library.uns.ac.id digilib.uns.ac.

id

PERAN KADER ASUH MELALUI POLA SURVEILANS KIA UNTUK

OPTIMALISASI PEMANTAUAN KESEHATAN IBU DAN ANAK
DI KABUPATEN PASURUAN

TESIS

Disusun Untuk Memenuhi Persyaratan Mencapai Derajat Magister

Program Studi Ilmu Kesehatan Masyarakat
Minat Utama Kebijakan dan Manajemen Pelayanan Kesehatan

Oleh
Ninil Dwi Pangestu
S021602034

PROGRAM STUDI S2 ILMU KESEHATAN MASYARAKAT

PASCASARJANA
UNIVERSITAS SEBELAS MARET
SURAKARTA
commit
2018 to user
library.uns.ac.id digilib.uns.ac.id

commit to user
library.uns.ac.id digilib.uns.ac.id

commit to user
library.uns.ac.id digilib.uns.ac.id

commit to user
library.uns.ac.id digilib.uns.ac.id

commit to user
library.uns.ac.id digilib.uns.ac.id

commit to user
library.uns.ac.id digilib.uns.ac.id

commit to user
library.uns.ac.id digilib.uns.ac.id

ABSTRAK

Ninil Dwi Pangestu. S021602034. Peran Kader Asuh melalui Surveilans KIA untuk
Optimalisasi Pemantauan Kesehatan Ibu dan Anak di Kabupaten Pasuruan. Tesis.
Pembimbing I: Prof. Dr. Hermanu Joebagio, M.Pd. Pembimbing II: Dr. Setyo Sri
Rahardjo, dr., M.Kes. Program Studi Ilmu Kesehatan Masyarakat Pascasarjana
Universitas Sebelas Maret Surakarta.

Latar Belakang: Kesehatan ibu dan anak merupakan salah satu indikator penilaian
derajat kesehatan masyarakat namun angka kematian ibu, bayi, dan balita di Indonesia
masih tinggi. Kabupaten Pasuruan merupakan salah satu kabupaten di Jawa Timur
dengan angka kematian bayi tertinggi. Salah satu upaya untuk menekan jumlah
kematian ibu, bayi, dan balita adalah melalui program kader asuh. Tujuan penelitian
adalah mendeskripsikan peran kader asuh melalui pola surveilans KIA untuk
optimalisasi pemantauan kesehatan ibu dan anak di Kabupaten Pasuruan.

Subjek dan Metode: Penelitian ini menggunakan metode studi kasus dengan
rancangan pengambilan data kualitatif, teknik pengambilan sampel secara purposive
sampling jenis criterion sampling. Teknik pengumpulan data menggunakan wawancara
mendalam, Focus Group Discussion (FGD), observasi, dan studi dokumentasi. Uji
keabsahan data menggunakan triangulasi, pengecekan anggota, dan perpanjangan
keikutsertaan.

Hasil: Program kader asuh di Kabupaten Pasuruan berjalan 4 tahun tetapi belum semua
kader mendapatkan pelatihan kader asuh. Latar belakang pembentukan program kader
asuh adalah salah satu upaya menurunkan angka kematian ibu, bayi, dan balita di
kabupaten Pasuruan. Kader asuh adalah kader kesehatanyang memiliki tugas
memberikan pendampingan dan pemantauan terhadap sasaran kesehatan yang
ditentukan dalam satu wilayah posyandu. Kader asuh membantu dalam penurunan
angka kematian, ibu, bayi, dan balita namun peran kader asuh dalam pelaksanaanya
masih menemukan beberapa hambatan diantaranya rendahnya insentif yang diperoleh
kader asuh, rendahnya tingkat kesadaran masyarakat terhadap kesehatan ibu dan anak,
dan faktor medis ibu hamil yang menyebabkan kematian.

Kesimpulan: Kader asuh membantu meningkatkan kualitas kesehatan ibu dan anak
namun belum optimal dalam menjalankan perannya.
Kata Kunci : Angka Kematian Ibu, Angka Kematian Bayi, Angka Kematian Balita,
Kader Asuh

commit to user

viii
library.uns.ac.id digilib.uns.ac.id

ABSTRACT

Ninil Dwi Pangestu. S021602034. The Role of Community Health Workers in Maternal
and Child Health Surveillance to Optimize in Monitoring Maternal and Child Health in
Pasuruan District, East Java. Thesis. Advisor I: Prof. Dr. Hermanu Joebagio, M.Pd.
Advisor II: Dr. Setyo Sri Rahardjo, dr., M.Kes. Master Program of Public Health,
Sebelas Maret University.

Background: Maternal mortality ratio, infant mortality rate, and underfive mortality
rate are still high in Indonesia. Pasuruan is one of the districts in East Java with the
highest infant mortality rate. One of the public health interventions that has been
undertaken to address this issue is maternal and child health surveillance program with
community health workers being the leading implementers. This study aimed to
describe the role of community health workers in maternal and child health surveillance
to optimize maternal and child health care services in Pasuruan District, East Java.

