NAMA 1

NO KECAMATAN 1. Sekolah yang ada di wilayah Puske

PUSKESMAS
Puskesmas melaksanakan KTR (

Total Target Pencapaia

Sasaran n
Sasaran (TS) (P)
1 2 3 4 5 6
1 KENCONG KENCONG 37 24.05 3

2 KENCONG CAKRU 29 18.85 4

3 GUMUKMAS GUMUKMAS 59 38.35 6
4 GUMUKMAS TEMBOKREJO 29 18.85 1
5 PUGER PUGER 46 29.9 20
6 PUGER KASIYAN 63 40.95 8
7 WULUHAN WULUHAN 73 47.45 36
8 WULUHAN LOJEJER 45 29.25 1
9 AMBULU AMBULU 44 28.6 3

10 AMBULU SABRANG 34 22.1 15

11 AMBULU ANDONGSARI 23 14.95 3

12 TEMPUREJO TEMPUREJO 46 29.9 4

13 TEMPUREJO CURAHNONGKO 31 20.15 4

14 SILO SILO I 37 24.05 2

15 SILO SILO II 70 45.5 0
16 MAYANG MAYANG 66 42.9 11
17 MUMBULSARI MUMBULSARI 62 40.3 3
18 JENGGAWAH JENGGAWAH 40 26 4
19 JENGGAWAH KEMUNINGSARI 43 27.95 11
20 AJUNG AJUNG 61 39.65 6
21 RAMBIPUJI RAMBIPUJI 48 31.2 5
22 RAMBIPUJI NOGOSARI 31 20.15 0
23 BALUNG BALUNG 47 30.55 3
24 BALUNG KARANGDUREN 51 33.15 3
25 UMBULSARI UMBULSARI 34 22.1 2
26 UMBULSARI PALERAN 31 20.15 3
27 SEMBORO SEMBORO 40 26 -
28 JOMBANG JOMBANG 61 39.65 6
29 SUMBERBARU SUMBERBARU 72 46.8 0
30 SUMBERBARU ROWOTENGAH 44 28.6 15
31 TANGGUL TANGGUL 52 33.8 1
32 TANGGUL KLATAKAN 26 16.9 8
33 BANGSALSARI BANGSALSARI 87 56.55 0
34 BANGSALSARI SUKOREJO 48 31.2 4
35 PANTI PANTI 70 45.5 6
36 SUKORAMBI SUKORAMBI 49 31.85 6
37 ARJASA ARJASA 36 23.4 0
38 PAKUSARI PAKUSARI 41 26.65 2
39 KALISAT KALISAT 99 64.35 -
40 LEDOKOMBO LEDOKOMBO 67 43.55 -
41 SUMBERJAMBE SUMBERJAMBE 63 40.95 -
42 SUKOWONO SUKOWONO 62 40.3 0
43 JELBUK JELBUK 42 27.3 8
44 KALIWATES KALIWATES 29 18.85 24
45 KALIWATES MANGLI 21 13.65 12
46 KALIWATES JEMBER KIDUL 39 25.35 4
47 SUMBERSARI SUMBERSARI 69 44.85 21
48 SUMBERSARI GLADAKPAKEM 29 18.85 3
49 PATRANG PATRANG 43 27.95 1
50 PATRANG BANJARSENGON 44 28.6 6
 1 2
yang ada di wilayah Puskesmas atau 2.Persentase merokok penduduk usia 10- 18 tahunB (<9
smas melaksanakan KTR (65%)

Cakupan Riil Target Sasaran Pencapaian

Ʃ (P/TS) Total Sasaran
(P/Tos) (TS) (P)

7 8 9 10 11
8,108,108,108 1,247,401,247 6810 613 265

1,379,310,345 2,122,015,915 3706 334 0

1,016,949,153 1,564,537,158 5734 516 388
3,448,275,862 5,305,039,788 3579 322 -
4,347,826,087 6,688,963,211 6009 541 66
126,984,127 1,953,601,954 8436 759 0
4,931,506,849 7,586,933,614 9027 812 140
2,222,222,222 3,418,803,419 7902 711 46
9544 859 112
6,818,181,818 1,048,951,049
4,411,764,706 6,787,330,317 5295 477 400
1,304,347,826 2,006,688,963 3313 298 0

