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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 928 Documents
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Faktor - faktor yang Berhubungan dengan Kepatuhan Petugas terhadap SOP Imunisasi pada Penanganan Vaksin Campak Yulianti, Dini; Achadi, Anhari
Kesmas Vol. 4, No. 4
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Campak adalah penyakit yang sangat menular dan menjadi salah satu penyebab utama kematian anak di negara berkembang termasuk Indonesia. Imunisasi campak di Indonesia telah berhasil dilaksanakan dengan baik, tetapi ternyata masih banyak ditemukan kasus campak di beberapa daerah. Salah satu faktor yang diduga menjadi penyebabnya adalah daya guna vaksin yang tidak maksimal karena sistem rantai vaksin yang sangat menentukan untuk pengamanan mutu vaksin tidak berfungsi dengan baik atau para petugas imunisasi tidak melakukan penanganan vaksin sesuai dengan prosedur yang telah ditentukan. Berdasarkan atas kenyataan ini, dilakukan penelitian mengenai faktor-faktor yang berhubungan kepatuhan petugas imunisasi terhadap SOP (Standard Operating Procedure) imunisasi dalam penanganan vaksin campak di Kabupaten Kebumen pada tahun 2009. Variabel yang diteliti adalah pendidikan, pelatihan, lama kerja, pengetahuan, sikap, motivasi, imbalan, persepsi kepemimpinan, supervisi dan sarana. Penelitian ini menggunakan pendekatan kuantitatif, dilakukan secara cross sectional dengan sampel seluruh total populasi sebanyak 69 responden, serta menggunakan data primer yang diperoleh melalui observasi dan wawancara. Hasil penelitian menunjukkan sebesar 60,9% petugas dapat dikategorikan patuh. Variabel independen yang memiliki hubungan yang bermakna secara statistik dengan kepatuhan petugas adalah pendidikan, pengetahuan, imbalan dan sarana. Pengetahuan dan sarana merupakan faktor yang paling dominan berhubungan dengan kepatuhan petugas, masing-masing dengan nilai OR sebesar 5,195 dan 5,287. Measles is one of the infectious diseases that pose as primary cause of death among children in developing countries, including Indonesia. Measles immunization program in Indonesia has been done relatively well, but the fact shows that there are still cases of measles found in several areas. It is suspected that vaccine’s efficiency is not optimal due to the ineffective cold chain system, or the vaccine officer does not administer vaccine following the established procedures. In turns, those aspects caused ill-functioning of vaccine system. Based on this fact, this study is carried out with to find out factors which are associated with vaccine officer’s compliance to the standard operating procedure of immunization in administrating measles vaccine in District of Kebumen in 2009. Variables of this study are education, training, work duration, knowledge, attitude, motivation, incentive, leadership perception, supervision and facility. This study is applying quantitative approach using cross sectional method. All the population (69 respondents) was taken as sample, and the primary data were solicited through observation and interview. The result of this study shows that the compliance rate of the officers is 60.9%. Independent variables which are significantly associated with officer’s compliance are education, knowledge, incentive and facility. Knowledge and facility are the two dominant factors associated with officer’s compliance, with ORs of 5.195 and 5.287, respectively.