Subjects and Method: This was a qualitative study using case study approach. It was
conducted in Pasuruan, East Java. Key informants were selected by criterion sampling.
The data were collected by in-depth interview, focus group discussion, observation, and
document review. Data validity was checked by triangulation.

Results: Community based maternal and child health surveillance program has been
implemented for 4 years. However, only some of all community health workes have
been trained in this program. The tasks of these community health workers included
advocacy and monitoring of maternal and child health in the areas of posyandu. The
implementation of these surveillance program had some obstacles, including low
insentive of community health worker, inactive community health worker, lack of
awareness among community members on maternal and child health issues, and
medical factors of pregnant mothers that caused mortality.

Conclusion: Community health workers help improve the quality of maternal and child
health care by surveillance program, although their performances have yet to be
enhanced.

Keyword: maternal mortality rate, infant mortality rate, community health workers

commit to user

ix
library.uns.ac.id digilib.uns.ac.id

DAFTAR ISI
Halaman
HALAMAN SAMPUL ............................................................................................ i
PENGESAHAN PEMBIMBING TESIS ............................................................... ii
PENGESAHAN PENGUJI TESIS ....................................................................... iii
PENGESAHAN PENGUJI TESIS ....................................................................... iv
PERNYATAAN KEASLIAN DAN PERSYARATAN PUBLIKASI ................. v
KATA PENGANTAR ............................................................................................ vi
ABSTRAK .............................................................................................................. viii
ABSTRACT ............................................................................................................ ix
DAFTAR ISI ........................................................................................................... x
DAFTAR TABEL ................................................................................................... xii
DAFTAR GAMBAR .............................................................................................. xiii
DAFTAR LAMPIRAN .......................................................................................... xiv

BAB I PENDAHULUAN
A. Latar Belakang .................................................................................... 1
B. Rumusan Masalah ............................................................................... 5
C. Tujuan Penelitian ................................................................................. 5
D. Manfaat Penelitian................................................................................ 6

BAB II LANDASAN TEORI

A. Tinjauan Pustaka
1. Ilmu Kesehatan Masyarakat ..............................................................7
2. Pemberdayaan Masyarakat ................................................................9
3. Posyandu ............................................................................................11
4. Kader Asuh ........................................................................................16
5. Peran Kader Asuh ..............................................................................20
6. Surveilans Kesehatan .........................................................................22
7. Kematian Ibu, Bayi, Balita ................................................................23
B. Penelitian Yang Relevan ........................................................................30
C. Kerangka Berpikir ..................................................................................35

BAB III METODE PENELITIAN

A. Waktu dan Tempat Penelitian ............................................................. 37
B. Jenis Penelitian .................................................................................... 37
C. Subjek Penelitian ................................................................................. 37
D. Data dan Sumber Data ......................................................................... 38
E. Teknik Pengumpulan Data .................................................................. 38
commit to user
F. Teknik Sampling ................................................................................. 39

x
library.uns.ac.id digilib.uns.ac.id

G. Keabsahan Data ................................................................................... 39

H. Analisis Data ....................................................................................... 41

BAB IV HASIL PENELITIAN

A. Deskripsi Lokasi Penelitian ................................................................. 42
B. Data Jumlah Kematian Ibu, Bayi, Balita, Cakupan
Pemeriksaan Kehamilan, Partisipasi Posyandu ................................... 45
C. Karakteristik Informan Penelitian ....................................................... 50
D. Hasil Penelitian ................................................................................... 51

BAB V PEMBAHASAN
A. Pembahasan Penelitian
1. Peran Kader Asuh melalui Surveilans Kader Asuh ...........................70
2. Peran Kader Asuh dalam Penurunan Jumlah Kematian Ibu,
Bayi, dan Balita .............................................................................. 71
3. Peran Kader Asuh dalam Peningkatan Cakupan Pemeriksaan
Kehamilan, Deteksi Dini Kehamilan, dan Monitoring
Ibu Hamil ....................................................................................... 73
4. Peran Kader Asuh dalam Peningkatan Partisipasi Posyandu
dan Deteksi Dini Tumbuh Kembang ............................................. 75
B. Keterbatasan Penelitian ....................................................................... 76

BAB VI KESIMPULAN DAN SARAN

A. Kesimpulan .......................................................................................... 77
B. Implikasi Penelitian ............................................................................. 77
C. Saran .................................................................................................... 78

DAFTAR PUSTAKA .............................................................................................. 80

DOKUMENTASI HASIL WAWANCARA dan FGD dengan INFORMAN
terkait KADER ASUH ............................................................................................ 85
LAMPIRAN ............................................................................................................. 99

commit to user

xi