Pelatihan meningkatkan pengetahuan dan keterampilan kader puskesmas dalam penerapan standar pemantauan pertumbuhan balita di Kota Bitung

Abstract

ABSTRACT
Background: Growth monitoring is one of major program of nutrition improvement that emphasizes on efforts to maintain and improve nutritional status of underfi ves. Technically, some errors often occur such as the use of inappropriate and non-calibrated scale, errors in placing the scale, and in reading the result of weighing. To improve knowledge, skills, and compliance of cadres, it is necessary to conduct training on growth monitoring standard of underfi ves in order that cadres can improve the capacity in evaluating growth and improve their effectiveness and effi ciency in working at the integrated post (posyandu).

Objective: To identify the effect of training to the improvement of knowledge, skills, and compliance of cadres in implementing growth monitoring standard of underfi ves at Bitung Municipality, North Sulawesi.

Method: The study was a quasi experiment which used non-equivalent control group design. It was carried out at Bitung Barat and Aer Tembaga Health Center of Bitung Municipality, North Sulawesi to the two groups of cadres. The experiment group consisted of 44 cadres who got training twice, each was carried out a month before the evaluation on knowledge, skills, and compliance. The control group consisted of 46 cadres that got modul of growth monitoring standard of underfi ves. Research instruments used were questionnaire/checklist of knowledge, skills, and compliance. The result was analyzed using Chi-Square.

Result: Training improved knowledge and skills of cadres in implementing growth standard of underfi ves. This was indicated from average knowledge of the experiment group during pre test as much as 0.328+0.086, post-test 1 as much as 0.335+0.554, post-test 2 as much as 0.328+0.106. Average skills of experiment group during pre-test were 0.446+0.067, post-test 1 was 0.549+0.544, post-test 2 was 0.873±0.106. Average compliance of the experiment group during pre-test was 0.457+1.08, post-test 1 was 0.548+0.321, post-test 2 was 0.542±0.365. This was indicated from average knowledge of the control group during pre- test as much as 0.122+0.155, post-test 1 as much as 0.154+0.856, post-test 2 as much as 0.195+0.235. Average skills of control group during pre-test was 0.366+0.103, post-test 1 was 0.431+0.856, post-test 2 was 0.426+0.235. Average compliance of the control group during pre-test was 0.352+0.363, post-test 1 was 0.362+0.363, post-test 2 was 0.365±0.368. The result of statistical analysis in average difference was p=0.000 for knowledge, p=0.000 for skills and p=0.004 for compliance in post-test 2, showing that the improvement was signifi cant (p<0.05).

Conclusion: There was signifi cant improvement in knowledge skills and compliance of cadres who got training on the implementation of growth monitoring standard of underfi ves at Posyandu.

KEYWORDS: training, cadres, posyandu, growth standard of underfi ves

ABSTRAK

Latar Belakang: Pemantauan pertumbuhan merupakan salah satu kegiatan utama program perbaikan gizi yang menitik beratkan pada upaya pencegahan dan peningkatan keadaan gizi balita. Secara teknis, sering ditemui beberapa kesalahan antara lain dalam menggunakan timbangan yang tidak layak dan tidak dikalibrasi dan dalam pemasangan timbangan dan pembacaan hasil. Untuk meningkatkan pengetahuan, keterampilan, dan kepatuhan kader, perlu diadakan pelatihan standar pemantauan pertumbuhan balita agar kader dapat meningkatkan kemampuan dalam menilai pertumbuhan, serta meningkatkan efektivitas dan efi siensi kerjanya di posyandu.

Tujuan: Mengetahui pengaruh pelatihan terhadap peningkatan pengetahuan, keterampilan, dan kepatuhan kader dalam menerapkan standar pemantauan pertumbuhan balita di Kota Bitung, Sulawesi Utara.

Metode:Jenis penelitian ini adalah quasi eksperimental dengan rancangan non-equivalent control group design, berlokasi di Puskesmas Bitung Barat dan Puskesmas Aertembaga, Kota Bitung, Sulawesi Utara. Kelompok perlakuan adalah kader Puskesmas Aertembaga yang berjumlah 44 orang yang mendapat pelatihan standar pemantauan pertumbuhan balita 2 kali. Setiap pelatihan dilaksanakan 2 hari dan evaluasi pengetahuan, keterampilan, dan kepatuhan 1 bulan setelah pelatihan. Kelompok pembanding kader adalah Puskesmas Bitung Barat berjumlah 46 orang yang mendapat modul standar pemantauan pertumbuhan balita. Hasil penelitian dianalisis dengan T-test,Chi-Square dan uji multivariat. Alat penelitian adalah kuesioner/Cheklist pengetahuan, daftar tilik keterampilan, dan kepatuhan.

Hasil: Pelatihan meningkatkan pengetahuan dan keterampilan kader untuk menerapkan standar pertumbuhan balita. Hal ini ditunjukkan dengan nilai rerata pengetahuan kelompok perlakuan pada pretest sebesar 0,328±0,086, post-test 1 sebesar 0,335±0,554, post-test 2 sebesar 0,328±0,106 Nilai rerata keterampilan kelompok perlakuan pada pretest sebesar 0,446±0,067, post-test 1 sebesar 0,549±0,554, post-test 2 sebesar0,873±0,106. Nilai rerata kepatuhan kelompok perlakuan pada pretest sebesar 0,457±0,108, post-test 1 sebesar 0,548±0,321, post-test 2 sebesar 0,542±0,365. Pada kelompok pembanding, nilai rerata pengetahuan pretest sebesar 0,122±1.55, post-test 1 sebesar 0,154±856, post-test 2 sebesar 0,195±0,235. Nilai rerata keterampilan pretest sebesar0,366±0,103, post-test 1 sebesar 0,431±0,856, post-test 2 sebesar 0,426±0,235. Nilai rerata kepatuhan pretest sebesat 0,359± 0,108,post-test 1 sebesar 0,362±0,363, post-test 2 0,365±0,368. Hasil analisis statistik beda rerata antara kelompok perlakuan dan pembanding menunjukkan peningkatan yang bermakna (p<0.05). Beda rerata peningkatan kelompok perlakuan dari pretest ke post-test 2 pengetahuan dari 0,047 menjadi 0,364, keterampilan dari 0,103 menjadi 0,427 dan kepatuhan dari 0,091 menjadi -0,085

Kesimpulan: Dengan pelatihan standar pemantauan pertumbuhan balita, pengetahuan, keterampilan, dan kepatuhan kader meningkat secara bermakna dibandingkan hanya diberikan modul.

KATA KUNCI: pelatihan, kader posyandu, standar pertumbuhan balita