DINAS KESEHATAN KABUPATEN AGAM

UPTD PUSKESMAS TIKU

Jln. Bundo Kanduang No.1 Tiku Kecamatan Tanjung Mutiara
Telpon: 0751-699059 KodePos 26473

FORMULIR TARGET CAKUPAN PELAYANAN UPAYA KEGIATAN WAJIB PUSKESMAS PER DESA

PUSKESMAS TIKU TAHUN 2019

TIKU SELATAN TIKU UTARA

CAKUPAN PELAYANAN Gasan Banda Sungai Bukik Cacang Cacang Durian
pasa Pasia Kp. Darek Pasia Paneh
kaciak gadang Nibung Malintang Randah Tinggi Kapeh
T 38 35 42 78 36 13 17 24 25 31 100
Ibu Hamil (K1)
H 30(78.9 %) 27(77.1%) 37(88.1%) 77(98.7%) 36(100%) 10(76.9%) 16(94.1%) 19(79.2%) 21(84%) 24(77.4%) 100(100%)
KIA
T 38 35 42 78 36 13 17 24 25 31 100
Ibu Hamil (K4)
H 29(76%) 28(80%) 30(71%) 55(71%) 30(83%) 12(92%) 14(82%) 17(71%) 20(80%) 20(65%) 80(80%)
T
KB Akseptor AKTIF
H
T
B.C.G
H
T
D.P.T.I
H
T
POLIO III
H
Imuninasi T
CAMPAK
H
T
T.T.2.BUMIL
H
T 135 138 95 195 110 40 45 82 78 120 352
D/S
H 135(100%) 136(98.5%) 93(98.8%) 193(98.9%) 108(98.1%) 38(95%) 43(95.5%) 80(97.5%) 77(98.7%) 118(98.3%) 350(99.4%)
T 102 128 82 160 98 36 32 78 65 105 350
GIZI N/D
H 100(98%) 127(99.2%) 80(97.5) 158(98.7%) 97(98.9%) 35(97.2%) 30(93.7%) 77(98.7%) 63(96.9%) 103(98%) 348(99.4%)
IBU HAMIL DI T 40 35 24 46 25 15 18 18 17 38 55
BERI Fe H 38(95%) 35(100%) 23(95.8%) 45(97.8%) 24(96%) 15(100%) 16(88.8%) 17(94.4%) 16(94.1%) 36(94.7%) 53(96.3%)
DIARE DIBERI T 6 8 20 12 12 14 16 4 3 5 12
ORALIT H 6(100%) 8(100%) 20(100%) 12(100%) 12(100%) 14(100%) 16(100%) 4(100%) 3(100%) 5(100%) 12(100%)
P2M T
PENGOBATAN TB
H

T= TARGET H= HASIL
FORMAT: ANALISA MASALAH, PENYEBAB MASALAH DAN CARA PEMECAHAN MASALAH

DESA PETUGAS KEGIATAN MASALAH PENYEBAB KESEPAKATAN CARA

PEMECAHAN
MASALAH
1 2 3 4 5 6
 DINAS KESEHATAN KABUPATEN AGAM
UPTD PUSKESMAS TIKU
Jln. Bundo Kanduang No.1 Tiku Kecamatan Tanjung Mutiara
Telpon: 0751-699059 KodePos 26473

FORMULIR TARGET CAKUPAN PELAYANAN UPAYA KEGIATAN WAJIB PUSKESMAS PER DESA

PUSKESMAS TIKU TAHUN 2020

TIKU SELATAN TIKU UTARA

CAKUPAN PELAYANAN Gasan Banda Sungai Bukik Cacang Cacang Durian
pasa Pasia Kp. Darek Pasia Paneh
kaciak gadang Nibung Malintang Randah Tinggi Kapeh
T 42 36 42 70 36 14 15 25 25 34 100
Ibu Hamil (K1)
H 41(97.6%) 39 35(83.3%) 77 32(88.9%) 16 13(86.7%) 21(84%) 23(92%) 22(64.7%) 90(90%)
KIA
T 42 36 42 70 36 14 15 25 25 34 100
Ibu Hamil (K4)
H 34(81%) 30(83.3%) 29(69%) 68(97.1%) 26(72.2) 9(64.3%) 11(73.3%) 22(88%) 17(68%) 21(61.8%) 87(87%)
T 231 215 273 442 121 85 89 139 212 215 448
KB Akseptor AKTIF
H 173(74.8%) 161(74.8%) 191(69.9%) 296(66.9%) 76(62.8%) 75(88.2%) 61(68.5%) 120(86.3%) 125(58.9%) 160(74.4%) 279(62.2%)
T
B.C.G
H
T
D.P.T.I
H
T
POLIO III
H
Imuninasi T
CAMPAK
H
T
T.T.2.BUMIL
H
T 140 142 98 198 115 48 40 85 80 122 350
D/S
H 138(98.5%) 140(98.5%) 97(98.9%) 196(98.9%) 113(98.2%) 46(95.8%) 38(95%) 83(97.6%) 78(97.5%) 120(98.3%) 348(99.4%)
T 105 125 84 162 95 40 35 83 72 108 245
GIZI N/D
H 103(98%) 123(98.4%) 82(97.6%) 160(98.7%) 93(97.8%) 38(95%) 34(97.1%) 81(97.5%) 70(97.2%) 107(99%) 243(99.1%)
IBU HAMIL DI T 52 41 26 48 27 18 20 24 28 41 62
BERI Fe H 51(98%) 40(97.5%) 24(92.%) 47(97.9%) 26(96.2%) 16(88.8%) 18(90%) 23(95.8%) 26(92.8%) 40 (97.5%) 60(96.7%)
DIARE DIBERI T 4 3 4 8 8 7 4 5 5 8 5
P2M ORALIT H 4(100%) 3(100%) 4(100%) 8(100%) 8(100%) 7(100%) 4(100%) 5(100%) 5(100%) 8(100%) 5(100%)
PENGOBATAN TB T
 H

