HALAMAN JUDUL............................................................................................i
KATA PENGANTAR.........................................................................................ii
LEMBAR PENGESAHAN................................................................................. iv
DAFTAR ISI........................................................................................................vi
DAFTAR TABEL................................................................................................xv
DAFTAR GAMBAR...........................................................................................xx
BAB I PENDAHULUAN
1.1 Latar belakang..............................................................................................1
1.2 Tujuan..........................................................................................................2
1.2.1 Tujuan Umum..................................................................................2
1.2.2 Tuhuan Khusus................................................................................3
1.3 Prosedur dan Langkah Kepaniteraan Klinik Senior Ilmu
Kesehatan Masyarakat.................................................................................3
1.3.1 Mengikuti Kepaniteraan Klinik Senior di Dinas
Kesehatan Provinsi Sumatera Utara.................................................3
1.3.2 Mengikuti Kepaniteraan Klinik Senior di Dinas
Kesehatan Kota Medan....................................................................3
1.3.3 Mengikuti Kepaniteraan Klinik Senior di UPT
Puskesmas Desa Binjai Kota Medan...............................................4
1.3.4 Mengikuti Kepaniteraan Klinik Senior di UPT
Puskesmas Medan Area Selatan Kota Medan..................................4
1.4 Manfaat Penelitian.......................................................................................5
vii
2.3.1 Pendidikan...........................................................................................14
2.3.2 Agama.................................................................................................22
2.3.3 Ketenaga Kerjaan................................................................................22
2.4 Keadaan Lingkungan...................................................................................23
2.4.1 Rumah Sehat....................................................................................23
2.4.2 Persentase Rumah Tangga Memiliki Akses Terhadap
Air Minum........................................................................................24
2.4.3 Persentase Rumah Tangga menurut Tempat
Pembuangan Kotoran/Tinja.............................................................26
2.4.4 Tempat-Tempat Umum (TTU) dan Tempat
Pengelolaan Makanan (TPM) .........................................................29
2.5 Keadaan Perilaku Manusia...........................................................................32
2.6 Derajat Kesehatan........................................................................................37
2.6.1 Mortalitas (Angka Kematian)..........................................................38
2.6.2 Angka Harapan Hidup (AHH).........................................................41
2.6.3 Morbiditas (Angka Kesakitan).........................................................43
2.6.4 Status Gizi Masyarakat....................................................................61
viii
3.2 Program Pembangunan Kesehatan Dinas Kesehatan Provinsi
Sumatera Utara.............................................................................................119
3.2.1. Program Pembangunan Kesehatan Provinsi Sumatera
Utara Tahun 2013-2020...................................................................119
ix
5.2.2 Misi Puskesmas................................................................................150
5.3 Azas dan Upaya Penyelenggaraan Puskesmas.............................................151
5.3.1 Azas Penyelenggaraan Puskesmas...................................................151
5.3.2 Upaya Penyelenggaraan Puskesmas.................................................156
5.4 Kedudukan, Organisasi dan tata kerja Puskesmas.......................................157
5.4.1 Kedudukan puskesmas.....................................................................157
5.4.2 Organisasi Puskesmas......................................................................158
5.4.3 Tata Kerja Puskesmas......................................................................159
5.5 Gambaran Umum Puskesmas Desa Binjai ..................................................161
5.5.1 Sejarah Singkat Puskesmas Desa Binjai .........................................161
5.5.2 Wilayah Kerja Puskesmas................................................................163
5.5.3 Data Wilayah/Data Geografis..........................................................163
5.5.4 Data Kependudukan / Demografi.....................................................163
5.5.5 Data Kesehatan.................................................................................164
5.5.6 Tenaga Kesehatan Puskesmas..........................................................166
5.5.7 Fasilitas Fisik Puskesmas Desa Binjai.............................................168
5.6 Program Kerja Puskesmas...........................................................................172
5.6.1 Program Dasar dan Program PengembangaPuskesmas...................172
5.6.2 Program Prioritas Puskesmas...........................................................173
5.6.3 Upaya Pencatatan dan Pelaporan.....................................................193
5.7 Laporan Kegiatan di Puskesmas Desa Binjai..............................................204
5.7.1 Kegiatan dalam Puskesmas..............................................................204
5.8 Dokumentasi................................................................................................213
5.9 Sejarah Singkat Puskesmas .........................................................................215
5.9.1 Visi...................................................................................................216
5.9.2 Misi..................................................................................................216
5.9.3 Tujuan..............................................................................................216
5.9.4 Tata Nilai..........................................................................................216
5.9.5 Wilayah Kerja Puskesmas................................................................216
5.9.6 Data Wilayah/Data Geografis..........................................................217
5.9.7 Data Kependudukan / Demografi.....................................................217
x
5.10 Data Kesehatan..............................................................................................218
