Evaluasi Program Desa Siaga Sehat Jiwa (DSSJ) di Wilayah Puskesmas Galur II Kabupaten Kulon Progo Yogyakarta

Abstract

Background: Community-based mental health services is a solution to bridging the limited access of the society to the healthcare facilities. Calculation of utilization of mental health healthcare at primary health care, secondary healthcare, and tertiary healthcare levels revealed a disparity of 90%. It means that only 10% of the mental health patients had been cared for by the healthcare facilities. Accordingly, primary healthcare facilities have become the spearhead in the implementation of mental healthcare since they can easily be accessed by the community due to geographical proximity, avoid the risk of stigma, and reduced the required cost. DSSJ program was an implementation of primary healthcare with the concept of community mental health nursing. Objective: The objective of the research is to describe implementation of DSSJ program in the working area of Puskesmas Galur II, Kulon Progo Regency. Method: This was a qualitative research using case study design. Informants were those individuals related to the DSSJ program from the planning to the implementation phase. The data were collected through in-depth interviews and observation. The research was conducted from November 2012 to January 2013. Results: Planning of the program was limited to the technical implementation phase and there is no plan for any annual monitoring and evaluation program. In general, no program had been implemented to improve human resource capacity at the level of both Health Center and Mental Hospital. The program was faced with some obstacles, including limited human resource, limitation on communication, fund, regionalism, and policy. The study found that the program could run consistently and continuously at the time when there are some university students had community internship at the Health Centers. Conclusion: The planning phase did not identify local human resource potentials and thus implementation was not optimum. Participation of educational institutions should be planned more thoroughly in line with DSSJ program for sustainability of the program.

Latar belakang. Pelayanan kesehatan jiwa berbasis komunitas merupakan salah satu solusi untuk menjembatani keterbatasan akses masyarakat ke fasilitas pelayanan kesehatan. Berdasarkan perhitungan utilisasi layanan kesehatan jiwa di tingkat primer, sekunder, dan tersier terdapat kesenjangan pengobatan sebesar 90%. Pelayanan kesehatan dasar ( puskesmas) merupakan ujung tombak dalam mengimplementasikan pelayanan kesehatan jiwa yang dapat dengan mudah dijangkau masyarakat karena akses yang dekat, mengurangi stigma, dan mengurangi biaya. DSSJ merupakan salah satu implementasi primary health care dengan pendekataan konsep community mental health nurse. Tujuan. Untuk mengetahui pelaksanaan program DSSJ di Wilayah Puskesmas Galur II Kabupaten Kulon Progo. Metode. Penelitian ini merupakan penelitian kualitatif dengan rancangan studi kasus. Informan penelitian ini adalah pihak- pihak yang terkait dalam program DSSJ berjumlah 16 orang. Data penelitian diambil dengan wawancara mendalam dan observasi. Penelitian dilakukan November 2012-Januari 2013 Hasil : Perencanaan program di RSG baru pada tahap pelaksanaan teknis kegiatan. Peningkatkan kapasitas SDM baik di puskesmas maupun RSG belum dilakukan. Terdapat beberapa hambatan dalam pelaksanaan program, diantaranya adalah faktor SDM, komunikasi, dana, kewilayahan, dan kebijakan. Penelitian menemukan bahwa program dapat berjalan secara konsisiten dan kontiyu pada saat mahasiswa institusi pendidikan melakukan praktek komunitas di puskesmas. Kesimpulan Perencanaan DSSJ belum mengidentifikasi potensi sumber daya setempat secara lebih luas dan tidak merencanakan monitor evaluasi tahunan. Implementasi belum dilaksanakan secara optimal. Adanya keterlibatan institusi pendidikan menjadikan program DSSJ lebih sustainable.