BAB I

PENDAHULUAN

1.1. Latar Belakang

Pembangunan kesehatan adalah bagian integral dari Pembangunan

Nasional yang pada hakekatnya merupakan upaya untuk mencapai

kemampuan hidup sehat bagi setiap penduduk agar terwujud derajat

kesehatan yang optimal. Hal ini sejalan dengan Undang-Undang Dasar 1945

Pasl 28 ayat (1) dan Undang -Undang Nomor 23 Tahun 1992 tentang

Kesehatan, yaitu melalui pembangunan kesehatan salah satu hak dasar

masyarakat yaitu hak untuk memperoleh pelayanan kesehatan sesuai dapat

dipenuhi. Pembangunan kesehatan harus dipandang sebagai investasi untuk

peningkatan kualitas Sumber Daya Manusia (SDM)yang dapat diukur melalui

Index Pembangunan Manusia (IPM). Kesehatan merupakan salah komponen

utama dalam IPM yang dapat mendukung terciptanya SDM yang sehat,

cerdas, terampil dan ahli menuju keberhasilan Pembangunan Kesehatan.

Dalam pelaksanaan pembangunan kesehatan telah dilakukan perubahan

cara pandang (mindset) dari paradigma sakit menuju paradigma sehat

sejalan dengan Visi Indonesia Sehat 2010. Seiring dengan visi tersebut,

maka Visi Pembangunan Kesehatan di Kota Semarang yang merupakan Ibu

Kota Provinsi Jawa Tengah adalah Terwujudnya Masyarakat Kota Pantai Metropolitan yang Sehat Didukung dengan Profesionalisme dan Kinerja

yang Tinggi.Dalam rangka memberikan gambaran situasi kesehatan di Kota

Semarang Tahun 2007 perlu diterbitkan Buku Profil Kesehatan Kota

Semarang Tahun 2007. Media Profil Kesehatan Kota Semarang merupakan

salah satu sarana untuk menilai pencapaian kinerja pembangunan kesehatan

dalam rangka mewujudkan Kota Semarang Sehat 2010.

Profil Kesehatan menyajikan berbagai data dan informasi diantaranya

meliputi data kependudukan, fasilitas kesehatan, pencapaian program –

program kesehatan, masalah kesehatan dan lain-lain. Tersusunnya Buku

Profil Kesehatan Kota Semarang Tahun 2007 didukung oleh pengelola data

dan informasi Dinas Kesehatan Kota Semarang, Puskesmas, Instalasi

Perbekalan Farmasi, juga lintas sektor terkait (Badan Pusat Statistik, ASKES,

Profil Kesehatan Kota Semarang Tahun 2007

1

JAMSOSTEK, BKKBN, POLWILTABES Kota Semarang).

1.2. T u j u a n1.2.1. U mum

Tujuan disusunnya Profil Kesehatan Kota Semarang Tahun 2007

adalah tersedianya data / informasi yang relevan, akurat, tepat waktu dan

sesuai kebutuhan dalam rangka meningkatkan kemampuan manajemen

kesehatan secara berhasilguna dan berdayaguna sebagai upaya menuju

Kota Semarang yang Sehat.

1.2.2. KhususSecara khusus tujuan penyusunan Profil Kesehatan adalah :

1.2.2.1. Diperolehnya Data / informasi umum dan lingkungan yang meliputi

lingkungan fisik dan biologi, perilaku masyarakat yang berkaitan dengan

kesehatan masyarakat, data kependudukan dan sosial ekonomi;

1.2.2.2. Diperolehnya Data / informasi tentang status kesehatan masyarakat yang

meliputi angka kematian, angka kesakitan dan status gizi masyarakat;

1.2.2.3. Diperolehnya Data / informasi tentang upaya kesehatan,

yang meliputi cakupan kegiatan dan sumber daya

kesehatan.

1.2.2.4. Diperolehnya Data / informasi untuk bahan penyusunan

perencanaan kegiatan program kesehatan;

1.2.2.5. Tersedianya alat untuk pemantauan dan evaluasi tahunan

program – program kesehatan;

1.2.2.6. Tersedianya wadah integrasi berbagai data yang telah

dikumpulkan oleh berbagai sistem pencatatan dan

pelaporan yang ada di Puskesmas, Rumah Sakit maupun

Unit-Unit Kesehatan lainnya;

1.2.2.7. Tersedianya alat untuk memacu penyempurnaan sistem

pencatatan dan pelaporan kesehatan.

1.3. Sistematika PenulisanUntuk lebih menggambarkan situasi derajat kesehatan, peningkatan

upaya kesehatan dan sumber daya kesehatan di Kota Semarang pada Tahun

2007, maka diterbitkanlah Buku Profil Kesehatan Kota Semarang yang

disusun dengan sistematika sebagai berikut :

BAB I PENDAHULUAN

BAB II GAMBARAN UMUM KOTA SEMARANG

BAB III PEMBANGUNAN KESEHATAN DAERAH

BAB IV PENCAPAIAN PEMBANGUNAN KESEHATAN

BAB V KESIMPULAN DAN SARAN

LAMPIRAN

Profil Kesehatan Kota Semarang Tahun 2007

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BAB II

GAMBARAN UMUM DAN LINGKUNGANYANG MEMPENGARUHI KESEHATAN MASYARAKAT

2.1. Keadaan Geografis 2.1.1. Letak

Kota Semarang terletak antara garis 6º50’ - 7º10’ Lintang Selatan dan

garis 109º35’ - 110º50’ Bujur Timur. Dibatasi sebelah Barat dengan

Kabupaten Kendal, sebelah Timur dengan Kabupaten Demak, sebelah

Selatan dengan Kabupaten Semarang, dan sebelah Utara dibatasi oleh Laut

Jawa dengan panjang garis pantai meliputi 13,6 Km. Ketinggian Kota

Semarang terletak antara 0,75 sampai dengan 348,00 di atas garis pantai.

2.1.2. Luas Wilayah Kota Semarang

Dengan luas wilayah sebesar 373,70 km2 , Kota Semarang terbagi dalam 16 kecamatan dan 177 kelurahan. Dari 16 kecamatan yang ada,

kecamatan Mijen (57,55 km2) dan Kecamatan Gunungpati (54,11 km2), dimana sebagian

besar wilayahnya berupa persawahan dan perkebunan. Sedangkan kecamatan dengan

luas terkecil adalah Semarang Selatan (5,93 km2) dan kecamatan Semarang Tengah (6,14 km2), sebagian besar wilayahnya berupa pusat perekonomian dan bisnis Kota Semarang, seperti bangunan toko/mall, pasar, perkantoran dan sebagainya.

2.2 Kependudukan2.2.1. Pertumbuhan Penduduk, Persebaran dan Kepadatan

Penduduk, Komposisi Penduduk, Kelahiran, Kematian dan Perpindahan

2.2.1.1. Jumlah dan Laju Pertumbuhan PendudukJumlah penduduk Kota Semarang menurut registrasi sampai dengan

akhir Desember tahun 2007 sebesar : 1.454.594. jiwa, terdiri dari 722.026

jiwa penduduk laki-laki dan 732.568 jiwa penduduk perempuan. Dengan

jumlah sebesar itu Kota Semarang termasuk dalam 5 besar

Kabupaten/Kota yang mempunyai jumlah penduduk terbesar di Jawa

Tengah.

Tabel 1 : Jumlah dan Pertumbuhan Penduduk Tahun 2003 - 2007

Tahun Jumlah Penduduk Tingkat pertumbuhanSetahun ( % )

2003

2004

2005

2006

2007

1.378.193

1.399.133

1.419.478

1.434.132

1.454.594

2,09

1,52

1,45

2,03

2,37

Sumber data : Kantor BPS Kota Semarang

Perkembangan dan pertumbuhan penduduk selama 5 tahun terakhir

menunjukkan hasil yang bervariasi. Hal ini dapat dilihat pada tabel diatas,

dimana selama kurun waktu tahun 2004 – 2007 terjadi peningkatan

pertumbuhan penduduk dengan rata-rata sebesar 0.35%.

2.2.1.2. Persebaran dan Kepadatan PendudukPenyebaran penduduk yang tidak merata perlu mendapat perhatian

karena berkaitan dengan daya dukung lingkungan yang tidak seimbang.

Secara geografis wilayah Kota Semarang terbagi menjadi dua yaitu

daerah dataran rendah ( Kota Bawah ) dan daerah perbukitan (Kota

Atas). Kota Bawah merupakan pusat kegiatan pemerintahan, perdagangan

dan industri, sedangkan Kota Atas lebih banyak dimanfaatkan untuk

perkebunan, persawahan, dan hutan.

Sedangkan ciri masyarakat Kota Semarang terbagi dua yaitu

masyarakat dengan karakteristik perkotaan dan masyarakat dengan

karakteristik pedesaan.

Sebagai salah satu kota metropolitan, Semarang boleh dikatakan

belum terlalu padat. Pada tahun 2007 kepadatan penduduknya sebesar

3.892 jiwa per km2. Bila dilihat menurut Kecamatan yang mempunyai

kepadatan penduduk paling kecil adalah Kecamatan Mijen sebesar 819 jiwa

per km2, diikuti dengan Kecamatan Tugu 832 jiwa per km2 dan Kecamatan

Gunungpati 1.168 jiwa per km2. Ketiga Kecamatan tersebut merupakan

daerah pertanian dan perkebunan, sehingga sebagian wilayahnya masih

banyak terdapat areal persawahan dan perkebunan,

Namun sebaliknya untuk Kecamatan-Kecamatan yang terletak di

pusat kota, dimana luas wilayahnya tidak terlalu besar tetapi jumlah

Profil Kesehatan Kota Semarang Tahun 2007

5

penduduknya sangat banyak, kepadatan penduduknya sangat tinggi.

Yang paling tinggi kepadatan penduduknya adalah Kecamatan Semarang

Selatan 14.444 jiwa/km2, kemudian Kecamatan Candisari 12.318 jiwa/km2

Kecamatan Semarang Tengah 12.158 jiwa/km2, diteruskan dengan

Semarang Utara 11.468 jiwa/km2 dan Kecamatan Gayamsari 11. 270

jiwa/km2 .

Bila dikaitkan dengan banyaknya keluarga atau rumah tangga, maka

dapat dilihat bahwa rata-rata setiap keluarga di Kota Semarang memiliki 4,13

atau 4 (empat) anggota keluarga, dan kondisi ini terjadi pada hampir seluruh

Kecamatan yang ada .

2.2.1.3. Komposisi PendudukUntuk dapat menggambarkan tentang keadaan penduduk secara

khusus dapat dilihat dari komposisinya, salah satunya adalah penduduk

menurut jenis kelamin. Dari 1.454.594 penduduk Kota Semarang pada tahun

2007 terdiri dari 722.026 jiwa penduduk laki-laki dan 732.568 jiwa penduduk

perempuan . Indikator dari variabel jenis kelamin adalah rasio jenis kelamin

yang merupakan angka perbandingan antara penduduk laki-laki dan

perempuan.

Rasio jenis kelamin pada tahun 2007 di Kota Semarang adalah 986

yang berarti jumlah penduduk perempuan lebih besar dibandingkan dengan

jumlah penduduk laki-laki, dimana setiap 100 penduduk perempuan, terdapat

pula 986 penduduk laki-laki.

2.2.1.4. Kelahiran, Kematian dan PerpindahanPotensi permasalahan jumlah penduduk yang besar dipengaruhi oleh

tingkat pertumbuhan penduduk yang dimiliki. Bila jumlah penduduk yang

besar sedangkan tingkat pertumbuhannya tinggi, maka beban untuk

mencukupi kebutuhan pangan, sandang, perumahan, pendidikan, kesehatan

dan sebagainya menjadi sangat berat.

Tingkat pertumbuhan penduduk dibedakan atas tingkat pertumbuhan

alamiah dan tingkat pertumbuhan karena migrasi. Tingkat pertumbuhan

alamiah secara sederhana dihitung dengan membandingkan jumlah

penduduk yang lahir dan mati. Pada periode waktu tertentu digambarkan

dengan Angka Kelahiran Kasar atau Crude Birth Rate ( CBR ) dan Angka

Kematian Kasar atau Crude Death Rate ( CDR ) yang merupakan

perbandingan antara jumlah kelahiran dan kematian selama 1 tahun dengan

jumlah penduduk pertengahan tahun.

Selama periode 5 tahun terakhir perkembangan kelahiran dan

kematian penduduk di Kota Semarang terlihat cukup berfluktuasi. Hal ini

dilihat bahwa untuk CBR periode 2003 – 2007 mengalami kenaikan yang

cukup berarti yaitu menjadi 16,06/1.000 penduduk. Sedangkan CDR juga

mempunyai pola yang sama berfluktuasi selama periode 2003 – 2006

mengalami peningkatan dan menurun pada tahun 2007 menjadi 7,04/1.000

penduduk. Data selengkapnya pada tabel berikut :

Tabel 2: Perkembangan Kelahiran dan Kematian PendudukKota Semarang Periode 2003 – 2007

Tahun Jml Penduduk CBR(/1000 pddk)

CDR(/1000 pddk)

2003

2004

2005

2006

2007

1.378.193

1.399.133

1.419.478

1.434.132

1.454.594

12,56

12,64

15,23

15,46

16,06

5,09

5,27

6,41

7,56

7,04

Sebagai gambaran pada tahun 2007 Angka Kelahiran Kasar ( CBR )

sebesar 16,06 per 1.000 penduduk yang berarti bahwa setiap 1.000

penduduk jumlahnya bertambah karena kelahiran sebanyak 16,06 atau bila

dibulatkan sebesar 16 orang. Sedangkan Angka Kematian Kasar (CDR)-nya

sebesar 7,04 per 1.000 penduduk yang artinya setiap 1.000 penduduk Profil Kesehatan Kota Semarang Tahun 2007

7

selama setahun jumlah penduduknya berkurang karena meninggal sebanyak

7 orang. Dengan demikian selisih dari keduanya adalah 9 orang per 1.000

penduduk.

2.3. PENDIDIKANPendidikan merupakan salah satu aspek penting dalam kehidupan

masyarakat yang berperan meningkatkan kualitas hidup. Semakin tinggi

pendidikan suatu masyarakat, semakin baik kualitas sumber dayanya.

Sebagai gambaran tingkat pendidikan penduduk Kota

Semarang pada tahun 2007 adalah sebagai berikut :

Tabel 3 : Prosentase Tingkat Pendidikan di Kota SemarangTahun 2007

No Tingkat Pendidikan Laki-laki dan Perempuan

Jumlah %

1. Tdk / blm pernah sekolah

91.786 6,53

2. Tidak / belum tamat SD

286.062 20,37

3. S D/MI 320.899 22,85

4. S L T P/MTs 284.641 20,27

5. S L T A/MA 296.172 21,09

6. Akademi 61.003 4,34

7. Universitas 63.311 4,51

J u m l a h : 1.403.874 100,00

Sumber data : BPS Kota Semarang

Menurut Badan Pusat Statistik Kota Semarang bahwa perkembangan

tingkat pendidikan yang ditamatkan penduduk Kota Semarang selama

5 ( lima ) tahun terakhir mengalami peningkatan yang cukup berarti. Yang

paling menonjol adalah peningkatan penduduk yang pendidikannya tamatan

SLTA ke atas ( D I, II, III, dan D IV/ S1/ S2/ S3 ), kenaikan ini terjadi baik

untuk penduduk laki-laki maupun perempuan.