Perencanaan Penanggulangan Keadaan Darurat Transportasi Darat Bahan Kimia Butadien Rute Bojonegara - Cengkareng pada PT X Indonesia Roza, Nelvy; Lestari, Fatma
Kesmas Vol. 4, No. 4
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PT X Indonesia mentransport butadien dari terminal penimbunan di Bojonegara ke pengolahan di Cengkareng. Penelitian ini bertujuan mengidentifikasi potensi bahaya, memprediksi risiko, dan mengevaluasi prosedur penanggulangan keadaan darurat. Sampel diambil di salah satu rute perjalanan Bojonegara - Cengkareng. Data diperoleh dari observasi, wawancara, catatan, pelaporan dan prosedur penanggulangan keadaan darurat. Rencana penanggulangan keadaan darurat dianalisis secara kualitatif dengan membandingkan PT X Indonesia dengan standar Manitoba Industrial Accidents Council dan Advisory Committee on the Transport of Dangerous Goods - Prosedur penanggulangan keadaan darurat meliputi kebijakan perusahaan, analisa risiko, organisasi, sarana dan prasarana, tindakan penanggulangan serta pelatihan dan simulasi. Hasil penelitian menunjukkan perusahaan telah menetapkan prosedur tindakan keadaan darurat yang sudah dikaji, direvisi dan didistribusikan kepada semua personil terlibat. Risiko diidentifikasi berdasarkan penelusuran Material Safety Data Sheet dan Transport Emergency Card. Perusahaan menetapkan tim tanggap darurat dengan program pencegahan antara lain pemeriksaan kendaraan sebelum berangkat, penentuan kualifikasi pengemudi, dan kondisi kendaraan. Perusahaan menyediakan peralatan keadaan darurat seperti pemadam kebakaran, safety shoes, helm, dan sarung tangan, membekali pengemudi pengetahuan tindakan dalam keadaan darurat. Pelatihan dan simulasi perlu ditingkatkan khususnya penanggulangan keadaan darurat angkutan butadien. PT X Indonesia transports butadiene from its storage terminal in Bojonegara to processing plant in Cengkareng. This research identified potential hazard during butadiene transport, evaluate risk, and evaluate the emergency response preparedness during butadiene transport. Sample is taken from one route from Bojonegara to Cengkareng and data were obtained from observation, interview, records, reports and emergency response preparedness procedure. Qualitative and comparative analysis was conducted between existing emergency response procedures at PT X Indonesia with Manitoba Industrial Accidents Council Standards and Advisory Committee on the Transport of Dangerous Goods - Australia. Elements analysed including company policy, risk analysis, organization, facilities and equipment, emergency response steps, training and emergency drill. Results suggested that company’s policy has been set up for emergency response procedure and has been reviewed, revised, and distributed to all related parties. Risk analysis conducted using hazard identification method by reviewing Material Safety Data Saheet and Transport Emergency Card to determine butadiene toxicity, carcinogenicity, and flammability. Consequences analysis was conducted based on worst case scenario of Boiling Liquid Expanding Vapour Explosion. Emergency Response Preparedness organization was established. Accident prevention was also implemented such as tank inspection, driver’s qualification, and tank condition inspection. Emergency response equipment and facilities included fire extinguishers, safety shoes, helm, and gloves that included emergency steps, knowledge to the driver regarding emergency response . Emergency drill element should be improved, as existing drill not specific for butadiene transport emergency response.
Pengetahuan dan Praktek Keluarga Sadar Gizi Ibu Balita Fatmah, Fatmah
Kesmas Vol. 4, No. 4
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Untuk mengantisipasi masalah gizi kurang utamanya pada keluarga miskin, pemerintah telah mengeluarkan gerakan Kadarzi (Keluarga Sadar Gizi). Hingga saat ini, hampir tidak diketahui perilaku Kadarzi ibu balita di DKI Jakarta karena masih sedikitnya data hasil penelitian yang mengukur hal tersebut. Oleh karena itu, diperlukan suatu penelitian dasar yang bertujuan untuk mengeksplorasi bagaimana gambaran pengetahuan dan praktek kelima indikator Kadarzi ibu balita di Kelurahan Penjaringan, Jakarta Utara. Metode kualitatif dengan teknik Diskusi Kelompok Terarah (DKT) dan wawancara mendalam telah dilakukan pada ibu balita, tokoh agama/masyarakat, dan kader posyandu. Hasil studi menyatakan bahwa pengetahuan ibu balita pada 4 indikator Kadarzi cukup baik, kecuali konsumsi aneka ragam makanan. Praktek 3 indikator