8,695,652,174 1,337,792,642 7407 667 0

1,290,322,581 1,985,111,663 4929 444 9

5,405,405,405 8,316,008,316 4133 372 0
0 0 5015 451 0
1,666,666,667 2,564,102,564 6670 600 119
4,838,709,677 7,444,168,734 10421 938 250
10 1,538,461,538 4728 426 37
2,558,139,535 3,935,599,284 7747 697 0
9,836,065,574 1,513,240,858 7503 675 714
1,041,666,667 1,602,564,103 7179 646 0
0 0 4573 412 1
6,382,978,723 9,819,967,267 5843 526 39
5,882,352,941 9,049,773,756 6739 607 -
5,882,352,941 9,049,773,756 5921 533 0
9,677,419,355 1,488,833,747 4110 370 0
0 0 5309 478 440
9,836,065,574 1,513,240,858 7243 652 -
0 0 6856 617 0
3,409,090,909 5,244,755,245 6173 556 0
1,923,076,923 2,958,579,882 7700 693 153
3,076,923,077 4,733,727,811 2924 263 5
0 0 9300 837 0
8,333,333,333 1,282,051,282 6411 577 0
8,571,428,571 1,318,681,319 8507 766 18
1,224,489,796 1,883,830,455 6592 593 67
0 0 4251 383 0
487,804,878 7,504,690,432 6188 557 0
0 0 10920 983 -
0 0 9750 878 -
0 0 8290 746 -
0 0 4094 368 22
1,904,761,905 293,040,293 4407 397 397
8,275,862,069 100 6904 621 0
5,714,285,714 8,791,208,791 3571 321 0
1,025,641,026 157,790,927 7156 644 82
3,043,478,261 4,682,274,247 11575 1042 104
1,034,482,759 1,591,511,936 6246 562 0
2,325,581,395 3,577,817,531 8582 772 0
1,363,636,364 2,097,902,098 4538 408 0
 2.1.5.11
2 3
uduk usia 10- 18 tahunB (<9%) 3.Puslesmas dan jejaringnya /faskes diwilayahnya melayani Upa
Merokok (UBM)

Cakupan Riil Target Sasaran Pencapaian

Ʃ (P/TS) Total Sasaran
(P/Tos) (TS) (P)

12 13 14 15 16
389,133,627 2,312,830,189 4 2 2
0 #DIV/0! 1 0.5 1
676,665,504 1,330,051,546 4 2 1
0 #DIV/0! 3 1.5 3
1,098,352,471 8,194,090,909 5 2.5 1
0 #DIV/0! 3 1.5 1
1,550,902,847 5,803,071,429 7 3.5 4
0.582131106 1,546,043,478 3 1.5 1
1,173,512,154 7,669,285,714 3 1.5 1
7,554,296,506 1,191,375 1 0.5 1
0 #DIV/0! 7 3.5 1
0 #DIV/0! 3 1.5 1
0.182592818 4929 1 0.5 1
0 #DIV/0! 3 1.5 1
0 #DIV/0! 3 1.5 1
1,784,107,946 5,044,537,815 6 3 3
2,399,002,015 375,156 4 2 1
0.782571912 1,150,054,054 3 1.5 3
0 #DIV/0! 2 1 1
9,516,193,523 9,457,563,025 2 1 1
0 #DIV/0! 1 0.5 1
0.02186748305 41157 1 0.5 1
0.6674653431 1,348,384,615 8 4 1
 0 #DIV/0! 1 0.5 1
0 #DIV/0! 27 13.5 13
0 #DIV/0! 1 0.5 1
8,287,813,147 1,085,931,818 1 0.5 1
0 #DIV/0! 3 1.5 1
0 #DIV/0! 1 0.5 1
0 #DIV/0! 1 0.5 1
1,987,012,987 4,529,411,765 1 0.5 1
0.170998632 5263.2 1 0.5 1
0 #DIV/0! 1 0.5 1
0 #DIV/0! 1 0.5 1
0.2115904549 4253.5 1 0.5 1
1,016,383,495 8,854,925,373 1 0.5 1
0 #DIV/0! 1 0.5 1
0 #DIV/0! 2 1 2
0 #DIV/0! 1 0.5 1
0 #DIV/0! 1 0.5 1
0 #DIV/0! 1 0.5 1
0.5373717636 1,674,818,182 1 0.5 1
9,008,395,734 9,990,680,101 1 0.5 12
0 #DIV/0! 15 7.5 5
0 #DIV/0! 25 12.5 20
114,589,156 7,854,146,341 1 0.5 1
0.898488121 1,001,682,692 154 77 4
0 #DIV/0! 52 26 4
0 #DIV/0! 1 0.5 1
0 #DIV/0! 5 2.5 5
 REKAP PKP 2021 PROGRAM PTM
2.1.5.11.Pencegahan dan Pengendalian Penyakit Tidak Menular
3 4
diwilayahnya melayani Upaya Berhenti 4. Pelayanan Kesehatan Usia Produktif (100%)
ok (UBM)