Tabel 4 : Prosentase Sarana Pendidikan di Kota Semarang Tahun 2007

No Jenis Sarana Pendidikan Jumlah %

1. TK / Diniyah 594 38,42

2. SD / MI 640 41,39

3. SLTP / MTs 164 10,60

4. SLTA / SMK / MA 148 9,57

Jumlah 1.546 100,00

Sumber data : BPS Kota Semarang

2.4. SOSIAL EKONOMIProsentase jenis mata pencaharian penduduk Kota Semarang

pada tahun 2007, adalah sebagai berikut :

Tabel 5 : Prosentase Jenis Mata Pencaharian Penduduk Kota Semarang Tahun 2007

No Jenis Mata Pencaharian Jumlah ( % )

1. Petani sendiri 26.494 4,30

2. Buruh tani 18.992 3,08

3. Buruh Industri 152.557 24,79

4. Buruh bangunan 71.328 11,57

5. Nelayan 2.506 0,40

Profil Kesehatan Kota Semarang Tahun 2007

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6. Pengusaha 51.304 8,33

7. Pedagang 73.431 11,93

8. Angkutan 22.187 3,60

9. PNS/ TNI/ POLRI 86.918 14,12

10. Lain-lain 109.512 17,80

J u m l a h : 615.229 100,00

Sumber data : BPS Kota Semarang

2.5. SARANA DAN PRASARANA KESEHATAN Tabel 6 : Prosentase Sarana dan Prasarana di Kota Semarang

Tahun 2006 - 2007A. SARANA DAN PRASARANA KESEHATAN 2006 2007

1. Rumah Sakit Umum :

a. Rumah Sakit Swasta

b. Rumah Sakit Umum Daerah

c. Rumah Sakit Umum Pusat

8

2

1

9

2

1

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

d. Rumah Sakit TNI / POLRI

e. Rumah Sakit Khusus, terdiri dari :

- RS Jiwa

- RS Bedah Plastik

- Rumah Sakit Ibu dan Anak ( RSIA )

- Rumah Sakit Bersalin ( RSB )

Rumah Bersalin ( RB ) / BKIA

Puskesmas , terdiri dari :

a. Puskesmas Perawatan

b. Puskesmas Non Perawatan

Puskesmas Pembantu

Puskesmas Keliling

Posyandu yang ada

Posyandu Aktif

Apotik

Laboratorium Kesehatan Swasta

Klinik Spesialis

Optik

Klinik 24 Jam

Toko Obat

BP Umum

BP Gigi

PBDS

Tabib ( yang memiliki Wajib Daftar )

Sinshe ( yang memiliki Wajib Daftar )

Akupunktur (yang memiliki Wajib Daftar)

Pijat Urut ( yang memiliki Wajib Daftar )

Terapi Zona (yang memiliki Wajib Daftar)

Rei Ki ( yang memiliki Wajib Daftar )

3

10

1

1

4

4

23

37

11

26

33

37

1.446

1.442

310

31

13

42

20

73

165

31

6

7

30

50

14

49

12

3

10

1

1

4

4

23

37

11

26

33

37

1.454

1.454

316

33

13

46

20

78

186

38

7

11

33

64

15

53

13

Sumber data : Sie Informasi Kesehatan Dinas Kesehatan Kota Semarang

Profil Kesehatan Kota Semarang Tahun 2007

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BAB IIIPEMBANGUNAN KESEHATAN KOTA

3.1 DASARDasar pembangunan kesehatan adalah nilai kebenaran dan aturan pokok

yang menjadi landasan untuk berfikir dan bertindak dalam penyelenggaraan

pembangunan kesehatan. Dasar-dasar berikut ini merupakan landasan dalam

penyusunan visi, misi dan strategi serta sebagai petunjuk pokok pelaksanaan

pembangunan kesehatan:

3.1.1 PerikemanusiaanSetiap kegiatan proyek, program kesehatan harus berlandaskan

perikemanusiaan yang dijiwai, digerakkan dan dikendalikan oleh keimanan dan

ketakwaan kepada Tuhan Yang Maha Esa.

3.1.2 Pemberdayaan dan KemandirianIndividu, keluarga, masyarakat beserta lingkungannya bukan saja sebagai

obyek namun sekaligus pula subyek kegiatan, proyek, program kesehatan. Segenap

komponen bangsa bertangggung jawab untuk memelihara dan meningkatkan derajat

kesehatan individu, keluarga, masyarakat beserta lingkungannya. Setiap kegiatan,

proyek, program kesehatan harus mampu membangkitkan peran serta individu,

keluarga dan masyarakat sedemikian rupa sehingga setiap individu, keluarga dan

masyarakat dapat menolong dirinya sendiri.

Dengan dasar ini, setiap individu, keluarga dan masyarakat melalui kegiatan,

proyek, program kesehatan difasilitasi agar mampu mengambil keputusan yang tepat

ketika membutuhkan pelayanan kesehatan. Warga masyarakat harus mau bahu

membahu menolong siapa saja yang membutuhkan pertolongan agar dapat

menjangkau fasilitas kesehatan yang sesuai kebutuhan dalam waktu yang sesingkat

mungkin. Di lain pihak, fasilitas pelayanan kesehatan yang ada perlu terus

diberdayakan agar mampu memberikan pertolongan kesehatan yang berkualitas,

terjangkau, sesuai dengan norma sosial budaya setempat serta tepat waktu.

3.1.3 Adil dan MerataSetiap individu, keluarga dan masyarakat mempunyai kesempatan yang

sama untuk memperoleh pelayanan kesehatan yang dibutuhkan sehingga dapat

mencapai derajat kesehatan yang setinggi-tingginya. Kesempatan untuk

memperoleh pelayanan kesehatan yang berkualitas, terjangkau dan tepat waktu,

tidak boleh memandang perbedaan ras, golongan, agama, dan status sosial individu,

keluarga dan masyarakat.

Pembangunan kesehatan yang cenderung urban-based harus terus

diimbangi dengan upaya-upaya kesehatan yang bersifat rujukan, bersifat luar

gedung maupun yang bersifat satelit pelayanan. Dengan demikian pembangunan

kesehatan dapat menjangkau kantong-kantong penduduk beresiko tinggi yang

merupakan penyumbang terbesar kejadian sakit dan kematian. Kelompok-kelompok

penduduk inilah yang sesungguhnya lebih membutuhkan pertolongan karena selain

lebih rentan terhadap penyakit, kemampuan membayar mereka jauh lebih sedikit.

3.1.4 Pengutamaan dan ManfaatPemanfaatan ilmu pengetahuan dan tekhnologi kedokteran dan atau

kesehatan dalam kegiatan, proyek, program kesehatan harus mengutamakan

peningkatan kesehatan dan pencegahan penyakit. Kegiatan, proyek dan program

kesehatan diselenggarakan agar memberikan manfaat yang sebesar-besarnya bagi

peningkatan deajat kesehatan masyarakat. Kegiatan, proyek dan program kesehatan

diselenggarakan dengan penuh tanggung jawab, sesuai dengan standar profesi dan

peraturan perundang-undangan yang berlaku serta mempertimbangkan dengan

sungguh-sungguh kebutuhan dan kondisi spesifik daerah.

3.2 VISI DAN MISI3.2.1 VISI

Gambaran masyarakat Semarang di masa depan yang ingin dicapai melalui

pembangunan kesehatan adalah “Terwujudnya masyarakat kota metropolitan

yang sehat didukung dengan profesionalisme dan kinerja yang tinggi”Visi tersebut mengandung dua filosofi pokok yang akan dilaksanakan

perwujudannya, yaitu masyarakat kota metropolitan yang sehat dan upaya

pelayanan kesehatan dilakukan secara profesional dan didukung oleh tenaga yang

memiliki kinerja yang tinggi.

Masyarakat kota metropolitan yang sehat adalah masyarakat yang ditandai

oleh penduduknya hidup dalam lingkungan dan dengan perilaku hidup sehat,

memiliki kemampuan untuk menjangkau pelayanan kesehatan yang bermutu secara

adil dan merata serta memiliki derajad kesehatan yang setinggi-tingginya.

Profil Kesehatan Kota Semarang Tahun 2007

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Upaya pelayanan kesehatan secara profesional adalah tatanan dari stake

holder kesehatan di kota Semarang yang memiliki kemampuan cipta, rasa, karsa dan

karya yang tinggi dengan karakteristik mandiri, kreatif, berbudaya, partisipatif dan

menguasi ilmu pengetahuan teknologi sehingga mampu memberikan upaya

pelayanan kesehatan masyarakat maupun perorangan yang prima.

3.2.2 MISIMisi mencerminkan peran, fungsi dan kewenangan seluruh jajaran organisasi

kesehatan di seluruh wilayah Kota Semarang, yang bertanggung jawab secara

teknisterhadap pencapaian tujuan dan sasaran pembangunan kesehatan Kota

Semarang. Untuk mewujudkan visi tersebut ditetapkan misi yang diemban oleh

seluruh jajaran petugas kesehatan di masing-masing jenjang administarsi

pemerintahan, yaitu :

1. Memberi perlindungan kesehatan dan memberi pelayanan kesehatan

paripurna yang terbaik kepada seluruh lapisan masyarakat agar tercapai

derajat kesehatan yang optimal

2. Melibatkan peran serta masyarakat melalui upaya di bidang kesehatan

dengan cara efektif dan efisien

3.2.3 TUJUAN1. Meningkatkan mutu upaya pelayanan kesehatan yang berhasil

guna, beradya guna dan dapat menjangkau seluruh lapisan

masyarakat. (Misi 1)

2. Menyediakan pelayanan kefarmasian yang memenuhi

persyaratan mutu, keamanan dan kemanfaatan. (Misi 1)

3. Meningkatkan kualitas manajemen upaya pelayanan

kesehatan dalam mendukung pencapaian derajad kesehatan

masyarakat yang optimal. (Misi 1)

4. Memberdayakan individu, kelompok masyarakat di bidang

kesehatan untuk memelihara, meningkatkan, melindungi

kesehatannya sendiri dan lingkungannya menuju masyarakat

yang sehat, mandiri, produktif. (Misi 2)

3.2.4. SASARAN

1. Menurunnya angka kesakitan, kematian akibat penyakit menular dan tidak

menular serta penyakit yang dapat dicegah dengan imunisasi sehingga

dapat mencegah penyebaran penyakit.

2. Tersedianya pelayanan kesehatan dasar & rujukan baik pemerintah dan

swasta yang bermutu menuju peningkatan derajad kesehatan masyarakat

yang optimal.

3. Meningkatnya derajad kesehatan ibu, ibu maternal, bayi, balita, anak

prasekolah, remaja, usia lanjut serta meningkatnya status gizi

masyarakat.

4. Meningkatnya kualitas air, lingkungan pemukiman, tempat umum, tempat

pengelolaan makanan yang lebih sehat sehingga dapat melindungi

masyarakat dari penyakit yang ditularkan melalui lingkungan.

5. Tersedianya kebutuhan obat pelayanan kesehatan dasar yang bermutu,

aman dan efektif sesuai kebutuhan medis masyarakat serta

meningkatnya keamanan, khasiat obat yang beredar termasuk obat

tardisional dan kosmetika.

6. Meningkatnya fungsi perencanaan dan evaluasi pelayanan kesehatan

yang didukung tersedianya sistem informasi yang handal serta kapasitas

sumber daya manusia kesehatan yang memadai.

7. Tersedianya sarana prasarana pelayanan kesehatan dasar pemerintah

yang memadai untuk pelayanan kesehatan bagi seluruh lapisan

masyarakat

8. Meningkatnya perilaku hidup bersih sehat dan peran aktif masyarakat

dalam memelihara, meningkatkan, melindungi kesehatan diri dan

lingkungannya.

3.2.5 STRATEGI KEBIJAKAN

Program yang telah disusun dan ditetapkan sebagai strategi kebijakan Dinas

Kesehatan Kota Semarang terdiri dari 8 (delapan) program, antara lain

1. Pelayanan Kesehatan

2. Pencegahan dan Pemberantasan Penyakit

3. Kesehatan Keluarga dan Gizi Masyarakat

4. Lingkungan Sehat

5. Pemberdayaan Masyarakat

6. Manajemen Kesehatan dan Perijinan

Profil Kesehatan Kota Semarang Tahun 2007

15

7. Obat dan Perbekalan Kesehatan

8. Peningkatan Sarana dan Prasarana Pelayanan Kesehatan

3.3 SASARAN PROGRAM PEMBANGUNAN DINAS KESEHATAN KOTA SEMARANG TAHUN 2007Kinerja dinas yang ingin diwujudkan/ dicapai dalam tahun 2007 (target)

tercermin dalam sasaran-sasaran beserta indikatornya sebagai berikut :

I. Menurunnya angka kesakitan, kematian akibat penyakit menular

dan tidak menular serta penyakit yang dapat dicegah dengan

imunisasi sehingga dapat mencegah penyebaran penyakit.

1. Kasus demam berdarah yang dilakukan penyelidikan epidemiologi < 48

jam : 30%

2. Kasus demam berdarah yang difogging sesuai standar < 2 minggu :

60%

3. Penderita demam berdarah yang ditangani : 100%

4. Incident rate demam berdarah : 20/10.000 penduduk

5. Case fatality rate demam berdarah : 2 %

6. Kesembuhan penderita TB BTA + (cure rate) : > 85%

7. Penemuan kasus TB BTA + (case detection rate) : 55%

8. Angka kesakitan diare : 16,24/1000 penduduk

9. Balita dengan diare yang ditangani : 100%

10. Angka kematian diare : < 1/10.000 penduduk

11. Cakupan penemuan pnemoni balita : 25%

12. Cakupan balita dengan pnemoni yang ditangani : 100%

13. Angka kesakitan pnemoni balita : 11,25/10.000 penduduk

14. Klien yang mendapat penanganan HIV-AIDS : 75%

15. Kasus infeksi menular seksual yang diobati : 100%

16. Prevalensi HIV-AIDS : < 1/10.000 penduduk

17. Darah donor diskrining HIV-AIDS : 100%

18. Penderita kusta yang selesai berobat (RFT rate) : > 90%

19. Kelurahan mengalami KLB PD3I & keracunan makanan yang ditangani

< 24 jam : 85%

20. Kelurahan mengalami KLB penyakit bersumber binatang yang ditangani

< 24 jam : 35%

21. Acute flacid paralysis rate < 15 tahun : 2/100.000 penduduk

22. Jejaring deteksi surveilens PTM di RS & puskesmas yang mantap :

80%

23. Puskesmas yang melakukan deteksi dini PTM tertentu : 80%

24. Ketepatan laporan surveilens penyakit menular : 80%

25. Kelengkapan laporan surveilens penyakit menular : 90%

26. Ketepatan laporan penyakit tidak menular : 65%

27. Kelengkapan laporan penyakit tidak menular : 80%

28. Kelurahan mencapai Universal Child Imunization (UCI) : 78%

29. Cakupan BIAS : 95%

30. Imunisasi TT ibu hamil : 70%

31. Imunisasi calon jemaah haji : 100%

32. Pelacakan K3JH : 90%

II. Tersedianya pelayanan kesehatan dasar & rujukan baik pemerintah

dan swasta yang bermutu menuju peningkatan derajad kesehatan

masyarakat yang optimal

1. Cakupan rawat jalan di sarana kesehatan

dasar (puskesmas) : 65%

2. Cakupan rawat inap di sarana kesehatan

dasar (puskesmas) : 0,27%

3. Pelayanan kesehatan kepada korban

bencana :

4. Cakupan rawat jalan di sarana kesehatan

rujukan : 15%

5. Cakupan rawat inap di sarana kesehatan

rujukan : 1,5%

6. Pemenuhan darah di Rumah Sakit : 80%

7. Sarana kesehatan dengan kemampuan gawat

darurat yang dapat diakses masyarakat :

100%

8. Pelayanan gangguan jiwa di sarana

pelayanan kesehatan umum : 0,4%

9. Pembinaan di laboratorium kesehatan swasta

: 100%

10. Pembinaan di laboratorium puskesmas :

100%

Profil Kesehatan Kota Semarang Tahun 2007

17

11. Pembinaan di laboratorium rumah sakit :

100%

12. Pembinaan di optik : 40%

13. Perijinan sarana kesehatan yang selesai

diproses :

- Balai pengobatan : 30 buah

- Balai pengobatan gigi : 3 buah

- klinik 24 jam : 3 buah

- laboratorium klinik swasta : 2 buah

- optic : 4 buah

- praktek bersama dokter spesialis : 1 buah

- klinik spesialis : 2 buah

- rumah bersalin : 2 buah

- toko obat : 12 buah

- toko obat tradisional : 1 buah

- rumah sakit : 1 buah

14. Jumlah perijinan tenaga kesehatan yang selesai diproses :

- dokter umum : 205 orang

- dokter gigi : 150 orang

- dokter spesialis : 130 orang

- dokter gigi spesialis : 14 orang

- apoteker : 20 orang

- bidan : 15 orang

- perawat : 50 orang

- asisten apoteker : 50 orang

- pengobat tradisional : 5 orang

III. Meningkatnya derajad kesehatan ibu, ibu hamil, bayi, balita, anak

prasekolah, remaja, usia lanjut.

