Afifa, Irma and Dr. Lilik Zuhriyah,, SKM, M.Kes; and dr. Muljo Hadi Sungkono,, SpOG(K) (2019) Perbandingan Lama Menjadi Kader Terhadap Kinerja Kader Posyandu yang Dimediasi Pengetahuan dan Motivasinya pada Pencegahan Stunting di Puskesmas Pagelaran dan Gedangan. Magister thesis, Universitas Brawijaya.
Abstract
Stunting merupakan kondisi gizi kronis dengan indikator panjang atau tinggi badan menurut umur dengan nilai z-score kurang dari-2SD. Stunting dapat berdampak pada terganggunya tumbuh kembang balita. Salah satu penyebab terjadinya stunting dikarenakan kurangnya pengetahuan ibu dalam mengoptimalkan pemberian gizi dan nutrisi selama periode 1000 Hari Pertama Kehidupan. Kurangnya pengetahuan tersebut dapat diatasi dengan pemberian edukasi gizi oleh kader posyandu. Berdasarkan pilar penanganan stunting disebutkan bahwa pemberdayaan kesehatan masyarakat dilakukan dengan melibatkan kader posyandu. Kader posyandu berwewenang untuk memberikan penyuluhan gizi ataupun kesehatan kepada ibu hamil, menyusui, dan ibu balita. Berdasarkan latar belakang tersebut, penelitian ini bertujuan untuk mengetahui peranan pengetahuan, motivasi, lama menjadi kader terhadap kinerja kader pada program pencegahan stunting. Penelitian dilakukan di wilayah Puskesmas Pagelaran dan Puskesmas Gedangan dikarenakan Puskesmas Pagelaran memiliki prevalensi stunting tertinggi di Kabupaten Malang,sedangkan Puskesmas Gedangan memiliki prevalensi stunting terendah di Kabupaten Malang. Kabupaten Malang juga termasuk dalam 100 wilayah prioritas stunting. Penelitian ini dilakukan dengan cara membandingkan peranan lama menjadi kader, motivasi, pengetahuan, dan kinerja kader pada program pencegahan stunting di masing-masing wilayah Puskesmas Pagelaran dan Gedangan. Metode penelitian ini menggunakan penelitian observasional analitik dengan pendekatan studi komparatif. Data dianalisis menggunakan uji beda untuk membandingkan variabel lama menjadi kader, pengetahuan, motivasi, dan kinerja kader. Sebelum dilakukan analisis uji beda terlebih dulu variabel tersebut dilakukan transformasi data MSI dari data ordinal menjadi data interval. Perbandingan mekanisme peranan lama menjadi kader terhadap kinerja kader yang dimediasi pengetahuan dan motivasi kader di masing-masing wilayah Puskesmas Pagelaran dan Gedangan dianalisis menggunakan analisis jalur. Sebelum dilakukan uji analisis tersebut terlebih dulu dilakukan uji homogenitas pada karakteristik kader meliputi usia, pendidikan, dan pekerjaan. Data dianalisis menggunakan SPSS windows 25. Penelitian menghasilkan karakteristik demografi kader posyandu Pagelaran dan Gedangan teridentifikasi sebagian besar berusia 34-40 tahun, berpendidikan SMP dan bekerja sebagai ibu rumah tangga. Pengetahuan kader posyandu