Kadarzi juga sudah baik, kecuali pemberian ASI eksklusif dan konsumsi aneka ragam makanan. Tokoh masyarakat dan kader posyandu belum mengenal indikator Kadarzi dengan baik. Mereka hanya sebatas mendengar dan tidak familiar dengan istilah Kadarzi. Kadarzi identik dengan makanan 4 sehat 5 sempurna bagi balita dan ibu hamil untuk meningkatkan status gizi dan kesehatan masyarakat. Disimpulkan bahwa ibu balita belum berperilaku Kadarzi karena belum mengaplikasikan lima indikator Kadarzi. Disarankan agar Sudinkes Wilayah Jakarta Utara melakukan sosialisasi Kadarzi lebih intensif lagi bagi masyarakat melalui media cetak dan elektronik di posyandu dan puskesmas. Poor family in Jakarta is a vulnerable group faced undernutrition problem with poor sanitation and health due to poverty. To anticipate it, the government has declared Kadarzi (Nutrition Awareness Family) movement. Up to now, mother’s behavior on Kadarzi in poor urban villages areas in DKI Jakarta were almost unknown which caused by limited data studied about Kadarzi. Therefore, it was necessary to conduct a study aimed to explore how is the knowledge and practice of Kadarzi’s five indicators among underfives mothers at Penjaringan Village, Penjaringan Sub-district, North Jakarta. The study used qualitative data techniques through Focus Group Discussion (FGD) and in-depth interviews. Informants of the study were mother of underfive children, religious/community leaders, and posyandu cadres. The study revealed that the majority of informants had low knowledge and practice of Kadarzi due to lack of socialization from community health centers. They were unfamiliar with the terminology of Kadarzi. They considered that Kadarzi was identical with four healthy and five perfect for toddlers and pregnant women to improve their nutrition and health status. It was recommended to District Health Office of North Jakarta City to disseminate Kadarzi information for the community through printed and electronic media.
Faktor Dominan yang Mempengaruhi Kejadian Malaria di Perdesaan Susanna, Dewi; Eryando, Tris
Kesmas Vol. 4, No. 4
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KLB malaria selama periode 1998-2003 telah menyerang 15 propinsi yang meliputi 84 desa endemis dengan jumlah penderita 27.000 dengan kematian 368. Hewan besar seperti sapi, kerbau dan kuda adalah merupakan cattle barrier malaria. Hewan tersebut perlu diteliti agar dapat diketahui jenis hewan dan tempat hidup hewan (kandang) terhadap kejadian malaria. Tujuan umum penelitian ini adalah untuk mengetahui faktor dominan yang mempengaruhi kejadian malaria di pedesaan. Jenis penelitian adalah non-intervensi, merupakan analisis lanjut data sekunder yaitu “Riset Kesehatan Dasar 2007”. Subyek yang dianalisis sebanyak 618.593 yang bertempat tinggal di perdesaan. Analisis dilakukan dengan metoda multivariat menggunakan regresi logistik. Ternak dibagi menjadi empat kategori, yaitu unggas (ayam, burung, dan bebek/itik), ternak besar (sapi, kuda, dan kerbau), ternak sedang (babi, domba,dan kambing), dan ternak kecil (kucing, anjing, dan kelinci). Faktor yang paling dominan mempengaruhi kejadian malaria adalah kepemilikan ‘ternak sedang’ (kambing, babi, dan domba), dengan OR = 0,52 (0,50-0,54). Faktor yang paling dominan mempengaruhi kejadian malaria adalah tidak adanya ‘ternak sedang, yaitu kambing, babi, dan domba. Malaria outbreak in the period of 1998-2003 was occurred in 15 province including 84 endemic villages with number of cases of 27 000 and deaths of 368. Big cattles such as cow, horse and buffalo have been known as cattle barrier for malaria, while others have not been investigated yet. The objective of this research was to know the dominant factor related to cattle which influenced malaria in village area. The secondary data from ‘Riset Kesehatan Dasar 2007” had been used in this research with total population of 618593 who lived in village area and was analyzed using logistic regression test. Cattle as independent variable was divided into four categories, they were poultry (chicken, bird, and duck), big cattle (cow, horse and buffalo), medium cattle (pig, sheep, and goat), and small cattle (cat, dog, and rabbit). The most dominant factor for protection of malaria was medium cattle (pig, sheep, and, goat) as protective with Odds Ratio of 0.52 (0.50-0.54). The other cattle had Odds Ratios less than 2, although they had p value < 0.05. The medium cattle was the dominant factor influenced malaria in village area, while others did not have effect.