1. Kunjungan ibu hamil 1 : 95%

2. Kunjungan ibu hamil 4 : 87%

3. Pertolongan persalinan oleh tenaga kesehatan yang memiliki

kompetensi kebidanan : 87%

4. Deteksi risiko tinggi oleh tenaga kesehatan : 20%

5. Deteksi risiko tinggi oleh masyarakat : 10%

6. Jumlah pemeriksaan papsmear : 375 orang ibu

7. Ibu hamil dengan risiko tinggi yang dirujuk : 45%

8. Ibu hamil dengan risiko tinggi yang ditangani : 100%

9. Ibu hamil komplikasi yang ditangani : 90%

10. Neonatal risiko tinggi /komplikasi yang ditangani : 80%

11. Cakupan kunjungan neonatus : 87%

12. Cakupan kunjungan bayi : 87%

13. Cakupan bayi berat badan lahir rendah (BBLR) : 0,8%

14. Cakupan BBLR yang ditangani : 100%

15. Cakupan Deteksi Dini Tumbuh Kembang balita & anak prasekolah :

68%

16. Cakupan peserta KB aktif : 78,81%

17. Cakupan pelayanan kesehatan usila : 55%

18. Kelompok usila aktif : 80%

19. Jaminan pemeliharaan kesehatan keluarga miskin & masyarakat rentan:

V. Meningkatnya status gizi masyarakat terutama pada ibu hamil,

bayi dan balita.

1. Balita yang datang dan ditimbang (D/S) : 74%

2. Balita yang naik berat badannya (N/D) : 72%

3. Balita bawah garis merah (BGM) : 1,8%

4. Prevalensi gizi kurang balita : 16,70%

5. Prevalensi gizi buruk balita : 1,8%

6. Ibu hamil mendapat 90 tablet Fe : 84%

7. Bayi yang mendapat kapsul vit A 1 kali/th : 92%

8. Balita yang mendapat kapsul vit A 2 kali/th : 92%

9. Ibu nifas yang mendapat kapsul vit A: 84%

10. Anemi gizi besi ibu hamil : 25%

11. Pemberian makanan pendamping ASI pada bayi BGM

dari gakin : 80%

12. Ibu hamil KEK : 8%

13. Balita gizi buruk mendapat perawatan : 100%

14. Bayi mendapat ASI eksklusif : 35%

15. Keluarga sadar gizi : 62%

16. Kelurahan dengan garam beriod baik : 66%

Profil Kesehatan Kota Semarang Tahun 2007

19

20. Kecamatan bebas rawan gizi : 50%

V. Meningkatnya kualitas air, lingkungan pemukiman, tempat umum,

tempat pengelolaan makanan yang lebih sehat sehingga dapat

melindungi masyarakat dari penyakit yang ditularkan melalui

lingkungan.

1. Cakupan air bersih : 92,6%

2. Kualitas air minum yang memenuhi syarat kesehatan : 80,8%

3. Kualitas air bersih yang memenuhi syarat kesehatan : 64%

4. Rumah sehat : 80,44%

5. Penduduk yang memanfaatkan jamban : 83,94%

6. Rumah yang mempunyai SPAL : 72,14%

7. TPA-TPS yang memenuhi syarat kesehatan : 75%

8. Institusi yang dibina : 77%

9. Tempat umum yang memenuhi syarat kesehatan : 71%

10. Tempat pengelolaan pestisida sehat : 85%

11. Industri rumah tangga makanan minuman yang memenuhi syarat

kesehatan : 71,15%

12. Tempat pengelolaan makanan sehat : 69,15%

VI. Tersedianya kebutuhan obat pelayanan kesehatan dasar yang

bermutu, aman dan efektif sesuai kebutuhan medis masyarakat

serta meningkatnya keamanan, khasiat obat yang beredar

termasuk obat tradisional dan kosmetika.

a. Ketersediaan obat sesuai kebutuhan : 90%

b. Pengadaan obat esensial : 90%

c. Pengadaan obat generik : 95%

d. Ketersediaan narkotika, psikotropika sesuai kebutuhan pelayanan

kesehatan : 100%

e. Pengelolaan & peredaran obat di sarana distribusi obat :

– Puskesmas : 100%

– Apotek : 50%

– Toko obat : 80%

– BP/RB : 85%

– Industri Kecil Obat Tradisional : 15%

– Toko kosmetik : 30%

f. Penerapan pengobatan rasional di puskesmas : 70%

g. Pelanggaran distribusi obat di sarana distribusi obat swasta (apotek,

toko obat, BP/RB, toko kosmetik) : 3%

h. Penulisan resep obat generik : 90%

i. Industri Kecil Obat Tradisional (IKOT) yang menerapkan Cara

Pembuatan Obat Tradisional Benar : 100%

j. Upaya penyuluhan pencegahan penanggulangan penyalahgunaan

NAPZA oleh petugas kesehatan : 10%

VII. Meningkatnya fungsi perencanaan dan evaluasi pelayanan

kesehatan yang didukung tersedianya sistem informasi yang

handal serta kapasitas sumber daya manusia kesehatan yang

memadai.

1. Penyusunan rencana kinerja tahunan dan

pengukuran kinerja kegiatan : 100%

2. Monitoring evaluasi kegiatan : 12 kali per tahun

3. Data dan informasi kesehatan yang akurat, lengkap,

tepat waktu :

4. Pelaksanaan diklat teknis fungsional

5. Pelayanan pemberian izin belajar pendidikan formal

6. Pengetahuan tenaga fungsional tentang angka kredit

7. Pengetahuan SDM tentang administrasi kepegawaian

VIII. Tersedianya sarana prasarana pelayanan kesehatan dasar

pemerintah yang memadai untuk pelayanan kesehatan bagi

seluruh lapisan masyarakat

1. Tersedianya prasarana/bangunan fisik pelayanan kesehatan

dasar pemerintah yang memenuhi syarat :

2. Tersedianya alat kesehatan medis yang memadai yang

sesuai dengan kebutuhan pelayanan kesehatan :

IX. Meningkatnya perilaku hidup bersih sehat dan peran serta aktif

Profil Kesehatan Kota Semarang Tahun 2007

21

masyarakat dalam memelihara, meningkatkan, dan melindungi

kesehatan diri dan lingkungannya.

1. Rumah tangga sehat (sehat utama & paripurna) :

56%

2. Posyandu purnama : 36%

3. Posyandu mandiri : > 2%

4. Sekolah sehat : 81%

5. Cakupan penduduk yang menjadi peserta

jaminan pemeliharaan kesehatan pra bayar :

13%

6. Kelompok upaya kesehatan kerja : 20 buah

7. Rumah bebas jentik nyamuk aedes (ABJ) :

88%

8. Cakupan pemeriksaan kesehatan siswa SD

& setingkat (kelas 1) oleh tenaga kesehatan

atau tenaga terlatih (guru UKS, dokter kecil)

: 100%

9. Cakupan pemeriksaan kesehatan siswa TK

oleh tenaga kesehatan : 50% dari sasaran

10. Cakupan pemeriksaan kesehatan siswa

SLTP oleh tenaga kesehatan atau tenaga

terlatih (guru UKS) : 30%

11. Cakupan pemeriksaan kesehatan siswa

SLTA oleh tenaga kesehatan atau tenaga

terlatih (guru UKS) : 30%

BAB IVPENCAPAIAN PEMBANGUNAN KESEHATAN

Gambaran masyarakat Kota Semarang masa depan yang ingin dicapai oleh

segenap komponen masyarakat melalui pembangunan kesehatan Kota Semarang

adalah : Kota Semarang Sehat 2010 yang mandiri dan bertumpu pada potensi

daerah. Terdapat beberapa keterkaitan dari beberapa aspek yang dapat mendukung

meningkatnya kinerja yang dihubungkan dengan pencapaian pembangunan

kesehatan, diantaranya adalah : (1) indikator derajat kesehatan sebagai hasil akhir,

yang terdiri atas indikator mortalitas, morbiditas dan status gizi. (2) indikator hasil

antara, yang terdiri atas indikator keadaan lingkungan, perilaku hidup masyarakat,

akses mutu pelayanan kesehatan serta (3) indikator proses dan masukan yang terdiri

atas indikator pelayanan kesehatan, sumber daya kesehatan, manajemen kesehatan

dan kontribusi sektor terkait.

IV. 1 Situasi Derajat KesehatanIV.1.1. Kematian

Kejadian kematian dalam masyarakat dari waktu ke waktu dapat

menggambarkan status kesehatan masyarakat secara kasar, kondisi/ tingkat

permasalahan kesehatan, kondisi lingkungan fisik dan biologik secara tidak

langsung. Selain itu dapat pula digunakan sebagai indikator dalam penilaian

keberhasilan pelayanan kesehatan dan program pembangunan kesehatan :

IV.1.1.1 Kematian Bayi dan BalitaAngka kematian bayi di Provinsi Jawa Tengah Tahun 2006 yaitu

sebesar 7,50 per 1.000 kelahiran hidup. Untuk tahun 2007, berdasarkan hasil

Survei Kesehatan Daerah (SURKESDA) jumlah kematian bayi yang terjadi di

Kota Semarang sebanyak 466 dari 24.746 kelahiran hidup, terdiri dari 226

kematian bayi yang berasal dari laporan Puskesmas se-Kota Semarang dan

240 kematian bayi di tingkat Rumah Sakit, sehingga didapatkan Angka

Kematian Bayi (AKB) sebesar 18,8 per 1.000 KH. Berdasarkan pencapaian

tersebut maka terdapat penurunan dari tahun sebelumnya yang mencapai

483 bayi dari 24.498 kelahiran hidup. Hal ini dapat disebabkan karena

tersedianya berbagai fasilitas atau faktor aksesibilitas bagi pelayanan

kesehatan ibu dan anak serta dukungan kemampuan dari tenaga medis yang

Profil Kesehatan Kota Semarang Tahun 2007

23

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terampil dalam memberikan pelayanan kesehatan yang berkualitas. Selain itu

sistem pencatatan serta pelaporan yang semakin baik dan tepat waktu turut

mendukung pencapaian indikator tersebut.

Sedangkan untuk kematian Balita di Kota Semarang Tahun 2007

sebanyak 113 anak terdiri dari 47 balita (laporan Puskesmas) dan 66 balita

(laporan Rumah Sakit), sehingga diperoleh Angka Kematian Balita (AKABA)

Kota Semarang sebesar 4,6 per 1.000 KH.

IV.1.1.2 Kematian Ibu Maternal (AKI) Angka kematian ibu dapat diperoleh dari berbagai macam studi yang

dilakukan dalam bentuk survey dengan cakupan wilayah terbatas. Angka

kematian ibu yang berasal dari kegiatan Survei Kesehatan Rumah Tangga

(SKRT) pada tahun 2002/2003 yaitu sebesar 307 per 100.000 kelahiran

hidup merupakan angka nasional yang tidak dapat diuraikan di tingkat

Kabupaten / Kota. AKI di Provinsi Jawa Tengah tahun 2006 yaitu sebesar

101 per 100.000 kelahiran hidup. Berdasarkan laporan Puskesmas jumlah

kematian ibu maternal di Kota Semarang pada tahun 2007 sebanyak 20

orang dengan jumlah kelahiran hidup sebanyak 24.746 orang.

Kematian tersebut umumnya terjadi di tempat pelayanan kesehatan

ibu dan anak seperti Bidan Praktek Swasta (BPS) serta tempat pelayanan

kesehatan rujukan, yaitu di Rumah Sakit akibat keterlambatan rujukan dari

pelayanan dasar tersebut. Terdapat beberapa hal yang dapat menjadi faktor

penyebab yaitu kualitas ketrampilan pelayanan Bidan Praktek Swasta dalam

pemeriksaan kehamilan (ANC) dan pertolongan persalinan yang sesuai

standar Asuhan Persalinan Normal (APN), kecepatan dan ketanggapan

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dalam menangani masalah kegawat daruratan pada saat persalinan maupun

pasca persalinan, dimana hal ini berpengaruh terhadap penentuan diagnosa

maupun dalam pengambilan keputusan klinik. Faktor lainnya yang turut

menentukan adalah keteraturan ibu hamil memeriksakan kehamilannya

(ANC) di petugas kesehatan, deteksi dini terhadap resiko tinggi dan

komplikasi kehamilan ataupun persalinan, serta dukungan keluarga dalam

memperoleh pelayanan kehamilan, persalinan maupun rujukan

kegawatdaruratan. Disamping itu mulai membaiknya sistem pencatatan dan

pelaporan baik di sarana pelayanan kesehatan khususnya Rumah Sakit dan

Puskesmas turut membantu dalam pendataan kematian ibu maternal.

Kejadian kematian ibu maternal paling banyak terjadi pada masa nifas

sebesar 60%, kemudian pada persalinan 25% dan masa kehamilan 15%.

Sebagai upaya untuk menurunkan Angka Kematian Ibu (AKI), telah

dilaksanakan berbagai pelatihan peningkatan kualitas pelayanan kesehatan

ibu dan anak diantaranya Pelatihan Asuhan Persalihan Normal (APN) yang

merupakan standar pertolongan persalinan dan pendampingan persalinan

dukun bayi oleh tenaga kesehatan, Pelayanan Obstetri dan Neonatal

Emergensi Dasar (PONED) dan Pelayanan Obstetri dan Neonatal Emergensi

Komprehensif (PONEK) serta yang lainnya.

Profil Kesehatan Kota Semarang Tahun 2007

25

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IV.1.2. Penyakit MenularIV.1.2.1. Pemberantasan Penyakit Demam Berdarah Dengue (DBD)

a. Angka KesakitanPenyakit DBD di Kota Semarang pada tahun 2007 mengalami

peningkatan dari tahun sebelumnya yaitu dari 1.845 kasus menjadi 2.924

kasus. Hal yang serupa juga terdapat pada kelurahan dengan katagori

endemis meningkat dari tahun sebelumnya (143 kelurahan) menjadi 154

kelurahan, sedangkan kelurahan non endemis/sporadis sebanyak 22

kelurahan dan kelurahan potensil 1 kelurahan dan tidak ada kelurahan yang

bebas DBD.

Berdasarkan data pada tabel 10, angka kesakitan DBD pada tahun

2007 mencapai 19,64 per 10.000 penduduk, meningkat dari tahun 2006

(12,99 per 10.000 penduduk),

Berdasarkan grafik diatas, angka kesakitan (incidence rate = IR)

Kota Semarang mulai tahun 2002 – 2007 rata-rata diatas target nasional (IR

= 2/100.000 penduduk) maupun target Kota Semarang sendiri yaitu 7/10.000

penduduk. Jumlah penderita DBD tahun 2007 merupakan tahun dengan

jumlah penderita terbanyak apabila dibandingkan data 5 tahun terakhir.

b. Angka KematianPada tahun 2007, jumlah kematian akibat DBD menurun menjadi 32

orang dari 42 orang pada tahun 2006, sehingga diperoleh CFR sebesar

1,1%, dimana angka tersebut masih dibawah target Kota Semarang dan SPM

yaitu < 2%. Penurunan CFR menunjukkan semakin baiknya pelayanan medis

penderita DBD pada Rumah Sakit di Kota Semarang. Pencapaian CFR

tertinggi terdapat pada Puskesmas Karangmalang (16,7%) dan CFR

terendah pada Puskesmas Kedungmundu (0.4%). Dan terdapat 16

puskesmas dengan CFR = 0%.

IV.1.2.2. Pemberantasan Penyakit Malariaa. Keadaan kasus

Berdasarkan laporan Puskesmas, jumlah kasus malaria pada tahun

2007 ditemukan 34 orang (API = 0.02 pddk) meningkat dari tahun

sebelumnya yaitu 27 orang (API = 0.02 pddk). Semuanya merupakan kasus

import karena berdasarkan hasil penyelidikan epidemiologi yang dilakukan

diketahui bahwa sebelumnya penderita pernah mengunjungi daerah endemis

malaria. Kecamatan dengan kasus malaria (+) tertinggi pada tahun 2007

adalah Bugangan 15 kasus.

b. Pelayanan terhadap PenderitaBentuk pelayanan yang diberikan terhadap penderita malaria adalah

pemeriksaan darah dan pengobatan. Pemeriksaan darah dilakukan terhadap

penderita klinis sedangkan pengobatan dilakukan terhadap baik penderita

klinis maupun yang positif malaria.

Pemeriksaan darah dilakukan untuk menegakkan diagnosa. Seorang

penderita klinis baru dinyatakan positif malaria apabila sediaan darah yang

diperiksa terdapat plasmodium. Selain dilakukan pemeriksaan darah, semua

penderita klinis memperoleh pengobatan klinis. Sedangkan untuk yang positif

malaria diberikan pengobatan radikal. Dengan demikian semua penderita

malaria yang ditemukan di Kota Semarang diberikan pengobatan (100%)

IV.1.2.3. Pemberantasan Penyakit TB Paru

Profil Kesehatan Kota Semarang Tahun 2007

27

a. Penemuan Penderita Baru (CDR)Penemuan suspek tahun 2007 sebanyak 8.437 mengalami penurunan

dibandingkan tahun 2006 (10.012 suspek). Begitu pula untuk penemuan

penderita TB Paru BTA positif pada tahun 2007 sebanyak 747 orang

mengalami penurunan bila dibandingkan tahun 2006 (901 orang). Hal ini

kemungkinan disebabkan karena beberapa UPK belum memenuhi target

program.