5.11 Sumber Daya Manusia..................................................................................221
5.12 Fasilitas Administratif...................................................................................222
5.13 Fasilitas Imunisasi.........................................................................................223
5.14 Fasilitas Alat-Alat Kesehatan........................................................................223
5.15 Fasilitas Obat-Obatan....................................................................................241
5.16 Program Dasar dan Program Pengembangan Puskesmas............................243
5.16.1 Upaya Kesehatan Esensial...............................................................243
5.16.2 Upaya Kesehatan Pengembangan....................................................243
5.17 Program Wajib Puskesmas...........................................................................244
5.17.1 Upaya Promosi Kesehatan..................................................................244
5.17.2 Upaya Kesehatan Lingkungan............................................................249
5.17.3 Kesehatan Ibu dan Anak serta Keluarga Berencana..........................250
5.17.4 Upaya Perbaikan Gizi.........................................................................255
5.17.5 Upaya Pencegahan Dan Pengendalian Penyakit................................259
5.18 Upaya Kesehatan Pengembangan Puskesmas..............................................265
5.18.1 Upaya Kesehatan Sekolah..................................................................265
5.18.2 Upaya Kesehatan Olahraga................................................................267
5.18.3 Upaya Perawatan Kesehatan..............................................................269
5.18.4 Upaya Kesehatan Kerja......................................................................270
5.18.5 Upaya Kesehatan Gigi Dan Mulut.....................................................271
5.18.6 Upaya Kesehatan Jiwa........................................................................273
5.18.7 Upaya Kesehatan Mata.......................................................................276
5.18.8 Upaya Kesehatan Usia Lanjut............................................................277
5.18.9 Upaya Pembinaan Pengobatan Tradisional........................................280
5.19 Kegiatan Di Puskesma Medan Area Selatan................................................281
5.19.1 Kegiatan Selama di Puskesmas Medan Area Selatan........................281
5.19.2 Kegiatan di dalam dan diluar Puskesmas Medan Area
Selatan................................................................................................284
5.19.3 Kegiatan di Ruangan Puskesmas Medan Area Selatan......................287
5.19.4 Lampiran............................................................................................289
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BAB VI FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN
KEJADIAN PENYAKIT TUBERKULOSIS PARU DI WILAYAH KERJA
PUSKESMAS MEDAN AREA SELATAN
6.1 Latar Belakang.............................................................................................293
6.2 Rumusan Masalah........................................................................................296
6.3 Tujuan Penelitian.........................................................................................296
6.3.1 Tujuan Umum..................................................................................296
6.3.2 Tujuan Khusus.................................................................................296
6.4 Manfaat Penelitian..........................................................................................296
6.5 Tuberkulosis Paru............................................................................................297
6.5.1 Gejala Klinis.....................................................................................299
6.5.2 Penyebab TB Paru ...........................................................................300
6.5.3 Patogenesis TB Paru........................................................................300
6.5.4 Klasifikasi TB Paru..........................................................................301
6.5.5 Diagnosis TB Paru...........................................................................303
6.5.6 Cara Penularan.................................................................................305
6.5.7 Inkubasi............................................................................................305
6.5.8 Program Penanggulangan TB .........................................................305
6.5.9 Epidemiologi Penyakit TB Paru.......................................................306
6.5.10 Faktor-Faktor yang Berhubungan Dengan terjadinya
peningkatan Angka kejadian Penyakit Tb Paru...............................307
6.6 Kerangka Konsep..........................................................................................315
6.7 Hipotesis Penelitian.......................................................................................315
6.8 Desain Penelitian...........................................................................................317
6.9 Tempat dan Waktu Penelitian.......................................................................317
6.10 Subjek Penelitian..........................................................................................317
6.10.1 Populasi............................................................................................317
6.10.2 Sampel .............................................................................................317
6.11 Identifikasi Variabel Penelitian....................................................................319
6.12 Definisi Operasional....................................................................................319
6.13 Pengumpulan Data.......................................................................................321
xii
6.13.1 Data Primer......................................................................................321
6.14 Instrumen Penelitian....................................................................................321
6.15 Pengelolaan Data..........................................................................................321
6.16 Analisis Data................................................................................................322
6.16.1 Analisis Univariat.............................................................................322
6.16.2 Analisis Bivariat................................................................................323
6.16.3 Analisis Multivariat...........................................................................323
6.17 Cara kerja.....................................................................................................323
6.18 Hasil Analisis Univariat...............................................................................324