Langkah Kedepan Mempercepat Penurunan Kematian Ibu di Indonesia Achadi, Anhari
Kesmas Vol. 4, No. 4
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Kematian ibu tidak hanya menjadi masalah kesehatan masyarakat, tetapi juga menjadi masalah sosial karena akan berpengaruh besar terhadap keluarga, terutama anak-anak. Di negara maju dengan status sosial ekonomi yang tinggi kematian ibu telah turun mencapai tingkat minimal kurang dari 10 per 100.000 kelahiran hidup. Hal tersebut belum terjadi di negara-negara berkembang, termasuk Indonesia. Di samping pertumbuhan ekonominya yang terus membaik, kematian ibu di Indonesia masih tergolong tinggi, bahkan di antara sesama negara Asia Tenggara. Berdasarkan data SDKI, telah terjadi penurunan angka kematian ibu, tetapi dengan penurunan seperti sekarang target Pembangunan Milenium tidak akan tercapai. Dari aspek demand, supply, maupun kebijakan, penurunan kematian ibu masih mengalami berbagai hambatan. Untuk mempercepat penurunan kematian ibu perlu dikembangkan kebijakan yang dapat mengatasi hambatan utama berupa kelangkaan petugas pelayanan kesehatan yang terampil, infrastuktur pelayanan kesehatan ibu yang belum memadai, kualitas pelayanan yang sub-standar, dan keengganan para ibu untuk menggunakan fasilitas pelayanan kebidanan karena biaya yang sangat tinggi dan pelayanan yang masih buruk atau karena masih lebih menyukai pelayanan dukun dengan berbagai alasan lingkungan yang spesifik. Dalam mempercepat penurunan kematian ibu, kebijakan dan manajemen di tingkat kabupaten berperan sangat menentukan. Maternal mortality is both public health and social problem. The death of a mother will affect the family, especially the children. In the developed countries, with their high socio-economic status, maternal deaths have declined to its minimal level, less than 10 deaths among 100,000 life births. That is not the case in the developing countries, Indonesia included. Despite its continued economic growth, maternal death in Indonesia is still high, even within Southeast Asian countries. According to IHDS data, maternal mortality eduction happened over time, however, with its current rate of decline the MDGs target on maternal mortality will unlikely be met. Maternal mortality reduction is still facing various demand, supply, and policy constraints. In order to accelerate maternal mortality reduction, policies are required to overcome various barriers, which include shortage of skilled health providers, inadequate maternal health infrastructures, sub-standard service quality, and unwillingness women to use maternity facilities due to its high cost and inadequate services, or their preference towards traditional birth attendant (TBA) services. Role of district policies and management on maternal health is crucial in accelerating maternal death reduction.
Kesehatan Jiwa yang Terabaikan dari Target Milenium Idaiani, Sri
Kesmas Vol. 4, No. 3
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Millenium Development Goals (MDG) yang dicanangkan pada tahun 2000 sangat didominasi oleh penyakit menular serta kesehatan ibu dan anak, tetapi mengabaikan berbagai masalah penyakit tidak menular. Tidak sedikitpun terlintas dalam benak para pemimpin dunia itu target dan indikator yang menyentuh atau berhubungan dengan masalah kesehatan jiwa. Tulisan ini bertujuan membahas posisi kesehatan jiwa di seluruh dunia yang cenderung semakin memprihatinkan, tetapi justru terabaikan dari target MDG. Pencapaian target milenium tampaknya tidak memperhitungkan beban penyakit akibat berbagai masalah kejiwaan. Padahal, jika dibiarkan, pada masa mendatang masalah kesehatan jiwa akan menjadi besar seperti yang tengah dihadapi oleh berbagai negara maju. Berdasarkan prediksi tahun 2020, depresi unipolar akan menempati rangking ke-2 penyebab beban penyakit. Beberapa upaya dapat ditempuh untuk memelihara kelangsungan program kesehatan jiwa, antara lain tetap menjalankan kebijakan kesehatan jiwa dan upaya advokasi untuk mendapatkan anggaran yang memadai. Hal tersebut dapat dilakukan dengan memasukkan berbagai isu internasional dan lokal spesifik serta mempersiapkan landasan hukum yang merupakan salah satu persyaratan pengajuan pendanaan. Since the Millenium Development Goals was developed in 2000, many health priorities are directed to that goals. The MDGs dominated by communicable diseases, maternal and child health, meanwhile non-communicable diseases get less attention and was allocated relatively low budget to maintain their programs. The objective of this study was to discuss mental health position from MDGs perspectives. MDGs have ignored mental health by no target or indicator of MDGs is related to mental disorders. The MDGs did not calculate the non-communicable burden of those diseases. That condition affected not only Indonesia as developing country but also in developed country, which cause low mental health budget from the total health budget country. It will become serious problem in the future as it was predicted that that uni-polar depression will rank second as the leading burden of disease. The mental health policy and advocacy have to implement to maintain the program by proposing sufficient budget and developing international and local specific issues while preparing the legal foundation as a requirement to propose the budget.