Angka penemuan penderita baru (CDR) tahun 2007 sebesar 49%

mengalami penurunan bila dibandingkan tahun 2006 (59%). Selain itu

pencapaian ini juga masih belum memenuhi target Kota Semarang (55%).

Hal ini dikarenakan belum semua Unit Pelayanan Kesehatan (UPK) belum

mencapai target yang ditetapkan.

b. Angka kesembuhan (Cure Rate)Pencapaian angka kesembuhan TB Paru di Kota Semarang pada

tahun 2006 sebesar 67% mengalami penurunan sebesar 3% dari tahun

2005 yang mencapai 70% dan masih belum memenuhi target yang

ditetapkan yaitu 85%. Hal ini kemungkinan disebabkan masih ada follow up

di akhir pengobatan yang tidak dapat diperiksa. Angka kesembuhan

tertinggi di Puskesmas Karangayu, Rowosari, Pudak Payung, Sekaran,

Purwoyoso dan Karanganyar sebesar 100%. Sedangkan angka

kesembuhan terendah (0%) di Puskesmas Karang Malang.

IV.1.2.4. Pemberantasan Penyakit Diarea. Angka Kesakitan

Penderita diare di Kota Semarang pada tahun 2007 sebanyak

29.943 penderita dengan angka kesakitan sebesar 20,11 per 1.000

penduduk, dimana terdapat peningkatan dari tahun sebelumnya. Cakupan

penderita diare tertinggi ditemukan pada golongan umur > 5 tahun yaitu

sebanyak 17.530 orang sedangkan pada golongan umur < 5 tahun

sebanyak 12.413 penderita.

Untuk Case Fatality rate (CFR) dihitung berdasarkan jumlah penderita

yang meninggal akibat penyakit Diare yang berobat di Puskesmas dan

berdasarkan data 5 tahun terakhir tidak ada laporan mengenai penderita

yang meninggal (CFR = 0)

IV.1.2.5. Pemberantasan Penyakit PneumoniaSampai saat ini diketahui 80 – 90%, penyebab kematian bayi dan

balita adalah pneumonia dan merupakan peringkat pertama penyebab

kematian bayi dan balita menurut Survei Kesehatan Nasional (2001).

Kasus pneumonia di Kota Semarang pada tahun 2007 mencapai 3.230

penderita, meningkat dari tahun 2006 yang hanya mencapai 2.286

penderita, sehingga diperoleh IR untuk tahun 2007 sebesar 219,88 per

10.000 balita. Namun apabila dilihat dari cakupan penemuan penderita

Pneumonia yang dilaporkan di Kota Semarang pada tahun 2007

cenderung mengalami penurunan apabila dibandingkan tahun 2006 yaitu

dari 35,02% menjadi 31%. Adanya peningkatan kasus pneumonia dapat

disebabkan oleh semakin meningkatnya tingkat pencemaran di wilayah

Kota Semarang dan status gizi balita yang kurang baik, dikarenakan

makanan yang dikonsumsi balita tidak mengandung cukup gizi yang

diperlukan oleh balita serta daya tahan tubuh Balita yang menurun akibat

status gizi kurang ataupun buruk.

Untuk pelayanan dan penanganan penderita pneumonia, dari 3.230

penderita yang ditemukan, seluruhnya (100%) mendapatkan penanganan

sesuai dengan prosedur penanganan penderita yang ada. Oleh karena itu,

kasus pneumonia maupun pneumonia berat yang ditemukan tidak sampai

menyebabkan terjadinya kematian ( CFR = 0 )

IV.1.2.6. Pemberantasan Penyakit KustaPada tahun 2007, penderita kusta di Kota Semarang yang dilaporkan

dari 16 kecamatan sebanyak 34 orang mengalami peningkatan dari 14

orang pada tahun 2006, yaitu terdiri dari penderita Kusta tipe MB = 27

orang dan PB = 7 orang. Prevalensi kusta tahun 2007 sebesar 0,2 per

10.000 penduduk, mengalami peningkatan dari tahun sebelumnya yang

mencapai 0,15 per 10.000 penduduk. Penderita yang ditemukan di

Puskesmas masih rendah, hal ini disebabkan karena banyak penderita

yang berobat ke RS Tugu. Dari seluruh penderita kusta yang ditemukan, 5

orang RFT PB (57%) dan RFT MB (13,04%) dinyatakan telah selesai

berobat (RFT, Releasing From Treatment ). Namun jumlah ini masih belum

memenuhi target yang ditetapkan dalam SPM yaitu >90%.

Profil Kesehatan Kota Semarang Tahun 2007

29

IV.1.2.7. Pemberantasan Penyakit Infeksi Menular Seksual a. Infeksi Menular Seksual (IMS)

Jumlah kasus Infekasi Menular Seksual (IMS) di Kota Semarang

pada tahun 2007 berdasarkan laporan Puskesmas mencapai 550 kasus.

Dari jumlah tersebut, 436 kasus (79,27%) sudah mendapatkan

penanganan/pengobatan. Terdapat 4 (empat) puskesmas yang

melaporkan cakupan pelayanan pengobatan kasus IMS, yaitu Puskesmas

Halmahera (75 kasus), Puskesmas Bugangan ( 20 kasus) dan Puskesmas

Gunungpati (4 kasus) serta Puskesmas Mangkang (451 kasus).

Sedangkan hasil kegiatan di klinik IMS tahun 2007, terdapat beberapa

IMS yang mengalami penurunan dibandingkan pada tahun 2006,

diantaranya Servisitis, Kandidiasis, Kandiloma ,Trichomonas vaginalis

Herpes Simplex. Sedangkan yang meningkat adalah Gonorhoe, Siphilis

dan Penyakit Radang Panggul. Hal ini kemungkinan disebabkan karena

pada Tahun 2007 ada kegiatan PPT ( Periodic Presumtive Treatment)

yang dilaksanakan di semua klinik IMS di Kota Semarang.

b. HIV/AIDSJumlah kasus HIV (+) yang ditemukan tahun 2007 sebanyak 18

orang menurun apabila dibandingkan tahun 2006 yaitu sebesar 19 orang.

Cakupan HIV/AIDS didapat dari hasil skrining sero survei pada kelompok

perilaku resiko tinggi sebanyak 363 orang terdiri dari Wanita Penjaja Seks

(WPS). Sedangkan dari hasil kegiatan VCT tahun 2007 ditemukan 195

kasus (120 orang dari klinik VCT, 42 orang BP4 dan 33 orang dari LSM).

Jumlah ini meningkat 16 orang dibandingkan tahun sebelumnya (179

kasus).

Sedangkan untuk kasus AIDS ditemukan sebanyak 33 kasus

meningkat dari tahun 2006 yang mencakup 25 kasus, Hal ini disebabkan

karena semakin meningkatnya pengetahuan masyarakat tentang HIV /

AIDS sehingga meningkat pula kunjungan ke klinik VCT.

Dari hasil skrining darah di PMI terhadap virus HIV selama tahun

2007 telah diperiksa darah donor sejumlah 47.059 orang. Dari jumlah

tersebut yang positif HIV/AIDS sebanyak 62 (0,13%). Hasil tersebut

menunjukkan bahwa HIV/AIDS tidak hanya menjangkiti kelompok resiko

tinggi saja tetapi juga sudah mengenai masyarakat umum. Namun

demikian darah tersebut sudah langsung dimusnahkan sehingga semua

pasien yang akan menerima darah donor bebas dari virus HIV.

Berikut ini data 10 besar penyakit yang ada di Kota Semarang pada

tahun 2007 berdasarkan laporan dari Puskesmas dan Rumah Sakit:

Tabel 6 : Data 10 Besar Penyakit di RS dan Puskesmas Tahun 2007No Rumah Sakit

(Rawat Inap)Jumlah Puskesmas Jumlah

1. Demam Berdarah Dengue 733 Infeksi akut lain pada saluran nafas

181.953

2. Diare dan gastroenteritis oleh penyebab infeksi tertentu

727 Faringitis 41.993

3. Demam tifoid dan paratifoid 589 Influensa 34.363

4. Diabetes mellitus YTT 195 Hipertensi esensial 28.304

5. Pneumonia 133 Diare 27.368

6. Infeksi saluran nafas bagian atas akut lainnya

116 Peny. Pulpa dan Jar. Peripikal

22.972

7. Peny. System kemih lainnya 116 Gastritis 22.456

8. Katarak dan gangguan lensa lainnya

114 Osteoporosis 20.674

9. Cedera intracranial 110 Gangguan otot lainnya 17.953

10. Hipertensi esensial 107 Nyeri kepala 15.113

Sumber data : Laporan SP3 dan SP2RS

IV.1.2.8. Surveilans Acute Flaccid Paralysis (SAFP)Untuk membebaskan Indonesia dari penyakit polio, maka pemerintah

telah melaksanakan program Eradikasi Polio (ERAPO) yang terdiri dari

pemberian imunisasi polio secara rutin, pemberian imunisasi massal pada

anak balita melalui PIN (Pekan Imunisasi Nasional) dan Surveilans AFP.

Surveilans AFP pada hakekatnya adalah pengamatan dan penjaringan semua

kelumpuhan yang terjadi secara mendadak dan sifatnya flaccid (layuh), seperti

sifat kelumpuhan pada poliomyelitis. Prosedur pembuktian penderita AFP

terserang virus polio liar atau tidak adalah sebagai berikut :

1. Melakukan

pelacakan

terhadap anak usia

Profil Kesehatan Kota Semarang Tahun 2007

31

sama atau kurang

dari 15 tahun yang

mengalami

kelumpuhan layuh

mendadak (<14

hari) dan

menentukan

diagnosa awal

2. Mengambil

spesimen tinja

penderita tidak

lebih dari 14 hari

sejak kelumpuhan,

sebanyak 2 kali

selang waktu

pengambilan I dan

II > 24 jam

3. Mengirim kedua

specimen tinja ke

laboratorium Bio

Farma Bandung

dengan

pengemasan

khusus/baku

4. Hasil pemeriksaan

spesimen tinja

akan menjadi bukti

virologis adanya

virus polio liar di

dalamnya

5. Diagnosa akhir

ditentukan pada 60

hari sejak

kelumpuhan.

Pemeriksaan klinis

ini dilakukan oleh

dokter spesialis

anak atau syaraf

untuk menentukan

adanya

kelumpuhan atau

tidak

Kasus AFP yang ditemukan di Kota Semarang tahun 2007 sebanyak

11 kasus, meningkat dari tahun sebelumnya sebanyak 8 kasus, terbanyak

pada golongan umur 5 -15 thn sebanyak 6 kasus, 1-4 thn sebanyak 5 kasus

sehingga untuk tahun 2007 diperoleh AFP rate sebesar 2,75 per 100.000

( target ≥ 2/100.000 penduduk ). Sumber penemuam kasus AFP ditemukan

pada 7 Rumah Sakit, 2 praktek swasta, 2 dari masyarakat.

IV.1.3. PENYAKIT TIDAK MENULARSaat ini di negara berkembang telah terjadi pergeseran penyebab

kematian utama yaitu dari penyakit menular ke penyakit tidak menular.

Kecenderungan transisi ini dipengaruhi oleh adanya berubahnya gaya hidup,

urbanisasi dan globalisasi. Penyakit yang tergolong dalam penyakit tidak

menular (degeneratif) yaitu : Neoplasma (Kanker), Diabetes Mellitus,

Gangguan mental, Penyakit Jantung dan Pembuluh Darah, dan lain-lain.

Neoplasma (Kanker), kanker adalah tumor ganas yang

ditandai dengan pertumbuhan abnormal sel-sel tubuh. Berdasarkan hasil

Survei Kesehatan Rumah Tangga (SKRT) tahun 2002, kanker merupakan

penyebab kematian ketiga setelah penyakit jantung dan stroke. Pada tahun

2007 di Kota Semarang berdasarkan laporan program yang berasal dari

Rumah Sakit dan Puskesmas, kasus penyakit kanker yang ditemukan

sebanyak 10.171, terdiri dari Kanker Payudara 4.844 kasus, Kanker Serviks

4.537 kasus, Kanker Hati dan Empedu 434 kasus, Kanker Bronkus dan Paru

256 kasus.

Diabetes Mellitus (Kencing Manis), Kencing manis adalah

Profil Kesehatan Kota Semarang Tahun 2007

33

suatu keadaan dimana terjadi kelebihan kadar gula darah (glukosa) dalam

darah. Kencing manis dapat disebabkan oleh faktor lingkungan seperti

kegemukan, makan makanan yang berlebihan, penyakit infeksi atau juga

dapat disebabkan oleh faktor keturunan yang mengganggu hormon insulin.

Data laporan program tahun 2007 untuk kasus Diabetes Mellitus adalah

sebanyak 50.129 kasus, terdiri atas 4.084 Diabetes tergantung insulin dan

46.063 kasus Diabetes non insulin.

Penyakit Jantung dan Pembuluh Darah, merupakan penyakit

yang mengganggu sistem pembuluh darah atau lebih tepatnya menyerang

jantung dan urat-urat darah, misalnya : Angina Pektoris, Acute Myocard Infark

(AMI), Hipertensi dan Stroke. Pada tahun 2007 di Kota Semarang kasus

Penyakit Jantung dan Pembuluh Darah terdiri dari Angina Pektoris 3.807

kasus, AMI 2.088 kasus, Hipertensi Esensial 54.780 kasus dan Stroke

Hemoragik 2.958 kasus. Kasus-kasus penyakit jantung dan pembuluh darah

banyak yang menyebabkan terjadinya kematian. Menurut data pendukung

yang ada, angka kematian karena penyakit tidak menular tahun 2007

meningkat tajam dibandingkan tahun-tahun sebelumnya. Urutan lima besar

penyakit tidak menular yang menyebabkan kematian yaitu :

1. Hipertensi

2. Diabetes mellitus non

insulin

3. Hipertensi lain

4. Stroke Hemoragik

5. Asma bronkiale

IV.1.4. Kejadian Luar BiasaDilaporkan pada tahun 2007 di Kota Semarang terjadi Kejadian Luar

Biasa (KLB) sebanyak 33 kejadian yaitu : Difteri (26 kejadian), Keracunan

Makanan (5 kejadian), Meningitis ( 1 kejadian) dan Campak (1 kejadian). Dari

kasus KLB yang ada, terjadi kematian akibat KLB Difteri (1 orang). Data

secara lengkap dapat dilihat pada tabel 31.

Dari 177 kelurahan yang ada di Kota Semarang terdapat 25 kelurahan

yang terkena kejadian luar biasa (KLB). Dari jumlah tersebut seluruhnya

(100%) telah dilakukan kegiatan penanganan/penanggulangan dengan cepat

dalam waktu kurang dari 24 jam (data selengkapnya pada tabel 30).

IV.1.5. Keadaan GiziIV.1.5.1 Status Gizi Bayi dan Balita

Perkembangan keadaan gizi masyarakat dapat dipantau melalui hasil

pencatatan dan pelaporan program perbaikan gizi masyarakat yang

tercermin dalam hasil penimbangan bayi dan balita setiap bulan di

posyandu. Pada tahun 2007 di Kota Semarang menunjukkan jumlah Bayi

Lahir Hidup sebanyak 24.746 bayi dan jumlah Balita yang ada (S) sebesar

115.400 anak. Untuk kasus bayi dengan Berat Badan Lahir Rendah (BBLR)

pada tahun 2007 yaitu sebanyak 137 bayi (0,55%), meningkat dari tahun

sebelumnya yaitu 133 bayi (0,53%). Sedangkan jumlah Balita yang datang

dan ditimbang (D) di posyandu dari seluruh balita yang ada 115.400 anak

(S) yaitu sejumlah 93.272 anak (80,82%) dengan rincian jumlah balita yang

naik berat badannya sebanyak 74.775 anak (80,17%) dan Bawah Garis

Merah (BGM) sebanyak 897 anak (0,96%).