6.19 Hasil Analisis Bivariat.................................................................................326
6.20 Hasil Analisis Multivariat............................................................................329
6.21 Pembahasan Analisis Bivariat......................................................................329
xiii
8.2.1 Saran Di Puskesmas Desa Binjai.....................................................339
8.2.2 Saran Di Puskesmas Medan Area Selatan........................................339
8.2.3 Saran Dari Hasil Penelitian Faktor-Faktor Yang
Berhubungan Dengan Kejadian TB Paru Di Puskesmas
Medan Area Selatan Medan 2019....................................................340
Daftar Pustaka.......................................................................................................343
xiv
DAFTAR TABEL
Nomor
Utara.............................................................................................................14
Utara ............................................................................................................20
2.5 Jumlah dan Jenis Sarana Air Minum di Provinsi Sumatera Utara...............26
Kabupaten/Kota...........................................................................................27
Desa Binjai...................................................................................................163
Medan Area..................................................................................................164
xv
5.10 Laporan KIA Wilayah Kerja Puskesmas Desa Binjai..............................179
5.11 Laporan Anemi atau Resiko Ibu Hamil Puskesmas Desa Binjai..............180
5.14 Laporan Kegiatan Bulanan Gizi Wilayah Kerja Puskesmas Desa Binjai.184
5.22 Pelayanan Medik Dasar Kesehatan Gigi Di Wilayah Kerja Puskesmas Desa
Binjai.........................................................................................................198
5.24 Data Kunjungan Peserta JKN/KIS Di Wilayah Puskesmas Desa Binjai. .203
xvi
5.30 Data Sarana Pendukung Kesehatan di Medan Area Selatan.....................220
5.33 Data Peralatan di Poli Gigi dan Mulut di Puskesmas Medan Area
Selatan......................................................................................................226
5.34 Data Peralatan di Poli Ibu Hamil dan KB di Puskesmas Medan Area
Selatan.......................................................................................................231
5.38 Distribusi Posyandu di Wilayah Kerja Puskesmas Medan Area Selatan. 246
Area Selatan..............................................................................................247
5.40 Data Program Promosi Kesehatan di Wilayah Kerja Puskesmas Medan Area
Selatan.......................................................................................................248
5.43 Laporan Kegiatan Bulanan Gizi Wilayah Kerja Puskesmas Medan Area
Selatan.......................................................................................................257
xvii
Selatan.......................................................................................................264
5.49 Program UKS dalam Upaya Promosi Kesehatan di Puskesmas Medan Area
Selatan.......................................................................................................266
Selatan.......................................................................................................272
Area Selatan..............................................................................................274
Selatan.......................................................................................................275
Selatan.......................................................................................................277
Selatan.......................................................................................................280
xviii
Selatan..........................................................................................................324
6.3 Distribusi Frekuensi Jenis Kelamin di Wilayah Kerja Puskesmas Medan Area
Selatan..........................................................................................................324
Selatan..........................................................................................................324
Area Selatan.................................................................................................325
Selatan..........................................................................................................326
6.7 Hubungan Status Gizi dengan Kejadian TB Paru di Puskesmas Medan Area
Selatan..........................................................................................................327
Area Selatan.................................................................................................327
Area Selatan.................................................................................................328
xix
DAFTAR GAMBAR
Nomor
2.1 Jumlah Penduduk Provinsi Sumatera Utara (dalam jutaan) Menurut Jenis
Kelamin.......................................................................................................10
Utara ...........................................................................................................11
.....................................................................................................................18
.....................................................................................................................19
Sumatera Utara............................................................................................29
xx
2.12 Angka Kematian Bayi (AKB)/Infant Mortality Rate (IMR) di Provinsi
Sumatera Utara............................................................................................40
2.14 Persentase Kasus Diare Pada Semua Umur Dan Balita Menurut Kabupaten/
2.15 Angka Penemuan Kasus (CNR) TB Paru BTA (+) Menurut Kabupaten/
Kota.............................................................................................................48
2.18 Jumlah Kasus HIV Positif dan AIDS yang Dilaporkan di Provinsi Sumatera
Utara............................................................................................................51
2.19 Angka Prevalensi Dan Angka Penemuan Kasus Baru Kusta (Ncdr).........53
2.20 Kasus Penderita Kusta, Penderita,15 tahun dan cacat tingkat 2 Berdasarkan
Utara............................................................................................................56
.....................................................................................................................60
2.25 Cakupan Pemberian Tablet Besi (Fe) pada Ibu Hamil Per Kabupaten Kota
xxi
2.26.....................................................................................................................
5.1 Peta Wilayah Puskesmas Medan Area Selatan Kecamatan Medan Area.....215
xxii