Evaluasi Faktor-faktor Pengelolaan Vaksin di Puskesmas dan Praktek Mandiri Bidan di Kabupaten Lampung Timur

Abstract

Abstrak Fasilitas pelayanan kesehatan dasar pemerintah dan swasta memiliki peran penting dalam menjaga mutu vaksin sebelum diberikan kepada sasaran imunisasi. Vaksin yang berkualitas menentukan keberhasilan program imunisasi. Dalam penelitian ini evaluasi dilakukan terhadap faktor-faktor yang mempengaruhi kualitas vaksin di Puskesmas dan Praktik Mandiri Bidan (PMB) di Kabupaten Lampung Timur. Desain penelitian adalah potong lintang dengan populasi berupa instansi atau fasilitas pengelola vaksin imunisasi dasar, sedangkan sampel meliputi 10 Puskesmas dan 30 PMB yang dipilih secara purposif. Pengumpulan data dilakukan melalui pengisian kuesioner mandiri, wawancara mendalam dan observasi. Wawancara mendalam dilakukan terhadap 16 orang pengelola vaksin puskesmas dan PMB yang dipilih secara purposif berdasarkan kesediaan mereka menjadi informan. Analisis data kuantitatif dilakukan secara deskriptif sedangkan data kualitatif diolah dengan metode konten analisis. Kegiatan diakhiri dengan focus group discussion (FGD) terhadap 20 orang informan secara purposif. Penelitian dilakukan pada bulan Agustus sampai Desember 2020 di 10 kecamatan di Kabupaten Lampung Timur. Berdasarkan hasil observasi, seluruh vaksin memiliki mutu yang baik di 10 puskesmas dan 20 Praktik Mandiri Bidan (PMB). Akan tetapi tingkat pengetahuan, sarana prasarana penyimpanan dan distribusi vaksin, SOP, proses pelatihan, sosialisasi, supervisi dan bimbingan teknis belum optimal khususnya di PMB. Secara umum kualitas vaksin masih memenuhi syarat namun pengetahuan pengelola vaksin, penyediaan dan kepatuhan SOP perlu ditingkatkan baik di puskesmas maupun di PMB. Selain itu, perlu peningkatan ketersediaan sarana parasarana penyimpanan dan distribusi vaksin terutama di PMB. Peningkatan kapasitas pengelolaan vaksin perlu dilakukan melalui proses pelatihan, supervisi dan bimbingan teknis bekerjasama dengan organisasi profesi. Kata Kunci: Mutu Vaksin, Puskesmas, PMB, Lampung Timur Abstract Both public and private basic health care facilities play an important role in maintaining the quality of vaccines which determines the success of the immunization program. In this study, an evaluation was carried out on the factors influencing the quality of vaccines at the community health center (CHC) and the Independent Midwife Practice (IMP) in the East Lampung Regency. The research design was cross-sectional using the population of institutions or facilities managing basic immunization vaccines and purposively selected samples of 10 Puskesmas and 30 IMPs. Data were collected through self-administered questionnaires, in-depth interviews, and observations. Depth, interviews were conducted with 16 vaccine managers at the Puskesmas and IMPs who were also selected purposively. Quantitative data was processed descriptively while qualitative data were analyzed using the content analysis method and finalized by a focus group discussion (FGD) for 20 purposively chosen informants. The study was conducted from August to December 2020 in 10 sub-districts in East Lampung Regency. Based on the observations, all vaccines had good quality in 10 Puskesmas and 20 IMPs. However, the level of knowledge, facilities for storing and distributing vaccines, SOPs, training processes, socialization, supervision, and technical guidance have not been optimal, especially in IMPs. The quality of vaccines is generally still as the requirements, yet the knowledge of vaccine managers as well as the provision and compliance with SOPs needs to be improved in both CHCs and IMPs. The availability of vaccine storage and distribution facilities at PMB and strengthening SOPs related to vaccine management are necessary. Capacity building needs to be done through training, supervision, and technical guidance in collaboration with professional organizations. Keywords: vaccine quality, Community Health Center, Independent Midwife Practice, East Lampung Regency