Modal Sosial Kader Kesehatan dan Kepemimpinan Tokoh Masyarakat Dalam Penemuan Penderita Tuberkulosis
Authors
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Endang Sutisna
Magister Study Program of Public Health Postgraduate Program of Surakarta Sebelas Maret University
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Reviono Reviono
Pulmonology Department of Medical Faculty of Surakarta Sebelas Maret University
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Arry Setyowati
Pulmonary Department of Saras Husada Local General Hospital of Purworejo
Keywords:
social capital, leadership, tuberculosis, case detection rateAbstract
Tuberkulosis (TB) merupakan kedaruratan global bagi kemanusiaan. WHO menggulirkan Strategi DOTS (Directly Observed Treatment Short-course) dan Strategi Stop TB Partnership bertujuan untuk menjangkau semua penderita TB. Kedua strategi tersebut belum mampu mencapai target CDR (Case Detection Rate) secara konsisten. Penelitian ini bertujuan menganalisis pengaruh dan peran modal sosial kader kesehatan dan kepemimpinan tokoh masyarakat dalam penemuan TB paru BTA positif (CDR). Metode yang digunakan adalah survei dan studi kasus. Sasaran penelitian adalah Tim Penanggulangan TB di Puskesmas dan Dinas Kesehatan Kabupaten, serta kader kesehatan, tokoh masyarakat, penderita TB, dan mantan penderita TB di Kabupaten Sukoharjo, Jawa Tengah. Hasil penelitian survei dengan analisis jalur menunjukkan, besaran pengaruh langsung modal sosial kader kesehatan terhadap CDR adalah 8,64%; pengaruh langsung kepemimpinan tokoh masyarakat terhadap CDR adalah 33%; dan pengaruh modal sosial kader kesehatan dan kepemimpinan tokoh masyarakat secara simultan terhadap CDR adalah 27,7%. Hasil penelitian studi kasus menyimpulkan, peran modal sosial kader kesehatan dalam CDR terdiri dari dimensi kognitif, relasional dan struktural. Dimensi kognitif meliputi kepedulian, saling percaya dan rasa memiliki antar anggota keluarga, warga masyarakat, serta kader dan petugas kesehatan. Dimensi relasional meliputi kerjasama dan komunikasi yang dilandasi nilai-nilai bersama. Dimensi struktural meliputi jaringan sosial, perkumpulan dan persatuan masyarakat. Peran kepemimpinan tokoh masyarakat dalam CDR adalah memberikan motivasi, tempat bertanya dan konsultasi, mengadakan pertemuan rutin, serta mengelola kegiatan dan menggalang donasi.
Tuberculosis (TB) is a global emergency for humanity. WHO launches DOTS (Directly Observed Treatment Short-Course) and Stop TB Partnership strategies aiming to reach all people with TB. Both strategies have not been able to reach the target of CDR (case detection rate) consistently. This research aimed to analyze the effect and the role of health cadres’ social capital and community figures’ leadership in finding the people with positive-BTA pulmonary tuberculosis (CDR). The methods employed were survey and case study. The target of research was TB management team in Puskesmas (Public Health Centre) and Regency Health Service, and health cadres, community figures, people with TB, and people with TB previously in Sukoharjo Regency, Central Java. The result of research with path analysis showed that the size of direct effect of health cadres’ social capital on CDR was 8.64%; that of community figures’ leadership on CDR was 33%; and that of health cadres’ social capital and community figures’ leadership simultaneously on CDR was 27.7%. The result of case study research concluded that the role of health cadres’ social capital in CDR consisted of cognitive, relational and structural dimensions. Cognitive dimension included care, mutual trust, and sense of belonging among the members of family, members of society, and health cadres and workers. Relational dimension included cooperation and communication based on commonness value. Structural dimension included social network, community association and unity. The role of community figures’ leadership in CDR was that it provided motivation, served as the one to which any one asking question and consulting, conducted routine meeting, and managed activity and raised donation.
References
Adrian M. 2010. The community leadershp and place-shaping roles of english local government synergy or tension? Public Policy and Administration 2010 25: 175
Agboatwalla M, Kazi GN, Shah SK, Noor, Domki A, Saeed S, et al. 2004. Community involvement in enhancing case detection and treatment success rates of tuberculosis patients under DOTS strategy in pakistan. National Program Manager TB Control Program Government of Pakistan.