Permasalahan gizi yang masih tetap ada dan jumlah cenderung

bertambah adalah masalah gizi kurang dan gizi buruk. Kurang gizi sangat

dipengaruhi oleh pengetahuan masyarakat yang kurang, keadaan sosial

ekonomi dan kejadian penyakit. Sedangkan untuk kasus gizi buruk

ditemukan sebanyak 30 kasus. Dari seluruh kasus gizi buruk tersebut juga

telah dilakukan intervensi khususnya upaya perbaikan gizi masyarakat

dalam bentuk kegiatan pemberian PMT pemulihan selama 180 hari,

perawatan serta pengobatan baik di puskesmas maupun di Rumah Sakit

dengan bantuan dana program Asuransi Kesehatan Masyarakat Miskin

(Askeskin) dan APBD II. Hasil Pemantauan Status Gizi di Kota Semarang

dari Tahun 2005 – Tahun 2007 dapat dilihat pada tabel di bawah ini :

Tabel 7 : Perkembangan Status Gizi Balita Tahun 2005 – 2007

Profil Kesehatan Kota Semarang Tahun 2007

35

No Status Gizi Prevalensi (kasus)

2005 2006 2007

1. Gizi buruk 0,94 1,73 1,68

2. Gizi kurang 11,09 14,00 15,19

3. Gizi baik 85,98 80,97 79,58

4. Gizi lebih 1,99 3,30 3,56

IV.1.5.2. ASI EkslusifASI (Air Susu Ibu) merupakan salah satu makanan yang sempurna

dan terbaik bagi bayi karena mengandung unsur-unsur gizi yang dibutuhkan

oleh bayi untuk pertumbuhan dan perkembangan bayi guna mencapai

pertumbuhan dan perkembangan bayi yang optimal. Oleh sebab itu ,

pemberian ASI perlu diberikan secara ekslusif sampai umur 6 (enam) bulan

dan dapat dilanjutkan sampai anak berumur 2 (dua) tahun. Walaupun

demikian masih terdapat kendala dalam pemantauan pemberian ASI Ekslusif

karena belum ada sistem yang dapat diandalkan. Selama ini pemantauan

tingkat pencapaian ASI Ekslusif dilakukan melalui laporan puskesmas yang

diperoleh dari hasil wawancara pada waktu kunjungan bayi di Puskesmas.

Berdasarkan hasil laporan puskesmas tahun 2007, pemberian ASI

Ekslusif mengalami penurunan dari tahun 2006 40,07% (9.129 bayi ) yang

hanya mencapai 4.281 bayi (38,44%). Jumlah ini masih belum memenuhi

target yang ditetapkan dalam Standar Pelayanan Minimal (SPM) yaitu 80%.

Terdapat beberapa hal yang menghambat pemberian ASI Ekslusif

diantaranya adalah : rendahnya pengetahuan ibu dan keluarga lainnya

mengenai manfaat dan cara menyusui yang benar, kurangnya pelayanan

konseling laktasi dan dukungan dari petugas kesehatan, faktor sosial budaya,

kondisi yang kurang memadai bagi para ibu yang bekerja dan gencarnya

pemasaran susu formula. Untuk itu tingkat pencapaian dalam program ASI

Ekslusif ini harus mendapatkan perhatian khusus dan memerlukan pemikiran

dalam mencari upaya-upaya terobosan serta tindakan nyata yang harus

dilakukan oleh provider di bidang kesehatan dan semua komponen

masyarakat dalam rangka penyampaian informasi maupun sosialisasi guna

meningkatkan pengetahuan dan kesadaran masyarakat.

IV.2. PERILAKU MASYARAKAT IV.2.1. Rumah Tangga Berperilaku Hidup Bersih dan Sehat (PHBS)

Menurut teori HL Blum salah satu faktor yang mempengaruhi derajat

kesehatan masyarakat adalah faktor perilaku. Dengan mewujudkan perilaku

yang sehat diharapkan dapat menurunkan angka kesakitan suatu penyakit

dan angka kematian ibu dan anak akibat terlambatnya/kurangnya kesadaran

dalam mengunjungi sarana pelayanan kesehatan.

Dalam rangka merubah perilaku masyarakat kepada perilaku yang

sehat, maka telah dilaksanakan kegiatan pembinaan Perilaku Hidup Bersih

dan Sehat. Dalam kegiatan PHBS terdiri dari beberapa sasaran kegiatan

yaitu PHBS tatanan institusi, tempat-tempat umum dan rumah tangga,

dimana tatanan rumah tangga dianggap merupakan tatanan yang

mempunyai daya ungkit paling besar terhadap perubahan perilaku

masyarakat secara umum. Pada tahun 2007 di Kota Semarang dari sampling

84.480 rumah tangga yang diperiksa diperoleh hasil yaitu Rumah Tangga

yang berperilaku hidup bersih dan sehat sebanyak 68.67%, terdiri dari strata

utama 63.083 RT (75%) strata paripurna 4.725 RT (5,59%).

IV.2.2. Posyandu Purnama dan Mandiri Salah satu Upaya Kesehatan Berbasis Masyarakat (UKBM) yang turut

mendukung pelaksanaan program kesehatan di masyarakat adalah pos

pelayanan terpadu (Posyandu) yang dilaksanakan oleh para kader yang

berasal dari masyarakat dengan pembinaan dari tenaga kesehatan di

puskesmas. Dalam perkembangannya ternyata posyandu mendapat

tanggapan positif dari masyarakat. Namun demikian tanggapan positif dari

masyarakat belum dibarengi dengan meningkatnya mutu pelayanan karena

masih banyak faktor yang menyebabkan mutu pelayanan posyandu masih

rendah antara lain : Sumber Daya Manusia (SDM) yang dimiliki masih sangat

rendah, banyak kader posyandu yang droup out, sarana dan prasarana yang

belum memadai.

Saat ini Posyandu yang ada di Kota Semarang berjumlah 1.464 buah,

terdiri dari 639 posyandu purnama (43,65%) dan 307 Posyandu mandiri

(20,97%) sehingga jumlah total posyandu yang tergolong purnama dan

Profil Kesehatan Kota Semarang Tahun 2007

37

mandiri adalah 946 posyandu (64,61%). Dari tabel 47 dapat dilihat bahwa

Kecamatan yang banyak memilki Posyandu dengan katagori Mandiri yaitu

Semarang Barat sebanyak 44 posyandu (14,33%) dan masih terdapat 8

(delapan) Puskesmas yang sama sekali tidak memiliki posyandu mandiri

diantaranya: Puskesmas Bugangan, Lamper Tengah, Gayamsari, Candilama,

Genuk, Pudak Payung, Gunungpati, dan Sekaran.

IV.2.3 Jaminan Pemeliharaan Kesehatan Masyarakat (JPKM)Salah satu kepedulian pemerintah terhadap kesehatan masyarakat

dalam pelayanan kesehatan adalah melalui pelaksanaan program Jaminan

Pelayanan Kesehatan Masyarakat (JPKM). JPKM merupakan upaya

pemeliharaan kesehatan secara paripurna, terstruktur yang dijamin

kesinambungan dan mutunya, dimana pembiayaannya dilaksanakan secara

pra-upaya. Penyelenggaraan pelayanan kesehatan pada JPKM bertujuan

untuk memelihara kesehatan para peserta, bukan hanya sekedar

menyembuhkan penyakit tetapi dituntut untuk aktif berusaha meningkatkan

derajat kesehatan dan mencegah peserta agar tidak jatuh sakit.

Berdasarkan laporan puskesmas, jumlah penduduk yang tercakup

dalam dalam berbagai JPK (Jaminan Pemeliharaan Kesehatan) sebesar

254.869 jiwa (20,62%) dari total jumlah penduduk , dengan perincian :

Peserta ASKES : 239.482 jiwa (19,92%)

Peserta BAPEL : 35.972 jiwa (2,99%)

Peserta JAMSOSTEK : 65.237 jiwa (5,43%)

Peserta Dana Sehat : 15.380 jiwa (1,28%)

Apabila dibandingkan dengan target Standar Pelayanan Minimal

(SPM) untuk pelayanan JPKM sebesar 30%, maka cakupan JPKM di Kota

Semarang masih belum memenuhi target.

IV.2.4. Pelayanan Kesehatan pada Keluarga MiskinSalah satu faktor yang menentukan bagi keberhasilan

pelaksanaan pembangunan kesehatan adalah kemudahan di dalam

akses terhadap pelayanan kesehatan yang ada. Kemampuan setiap

penduduk dalam hal ini berbeda-beda dimana dalam kondisi krisis

moneter seperti saat ini, terdapat sebagian besar penduduk yang

tidak mampu untuk menjangkau pelayanan kesehatan yang ada.

Untuk itu pemerintah memberikan bantuan/subsidi untuk pelayanan

kesehatan bagi keluarga miskin atau Maskin.

Cakupan jaminan pemeliharaan kesehatan Keluarga Miskin

dan Masyarakat Rentan terlindungi oleh JPK (subsidi Pemerintah

Pusat dan Pemerintah Daerah) di satu wilayah tertentu. Masyarakat

miskin yang terlindungi oleh JPK adalah masyarakat miskin yang telah

mempunyai kartu sehat atau Asuransi Kesehatan Keluarga Miskin

(Askeskin). Di Kota Semarang sampai dengan tahun 2007 terdapat

masyarakat miskin dan yang memiliki kartu ASKESKIN baru mencapai

175.716 jiwa (69,75%) dari 252.579 masyarakat miskin yang ada.

Pemanfaatan Asuransi Kesehatan Masyarakat Miskin

(ASKESKIN) oleh masyarakat miskin dalam pelayanan kesehatan

meningkat dari tahun sebelumnya, dimana untuk tahun 2007 jumlah

masyarakat miskin yang dengan kartu ASKESKIN yang mendapat

pelayanan kesehatan mencapai 79,69% dibandingkan tahun 2006

( 70,73%). Cakupan pelayanan kesehatan pada maskin berupa

kunjungan rawat jalan sebanyak 194.686 orang (110,99%) dan rawat

inap 922 orang (0,53%).

IV.3. PENYEHATAN LINGKUNGANUpaya penyehatan lingkungan dilaksanakan dengan lebih diarahkan

pada peningkatan kualitas lingkungan yaitu melalui kegiatan bersifat promotif,

preventif dan protektif. Adapun pelaksanaannya bersama-sama dengan

masyarakat, diharapkan secara epidemiologi akan mampu memberikan

kontribusi yang bermakna terhadap derajat kesehatan masyarakat.

Namun demikian pada umumnya yang menjadikan permasalahan

utama adalah masih rendahnya jangkauan program. Hal ini lebih banyak

Profil Kesehatan Kota Semarang Tahun 2007

39

diakibatkan oleh keterbatasan sumber daya kesehatan. Sedangkan

permasalahan utama yang dihadapi masyarakat adalah partisipasi

masyarakat terhadap upaya penyehatan lingkungan yang masih sangat

rendah. Lingkungan sehat merupakan salah satu pilar utama dalam

pencapaian Indonesia Sehat 2010.

IV.3.1 Rumah SehatRumah merupakan salah satu kebutuhan dasar manusia yang

berfungsi sebagai tempat tinggal atau hunian dan sarana pembinaan

keluarga. Oleh karena itu rumah haruslah sehat dan nyaman agar

penghuninya dapat berkarya untuk meningkatkan produktivitas hidup. Kota

Semarang pada tahun 2007, jumlah rumah yang ada sebanyak 294.351

buah, sedangkan kategori rumah yang memenuhi syarat kesehatan sebanyak

33.846 rumah (82,77%) dari 40.892 rumah yang dilakukan pemeriksaan.

Secara umum rumah dikatakan sehat apabila memenuhi beberapa

kriteria, diantaranya adalah bebas dari jentik nyamuk. Arti bebas disini

terutama pada bebas jentik nyamuk Aedes aegypti yang merupakan vektor

dari penyakit demam berdarah dengue (DBD). Nyamuk Aedes aegypti ini

hidup dan berkembang biak pada tempat-tempat penampungan air bersih

yang tidak langsung behubungan dengan tanah seperti bak mandi/wc, air

tandon, gentong, kaleng, ban bekas, dan lain-lain.

Demam Berdarah Dengue (DBD) merupakan penyakit endemis di

wilayah kota Semarang, untuk itu diperlukan upaya pencegahan dan

pemberantasan penyakit menular untuk menurunkan resiko penularan dan

kejadian sakit. Salah satu upaya tersebut adalah program pemberantasan

sarang nyamuk (PSN) melalui gerakan 3M (menguras, mengubur, dan

menutup) pada tempat-tempat yang potensial sebagai sarang nyamuk baik

yang ada di dalam rumah maupun di lingkungan sekitarnya.

Tahun 2007 di Kota Semarang terdapat rumah/gedung. Dimana dari

jumlah tersebut yang dilakukan pemeriksaan mengenai bebas jentik nyamuk

Aedes hanya sejumlah 31.276 buah (10,63%). Hal ini disebabkan karena

keterbatasan alokasi dana, waktu, dan tenaga guna menjangkau seluruh

bangunan yang ada. Namun demikian hasil yang didapatkan cukup baik dan

sudah memenuhi target yaitu sebanyak 27.115 buah rumah/bangunan

dinyatakan bebas jentik nyamuk Aedes atau sejumlah 86,70% dari

rumah/bangunan yang dilakukan pemeriksaan.

IV.3.2 Tempat – Tempat Umum dan Tempat Pengelolaan Makanan ( TTU dan TUPM)

Tempat-tempat umum adalah tempat kegiatan bagi umum yang

disediakan oleh badan – badan pemerintah, swasta atau perorangan yang

langsung digunakan oleh masyarakat yang mempunyai tempat dan kegiatan

tetap, memiliki fasilitas sanitasi (jamban, tempat pembuangan sampah dan

limbah) untuk kebersihan dan kesehatan di lingkungan. Tempat-tempat

umum yang sehat berpengaruh cukup besar di masyarakat karena

masyarakat menggunakan fasilitas umum tersebut untuk berbagai

kepentingan.

Pengawasan sanitasi tempat umum bertujuan untuk mewujudkan

kondisi tempat umum yang memenuhi syarat kesehatan agar masyarakat

pengunjung terhindar dari kemungkinan bahaya penularan penyakit serta

tidak menjadi sarang vektor penyakit yang dapat menimbulkan menyebabkan

gangguan terhadap kesehatan masyarakat di sekitarnya. Pengawasan

sanitasi tempat umum meliputi sarana wisata, sarana ibadah, sarana

transportasi, sarana ekonomi dan sosial. Pengawasan sanitasi tempat umum

dan pengelolaan makanan (TUPM) di Kota Semarang meliputi hotel,

restoran/rumah makan dan pasar.

- Jumlah hotel : 83 buah, jumlah diperiksa 69 buah, jumlah sehat 58 buah

(84,06%)

- Jumlah pasar : 51 buah, jumlah diperiksa 50 buah, jumlah sehat 30 buah

(60,00%)

- Jumlah restoran/rumah makan: 383 buah, jumlah diperiksa 250 buah,

jumlah sehat 191 buah (76,40%)

- Jumlah TUPM lainnya : 1.564 buah, jumlah diperiksa 1.169 buah, jumlah

sehat 979 buah (83,75%)

Jumlah tempat - tempat umum dan tempat pengelolaan makanan di

Kota Semarang Tahun 2007 sebanyak 2.081 buah, jumlah diperiksa 1.538

buah dan jumlah yang sehat 1.258 buah atau 81,79%. Data selengkapnya

pada tabel 50.

IV.3.3. Keluarga dengan Kepemilikan Sarana Sanitasi DasarProfil Kesehatan Kota Semarang Tahun 2007

41

IV.3.3.1 Persediaan Air Bersih Air bersih memiliki peranan penting dalam kehidupan manusia

karena diperlukan untuk memenuhi sebagian besar kebutuhan hidup

manusia. Oleh karena itu air bersih harus selalu tersedia dalam jumlah yang

cukup dan memenuhi syarat kesehatan (syarat fisik, kimiawi, dan

bakteriologi). Pada tahun 2007 jumlah KK yang memiliki persediaan air

bersih sebanyak 327.902 KK (92,91 %) dari 352.929 KK yang ada. Apabila

dibandingkan dengan target Renstra Kota Semarang ( 92,6%) maka target

tersebut sudah dapat tercapai. Upaya peningkatan kualitas air bersih akan

meningkat apabila diikuti upaya perbaikan sanitasi (sarana pembuangan

kotoran manusia, sampah, air limbah ). Selain itu adanya peran serta dan

kesadaran sektor swasta penyedia air bersih yang meningkat berkenaan

dengan kualitas air bersih. Secara umum sumber penyediaan air bersih di

Kota Semarang ini berasal dari ledeng / PDAM (60,21%), sumur gali

(27,61%), sumur pompa tangan (10,00%), dan lainnya (1,66%), dimana

sebagian besar pengelolaan sumber air bersih dilakukan oleh PDAM

(Perusahaan Daerah Air Minum) Kota Semarang.