Penyebab Keberhasilan dan Kegagalan Praktik Pemberian ASI Eksklusif Fikawati, Sandra; Syafiq, Ahmad
Kesmas Vol. 4, No. 3
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Target cakupan ASI eksklusif oleh Depkes RI sebesar 80% masih sulit dilaksanakan. Berbagai studi menunjukkan cakupan ASI eksklusif di Indonesia masih sangat rendah. Ada berbagai faktor yang mempengaruhi keberhasilan dan kegagalan pelaksanaan ASI eksklusif. Penelitian ini bertujuan untuk menggali berbagai faktor predisposisi, pemungkin, dan pendorong yang berhubungan dengan keberhasilan atau kegagalan pelaksanaan ASI eksklusif di Puskesmas Kecamatan Jagakarsa, Jakarta Selatan. Disain studi adalah studi kualitatif dengan 14 informan yaitu ibu bayi yang berusia >6-24 bulan yang dibagi berdasarkan keberhasilan pelaksanaan ASI eksklusifnya. Data dikumpulkan melalui wawancara mendalam dan dilakukan triangulasi sumber data mencakup bidan puskesmas dan suami serta triangulasi analisis oleh pakar. Pendidikan, pengetahuan, dan pengalaman ibu adalah faktor predisposisi yang berpengaruh positif terhadap keberhasilan ASI eksklusif, sedangkan IMD adalah faktor pemungkin yang kuat terhadap keberhasilan ASI eksklusif. Dari segi faktor pendorong, dukungan tenaga kesehatan penolong persalinan paling nyata pengaruhnya dalam keberhasilan pelaksanaan ASI eksklusif. Di sisi lain, iklan susu formula di media massa ternyata mempengaruhi keberhasilan ASI eksklusif terutama pada ibu yang berpendidikan rendah. Disarankan untuk meningkatkan pengetahuan ibu tentang pelaksanaan ASI eksklusif khususnya pada saat antenatal care dan bukannya setelah persalinan. Perlu ditegakkan aturan ketat iklan susu formula baik di media massa maupun kampanye terselubung melalui tenaga kesehatan penolong persalinan. Coverage of exclusive breastfeeding (EBF) was targeted by Ministry of Health RI to reach 80%. The target is very difficult to achieve. Studies showed that EBF rate in Indonesia are very low. There are various factors affecting the success or failure of EBF. This study aims at digging information on predisposing, enabling, and reinforcing factors associated with success of EBF in Jagakarsa community health center, South Jakarta. Design of the study is qualitative with 14 informants that is mother with infant age >6-24 months and divided based on the success of EBF implementation. Data was collected through in-depth interview and was triangulated based on data sources including midwives and husbands as well as analysis triangulation by expert. Education, knowledge, and experience are predisposing factors that influence the success of EBF, while early breastfeeding initiation is a strong enabling factor, and support from mid-wife acts as a strong reinforcing factor. The study also found that advertisement of formulated milk was very successful in influencing mother’s success in EBF especially for those with low education. It is suggested to increase mother’s knowledge about EBF during antenatal care and not after the delivery. Legal aspect and rules should be implemented in a stricter way and to cover both mass-media advertisement and hidden campaign through health personel.