Cakupan Riil Target Sasaran Pencapaian

Ʃ (P/TS) Total Sasaran
(P/Tos) (TS) (P)

17 18 19 20 21
50 100 25651.00 25651.00 21811.00
100 100 17994.00 17994.00 17994.00
25 50 35672.00 35672.00 27233.00
100 100 17383.00 17383.00 17383.00
20 40 38506.00 38506.00 34619.00
3,333,333,333 6,666,666,667 38180.00 38180.00 11259.00
5,714,285,714 100 40953.00 40953.00 40953.00
3,333,333,333 6,666,666,667 35857.00 35857.00 33153.00
3,333,333,333 6,666,666,667 26348.00 26348.00 26348.00
100 100 25716.00 25716.00 37571.00
1,428,571,429 2,857,142,857 18323.00 18323.00 17959.00
3,333,333,333 6,666,666,667 28889.00 28889.00 13687.00
100 100 18433.00 18433.00 13193.00
3,333,333,333 6,666,666,667 28287.00 28287.00 28287.00
3,333,333,333 6,666,666,667 41261.00 41261.00 21325.00
50 100 32387.00 32387.00 29599.00
25 50 41749.00 41749.00 23683.00
100 100 24631.00 24631.00 24446.00
50 100 29827.00 29827.00 13036.00
50 100 49836.00 49836.00 41402.00
100 100 32116.00 32116.00 18008.00
100 100 20745.00 20745.00 17163.00
12.5 20 26510.00 26510.00 26510.00
 100 100 25060.00 25060.00 15770.00
4,814,814,815 962,962,963 26612.00 26612.00 24199.00
100 100 19959.00 19959.00 19959.00
100 100 29115.00 29115.00 23103.00
3,333,333,333 6,666,666,667 33487.00 33487.00 33487.00
100 100 36597.00 36597.00 25248.00
100 100 29980.00 29980.00 12281.00
100 100 37383.00 37383.00 37383.00
100 100 18041.00 18041.00 18041.00
100 100 45153.00 45153.00 33346.00
100 100 31128.00 31128.00 11882.00
100 100 39778.00 39778.00 18851.00
100 100 25414.00 25414.00 25414.00
100 100 25486.00 25486.00 12139.00
100 100 27935.00 27935.00 27935.00
100 100 50203.00 50203.00 50203.00
100 100 41876.00 41876.00 32397.00
100 100 40266.00 40266.00 27876.00
100 100 39334.00 39334.00 15551.00
100 100 21405.00 21405.00 21405.00
3,333,333,333 6,666,666,667 33398.00 33398.00 33398.00
80 100 17343.00 17343.00 17343.00
100 100 21436.00 21436.00 16093.00
2,597,402,597 5,194,805,195 56211.00 56211.00 34016.00
7,692,307,692 1,538,461,538 28357.00 28357.00 4697.00
100 100 41233.00 41233.00 21595.00
100 100 22034.00 22034.00 22034.00
 nular
4 5
an Usia Produktif (100%) 5. Deteksi Dini Faktor Risiko PTM usia ≥ 15 tahun (80%

Cakupan Riil Target Sasaran Pencapaian

Ʃ (P/TS) Total Sasaran
(P/Tos) (TS) (P)

22 23 24 25 26
850,298,234 850,298,234 31993 25594.4 29712
100 100 22443 17954.4 18957
7,634,278,986 7,634,278,986 44490 35592 19955
100 100 21.682 17345.6 14.75
8,990,546,928 8,990,546,928 48024 38419.2 34345
2,948,926,139 2,948,926,139 47618 38094.4 9135
100 100 51078 40862.4 43090
924,589,341 924,589,341 44721 35776.8 33153
32861 56319
100 100 26288.8
100 100 32073 25658.4 35538
9,801,342,575 9,801,342,575 22853 18282.4 19544