IV.3.3.2 Jamban Keberadaan jamban keluarga sangat penting dalam sebuah keluarga.

Pengelolaan sebuah jamban yang memenuhi syarat kesehatan diperlukan

sebagai upaya untuk mencegah terjadinya penularan penyakit.

Berdasarkan laporan puskesmas, pada tahun 2007 diketahui bahwa

46.936 KK telah memanfaatkan jamban keluarga dan 44.191 KK telah

memenuhi syarat jamban yang sehat (94,15%) dari 49.324 KK yang

dilakukan pemeriksaan. Apabila dibandingkan dengan target Rencana

Strategik tahun 2007 yaitu 83,94%, maka cakupan keluarga yang telah

memiliki jamban keluarga sudah memenuhi target tersebut. Faktor yang

turut mendukung pencapaian target tersebut yaitu meningkatnya

pembangunan dan pengembangan perumahan yang memenuhi syarat

kesehatan.

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IV.3.3.3 Pengolahan Air Limbah Rumah TanggaDalam upaya mendukung terwujudnya kualitas lingkungan yang sehat

diperlukan pengelolaan air limbah yang sesuai standar dan memenuhi

syarat kesehatan. Saluran Pembuangan Air Limbah (SPAL) adalah suatu

bangunan yang digunakan untuk membuang air buangan kamar mandi,

tempat cuci, dapur dan lain-lain bukan dari jamban atau peturasan. SPAL

yang sehat hendaknya memenuhi persyaratan sebagai berikut :

• Tidak mencemari sumber air bersih (jarak dengan sumber air bersih

minimal 10 meter

• Tidak menimbulkan genangan air yang dapat dipergunakan untuk

sarang nyamuk (diberi tutup yang cukup rapat)

• Tidak menimbulkan bau (diberi tutup yang cukup rapat)

• Tidak menimbulkan becek atau pandangan yang tidak menyenangkan

(tidak bocor sampai meluap)

Pengelolaan limbah di rumah tangga yang diperiksa pada tahun

2007 sebanyak 46.649 KK dan yang memenuhi syarat kesehatan sebanyak

41.487 KK (88,93%). Jumlah ini telah melebihi target yang telah ditentukan

dalam renstra 2007 (72,14%).

IV.3.3.4 Pembinaan Kesehatan Lingkungan pada Institusi Lingkungan merupakan salah faktor yang dapat berperan dalam

peningkatan derajat kesehatan. Oleh karena itu upaya pembinaan

Profil Kesehatan Kota Semarang Tahun 2007

43

kesehatan lingkungan selain dilakukan pada rumah tangga dan tempat-

tempat umum, juga dilaksanakan pada beberapa institusi/sarana seperti:

- sarana kesehatan sejumlah 386 tempat, dan yang telah dilakukan

pembinaan sebanyak 308 tempat atau 79,79%.

- sarana pendidikan sejumlah 909 tempat, dan yang telah dilakukan

pembinaan sebanyak 867 tempat atau 95,38%.

- sarana ibadah sejumlah 896 tempat, dan yang telah dilakukan

pembinaan sebanyak 670 tempat atau 74,77%.

- perkantoran sejumlah 186 tempat, dan yang telah dilakukan pembinaan

sebanyak 162 tempat atau 87,09%.

- Dan sarana lain sejumlah 234 tempat, dan yang telah dibina sebanyak

167 tempat atau 71,36%.

Apabila dibandingkan dengan target pada renstra tahun 2007 yaitu

77%, maka pembinaan pada institusi telah memenuhi target tersebut

(pencapaian 85,83%).

IV.4. AKSES DAN MUTU PELAYANAN KESEHATAN IV.4.1. Cakupan Pelayanan Kesehatan

Cakupan pelayanan kesehatan oleh penduduk dapat diperoleh dari

data kunjungan rawat jalan dan rawat inap Puskesmas maupun Rumah Sakit.

Pada tahun 2007 di Kota Semarang jumlah penduduk yang memanfaatkan

pelayanan kesehatan rawat jalan di Puskesmas sebanyak 18.387 per

100.000 penduduk, sedangkan untuk rawat inap Puskesmas yaitu sebesar

296 per 100.000 penduduk. Sedangkan pemanfaatan pelayanan kesehatan

rawat jalan di Rumah Sakit yaitu sebanyak 24.437 per 100.000 penduduk

dan rawat inap 10.277 per 100.000 penduduk

Untuk cakupan rawat jalan di Kota Semarang pada tahun 2007 yaitu

sebesar 42,82%. Cakupan ini sudah memenuhi target SPM Tahun 2005

sebesar 10%. Sedangkan untuk cakupan rawat inap (kunjungan pasien baru)

di sarana pelayanan kesehatan pada tahun 2007 yaitu sebesar 10,57%,

dimana jumlah ini sudah melampaui target SPM Prop. Jawa Tengah Tahun

2005 yaitu 1% untuk kunjungan rawat inap di sarana kesehatan (Puskemas

dan Rumah Sakit). Peningkatan pencapaian cakupan ini didukung dengan

adanya penambahan jumlah tenaga medis dan paramedis di sarana

kesehatan, biaya yang terjangkau dalam pelayanan kesehatan (baik rawat

jalan maupun rawat inap) yang disertai juga dengan peningkatan kualitas

pelayanan kesehatan yang sesuai standar pelayanan yang telah ditetapkan.

Sedangkan untuk data pemanfaatan Rumah Sakit di Kota Semarang

dapat dilihat dari beberapa indikator kinerja Rumah Sakit yang meliputi :

a. Bed Occupation Rate (BOR), standar yang ideal untuk suatu

Rumah Sakit adalah antara 70% s.d 80%. Manfaat Angka

Penggunaan Tempat Tidur (BOR ) adalah untuk mengetahui

tingkat pemanfaatan tempat tidur Rumah Sakit. Prosentase

BOR yang digunakan pada penderita Rawat Inap di Rumah

Sakit se- Kota Semarang pada tahun 2007 mencapai 75,10%

dengan jumlah tempat tidur sebanyak sebesar sebanyak 3.434

buah. Apabila dibandingkan dengan BOR tahun 2006 sebesar

61,39%, maka terdapat peningkatan penggunaan tempat tidur

di RS, dimana angka ini sudah dapat mencapai standar yang

ideal untuk Rumah Sakit. Hal ini menunjukkan bahwa

pemanfaatan tempat tidur pada Rumah Sakit di Kota

Semarang telah dimanfaatkan secara optimal.

b. Length Of Stay ( LOS) adalah rata-rata dalam 1 (satu) tempat

tidur dihuni oleh 1 (satu) penderita rawat inap yang dihitung

dalam hari dengan standar ideal antara 6 – 9 hari. Manfaat

LOS adalah untuk mengukur efisiensi pelayanan Rumah Sakit,

dan untuk mengukur mutu pelayanan Rumah Sakit.

Pencapaian LOS RS tahun 2007 mencapai 6,3, dimana angka

ini menunjukkan peningkatan dibandingkan tahun 2006 (LOS =

5,43). Cakupan pencapaian tersebut dapat diartikan bahwa

penggunaan tempat tidur di RS di Kota Semarang sudah

memenuhi standar ideal. RS yang nilai LOS 1-5 hari sebanyak

14 RS, 2 RS dengan LOS lebih dari 10 hari dan 3 RS tidak

melaporkan data tersebut.

c. Turn of Interval (TOI) adalah rata-rata tempat tidur tidak

ditempati dengan standar ideal antara 1 – 3 hari. TOI untuk

Kota Semarang pada tahun 2006 sebesar 2,1 menurun dari Profil Kesehatan Kota Semarang Tahun 2007

45

tahun 2006 yaitu 3,42 namun angka ini masih dalam batas

standar ideal yang ditetapkan. Hal ini dapat menggambarkan

bahwa pemakaian tempat tidur di Rumah Sakit sudah optimal.

d. Gross Death Rate (GDR), adalah angka kematian untuk tiap-

tiap 1000 penderita keluar maksimum adalah 45. Manfaat

GDR (Gross Death Rate) untuk mengetahui mutu pelayanan /

perawatan Rumah Sakit. Angka ini bisa untuk menilai mutu

pelayanan jika angka kematian kurang dari 48 jam rendah.

GDR Kota Semarang pada tahun 2007 sebesar 3,5 menurun

dari tahun 2006 yang mencapai 3,73.

e. Neath Death Rate (NDR), manfaat NDR adalah untuk

mengetahui mutu pelayanan / perawatan Rumah Sakit.

Semakin rendah NDR suatu Rumah Sakit, berarti bahwa mutu

pelayanan / perawatan Rumah Sakit makin baik. NDR yang

masih dapat ditolerir adalah kurang dari 25 per 1000 penderita

keluar. Pencapaian NDR di Kota Semarang pada tahun 2007

sebesar 2,00 menurun dari tahun 2006 yaitu 2,18, namun

demikian secara keseluruhan pelayanan rumah sakit di Kota

Semarang telah tergolong baik.

IV.4.2. Pelayanan Kesehatan Ibu dan AnakIV.4.2.1. Pelayanan Kesehatan Antenatal

Cakupan pelayanan antenatal dapat dipantau melalui pelayanan

kunjungan baru ibu hamil K1 untuk melihat akses dan pelayanan kesehatan

ibu hamil sesuai standar paling sedikit empat kali (K4) dengan distribusi

sekali pada triwulan pertama, sekali pada triwulan kedua dan dua kali pada

triwulan ketiga.

Pelayanan yang diberikan oleh petugas kesehatan pada ibu hamil

yang berkunjung ke tempat pelayanan kesehatan atau antenatal care

(ANC) meliputi penimbangan berat badan, pemeriksaan kehamilannya,

pemberian tablet besi, pemberian imunisasi TT dan konsultasi.

Cakupan kunjungan ibu hamil K4 Kota Semarang pada tahun

2007 adalah 24.274 bumil (89,04%) dimana pencapaian ini juga telah

melampaui target yang ditetapkan dalam Renstra Tahun 2007 yaitu 86%.

Faktor pendukung dalam hal ini dapat disebabkan oleh meningkatnya

kesadaran ibu hamil dalam memeriksakan kehamilannya ke sarana

pelayanan kesehatan yang ada dan adanya dukungan peningkatan kualitas

pelayanan ANC oleh petugas puskesmas. Cakupan K4 Puskesmas dari

rentang antara yang terendah Puskesmas Mangkang (43,08%) dengan

yang tertinggi Puskesmas Bulu Lor (105,99%). Pencapaian melebihi target

dikarenakan mobilitas penduduk di Kota Semarang yang cukup tinggi

sehingga banyak penduduk luar wilayah yang menggunakan pelayanan

kesehatan yang ada di wilayah tersebut. Bila dibandingkan dengan target

SPM Provinsi Jawa Tengah Tahun 2005 sebesar 78%, maka pencapaian

K4 di Kota Semarang sudah melampaui target tersebut.

Anemi (kekurangan zat gizi besi) pada ibu hamil merupakan salah

satu penyebab utama terjadinya kematian pada ibu melahirkan dan

kematian bayi karena terjadinya perdarahan pada waktu melahirkan. Kasus

anemia ibu hamil di Kota Semarang pada tahun 2007 yaitu sebanyak 1.436

bumil (19,04%) dari 7.543 bumil yang diperiksa. Namun angka ini masih

dibawah target Renstra Kota Semarang tahun 2007 sebesar 25%. Untuk itu

diperlukan adanya upaya pencegahan dan penanganan terhadap

permasalahan tersebut, salah satunya melalui pemberian tablet besi (Fe)1

dan tablet besi (Fe)3.

Pada tahun 2007 cakupan pemberian tablet (Fe)1 sebanyak 28.069

bumil (102,96%) dan cakupan untuk tablet (Fe)3 sebanyak 24.240 bumil

(88,91%). Hal ini menunjukkan bahwa penjaringan pertama pada ibu hamil

sudah dapat dilaksanakan sesuai target namun untuk penjaringan

selanjutnya (Fe)3 90 tablet tidak dapat mencakup jumlah tersebut. Secara

keseluruhan angka tersebut telah memenuhi target yang telah ditentukan,

yaitu untuk tablet Fe1 90% dan tablet Fe3 82%. Keberhasilan pencapaian

target tersebut dapat disebabkan oleh adanya persediaan tablet Fe yang

mencukupi kebutuhan dan juga pelaksanaan kegiatan melalui koordinasi

dan kerjasama dengan lintas program dan sektor terkait.

Dalam pelayanan ibu hamil (antenatal) baik pada K1 maupun K4 ibu

hamil selain diberikan tablet Fe juga diberikan imunisasi TT sebagai upaya

perlindungan ibu dan bayinya dari kemungkinan terjadinya Tetanus pada

waktu persalinan. Oleh karena itu pemberian TT merupakan keharusan

Profil Kesehatan Kota Semarang Tahun 2007

47

pada setiap ibu hamil. Pemberian imunisasi TT pada Bumil mencakup TT1

sebesar 20.090 bumil (71,86%), masih belum memenuhi target yang

ditentukan yaitu 95%, imunisasi TT2 sebesar 18.189 bumil (65,06%), telah

mencapai target yaitu 65%, imunisasi TT3 sebanyak 2.543 bumil, imunisasi

TT4 sebanyak 1.926 (6,98%) dan imunisasi TT5 hanya mencapai 1.108

bumil (3,96%). Dari data tersebut dapat diketahui bahwa untuk pelayanan

imunisasi TT1 – TT2 pada Bumil di Tahun 2007 terjadi penurunan (Tahun

2006 TT1 – TT2 masing-masing 92% dan 85%), akan tetapi untuk TT3 –

TT5 untuk Tahun 2007 terdapat peningkatan dari Tahun 2006 ( TT3 – TT5

masing-masing 3% - 3% - 2%). Hal ini disebabkan pemberian imunisasi TT

pada Bumil dan juga pada Wanita Usia Subur (WUS) lebih diarahkan pada

pemberian TT 5 dosis.

Sedangkan untuk cakupan TT bagi Wanita Usia Subur (WUS) usia

15-39 tahun sebanyak 5 dosis dengan interval tertentu di Kota Semarang

pada tahun 2007 yaitu TT1 2.943 orang (10,53%), TT2 1.552 orang

(5,55%), TT3 309 orang (1,11%), TT4 256 orang (0,92%) dan TT5 384

orang (1,37%) dari 27.958 WUS yang ada. Secara keseluruhan cakupan

TT1 – TT5 WUS Tahun 2007 mengalami peningkatan apabila dibandingkan

tahun sebelumnya.

IV.4.2.2. Pertolongan Persalinan oleh Tenaga Kesehatan Upaya untuk menurunkan Angka Kematian Bayi dan Ibu Maternal,

salah satunya melalui persalinan yang sehat dan aman, yaitu persalinan

yang ditolong oleh tenaga kesehatan (dokter spesialis kebidanan, dokter

umum, bidan, pembantu bidan, dan perawat bidan) maupun dengan dukun

terlatih yang didampingi oleh tenaga kesehatan. Jumlah persalinan dengan

pertolongan tenaga kesehatan di Kota Semarang pada tahun 2007 sebesar

22.155 (85,14%) dari jumlah perkiraan persalinan sebesar 26.021 kelahiran.

Angka ini sudah dapat memenuhi target Renstra yang telah ditentukan

sebesar 86,00%. Pencapaian ini didukung dengan tersedianya Bidan di

seluruh Puskesmas dengan perbandingan Puskesmas dan Bidan yaitu 1 :

4. Disamping itu jumlah Rumah Sakit dan Rumah Bersalin di Kota

Semarang yang telah mencukupi.

IV.4.2.3 Ibu Hamil Resiko Tinggi dan Komplikasi

Yang dimaksud dengan risiko tinggi pada ibu hamil adalah

keadaan ibu hamil yang mengancam kehidupannya maupun janinnya,

misalnya umur, paritas, interval dan tinggi badan. Prosentase sasaran ibu

hamil risiko tinggi adalah 20% dari ibu hamil yang ada di masyarakat. Pada

tahun 2007 ibu hamil risiko tinggi/ komplikasi yang ditemukan di Kota

Semarang sebesar 3.366 orang dan bumil risti/ komplikasi yang dirujuk

yaitu sebanyak 885 orang (26,29%). Jumlah ini mengalami penurunan

dibandingkan tahun 2006 yaitu ibu hamil risti / komplikasi yang ditemukan

mencapai 2.547 orang, dan 820 ibu hamil risti yang dirujuk (32,19%).

