Cost Effectiveness Upaya Penanggulangan Gizi Metode Positif Deviance dan Pemberian Makanan Tambahan di Puskesmas Gekbrong Kabupaten Cianjur 2006 - Suharyati, Suharyati (Kesmas, 2007)
Provinsi Jawa Barat masih menghadapi masalah rawan gizi serius, terlihat pada 18.094 balita rawan pangan yang terhimpun di tiga kantong utama, Kabupaten Cirebon (4.005), Bandung (2.991) dan Cianjur (2.670). Di Kabupaten Cianjur, balita gizi buruk dan gizi kurang ditemukan 2.670 (1,3%) dan 24.447 (11,7%) dari 208.572 balita yang ada. Tujuan penelitian ini membandingkan cost effectiveness upaya perbaikan gizi pemberian Makanan Tambahan (PMT) yang bersifat top down dan Positive Deviance (PD) yang besifat bottom up. Data ditinjau dari sisi provider dan perhitungan biaya peraktifitas menggunakan metoda Activity Based Costing (ABC Methode). Komponen biaya penanggulangan gizi terbesar berturut-turut adalah biaya operasional, investasi dan pemeliharaan (85%, 14,5% dan 0,3%). Metoda PD memerlukan waktu 54 hari dan metoda PMT 102 hari. Rata-rata kenaikan berat badan (BB) selama tiga bulan pada metoda PD (920 gram) adalah lebih besar daripada metoda PMT (650 gram). Rata-rata kenaikan BB pada bulan I, II, dan II, pada metoda PD (470, 220 dan 230 gram) adalah lebih tinggi daripada metoda PMT (300, 170 dan 180 gram). Kenaikan BB balita dalam 3 bulan berdasar pita warna KMS, BB sangat kurang dan kurang pada PD (54%, 17%) lebih rendah daripada PMT (78%, 22%). Nilai CER metoda PD (Rp 446.828,- /balita) terlihat lebih kecil daripada metoda PMT (Rp 768.887,-/balita). Disimpulkan bahwa metoda PD lebih cost effective daripada metoda PMT. The Province of West Java still faces serious malnutrition problem that can be seen in 18094 cases of under 5 years old children who suffer from malnutrition particularly in districts of Cirebon (4005), Bandung (2991) and Cianjur (2670). In Cianjur it was found that 2670 (1.3%) cases of severe under-nutrition and 24447 (11.7%) cases of under-nutrition out of 208572 children. The objective of this study is to compare the cost effectiveness between positive deviance (PD) and food supplementation (PMT) methods. The data were observed from the provider side using Activity Based Costing (ABC) method. The study shows that the biggest cost component is the operational cost (85%), investment cost (14.5%) and maintenance cost (0.3%). The time frame for PD method (54 days) is shorter than that of PMT method (102 days). The average body weight gain in three months, the PD method (920 grams) is smaller than that of PMT method (650 grams). The monthly average gain in the first, second and third for the PD method (470, 220 and 230 grams) is higher than that of the PMT method (300, 170 and 180 grams). From growth chart (KMS) in three months, below red line (BGM) and under-weight in the PD method (54%, and 17%) is lower than the PMT (78% and 22%). The CER value for PD method is Rp 446,828,-/child, lower than that of the PMT method ( Rp 768,887,-/child). It was concluded that PD method is more cost effective than PMT method.