Puskesmas Pagelaran berbeda dengan pengetahuan kader posyandu Puskesmas Gedangan. Nilai mean pengetahuan kader posyandu Pagelaran (69.96) lebih rendah dibandingkan nilai mean pengetahuan kader posyandu Puskesmas Gedangan (79,44). Motivasi kader posyandu kedua puskesmas tidak berbeda signifikan (p>0,05). Meskipun demikian motivasi kader posyandu Puskesmas Gedangan (43,17) diketahui lebih tinggi dibandingkan motivasi kader posyandu Puskesmas Pagelaran (41,78) berdasarkan skor nilai mean motivasi kader. Lama menjadi kader tidak terbukti berbeda signifikan (p>0,05) pada kedua puskesmas. Namun, hasil mean lama menjadi kader menunjukkan kader posyandu di Puskesmas Pagelaran ( 2.17) memiliki durasi waktu yang lebih lama menjadi kader dibandingkan kader posyandu di Puskesmas Gedangan (2,08). Kinerja kader posyandu berbeda signifikan (p<0,05) di kedua wilayah Puskesmas Pagelaran dan Gedangan dengan perolehan nilai mean kinerja kader posyandu Puskesmas Gedangan (86,27) lebih tinggi dibandingkan kader posyandu Puskesmas Pagelaran (80,22).Mekanisme peran pengetahuan, motivasi, dan perananan lama menjadi kader dalam menentukan kinerja kader berbeda antara Puskesmas Pagelaran dan Puskesmas Gedangan. Pada Puskesmas Pagelaran variabel lama menjadi kader tidak berpengaruh terhadap pengetahuan, motivasi, dan kinerja kader. Hanya didapatkan pengaruh pengetahuan dan motivasi kader terhadap kinerja kader. Pada Puskesmas Gedangan lama menjadi kader berpengaruh terhadap pengetahuan kader, meskipun pengetahuan kader tidak berpengaruh terhadap kinerja kader. Lama menjadi kader juga tidak berpengaruh terhadap motivasi dan kinerja kader. Hanya didapatkan variabel motivasi kader yang berpengaruh terhadap kinerja kader. Hal ini dapat disimpulkan meskipun terdapat perbedaan mekanisme jalur di masing masing wilayah Puskesmas, namun di kedua wilayah tersebut variabel pengetahuan dan motivasi tidak terbukti sebagai variabel mediasi lama menjadi kader terhadap kinerja kader. Hasil analisis jalur motivasi kader Puskesmas Pagelaran berpengaruh (r=0,318), sedangakan motivasi kader di Puskesmas Gedangan berpengaruh (r=0,331) terhadap kinerja kadernya. Berdasar hasil analisis tersebut motivasi kader di wilayah Puskesmas Gedangan lebih tinggi dibandingkan motivasi kader di wilayah Puskesmas Pagelaran. Adapun angka kejadian stunting di kedua puskesmas tersebut dari tahun 2017-2018 juga menunjukkan bahwa penurunan angka kejadian stunting lebih signifikan terjadi di Puskesmas Gedangan dibandingkan Puskesmas Pagelaran. Pada tahun 2017 angka kejadian stunting di Puskesmas Gedangan pada tahun 2017 sebanyak 32.577 balita menjadi 11.101 balita. Angka kejadian stunting di Puskesmas Pagelaran sebanyak 27.374 balita menjadi 26.052 balita di tahun 2018.