T= TARGET H= HASIL

FORMAT: ANALISA MASALAH, PENYEBAB MASALAH DAN CARA PEMECAHAN MASALAH

DESA PETUGAS KEGIATAN MASALAH PENYEBAB KESEPAKATAN CARA

PEMECAHAN
MASALAH
1 2 3 4 5 6
 DINAS KESEHATAN KABUPATEN AGAM
UPTD PUSKESMAS TIKU
Jln. Bundo Kanduang No.1 Tiku Kecamatan Tanjung Mutiara
Telpon: 0751-699059 KodePos 26473

FORMULIR TARGET CAKUPAN PELAYANAN UPAYA KEGIATAN WAJIB PUSKESMAS PER DESA

PUSKESMAS TIKU TAHUN 2021

TIKU SELATAN TIKU UTARA

CAKUPAN PELAYANAN Gasan Banda Sungai Bukik Cacang Cacang Durian
pasa Pasia Kp. Darek Pasia Paneh
kaciak gadang Nibung Malintang Randah Tinggi Kapeh
T 32 39 35 60 25 12 18 26 22 41 80
Ibu Hamil (K1)
H 30(93.8%) 38(97.4%) 33(94.3%) 58(96.7%) 24(96%) 12(100%) 18(100%) 26(100%) 22(100%) 41(100%) 72(90%)
KIA
T 32 39 35 60 25 12 18 26 22 41 80
Ibu Hamil (K4)
H 29(90.6%) 37(94.9%) 33(94.3%) 54(90%) 23(92%) 11(91.7%) 15(83.3%) 13(50%) 16(72.7%) 27(65.9%) 60(75%)
T 286 273 437 506 157 159 113 257 276 255 737
KB Akseptor AKTIF
H 232(81.1%) 227(83.1%) 226(51.7%) 393(77.6%) 96(61.1%) 79(49.7%) 91(80.5%) 208(80.9%) 157(56.8) 197(77.2%) 352(47.7%)
T 28 35 27 65 22 12 18 19 16 21 59
B.C.G
H 31 20(57.1%) 22(81.5%) 43(66.1%) 14(63.6%) 14 15(83.3%) 19(100%) 14(87.5%) 22 38(64.4%)
T 30 30 24 61 22 14 13 19 13 20 63
D.P.T.I
H 30(100%) 26(86.6%) 12(50%) 30(49.1%) 14(63.6%) 22 16 21 8(61.5%) 19(95%) 37(58%)
T 31 32 27 58 25 14 14 21 15 19 67
POLIO III
H 32 20(62.5%) 21(77.7%) 39(67.2%) 14(56%) 16 15 16(76.1%) 7(46.6^%) 12(63.1%) 47(70.1%)
Imuninasi T 28 27 27 57 23 15 13 19 13 17 68
CAMPAK
H 17(60.7%) 24(88.8%) 21(77.7%) 49(85.9%) 15(65.2%) 18 11(84.6%) 16(84.2%) 13(100%) 12(70.5%) 50(73.5%)
T 0 0 0 0 0 0 0 0 0 0 0
T.T.2.BUMIL
H 0 0 0 0 0 0 0 0 0 0 0
T 130 149 103 204 118 43 42 77 79 115 344
D/S
H 130(100%) 145 (97.3%) 100(97%) 200(98%) 115(97.4%) 43(100%) 42(100%) 76(98.7%) 77(97.4%) 113(98.2%) 340(98.8%)
T 98 126 75 159 89 31 29 70 67 101 248
GIZI N/D
H 98(100%) 124(98.4%) 73(97.3%) 157(98.7%) 87(97.7%) 30(96.7%) 27(93.1%) 68(97.1%) 65(97%) 100(99%) 146(58.8%)
IBU HAMIL DI T 35 38 20 44 22 13 15 16 17 36 50
BERI Fe H 35(100%) 38(100%) 20(100%) 44(100%) 22(100%) 13(100%) 15(100%) 16(100%) 17(100%) 36(100%) 50(100%)
P2M DIARE DIBERI T 10 12 6 8 13 4 7 4 2 5 8
 ORALIT H 10(100%) 12(100%) 6(100%) 8(100%) 13(100%) 4(100%) 7(100%) 4(100%) 2(100%) 5(100%) 8(100%)
T
PENGOBATAN TB
H

T= TARGET H= HASIL

FORMAT: ANALISA MASALAH, PENYEBAB MASALAH DAN CARA PEMECAHAN MASALAH

DESA PETUGAS KEGIATAN MASALAH PENYEBAB KESEPAKATAN CARA

PEMECAHAN
MASALAH
1 2 3 4 5 6