Ainy A, Makky M, Fajar NA. Alert village: an awareness and health promotion programme on healthy behaviors. BMC Public Health. 2012; 12: p. 1-2.
Ashwell HES dan Barclay L. 2009. A retrospective analysis of a community-based health program in Papua New Guinea. Health Promotion International, Vol. 24 No. 2. Published by Oxford University Press. Downloaded from hpp.sagepub.com at University of Wollongong on November 24, 2011
Awofeso N, Schelokova I, Dalhatu A. 2008. Training of front-line health workers for tuberculosis control: Lessons from Nigeria and Kyrgyzstan. Human Resources for Health. 6 (20): p. 1478-91.
Baral SC, Karki DK, Newell JN. Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study. BMC Public Health. 2007;7 (211):1-10.
Baum FE, Ziersch AM. Social capital. J Epidemiol Community Health. 2003. 57: p. 320-3.
Blakely T, Ivory V. Commentary: Bonding, bridging, and linking-but still not much going on. International Journal of Epidemiology. 2006;35:614-5.
Bolin K, Lindgren B, Lindstrom M, Nystedt P. Investments in social capital-implications of social interactions for the production of health. Social Science and Medicine. 2003;56:2379-90.
Bourdieu P. The forms of capital. In: J. Richardson, Editor. Handbook of Theory and Research for the Sociology of Education (New York, Greenwood), 1986; 241-58.
Coleman JS. Social capital in the creation of human capital. The American Journal of Sociology. Supplement: Organizations and institutions: Sociological and economic approaches to the analysis of social structure. 1988;94:S95-S120.
Conrad D. Defining social capital. Electronic Journal of Sociology 2007. [cited 2011Nov15]. Availablefrom:http://www.sociology.org/content/2007/_contrad_social_capital.pdf.
Datiko D, Lindtjom B. Health extension workers improve tuberculosis case detection and treatment success in Southern Ethiopia: A Community randomized trial. PLos one Community TB Care in Ethiopia. 2009; 4: p. 5443-50.
Dinas Kesehatan Kabupaten Sukoharjo. 2013. Profil kesehatan kabupaten Sukoharjo Provinsi Jawa Tengah. Sukoharjo
Dye C, Lonnroth K, Jaramillo E, Williams BG, Raviglione M. Trends in tuberculosis incidence and their determinants in 134 countries. Bull World Health Organ. 2009; 87: 683-91.
Ebi KL, Semenza J. Community-based adaptation to the health impacts of climate change. Am J Prev Med. 2008. 35(5): p. 501-7.
U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. Empowering America Grassroots. 2005. Successful strategies for recruiting, training, and utilizing volunteers. Washington DC
Ferguson KM, Kim MA, McCoy S. Enhancing empowerment and leadership among homeless youth in agency and community settings: A grounded theory approach. Child Adolesc Social Worker Journal (2011) 28:1-22. Published online: 30 September 2010. Springer Science+Business Media, LLC 2010. Downloaded from hpp.sagepub.com at University of Wollongong on November 24, 2011
Fujiwara T, Kawachi I. Social capital and health. A study of adult twins in the U.S. Am J Prev Med. 2008; 35 (2):139-44.
Harpham T, Grant E, Thomas E. Measuring social capital within health surveys: key issues. Health Policy and Planning. 2001;17( 1):106-11.
Holtgrave DR, Crosby RA. Social determinants of tuberculosis case rates in the United States. Am J Prev Med. 2004; 26 (2): 159-62.
Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public health. 1997; 87:1491-98.
Kawachi I, Berkman LF. Socialties and mental health. Journal of Urban Health. 2001;78 (3): 458-67.
Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. 2011. Pedoman nasional penanggulangan tuberkulosis. Jakarta.
Kironde S, Bajunirwe F. 2002. Lay workers in directly observed treatment (DOT) programmes for tuberculosis in high burden settings: Should they be paid? A review of behavioural perspectives. African Health Sciences. Vol 2(2): p. 73-8.
Krianto T. 2005. Pemberdayaan masyarakat dalam promosi kesehatan. Hal 254-280. dalam Notoatmodjo S. Promosi kesehatan teori dan aplikasi. Cetakan Pertama. Jakarta: PT Rineka Cipta.