473,778,947 473,778,947 36031 28824.8 13687

7,157,272,283 7,157,272,283 22990 18392 12915
100 100 35279 28223.2 28195
5,168,318,751 5,168,318,751 51460 41168 20535
9,139,160,774 9,139,160,774 40396 32316.8 28440
5,672,710,724 5,672,710,724 52069 41655.2 22986
9,924,891,397 9,924,891,397 30721 24576.8 30179
4,370,536,762 4,370,536,762 37199 29759.2 12080
8,307,649,089 8,307,649,089 62.157 49725.6 39.95
5,607,173,994 5,607,173,994 40055 32044 3383
8,273,318,872 8,273,318,872 25874 20699.2 16214
100 100 33064 26451.2 31875
6,292,897,047 6,292,897,047 31.254 25003.2 16.953
9,093,266,196 9,093,266,196 33187 26549.6 24643
100 100 24893 19914.4 20246
7,935,085,008 7,935,085,008 36.313 29050.4 20.427
100 100 41.765 33412 36.544
6,898,926,141 6,898,926,141 45644 36515.2 24436
4,096,397,598 4,096,397,598 37393 29914.4 16942
100 100 46625 37300 47282
100 100 22501 18000.8 19297
7,385,112,839 7,385,112,839 56314 45051.2 12326
3,817,142,123 3,817,142,123 38823 31058.4 10400
4,739,051,737 4,739,051,737 49613 39690.4 17257
100 100 31698 25358.4 22247
4,763,007,141 4,763,007,141 31785 25428 11746
100 100 34842 27873.6 60270
100 100 62.612 50089.6 61.005
7,736,412,265 7,736,412,265 52.229 41783.2 32.675
6,922,962,301 6,922,962,301 50.221 40176.8 27.26
3,953,577,058 3,953,577,058 49058 39246.4 20542
100 100 26695 21356 26197
100 100 41655 33324 33398
100 100 21631 17304.8 28484
7,507,464,079 7,507,464,079 26736 21388.8 14028
6,051,484,585 6,051,484,585 70.108 56086.4 31.67
165,638,114 165,638,114 35367 28293.6 8234
5,237,309,922 5,237,309,922 51425 41140 24210
100 100 27484 21987.2 19259
5 6
o PTM usia ≥ 15 tahun (80%) 6. Deteksi dini kanker payudara dan kanker serviks pada perempu
tahun atau perempuan yang memiliki riwayat seksual aktif

Cakupan Riil Target Sasaran Pencapaian

Ʃ (P/TS) Total Sasaran
(P/Tos) (TS) (P)

27 28 29 30 31
9,287,031,538 100 6090 4872 1205
844,673,172 100 4270 3416 10
448,527,759 5,606,596,988 8465 6772 855
6,802,877,963 8,503,597,454 4126 3300.8 5
7,151,632,517 8,939,540,646 9138 7310.4 342
1,918,392,205 2,397,990,256 9059 7247.2 505
8,436,117,311 100 9718 7774.4 512
7,413,295,767 9,266,619,709 8509 6807.2 5
684
100 100 6252 5001.6
100 100 6103 4882.4 516
8,552,050,059 100 4348 3478.4 1
3,798,673,365 4,748,341,706 6856 5484.8 549
5,617,659,852 7,022,074,815 4374 3499.2 0
7,992,006,576 999,000,822 6712 5369.6 0
3,990,478,041 4,988,097,551 9791 7832.8 5
704,030,102 8,800,376,275 7687 6149.6 16
4,414,526,878 5,518,158,597 9906 7924.8 350
9,823,573,451 100 5845 4676 413
3,247,399,124 4,059,248,905 7076 5660.8 5
6,427,272,874 8,034,091,092 11826 9460.8 60
8,445,886,906 1,055,735,863 7621 6096.8 349
6,266,522,378 7,833,152,972 4924 3939.2 67
9,640,394,387 100 6291 5032.8 255
5,424,265,694 6,780,332,117 5946 4756.8 591
7,425,497,936 928,187,242 6315 5052 5
8,133,210,139 100 4736 3788.8 5
5,625,258,172 7,031,572,715 6910 5528 5
8,749,910,212 100 7945 6356 5
5,353,606,169 6,692,007,712 8684 6947.2 400
4,530,794,534 5,663,493,167 7114 5691.2 5
100 100 8871 7096.8 1721
8,576,063,286 100 4281 3424.8 6
2,188,798,523 2,735,998,153 10715 8572 5
2,678,824,408 334,853,051 7387 5909.6 58
3,478,322,214 4,347,902,767 9440 7552 357
7,018,423,875 8,773,029,844 6031 4824.8 66
369,545,383 4,619,317,288 6047 4837.6 5
100 100 6628 5302.4 459
9,743,339,935 100 11915 9532 416
6,256,102,931 7,820,128,664 9935 7948 563
5,428,008,204 6,785,010,255 9555 7644 -
4,187,288,516 5,234,110,645 9335 7468 422
9,813,448,211 100 5079 4063.2 342
8,017,764,974 100 7926 6340.8 201
100 100 4116 3292.8 609
5,246,858,169 6,558,572,711 5087 4069.6 336
4,517,316,141 5,646,645,176 13338 10670.4 1.065
2,328,159,018 2,910,198,773 6729 5383.2 113
4,707,826,932 5,884,783,666 9784 7827.2 2
7,007,349,731 8,759,187,163 5229 4183.2 80
 6
nker serviks pada perempuan usia 30-50
emiliki riwayat seksual aktif (80%)
PROGRAM Kriteria
Cakupan Riil
Ʃ (P/TS)
(P/Tos)