Praktik Dokter Terkait Perilaku Merokok Pasien Pujianto, Pujianto; Thabrany, Hasbullah; Hidayat, Budi; Ong, Michael; Fitriah, Fitriah
Kesmas Vol. 4, No. 3
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Kini Indonesia berada pada awal tahap kedua epidemi tembakau dengan prevalensi perokok pada penduduk berumur di atas 10 tahun mencapai 23,7%. Dalam memerangi epidemi tembakau, dokter memegang peran kunci membantu pasien berhenti merokok. Untuk mengetahui praktik dokter terkait perilaku merokok pasiennya telah dilakukan survei di Jakarta dengan sampel 96 dokter yang dipilih secara acak. Hasil survei menunjukkan hanya 1 dari 50 dokter yang merokok setiap hari (2,1%). Pengetahuan dan sikap dokter tentang merokok pada umumnya sangat baik, yaitu 93,8% mengetahui dampak negatif perokok pasif, 84,4% mengetahui bahwa rokok dengan kadar tar/nikotin rendah tetap membahayakan, 93,8% setuju menjadikan dokter sebagai role model perilaku tidak merokok, dan 95,8% setuju dengan kondisi bebas asap rokok di rumah sakit. Namun, dokter yang tidak selalu menanyakan kebiasaan merokok pasien cukup tinggi (66,7%) dan dokter yang tidak selalu memberikan nasehat kepada pasien untuk berhenti merokok (38%). Analisis regresi logistik menemukan bahwa dokter yang bekerja di bagian jantung dan paru berpeluang 28,4 kali lebih besar untuk menanyakan kebiasaan merokok pasien daripada dokter yang bekerja di bagian penyakit dalam. Penulis menyarankan agar dilaksanakan pendidikan dokter berkelanjutan tentang bahaya merokok dan pengendalian merokok. Indonesia is in the second phase of tobacco epidemic shown by 23,7% of people age 10+ years are smoking. In tobacco control programs, physicians play significant roles. To know how Indonesian physicians behave in facing smoking habits, a survey to 96 practicing physicians in three clinical departments has been undertaken in Jakarta. The survey identified that only one in 50 (2,1%) physicians smoke daily. As high as 93.8% physicians know about negative impact of passive smokers, 84.4% know that low tar/nicotine has significant impact on health, 93.8% agree that physicians should be one of the role model to smoking cessation, and 95.8% agree on free smoke environment in all hospital premises. However, 66.7% physicians did not regularly asking smoking behavior of their patients and 38% did not advice patients to stop smoking. Logistic regression produce 28.4 times higher probability of physicians in Lung and Heart Clinic to ask smoking behavior of their patients as compared to physicians in Internal Medicines. The authors suggest to introduce a special continuing medical education on smoking and smoking cessation of practicing physicians.
Program Langit Biru : Kontribusi Kebijakan Pengendalian Pencemaran Udara Kota terhadap Penurunan Penyakit Pernapasan pada Anak Fitria, Laila
Kesmas Vol. 4, No. 3
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Pencemaran udara perkotaan yang berdampak buruk terhadap kesehatan masyarakat sering dikaitkan dengan PM 10, NO2, dan ozon, polutan reaktif yang memicu kerusakan jaringan dalam saluran napas melalui mekanisme stres oksidatif dan inflamasi saluran napas. Pajanan jangka panjang polutan tersebut berpengaruh terhadap gangguan pernapasan, penurunan fungsi paru, asma, serta penyakit sistem pernapasan kronik lain seperti penyakit paru-paru obstruktif kronik. Program Langit Biru merupakan salah satu upaya mengurangi pencemaran udara dari sektor transportasi yang dicanangkan sejak tahun 1996. Hingga kini, kontribusi Program Langit Biru terhadap penurunan kasus gangguan pernapasan pada anak belum dapat diperkirakan, antara lain disebabkan oleh karena pelaksanaan program melalui kegiatan riil yang baru terwujud beberapa tahun setelah dicanangkan, serta berbagai kendala lainnya. Padahal, beberapa penelitian di negara lain menunjukkan bahwa pengendalian pencemaran udara dapat memberikan kontribusi yang cukup signifikan bagi penurunan kasus-kasus penyakit pernapasan pada anak. Oleh karena itu, agar terwujud kualitas udara yang aman bagi kesehatan, dibutuhkan dukungan dan peran yang lebih besar dari pemerintah, pelaksana program, dan masyarakat. Urban air pollution that have negative impact on public health is frequently related to PM10, NO2, and ozone, the reactive pollutants that could trigger internal tissue of respiratory tract through mechanism of oxidative stress and respiratory tract inflammation. Long term exposure to the pollutant related to respiratory abnormality, lung function, asthma, chronic respiratory disease, and chronic obstructive pulmonary disease. The Blue Sky Program is one measure for reducing air pollutant of transportation sector and has been designed since 1996. Until now, the blue sky program contribution on respiratory track disorder reduction on children has not been predicted yet, due to delay in program implementation and real activities were just been realized years after the program declaration and also due to other constraints. Researches in other countries show that air pollution control contributes significantly to the reduction of respiratory track disease among children. To achieve healthy air quality, bigger support and more active role from government, program manager and public are essentially needed.
