keb
6 Desa Darini, SSt

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008
 JADWAL PELAKSANAAN KEGIATAN UKM

UPT PUSKESMAS GRIBIG

Bulan : Desember
JADWAL PELAKSANAAN KEGIATAN UKM

N
PROGRAM KEGIATAN WAKTU SASARAN
O
1 KIA-KB Pendataan sasaran 16, 17, 18, 19, Ibu hamil,
20, 21 bersalin, nifas
bayi, balita,
PUS, WUS,
Lansia
2 Pendampingan P4K Getassrabi : 5, Semua Ibu
6, 12, 13, 19, Hamil
26, 27. Klumpit:
3, 5, 10, 12, 17,
19. Gribig: 2, 9,
16, 21, 27.
Krgmalang: 4, 9,
16, 21, 27.
Padurenan: 3,
10, 17, 21.
Besito: 10, 12,
14, 17, 19.

3 Kunjungan rumah ibu nifas Getassrabi: 6, Bufas

Kf1, Kf 2,Kf 3 12, 13, 19, 20,
26. Klumpit: 6,
11, 13, 18, 20,
25, 27. Gribig: 6,
13, 20, 23, 27.
Krgmalang: 7,
14, 16, 21, 23.
Padurenan: 8,
15, 22, 29.
Besito: 11, 13,
18, 20, 25
4 Kunjungan rumah Neonatal Getassrabi: 6, Neonatal
Kn1, Kn 2, Kn 3 12, 13, 19, 20,
26. Klumpit: 6,
11, 13, 18, 20,
25, 27. Gribig: 6,
13, 20, 23, 27.
Krgmalang: 7,
14, 16, 21, 23.
Padurenan: 8,
15, 22, 29.
Besito: 11, 13,
18, 20, 25

5 Pemantauan pelayanan Getassrabi : 5, Semua Bayi dan

kesehatan bayi dan balita di 6, 12, 13, 19, Balita
Posyandu 26, 27. Klumpit:
3, 5, 10, 12, 17,
19. Gribig: 2, 9,
16, 21, 27.
Krgmalang: 4, 9,
16, 21, 27.
Padurenan: 3,
10, 17, 21.
Besito: 10, 12,
14, 17, 19.

6 Kunjungan Hamil s/d Bayi 6 Ibu hamil, Nifas

bulan dan Bayi

MENGETAHUI
KEPALA PUSKESMAS GRIBIG

MOKHAMAD NASIBAN
NIP. 197004061990031004
 Nomor FM : FM.11/UKM-IV/R.0
EGIATAN UKM

EGIATAN UKM

TEMPAT PELAKSANA KET

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Darini, SSt

6 Desa Ira Yulistiana, Amd

Keb

6 Desa Darini, SSt

PENANGGUNG JAWAB UKM

dr SETITI MARGANING RAHAYU

NIP. 198408062009032008