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ABSTRAKPermasalahan penelitian: HIV/AIDS dan Hepatitis B merupakan masalah kesehatan masyarakat yang sangat penting karena belum ditemukan obatnya sampai saat ini. Ibu usia subur, khususnya yang berpenghasilan rendah pengunjung Puskesmas semakin rentan terhadap risiko penularan kedua penyakit tersebut. Sampai saat ini belum ada model upaya promotif dan preventif di Puskesmas yang mengintegrasikan pelayanan penyakit hubungan seksual (PHS) ke dalam pelayanan Puskesmas (BP/KIA/KB).
Tujuan penelitian: Mengembangkan model intervensi guna menurunkan risiko infeksi PHS termasuk HIV/AIDS dan Hepatitis B bagi ibu usia reproduksi, ibu hamil dan peserta keluarga berencana yang berpenghasilan rendah melalui keterpaduan program PHS dengan program kesehatan reproduksi di klinik KIA/KB dan BP di Puskesmas daerah pedesaan dan perkotaan.
Metode Penelitian: Desain penelitian ini adalah Kuasi eksperimen, yaitu one group pre dan post test tanpa kelompok kontrol, dimana dilakukan observasi awal, intervensi. dan observasi akhir. Pengumpulan data yang dilakukan pada observasi awal adalah sebagai berikut: a) studi kualitatif, yaitu Wawancara Mendalam terhadap 4 dokter Puskesmas. Diskusi Kelompok Terarah (DKT) bidan/perawat Puskesmas sebanyak 4 kelompok (6-8 orang/kelompok), dan DKT ibu usia reproduksi pengunjung BP/Klinik KIA/KB sebanyak 8 kelompok (6-10 orang/kelompok), b) Observasi pada pelayanan BP/KIA/KB Puskesmas. c) survei PSP (Pengetahuan, Sikap, dan Praktek) terhadap 400 ibu pengunjung BP/Klinik KIA/KB yang dipilih secara acak. d) skrining terhadap 1.200 ibu pengunjung BP/Klinik KIA/KB Puskesmas terutama untuk mengindentifikasi Trichomonas dan Gonorrhoe, juga infeksi PHS lainnya. Lokasi penelitian ini adalah di 4 wilayah Puskemas, yaitu 2 Puskesmas perkotaan (Puskesmas Kec. Ciracas dan Puskesmas Kec. Koja di DKI Jakarta) dan 2 Puskesmas pedesaan (Puskesmas Kec. Pamanukan, Kai). Suhang dan Puskesmas Kec. Pulomerak, Kab. Serang di Jawa Barat).
ABSTRACTThe research problem:
HIV/AIDS and Hepatitis B are becoming two major and critical public health problems. Unfortunately, up to now there is no cure for these two diseases. The low income married women of reproductive age (MWRA) are becoming more and more susceptible to the risk of infection of sexually transmitted diseases (STDs) including HIV/ AIDS. So far, a model of integrating STD services into the existing ambulatory/ mother & child health (MCH)/ family planning (FP) services in the Puskesmas is presently unavailable.
The research objectives:
To develop an intervention model iii reducing the risk of STDs including HIV/AIDS and Hepatitis B infection for low income MWRA through integrating STD services into MCHl/FP services in the Puskesmas both for urban as well as rural areas.
Methodology:
The design of the study is one group pre and post test without a control group (a Quasi-experimental design). A measurement was conducted at the beginning of the study then followed by intervention and evaluation/ measurement after the intervention. Three different measurements were conducted prior to the intervention period namely both qualitative and quantitative study (survey) and STD screening. During the qualitative study, an in-depth interview was conducted for 4 Puskesmas doctors and a series of focus group discussions (FGD) was performed. Four (4) FGDs for midwives and nurses of the Puskesmas and four (4) FGDs for MWRA attending ambulatory, MCH and FP clinic of the Puskesmas. Each FGD consisted of 6 - 10 participants.
A survey of Knowledge, Attitude and Practice (KAP) was conducted among 400 MWRA visiting the four Puskesmas which were randomly selected. In addition, screening for STDs (except syphillis aiid HIV/AIDS) using wet-mount and Grain staining techniques were performed among 1200 MWRA visiting the Puskesmas both in the urban and in the rural areas.
Location of the study were two Puskesmas in the urban areas namely Puskesmas Kec. Koja and Ciracas of the Metropolitan Municipality of Jakarta. For the rural areas Puskesmas Pulomerak (district Serang) and Pamanukan (district Subang) from West Java were selected to participate in this study."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 1994