Lum T, Lightfoot E. The effects of volunteering on the physical and mental health of older people. Research on Aging. 2005; 27; p. 31-55.
Lynch J, Due P, Muntaner C, Smith GD. Social capital-Is it a good investment strategy for public health? J Epidemiol Community Health. 2000; 54:404-8.
Macinko J, Startfiiel B. The utility of social capital in research on health determinants. The Johns Hopkins Medical Institutions. 2001; 79 (3): p. 387-427.
Medina DG, Le QV. Infectious diseases and interpersonal trust: international evidence. 2011; 3 (4): 206-10.
Meulemans H, Ouytsel JV, Rigouts L, Mortelmans D, Heunis C, Matebesi Z, van Rensburg D. Social capital and community TB care in the Free State, South Africa. Acta Academica Supplementum. 2005 (1):128-53.
Murti B. 2010. Determinan sosio-ekonomi, modal sosial, dan implikasinya bagi kesehatan masyarakat. Pidato Pengukuhan Guru Besar Ilmu Kesehatan Masyarakat Fakultas Kedokteran Universitas Sebelas Maret. Surakarta.
Nahapiet J, Ghoshal S. Social capital, intellectual capital, and the organizational advantage. The academy of management review. 1998; 23 (2): 242-66.
Ngadaya ES, Mfinanga GS, Wandwalo ER, Morkve O. Detection of pulmonary tuberculosis among patients with cough attending outpatient departments in Dar Es Salaam, Tanzania: does duration of cough matter?. BMC Health Services Research. 2009; 9 (112):1-5.
Oksanen T. 2009. Workplace social capital and employee health.. [cited 2011 Des18]. http:// www.doria.fi/bitstream/handle/10024/47617/Annales D876 Oksanen.pdf? sequence=1
Pitts DW. Leadership, empowerment, and public organizations. Review of Public Personnel Administration 2005 25: 5. Downloaded from rop.sagepub.com at University of Wollongong on November 28, 2011
Portes A. 1998. Social Capital: Its origins and applications in modern sociology. Annual review of sociology. Vol 24: p. 1-24.
Pranata, Setia., Lely Pratiwi, Niniek., Rahanto, Sugeng. 2014. Pemberdayaan masyarakat di bidang kesehatan, gambaran peran kader posyandu dalam upaya penurunan angka kematian ibu dan bayi di kota Manado dan Palangkaraya. Buletin Penelitian Sistem Kesehatan. Vol 14 No 2 April 2011.
Pusat Pembinaan dan Pengembangan Bahasa Departemen Pendidikan dan Kebudayaan. 2007. Kamus umum bahasa indonesia. Jakarta: Balai Pustaka
Putnam R. Bowling alone: America's declining social capital. Journal of Democracy. 1995; 6 (1):65-78.
Rasanathan K, Kurup AK, Jaramillo E, Lonnroth K. The social determinants of health: key to global tuberculosis control. Int J Tuberc Lung Dis. 2011; Vo1 5 (6): p. 30-36.
Smith I. What is the health, social, and economic burden of tuberculosis?. In: Frieden T, editor. Toman's tuberculosis case detection, treatment, and monitoring: questions and answers. 2nd edition. Geneva: WHO; 2004. p. 233-7.
Sulaeman E.S. 2012. Pemberdayaan masyarakat di bidang kesehatan teori dan implementasi. Cetakan pertama. Yogyakarta : Gajah Mada University Press.
Sundquist K, Yang M. Linking social capital and self-rated health: A multilevel analysis of 11.175 men and women in Sweden. Health & Place. 2007;13 (2):324-34.
Widagdo. 2007. Ciri-ciri kepala desa yang berpengaruh terhadap peran serta kader kesehatan dalam meningkatkan kinerja Posyandu. Jurnal Promosi Kesehatan Indonesia (The Indonesian Journal oh Health Promotion). Volume 2/No.1/Januari 2007.
World Health Organization. 2006. The Stop TB Strategy, Building on and enhancing DOTS to meet the TB-related Millennium Development Goals. Switzerland: World Health Organization.
Zolowere D, Manda K, Panulo B, Muula AS. Experiences of self-disclosure among tuberculosispatients in rural Southern Malawi. Rural and Remote Health. 2008; 8 (1037):1-9.