Apabila dibandingkan dengan target Renstra tahun 2007 (100%),

maka cakupan untuk ibu hamil risti yang dirujuk masih belum terpenuhi

sesuai target. Hal ini bisa disebabkan beberapa faktor seperti : Adanya

bumil risiko tinggi yang langsung ditangani di rumah sakit sehingga tidak

tercatat di puskesmas, Bumil risiko tinggi dengan katagori ringan ditangani

sendiri oleh puskesmas, dimana seharusnya bumil risiko tinggi seluruhnya

dirujuk. Berdasarkan data yang ada, ibu hamil risiko tinggi yang dirujuk

seluruhnya (100%) telah mendapatkan penanganan.

IV.4.2.4. Pemberian Vitamin AKurang Vitamin A (KVA) masih merupakan masalah yang tersebar di

seluruh dunia terutama di negara berkembang dan dapat terjadi pada

semua umur terutama pada masa pertumbuhan. Salah satu dampak

kekurangan Vitamin A adalah kelainan pada mata yang umumnya terjadai

pada anak usia 6 bulan – 59 bulan yang menjadi penyebab utama

kebutaan di negara berkembang.

Salah satu program penanggulangan KVA yang telah dijalankan

adalah dengan suplementasi kapsul Vitamin A dosis tinggi 2 kali per tahun

pada Balita dan Ibu Nifas (Bufas)untuk mempertahankan bebas buta

karena KVA dan mencegah berkembangnya kembali masalah Xerofthalmia

dengan segala manifestasinya (gangguan penglihatan, buta senja, dan

bahkan kebutaan sampai kematian). Disamping itu pemantapan program

distribusi kapsul Vitamin A dosis tinggi juga dapat mendorong tumbuh

kembang anak serta meningkatkan daya tahan anakterhadap penyakit

infeksi, sehingga dapat menurunkan angka kesakitan dan kematian pada

bayi dan anak.

Balita yang dimaksud dalam program distribusi kapsul Vitamin A

Profil Kesehatan Kota Semarang Tahun 2007

49

adalah bayi berumur 6 – 11 bulan dan anak umur 12 – 59 bulan yang

mendapat kapsul Vitamin A dosis tinggi. Kapsul Vitamin A dosis tinggi terdiri

dari kapsul Vitamin A biru dengan dosis 100.000 SI yang diberikan pada

bayi berumur 6 – 11 bulan dan kapsul Vitamin A berwarna merah diberikan

pada anak umur 12 – 59 bulan dan diberikan pada bulan Februari dan

Agustus setiap tahunnya.

Berdasarkan data yang diperoleh dari Puskesmas, diketahui

bahwa cakupan pemberian suplementasi kapsul Vitamin A dosis tinggi pada

bayi sebanyak 28.634 bayi (100%), Balita sebanyak 93.600 anak (100%)

serta Bufas 25.178 orang (96,76%). Cakupan tersebut seluruhnya sudah

memenuhi target Renstra Kota Semarang Tahun 2007 yaitu cakupan

Vitamin A untuk bayi dan balita sebesar 92% dan untuk Bufas sebesar

84%.

IV.4.2.5. Pelayanan Kesehatan Neonatal, Bayi dan Balitaa. Kunjungan Neonatus (0 – 28 hari)

Cakupan kunjungan neonatus tingkat Kota Semarang tahun 2007

sebesar 23.643 (95,54%), dimana jumlah ini meningkat apabila

dibandingkan dengan tahun 2006 sebanyak 23.125 anak (94,40%).

Apabila dibandingkan dengan target Renstra Tahun 2007 yaitu 87%, maka

angka ini sudah melebihi target tersebut. Keberhasilan pencapaian ini

disebabkan : meningkatnya kesadaran masyarakat akan kesehatan

neonatus, peningkatan pelayanan kesehatan terutama kesehatan anak

(neonatus, bayi, balita) di Puskesmas, dan adanya pemeriksaan kunjungan

ke rumah oleh tenaga kesehatan bagi neonatus yang tidak dapat

berkunjung ke puskesmas serta sistem pencatatan dan pelaporan (PWS

KIA) yang sudah berjalan dengan baik. Cakupan kunjungan neonatus

dengan rentang antara yang terendah 65,79% (Puskesmas Karanganyar)

dengan rentang tertinggi 123,18% (Puskesmas Mangkang).

b. Kunjungan Bayi (1 - 12 bulan) Kunjungan bayi adalah kunjungan bayi (1 – 12 bulan) yang

memperoleh pelayanan kesehatan sesuai dengan standar oleh tenaga

kesehatan, paling sedikit 4 kali. Hasil cakupan kunjungan bayi di Kota

Semarang pada tahun 2007 sebesar 22.987 (92,89%) dimana jumlah ini

mengalami penurunan dari tahun 2006 yaitu 23.487 bayi (95,87%) namun

cakupan ini sudah memenuhi target Renstra Kota Semarang Tahun 2007

sebesar 87%.

Pada tahun 2007 ditemukan 14 (empat belas) Puskesmas dengan

cakupan kunjungan bayi sama dengan atau lebih dari 100% (data terlampir

pada tabel 15). Cakupan yang melebihi jumlah sasaran bayi (≥100%) dapat

disebabkan oleh beberapa faktor yaitu pada saat penentuan jumlah sasaran

melalui kegiatan pemantauan wilayah setempat (PWS) KIA belum

mencakup jumlah seluruh bayi yang ada di wilayah tersebut atau karena

penentuan target sasaran bayi terlalu rendah.

c. Deteksi Dini Tumbuh Kembang Anak Balita dan Pra Sekolah

Deteksi Dini Tumbuh Kembang (DDTK) anak balita dan pra

sekolah adalah anak umur 1 – 6 tahun yang dideteksi dini tumbuh kembang

sesuai dengan standar oleh tenaga kesehatan, paling sedikit 2 kali.

Pelayanan DDTK anak balita dan prasekolah meliputi kegiatan deteksi dini

masalah kesehatan anak menggunakan Manajemen Terpadu Balita Sakit

(MTBS), monitoring pertumbuhan menggunakan Buku KIA/KMS dan

pemantauan perkembangan (motorik kasar, motorik halus, bahasa dan

sosialisasi dan kemandirian), penanganan penyakit sesuai MTBS,

penanganan masalah pertumbuhan, stimulasi perkembangan anak balita

dan prasekolah, pelayanan rujukan ke tingkat yang lebih mampu.

Hasil cakupan deteksi dini tumbuh kembang (DDTK) anak balita dan

pra sekolah di tingkat Kota Semarang pada tahun 2007 yaitu 68,91%.

Apabila dibandingkan dengan target Rencana Strategik Tahun 2007 (68%),

maka cakupan DDTK anak balita dan prasekolah di Kota Semarang sudah

mencapai target tersebut, dan target SPM Propinsi Jawa Tengah Tahun

2005 yaitu sebesar 65%. Data secara terperinci dapat dilihat pada tabel 18.

IV.4.3. Pelayanan ImunisasiUntuk menurunkan angka kesakitan, kematian dan kecacatan bayi

serta anak balita perlu dilaksanakan program imunisasi untuk penyakit-

penyakit yang dapat dicegah dengan imunisasi (PD3I) seperti penyakit

Profil Kesehatan Kota Semarang Tahun 2007

51

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TBC, Difteri, Pertusis, Tetanus, Hepatitis B, Polio dan campak. Idealnya

bayi harus mendapat imunisasi dasar lengkap terdiri dari BCG 1 kali, DPT 3

kali, Polio 4 kali, HB 3 kali dan campak 1 kali.

Untuk menilai kelengkapan imunisasi dasar bagi bayi, biasanya

dilihat dari cakupan imunisasi DPT3, Polio 4 dan Campak ≥ 80%. Cakupan

bayi yang diimunisasi DPT3 pada tahun 2007 sebesar 23.472 anak

(92,37%), Polio 4 sebanyak 21.864 anak (86,04%) dan bayi yang telah

memperoleh imunisasi campak sebesar 23.274 (91,59%) dari sasaran

sejumlah 25.412 bayi. Dari data tersebut maka cakupan imunisasi di Kota

Semarang pada bayi telah dilaksanakan secara lengkap dan memenuhi

target yang ada.

Program imunisasi dapat berjalan secara efektif dan memberikan

dampak penurunan kejadian penyakit apabila kelengkapan imunisasi telah

terlaksana dan mutu pelayanan imunisasi diterapkan sesuai standar,

terutama dalam penangan col chain. Strategi operasional pencapaian

cakupan tinggi dan merata dapat dilihat dari pencapaian Universal Child

Immunization (UCI) desa/kelurahan. Tahun 2007 jumlah desa/kelurahan

yang sudah mencapai UCI dengan kriteria cakupan DPT 3, polio 4 dan

Campak ≥ 80% sebanyak 139 kelurahan (78,53%) dari 177 kelurahan yang

ada, jumlah ini meningkat dari Tahun 2006 yaitu 136 kelurahan (76,80%).

Selain itu angka ini juga telah memenuhi target Renstra Kota Semarang

Tahun 2007 sebesar 78%.

Untuk mengukur manajemen program / efisiensi program

menggunakan angka drop out dengan menghitung selisih cakupan

imunisasi DPT1 dengan cakupan imunisasi Campak. Angka Drop Out

(DO) imunisasi dasar lengkap di Kota Semarang Tahun 2007 sebesar 7,73,

menurun dari Tahun 2006 yang mencapai 8,63%, dan angka ini masih

belum melampaui batas maksimal DO yaitu 10%.

Selain imunisasi rutin, program imunisasi juga melaksanakan

program imunisasi tambahan seperti Bulan Imunisasi Anak Sekolah (BIAS).

Hasil pelaksanaan BIAS tahun 2007 di Kota Semarang meliputi BIAS

Campak dan BIAS DT dan TT. BIAS Campak dilaksanakan pada bulan

Agustus dengan sasaran siswa kelas I dengan hasil sebanyak 26.551

(97%) telah memenuhi target minimal yaitu 85%. BIAS DT dan TT

dilaksanakan pada bulan Nopember dengan sasaran siswa kelas I

divaksinasi DT dan kelas II dan III divaksinasi TT, dengan hasil : kelas I

26.214 siswa (97,02%); kelas II 25.841 siswa (97,27%); kelas III 23.607

siswa (97,85%) dimana seluruhnya juga telah memenuhi target yang

ditentukan sebesar 95%.

IV.4.4 Pelayanan Kesehatan Pra Usia Lanjut (Usila) dan Usia Lanjut Pelayanan kesehatan pra usila dan usila yang dimaksudkan adalah

penduduk usia 45 tahun ke atas yang mendapatkan pelayanan kesehatan

sesuai standar oleh tenaga kesehatan baik di puskesmas maupun di

Posyandu Kelompok Usia Lanjut. Hasil kegiatan pelayanan kesehatan Pra

Usila dan Usila di Kota Semarang pada tahun 2007 sebesar 69.840 orang

(80,25) terdiri atas pra usila (45 – 59 thn) sebanyak 40.803 orang dan Usila

(≥ 60 thn) sebanyak 29.037 orang, jumlah ini meningkat dari tahun 2006

sebanyak 32.381 (66,82%). Apabila dibandingkan dengan target SPM

Tahun 2005 (20%) dan Renstra Tahun 2007 (55%) maka cakupan

pelayanan kesehatan pada Pra Usila dan Usila di Kota Semarang sudah

bisa melampaui target tersebut. Keaktifan petugas puskesmas dalam

melakukan pembinaan dan pelayanan di dalam dan luar gedung terhadap

kelompok usia lanjut turut mendukung pencapaian indikator tersebut.

IV.4.5 Keluarga Berencana

Profil Kesehatan Kota Semarang Tahun 2007

53

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Salah satu program pemerintah dalam upaya mengendalikan jumlah

kelahiran dan mewujudkan keluarga kecil yang sehat dan sejahtera yaitu

melalui konsep pengaturan jarak kelahiran dengan program Keluarga

Berencana (KB).

1. Jumlah Pasangan Usia Subur (PUS)

Pada tahun 2007, jumlah PUS yang ada sebanyak 243.194. Yang

menjadi peserta KB baru sebanyak 33.874 (13,93%). Sedang jumlah

peserta KB aktif yang telah dibina sebesar 188.309 (77,43%)

2. Peserta KB Baru

Dari 33.874 peserta KB Baru (13,93%), secara rinci mix kontrasepsi

yang digunakan adalah sebagai berikut :

- Suntik : 61,92%

- Pil : 20,39%

- Kondom : 3,82%

- IUD : 5,16%

- Implant : 4,69%

- MOP/MOW : 5,43%

3. Peserta KB Aktif

Hasil pembinaan peserta KB Aktif selama tahun 2007 sebesar

188.309 (77,43%) dengan mix kontrasepsi sebagai berikut :

- Suntik : 42,13%

- Pil : 12,06%

- IUD : 6,33%

- Implant : 5,33%

- Kondom : 4,48%

- MOP/MOW : 7,09%

Dari keseluruhan peserta KB baru selama tahun 2007, pemakaian

kontrasepsi suntik merupakan yang tertinggi karena sifatnya yang praktis

dan juga cepat dalam mendapatkan pelayanannya. Apabila dibandingkan

dengan data tahun 2006, kontrasepsi suntik masih menduduki peringkat

teratas, sedangkan kontrasepsi pria merupakan yang paling sedikit

digunakan yaitu kondom dan MOP. Hal ini disebabkan banyak suami

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menganggap bahwa istri saja yang mempunyai kewajiban untuk

menggunakan kontrasepsi sebagai upaya pengaturan kelahiran.

IV.4.6 Kesehatan Kerja dan Kesehatan Institusia. Pelayanan Kesehatan Pekerja

Pelayanan kesehatan pada pekerja merupakan upaya untuk

pemeliharaan kesehatan yang dapat mendukung peningkatan produktivitas

pekerja, dimana biasanya pelayanan kesehatan dilaksanakan secara

bertahap yaitu berupa pemeriksaan awal bagi calon pekerja, pemeriksaan

berkala dan pemeriksaan pada akhir masa kerja. Hal ini dimaksudkan agar

kesehatan pekerja senantiasa terpelihara mulai awal bekerja hingga nanti

pada akhir masa kerjanya sehingga dapat terhindar dari resiko penyakit

akibat kerja (PAK). Umumnya pembinaan dan pelayanan kesehatan pada

pekerja khususnya pekerja formal dilaksanakan oleh klinik perusahaan atau

bekerja sama dengan sarana pelayanan kesehatan yang ada (Puskesmas,

Profil Kesehatan Kota Semarang Tahun 2007

55

Rumah Sakit). Sedangkan untuk pekerja sektor informal masih belum banyak

mendapatkan perhatian terutama dalam hal pelayanan kesehatan karena

umumnya mereka bekerja secara mandiri diluar tanggung jawab suatu

perusahaan/instansi. Apabila dibandingkan prosentase jumlah pekerja, maka

sektor informal merupakan bagian terbesar dari angkatan kerja. Selama ini

mereka hanya memperoleh pelayanan kesehatan secara umum, namun

belum dikaitkan dengan pekerjaannya.

Cakupan pelayanan kesehatan pekerja pada industri formal di Kota

Semarang pada tahun 2007 sebanyak 240.753 orang (79,14% dari 304.196

pekerja formal yang ada). Jumlah ini diperoleh dari pekerja sektor formal

yang datang untuk mendapatkan pelayanan kesehatan di puskesmas dengan

fasilitas asuransi berupa ASKES maupun Jamsostek.