English Abstract
Stunting is a chronic nutritional condition based on indicator of length or height according to age with z-score less than -2SD. Stunting could have impact to toddler growth disruption. One of the causes of stunting is the lack of mothers knowledge in optimizing the provision of nutrition during the First 1000 Days of Life period. This lack of knowledge could be overcomed by health volunteer to provide nutritional education. Based on the stunting intervention, it was stated that community health empowerment was carried out by involving health volunteer. Health volunteer have the authority to provide nutrition or health counseling to pregnant woman, lactating woman, and newly mother. Based on this background, this study aims to determine the role of health volunteer knowledge, motivation, time period, and performance on stunting prevention programs. The study was conducted in the Puskesmas Pagelaran and Puskesmas Gedangan because Puskesmas Pagelaran had the highest stunting prevalence in Malang Regency, while the Puskesmas Gedangan had the lowest stunting prevalence in Malang Regency. Malang Regency was included in the 100 priority areas of stunting. Therefore, this study was conducted by comparing long time as health volunteer, motivation, knowledge, and performance on stunting prevention program in Puskesmas Pagelaran and Puskesmas Gedangan. This study used observational analytic research with comparative study approach. This study used comparation analysis test to compare long time as health volunteer, health volunteer knowledge, motivation, and performance. Before analyzing the comparation tests, the variable was transformed into Interval Successive Method to convert ordinal data into interval data. The relationship pattern in each Puskesmas Pagelaran and Puskesmas Gedangan was compared using path analysis. Before the test was carried out, the homogeneity test was due first on health volunteer characteristics included age, education and employment. Data was analyzed using SPSS windows 25. The study showed that demographic characteristics of health volunteer in Puskesmas Pagelaran and Gedangan, mostly aged 34-40 years, having junior high school education and working as housewives. The knowledge of health volunteer in Puskesmas Pagelaran (p<0,05) was significantly different from the knowledge of health volunteer in Puskesmas Gedangan. The mean value of health volunteers knowledge in Puskesmas Pagelaran (69,96) was lower than the mean value of health volunteers knowledge in Puskesmas Gedangan (79,44). Both of health volunteers motivation in Puskesmas Pagelaran and Puskesmas Gedangan (p>0,05) were not significantly different. Nevertheless the health volunteers motivation in Puskesmas Gedangan (43,17) higher than the health volunteers motivation in Puskesmas Pagelaran (41,78) based on the health volunteer motivations mean value. The duration of being a health volunteer (p>0,05) did not prove significantly different in both Puskesmas Pagelaran and Puskesmas Gedangan. However, long time as a health volunteer mean value showed that health volunteers period in Puskesmas Pagelaran (2,17) longer than health volunteers period in Puskesmas Gedangan (2,08). The performance of health volunteer (p<0,05) was proved different significantly in both Puskesmas Pagelaran and Puskesmas Gedangan. The performance of health volunteer in Puskesmas Gedangan (86,27) has higher mean value than health volunteers performance in Puskesmas Pagelaran (80,22). The relationship pattern of health volunteer knowledge, motivation, and the long time as health volunteer and health volunteer performance was found different between Puskesmas Pagelaran and Puskesmas Gedangan. The long time as health volunteer in Puskesmas Pagelaran was not correlated to health volunteer knowledge, motivation, and performance. Its just health volunteer knowledge and motivation which correlated to health volunteer performance. The long time as health volunteer in Puskesmas Gedangan was correlated to health volunteers knowledge, but its not correlated to health volunteer performance. The long time as health volunteer was not correlated to health volunteer motivation and performance. Its just knew that the health volunteer motivation only which correlated to health volunteer performance. These could be concluded even though there were different relationship pattern in each Puskesmas Pagelaran and Puskesmas Gedangan, but in both regions the health volunteer knowledge and motivation variables were not proven to be the mediated variables between long time as helath volunteer and health volunteer performance. Based on the path analysis test, health volunteers motivation in Puskesmas Gedangan higher than the health volunteers motivation in Puskesmas Pagelaran. Thats correlated to stunting incidence rate in both Puskemas Pagelaran and Puskesmas Gedangan at 2017-2018, which the stunting incidence rate in Puskesmas Gedangan (32.577-11.101 childs) was better significantly decreased than stunting incidence rate in Puskesmas Pagelaran (27.374-26.052 childs).
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/362.042 5/AFI/p/2019/041906306 |
| Subjects: | 300 Social sciences > 362 Social problems of and services to groups of people > 362.04 Special topics of social problems of and services to groups of people > 362.042 Social problems > 362.042 5 Social action |
| Divisions: | S2/S3 > Magister Kebidanan, Fakultas Kedokteran |
| Depositing User: | soegeng sugeng |
| Date Deposited: | 24 Aug 2022 07:11 |
| Last Modified: | 24 Aug 2022 07:11 |
| URI: | http://repository.ub.ac.id/id/eprint/193526 |
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