32 33
197,865,353 2,473,316,913 92.25 BAIK
0.2341920375 0.2927400468 0.00 RENDAH
1,010,041,347 1,262,551,683 57.28 RENDAH
0.1211827436 0.1514784295 0.00 RENDAH
3,742,613,263 4,678,266,579 185.05 BAIK
5,574,566,729 6,968,208,412 0.00 RENDAH
5,268,573,781 6,585,717,226 160.46 BAIK
0.05876131155 0.07345163944 300.22 BAIK
1,094,049,904 136,756,238 176.29 BAIK
8,454,858,266 1,056,857,283 82.93 CUKUP
0.02299908004 0.02874885005 0.00 RENDAH
8,007,584,597 1,000,948,075 0.00 RENDAH
0 0 865.11 BAIK
0 0 0.00 RENDAH
0.05106730671 0.06383413339 0.00 RENDAH
0.2081436191 0.2601795239 134.96 BAIK
3,533,212,195 4,416,515,243 91.49 BAIK
7,065,868,263 8,832,335,329 245.59 BAIK
0.07066139062 0.08832673827 0.00 RENDAH
0.5073566717 0.6341958397 62.29 RENDAH
4,579,451,516 5,724,314,394 0.00 RENDAH
1,360,682,372 1,700,852,965 6903.29 BAIK
4,053,409,633 5,066,762,041 263.88 BAIK
 9,939,455,096 1,242,431,887 0.00 RENDAH
0.07917656374 0.09897070467 0.00 RENDAH
0.1055743243 0.1319679054 0.00 RENDAH
0.07235890014 0.09044862518 59.73 RENDAH
0.06293266205 0.07866582756 0.00 RENDAH
4,606,172,271 5,757,715,339 0.00 RENDAH
0.07028394715 0.08785493393 0.00 RENDAH
1,940,029,309 2,425,036,636 130.03 BAIK
0.1401541696 0.175192712 935.12 BAIK
0.04666355576 0.0583294447 0.00 RENDAH
0.7851631244 0.9814539055 0.00 RENDAH
3,781,779,661 4,727,224,576 743.71 BAIK
109,434,588 136,793,235 198.90 BAIK
0.08268562924 0.1033570365 0.00 RENDAH
6,925,165,963 8,656,457,453 0.00 RENDAH
3,491,397,398 4,364,246,748 0.00 RENDAH
5,666,834,424 708,354,303 0.00 RENDAH
0 0 0.00 RENDAH
4,520,621,318 5,650,776,647 312.06 BAIK
6,733,608,978 8,417,011,223 72.94 RENDAH
2,535,957,608 316,994,701 0.00 RENDAH
1,479,591,837 1,849,489,796 0.00 RENDAH
6,605,071,752 8,256,339,689 175.02 BAIK
7,984,705,353 9,980,881,691 196.78 BAIK
1,679,298,558 2,099,123,198 0.00 RENDAH
0.0204415372 0.0255519215 0.00 RENDAH
1,529,929,241 1,912,411,551 0.00 RENDAH