AILA, KARYUS (2016) MODEL PROMOSI KESEHATAN ANTISIPATIF ANTI MALARIA UNTUK MENINGKATKAN PERILAKU PENCEGAHAN MALARIA DI DAERAH ENDEMIS KABUPATEN PESAWARAN PROVINSI LAMPUNG. Doctoral thesis, Universitas Andalas.
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Abstract
MODEL PROMOSI KESEHATAN ANTISIPATIF ANTI MALARIA UNTUK MENINGKATKAN PERILAKU PENCEGAHAN MALARIA DI DAERAH ENDEMIS Aila Karyus Penyakit malaria merupakan salah satu masalah utama kesehatan masyarakat di seluruh dunia, terutama di negara-negara beriklim tropis seperti benua Asia dan Afrika. Malaria dapat menyebabkan gangguan berat dan anemia pada kehamilan bahkan kematian ibu, bayi berat lahir rendah (BBLR) dan kematian bayi. Kabupaten Pesawaran paling endemis malaria di Provinsi Lampung Angka kasus malaria tertinggi di wilayah Puskesmas Hanura dengan annual parasite incidence (API) 48,75‰. Keadaan lingkungan yang sudah “given”, perilaku masyarakat yang tidak mendukung serta kemiskinan membuat permasalahan malaria sulit diselesaikan. Berbagai intervensi sudah di lakukan dalam menurunkan angka kesakitan malaria, tetapi belum menunjukan hasil yang menggembirakan. Upaya pengendalian selama ini masih bersifat top down dan kuratif. Sebagai solusi dari permasalahan tersebut adalah dengan promosi kesehatan cost effective. Model promosi kesehatan AILA (Antisipatif Anti Malaria) diharapkan mampu menurunkan kasus malaria di daerah endemis. Jenis penelitian ini adalah penelitian kuasi eksperimental. Tahap pertama yaitu mengembangkan model dengan melakukan studi pendahuluan, desk research melalui studi literatur untuk mendapatkan model awal. Lalu dilakukan wawancara dengan pakar untuk mendapatkan upaya pengelolaan tempat perindukan vektor malaria melalui pemberdayaan ekonomi produktif. Sebelum model promosi kesehatan AILA diimplementasikan, dilakukan workshop tingkat desa. Tahap kedua untuk melihat pengaruh dari model dengan studi kuantitatif Kuasi Eksperimen rancangan pretest-postest nonequivalent group design dengan sampel di kelompok imtervensi dan kelompok kontrol masing-masing 66 responden. Hasil penelitian kualitatif, kegiatan ekonomi produktif yang dilakukan adalah revitalisasi tambak terlantar dan laguna untuk ditanami ikan nila, menanam bakau, menimbun tempat genangan air serta mengalirkan kembali air ke laut dengan gotong royong. Dalam rangkaian pengembangan kapasitas masyarakat, tipe modal sosial yang sebelumnya bonding social capital telah berkembang menjadi bridging dan linking social capital. Hasil penelitian kuantitatif, dari uji t dependent, didapatkan bahwa skor pengetahuan, sikap dan perilaku responden pada pretest dan posttest pada kelompok intervensi maupun kelompok kontrol secara statistik berbeda bermakna (nilai p=0,000), hal ini menunjukan bahwa terjadi perubahan pengetahuan, sikap dan perilaku di kelompok intervensi maupun kelompok kontrol. Hasil MBS (Mass Blood Survey) menunjukkan penurunan terjadi kasus lebih tinggi di daerah intervensi dibandingkan daerah kontrol. Saran kepada Kementerian Kesehatan RI, agar Model Promosi Kesehatan AILA menjadi metode pencegahan malaria di daerah endemik yang terintergrasi dengan program pemberdayaan ekonomi produktif. Kepada Pemerintah Provinsi Lampung dan Kabupaten Pesawaran melalui Dinas Kesehatan membuat peraturan daerah mengenai pelaksanaan pencegahan malaria dengan menggunakan Model Promosi Kesehatan AILA Kata kunci : promosi kesehatan, pencegahan malaria, ekonomi produktif ABSTRACT ANTICIPATORY ANTI MALARIA HEALTH PROMOTION MODEL IN IMPROVING MALARIA PREVENTION BEHAVIOR IN ENDEMIC AREAS Aila Karyus Malaria disease is one of main public health problems in all over the world, especially in tropical countries of Asia and Africa continents. Malaria is able to cause severe anemia at pregnancy and even maternal mortality, low birth weight, and infant mortality. Pesawaran district is the most malaria endemic area in Lampung province. The highest malaria case occurred in Hanura public health center working area with annual parasite incident (API) of 48.75‰. The environmental condition that was supportive for malaria endemic, unsupportive public behavior, and poverty made malaria problems were difficult to overcome. Some interventions had been done to reduce malaria cases but it produced less favorable results. The disease controlling efforts had been top-down in nature and curative. One of the solutions was a cost effective health promotion. AILA (anticipatory anti malaria) health promotion model was expected to be able to reduce malaria case in endemic areas. This was a quasi experimental research. The first stage was to develop a model by conducting a preliminary study with a desk research by studying literatures to obtain an initial model. Interviews with experts were conducted to obtain management efforts for malaria vector breeding by empowering a productive economy. Before AILA health promotion was implemented, workshops in village level was conducted. In the second stage, a quantitative study of quasi-experiment was conducted with pretest-posttest non-equivalent group design and 66 respective respondent samples for intervention and control groups. Findings from the quantitative research, using the Independent t test, showed a significant statistical difference (Pvalue =0.000) regarding the score of knowledge, attitude and behavior during the pretest and posttest in intervention and control groups. In other words, there were significant increase of knowledge, attitude and behavior in both groups. MBS (Mass Blood Survey) showed a decrease in cases is higher in the intervention than the control areas. It is suggested for the Indonesia Ministry of Health to apply the AILA health promotion model to be one of the methods in malaria prevention program in endemic areas integrated with the empowerment of productive economic. The researchers also suggest local governments, Lampung province and Pesawaran district, to design regulation in regards to malaria prevention program using the AILA health promotion model. Keywords: health promotion, malaria prevention, productive economy
| Item Type: | Thesis (Doctoral) |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Pascasarjana (Disertasi) |
| Depositing User: | S3 Kesehatan Masyarakat |
| Date Deposited: | 29 Jul 2016 03:06 |
| Last Modified: | 20 Oct 2017 17:04 |
| URI: | http://scholar.unand.ac.id/id/eprint/13161 |
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