Model Mitigasi Kebakaran Berbasis Masyarakat : Kajian Kualitatif pada Aparat Pemerintah dan LSM Fatmah, Fatmah
Kesmas Vol. 4, No. 3
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Abstract

Lingkungan masyarakat kota yang bebas kebakaran dapat tercipta melalui upaya pencegahan dan pemadaman kebakaran dini. Penelitian ini bertujuan mengembangkan model mitigasi kesiapsiagaan kebakaran berbasis masyarakat. Metoda kualitatif wawancara mendalam dilakukan terhadap 30 informan terpilih di Jabodetabek meliputi aparat kecamatan, kelurahan, Lembaga Swadaya Masyarakat, dan Suku Dinas Pemadam Kebakaran. Mayoritas informan mengenal organisasi Barisan Sukarelawan Kebakaran, tetapi dalam pelaksanaan ditemukan beberapa kendala antara lain meliputi tidak ada honorarium, status pekerjaan, dan anggota penduduk musiman. Hal tersebut berakibat banyak anggota yang berhenti dan sulit merekrut anggota baru. Bentuk upaya pencegahan kebakaran yang dilakukan masyarakat meliputi simulasi, penyuluhan, dan pelatihan bahaya kebakaran, serta menjadi anggota Barisan Sukarelawan Kebakaran. Tiap wilayah mempunyai bentuk yang bervariasi sesuai dengan aturan yang berlaku di masyarakat karena masih bersifat regional serta belum dilegitimasikan dalam Undang-Undang Nasional. Alternatif model berbasis masyarakat yang terbaik adalah memberdayakan Barisan Sukarelawan Kebakaran mengingat program tersebut telah berjalan dan dikenal masyarakat. Diharapkan model ini lebih mudah diterima masyarakat karena menjadi bagian program pembangunan di beberapa wilayah. Dukungan masyarakat yang kuat terhadap Barisan Sukarelawan Kebakaran menentukan kelancaran pelaksanaan di lapangan. Urban environment which is free from fire can be created through early fire prevention and controlling efforts. The research objective was to develop community-based model in mitigation of fire preparedness. Depth interviews were conducted in the selected 30 informants at Jakarta, Bogor, Depok, Tangerang, and Bekasi cities. They came from subdistrict authorities, villages, non government organizations, and Fire Government Institution staffs (Sudin Damkar). The majority of informants had familiarity with the organization, namely BALAKAR. However, its implementation had some constraints such as no provision of salary, employment status, and seasonal residents were attached to the members themselves. Consequently, many members were resigned and it was difficult to recruit new members. Type of fire prevention efforts undertaken in community were participating on fire simulation, extension, and training, and to be member of BALAKAR. However, the shapes were still scattered because each region had its own form depend on rules in society and had not yet legi-timized in a national law because on regional level. The best alternative community-based model was empowering BALAKAR because of this program is still running and known by community. It was expected that the model will be accepted easily by community for being part of development programs in several areas. Later on, strong support from the community will determine the successful of BALAKAR implementation in the field.

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