ABSTRAK
Eliminasi malaria merupakan komitmen global dan Pemerintah Indonesia. Pemerintah Kabupaten Aceh Besar melalui Peraturan Bupati No. 23/2013 menargetkan eliminasi malaria tahun 2015. Peranan pelayanan kesehatan swasta dalam konteks eliminasi malaria belum diketahui. Kajian ini bertujuan untuk mengetahui peranan pelayanan kesehatan swasta dalam hal diagnosis, pengobatan, pencegahan dan pencatatan pelaporan dalam pencapaian eliminasi malaria di Kabupaten Aceh Besar dan faktor-faktor yang mempengaruhi.
Jenis penelitian adalah potong lintang. Sampel menggunakan metode pencuplikan acak sederhana, jumlah 153 dibagi secara proporsional keenam jenis pelayanan kesehatan swasta. Data dari data primer dan sekunder. Analisis menggunakan uji Chi-Square dan logistik regresi ganda dengan aplikasi Epi Info versi 7.
Hasil penelitian: tingkat pendidikan (p = 0,045), pelatihan malaria (p = 0,004), karakteristik pekerjaan (p = 0,004), tingkat pengetahuan (p < 0,001) berpengaruh terhadap peran. Berpengetahuan baik berpengaruh 8 kali (OR 8,1; 95% CI 3,8 – 17,5) dan pelatihan berpengaruh 2,7 kali (OR 2,7; 95% CI 1,2 – 6,3). Kontribusi pelayanan kesehatan swasta, proporsi kasus suspek dikonfirmasi laboratorium 13,5%, proporsi kasus malaria diobati sesuai protokol 7,4%, proporsi kasus malaria terlapor ke pemerintah 5,6%. Pada apotek dan toko obat, mean pembeli suspek malaria per hari 4 orang, mean Klorokuin terjual perbulan 38 tablet.
Penyedia pelayanan kesehatan swasta masih berperan dalam pencapaian eliminasi malaria pada daerah endemis rendah menuju eliminasi. Perlu dibentuk jejaring kerjasama pemerintah-swasta formal untuk mengefektifkan komunikasi, koordinasi, peningkatan pengetahuan dan keterampilan, menjamin ketersediaan alat dan bahan, pembinaan dan pengawasan.
Kata Kunci: Peranan, Pelayanan Kesehatan Swasta, Eliminasi Malaria.
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ABSTRACT
Malaria elimination is a global commitment and a goal of the Government of Indonesia. The District of Aceh Besar has promulgated Regent’s Regulation No. 23/2013 which formally commits to achieve elimination by 2015. However, the role of private health care providers in progressing towards malaria elimination has not been identified. This study describes and quantifies the role of private health care in the malaria elimination effort in Aceh Besar.
A survey of six types of private health care providers through a simple random sampling method has been conducted. Primary and secondary data were collected from 153 providers. Data analysis was done using Chi-Square test and logictic regression with EPI Info version 7.
The result showed that educational background (p=0,045), participation in malaria training (p=0,004), occupational characteristics (p=0,004) and knowledge of malaria (p<0,001) were associated with involvement in malaria elimination program. Additionally, roles of private health care providers in malaria elimination were predominantly influenced by having good knowledge of malaria (OR 8.1; 95% CI 3.8–17.5) and participation in malaria training (OR 2.7; 95% CI 1.2–6.3). The contribution private providers to officially reported data for 2013 showed that, 13.5% of suspected malaria cases were laboratory-confirmed, 7.4% of malaria cases were treated by ACT, and 5.6% malaria cases treated were reported to government. At pharmacies and drug stores, an average of 4 people sought medication for malaria malaria daily, with pharmacies selling a mean of 38 chloroquine tablets monthly
Private health care providers play a pivotal role in low endemic area moving toward malaria elimination. This survey shows that the private sector in Aceh Besar falls far short of standards for diagnosis, treatment and reporting set by the public section. This highlights the need for established of an effective public-private network to ensure adherence to standards, effective monitoring, and good communication.
Keyword: Roles, Private Health Care, Malaria Elimination
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