Sedangkan untuk pelayanan kesehatan pada pekerja sektor informal

dari 665.530 pekerja yang terdata, yang mendapatkan pelayanan kesehatan

sebanyak 551.838 pekerja (82,92%). Walaupun pekerja informal tidak berada

dalam tanggung jawab suatu badan/instansi seperti pada pekerja formal,

tetapi mereka tetap mendapatkan pelayanan kesehatan dengan cara

membayar sendiri ataupun melalui kartu sehat maupun asuransi kesehatan

keluarga miskin (Askeskin).

b. P3 NAPZABerdasarkan data laporan puskesmas, kegiatan penyuluhan,

pencegahan dan penanggulangan dan penyalahgunaan NAPZA tahun 2007

sasarannya tidak hanya pada sekolah dan masyarakat saja melainkan juga

pada masyarakat umum. Cakupan pelayanan NAPZA pada tahun 2007

berupa kegiatan penyuluhan NAPZA oleh tenaga kesehatan, baru mencapai

375 kegiatan (21,61%) dari 1.735 kegiatan penyuluhan keseluruhan. Apabila

dibandingkan dengan target Kota Semarang (20%), angka ini masih jauh

berada di bawah target tersebut. Kondisi ini dapat disebabkan antara lain

karena pada sebagian besar puskesmas kegiatan penyuluhan NAPZA yang

dilaporkan yang hanya dilaksanakan pada forum resmi dengan sasaran anak

sekolah/remaja saja sedangkan yang sifatnya non formal pada masyarakat

yang berkunjung di puskesmas belum dilaporkan secara lengkap.

Kaitan Narkoba dengan anak sekolah/pelajar dewasa ini semakin

meningkat, dimana 88% pengguna narkoba menggunakan ganja, 36%

menggunakan jarum suntik (data ILO 2005, dikutip dari majalah forum edisi 6

Juli 2005). Penggunaan jarum suntik bersama dan bergiliran berpotensi untuk

menularkan penyakit seperti HIV/AIDS, Hepatitis C. Apabila kondisi tersebut

tidak segera mendapatkan penanganan yang serius dan berkelanjutan maka

jumlah kasus yang ada akan semakin meningkat. Data dari pemelitian

Country AHRN Indonesia ,sekolah merupakan tempat yang aman untuk

mendapatkan serta mengkonsumsi narkoba. Untuk itu perlu adanya

peningkatan kerja sama dan koordinasi dari jajaran instansi terkait, salah

satunya seperti yang telah dilaksanakan oleh Dinas Kesehatan Kota

Semarang bersama dengan Badan Narkotika Kota (BNK), dimana Dinas

Kesehatan Kota Semarang juga termasuk dalam keanggotaan BNK dan

berkoordinasi dengan BNK dalam kegiatan penyuluhan yang bekerja sama

dengan tenaga puskesmas dan ibu-ibu PKK. Selain itu bentuk dukungan

kegiatan lainnya dapat berupa : pentas seni, lomba poster, maupun deteksi

dini tes urine. Selain itu juga perlu adanya dukungan dari lintas sektor di

tingkat Provinsi dan Pusat.

c. Pelayanan Kesehatan Anak Usia SekolahPelayanan Kesehatan Anak Sekolah meliputi pemeriksaan kesehatan

siswa yang dilakukan oleh tenaga kesehatan atau tenaga terlatih (guru

UKS/dokter kecil) melalui penjaringan kesehatan, paling sedikit 1 kali.

Penjaringan kesehatan pada anak sekolah meliputi pemeriksaan umum

seperti : TB, BB, kulit, ketajaman mata, pendengaran, gigi dan mulut). Hasil

cakupan pelayanan kesehatan pada anak sekolah (siswa TK, SLTP dan

SLTA)pada tahun 2007 di Kota Semarang mencapai 99.729 siswa (97,08%).

Apabila dibandingkan dengan target SPM tahun 2005 Propinsi Jawa Tengah

(75%) dan Renstra tahun 2006 (60%), maka cakupan pelayanan tersebut

telah memenuhi target. Hal ini dapat disebabkan karena partisipasi dari Guru

UKS dan kader kesehatan (dokter kecil) sudah jauh lebih baik dalam

pelayanan kesehatan di sekolah dan tenaga kesehatan yang ada juga telah

berperan secara aktif dalam upaya pembina Usaha Kesehatan Sekolah.

Selain itu keterlibatan dan kerja sama lintas sektor yang erat antara Dinas

Kesehatan dengan Dinas Pendidikan serta Kantor Departemen Agama juga

turut mendukung keberhasilan program tersebut.

Profil Kesehatan Kota Semarang Tahun 2007

57

IV.4.4 Upaya Kesehatan KhususIV.4.4.1 Sarana Kesehatan dengan Kemampuan Gawat Darurat

Sarana kesehatan dengan kemampuan gawat darurat yang dapat

diakses oleh masyarakat di Kota Semarang pada tahun 2007 sebanyak 62

sarana kesehatan (58,06%) yaitu 15 Rumah Sakit Umum (100%), 1 RS

Jiwa (100%), 9 RS Khusus (100%) dan 11 puskesmas (29,73%). Data

selengkapnya dapat dilihat pada tabel 29. Apabila dibandingkan dengan

target SPM 2005 (40%), maka jumlah ini sudah mencapai target tersebut.

IV.4.4.2 Pelayanan Kesehatan JiwaSelain menyelenggarakan pelayanan kesehatan secara umum,

sarana kesehatan yang ada juga memberikan pelayanan terhadap

kesehatan jiwa. Target Renstra untuk pelayanan kesehatan jiwa pada

tahun 2007 yaitu 0,4% dari kunjungan kasus di sarana kesehatan.

Pelayanan kesehatan jiwa pada Puskesmas dan Rumah Sakit di Kota

Semarang pada tahun 2007 menunjukkan pencapaian sebesar 0,42%.

Pelayanan kesehatan jiwa di Kota Semarang pada umumnya telah

memenuhi target yang telah ditetapkan, hal ini disebabkan beberapa faktor

diantaranya yaitu :

• Peningkatan kemampuan dokter dan tenaga medis

dalam pelayanan kesehatan jiwa dalam bentuk

pelatihan dan refreshing

• Petugas kesehatan telah memiliki pengetahuan dan

kemampuan melakukan deteksi dini dari gejala yang

menjurus pada gangguan kejiwaan.

• Perbaikan sistem pencatatan dan pelaporan serta

monitoring dan evaluasi program kesehatan jiwa

• Adanya klinik kesehatan jiwa di sarana kesehatan

(Rumah Sakit Umum)

IV.4.4.3 Pelayanan Kesehatan Gigi dan MulutKegiatan pelayanan kesehatan gigi dan mulut yang dilaksanakan

di puskesmas pada tahun 2007 yaitu tumpatan gigi tetap sebanyak 9.590

dengan rata-rata per bulan sebesar 799 tindakan dan pencabutan gigi

tetap sebanyak 10.250 dengan rata-rata per bulan sebesar 854, dengan

rasio untuk tambal dibandingkan pencabutan gigi sebesar 0,94. Di dalam

pelayanan UKGS di sekolah dasar, dilaksanakan pemeriksaan kesehatan

gigi pada 41.317 siswa (26,52%), terdapat 8.182 siswa perlu perawatan

dan yang telah mendapatkan perawatan sebanyak 5.114 siswa (62,50%).

Apabila dibandingkan dengan target tahun 2007 perbandingan

tumpatan dan pencabutan gigi tetap minimal > 1, maka pencapaian

pelayanan kesehatan gigi dan mulut belum mencapai target. Hal ini

disebabkan kesehatan gigi dan mulut masih belum menjadi alasan

penting masyarakat untuk mendapatkan pelayanan kesehatan. Selain itu

pencatatan dan pelaporan pelayanan kesehatan gigi dan mulut masih

belum terlaksana dengan baik sehingga sering terjadi keterlambatan

dalam pelaporannya. Untuk itu perlu adanya peningkatan pelayanan

kesehatan gigi mulut khususnya pada upaya kesehatan secara promotif

dan preventif, peningkatan kemampuan tenaga kesehatan serta

peningkatan kualitas pencatatan dan pelaporan yang ada.

IV.4.4.4 Pelayanan Transfusi DarahTarget SPM Prop. Jawa Tengah tahun 2005 untuk kegiatan

pelayanan transfusi darah dalam hal pemenuhan kebutuhan permintaan

darah yaitu 90%. Hasil kegiatan pelayanan transfusi darah di Kota

Semarang pada tahun 2007 sebesar 66.489 (92,96%) kantong darah dari

kebutuhan 71.526 kantong darah. Jumlah ini mengalami peningkatan dari

tahun sebelumnya yang mencapai 88,63%, namun angka tersebut juga

belum memenuhi target yang telah ditetapkan. Terdapat beberapa faktor

yang menyebabkan belum tercapinya target untuk pelayanan transfusi

darah, yaitu :

Belum adanya program upaya pelayanan kesehatan di Dinas

Kesehatan yang menangani secara langsung bidang/ unit tansfusi

darah, selain PMI.

Rumah sakit yang memiliki Bank Darah Rumah Sakit masih terbatas

Partisipasi masyarakat sebagai pendonor masih relatif terbatas

sehingga belum mampu memenuhi kebutuhan darah yang ada.

Profil Kesehatan Kota Semarang Tahun 2007

59

IV.5. OBAT DAN PERBEKALAN KESEHATAN LAINNYAIV.5.1. Ketersediaan dan Kebutuhan Obat Esensial dan Obat Generik

Berdasarkan data ketersediaan obat pada tahun 2007 yang

berasal dari laporan Instalasi Perbekalan Farmasi Kota Semarang bersumber

dari laporan 37 Puskesmas se-Kota Semarang, jumlah jenis obat yang

dibutuhkan oleh Puskesmas rata-rata 129 item, sedangkan jenis obat yang

tersedia di Puskesmas rata-rata 145 item. Jika dibandingkan antara

kebutuhan obat dengan persediaan yang ada diperoleh ketersediaan obat

secara keseluruhan sebesar 112,87%. Berarti secara umum kebutuhan obat

di Kota Semarang telah terpenuhi (tersedia).

Khusus untuk obat generik, kebutuhan total jenis obat generik seluruh

Puskesmas Tahun 2007 adalah rata-rata 131 item. Sedangkan jumlah total

jenis obat generik yang tersedia sebanyak 145 item. Jika dibandingkan

dengan kebutuhan obat generik maka pemenuhannya sebesar 110,55%.

Artinya secara umum kebutuhan obat generik di Puskesmas seluruhnya

dapat dipenuhi (tersedia).

IV.5.2. Penulisan Resep Obat GenerikBerdasarkan laporan dari Rumah Sakit milik Pemerintah, diketahui

bahwa jumlah penulisan resep obat generik di fasilitas sarana kesehatan

tersebut sebesar 52.816 (55,81%) dari total penulisan resep yang ada yaitu

sejumlah 94.639 resep. Apabila dibandingkan dengan target SPM Provinsi

Jawa Tengah yaitu sebesar 80%, maka pencapaian ini masih belum

memenuhi target. Hal dapat disebabkan cakupan yang ada masih belum bisa

menggambarkan kegiatan penulisan resep obat generik yang dilakukan oleh

Rumah Sakit Pemerintah se-Kota Semarang, dimana data yang ada hanya

berasal dari Rumah Sakit milik Pemerintah Kota Semarang yaitu Rumah

Sakit Umum Daerah (RSUD) Kota Semarang, sedangkan data dari Rumah

Sakit Pemerintah lainnya belum tercakup dalam pelaporan yang ada.

IV.5.3. Ketersediaan Obat Narkotika dan Psikotropika Data yang dilaporkan untuk ketersediaan obat narkotika dan

psikotropika berasal dari 37 puskesmas. Jumlah seluruh kebutuhan obat

narkotika dan psikotropika di Kota Semarang tahun 2007 yaitu rata-rata 3

item per Puskesmas sedangkan untuk ketersediaan obat narkotika dan

psikotropika yaitu sebesar 4 item. Apabila dibandingkan antara kebutuhan

dan ketersediaan obat narkotika dan psikotropika maka diperoleh capaian

rata-rata sebesar 122,32%. Hal ini berarti untuk obat golongan narkotika dan

psikotropika di Puskesmas dapat terpenuhi sesuai kebutuhan.

IV.6. SUMBER DAYA KESEHATANIV.6.1. Tenaga Kesehatan

Penyelenggaraan upaya kesehatan tidak akan berjalan dengan baik jika tidak

didukung oleh ketersediaan sumber daya manusia yang berkualitas. Sesuai dengan

Visi Dinas Kesehatan Kota Semarang yaitu “Terwujudnya Masyarakat Kota Metropolitan yang Sehat Didukung dengan Profesionalisme dan Kinerja yang

Tinggi” maka diperlukan peningkatan kuantitas dan kualitas sumber daya manusia

(SDM) dibidang kesehatan, yang diharapkan mampu bekerja secara profesional dan

selalu berusaha untuk mengembangkan kemampuannya dalam rangka mewujudkan

pelayanan kesehatan yang optimal pada masyarakat.

Informasi tenaga kesehatan diperlukan bagi perencanaan dan pengadaan

tenaga serta pengelolaan kepegawaian. Kesulitan memperoleh data ketenagaan

yang mutakhir disebabkan antara lain karena sifat data ketenagaan yang selalu

berubah terus-menerus sehingga sistem pencatatan dan pelaporan belum dapat

ditampilkan secara lengkap, akurat dan sistematis. Sebagai gambaran hasil

pendataan tenaga kesehatan melalui Profil Kesehatan Kota Semarang Tahun 2007

yang berada di Puskesmas, Rumah Sakit, dan Dinas Kesehatan Kota Semarang

sebagai berikut:

Tabel m : Data Tenaga Kesehatan di Kota Semarang Tahun 2007

No Jenis Tenaga Kesehatan

Unit Kerja

Jumlah

DKK PuskesmasRSU/RS

RSB Khusus Lainnya

Institusi Diknakes

/Diktat

Sarana Kesh Lain

1 Dokter Spesialis 0 2 577 24 59662

2 Dokter Umum 5 106 312 71 1.0581.552

Profil Kesehatan Kota Semarang Tahun 2007

61

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P erbandingan Tenaga K esehatan B erdasar JenisnyaTahun 2006

3 Dokter Gigi 5 62 90 1 275433

4 Perawat 4 132 2.211 48 742.469

5Sarjana Keperawatan 0 1 82 2 0

85

6 Bidan 3 158 205 28 154548

7 Tenaga Farmasi 6 43 269 12 135465

8Sarjana Farmasi & Apoteker 3 0 37 34 277

351

9 Tenaga Sanitarian 8 36 23 0 067

10 Kesehatan Masy. 28 5 86 0 0119

11 Tenaga Gizi 4 43 96 12 0155

12 Tenaga Terapi Fisik 0 0 54 0 1266

13Tenaga Keteknisian Medik 0 42 301 0 0

343

Sumber : Sub Bag Kepegawaian dan Seksi Perijinan Tenaga Kesehatan

Rasio tenaga kesehatan Kota Semarang (puskesmas, Rumah Sakit dan

Dinas Kesehatan Kota Semarang) dibandingkan dengan jumlah penduduk

kota Semarang tahun 2007 dapat diperoleh data sebagai berikut:

a. jumlah Dokter Umum sebesar 107 per 100.000 penduduk

(target IS 2010 : 40/100.000 penduduk)

b. jumlah Dokter Spesialis sebesar 46 per 100.000 penduduk

(target IS 2010 : 6/100.000 penduduk)

c. jumlah Dokter Gigi sebesar 30 per 100.000 penduduk

(target IS 2010 : 11/100.000 penduduk)

d. jumlah Perawat sebesar 175 per 100.000 penduduk

(target IS 2010 : 117,5/100.000 penduduk)

e. jumlah Bidan sebesar 37 per 100.000 penduduk

(target IS 2010 : 100/100.000 penduduk)

f. jumlah Tenaga Farmasi sebesar 57 per 100.000 penduduk

(target IS 2010 : 10/100.000 penduduk)

g. jumlah Tenaga Gizi sebesar 11 per 100.000 penduduk

(target IS 2010 : 22/100.000 penduduk)

h. jumlah Tenaga Kesehatan Masyarakat sebesar 8 per

100.000 penduduk

(target IS 2010 : 40/100.000 penduduk)

i. jumlah Tenaga Sanitasi sebesar 4 per 100.000 penduduk

(target IS 2010 : 40/100.000 penduduk)

j. jumlah tenaga teknisi medis sebesar 28 per 100.000

penduduk

Dari data tersebut diatas maka dapat dilihat bahwa jumlah tenaga

kesehatan rata-rata sudah memenuhi target yang ditetapkan dalam Indonesia

Sehat 2010 seperti : Tenaga Medis (Dokter Umum, Dokter Spesialis, Dokter

Gigi), Tenaga Keperawatan, Tenaga Kefarmasian. Namun juga masih

terdapat tenaga kesehatan yang jumlahnya masih belum sesuai dengan

target (kebutuhan) yang ada yaitu : Tenaga Bidan, Tenaga Kesehatan

Masyarakat, Tenaga Gizi dan Tenaga Sanitasi.

Data secara lengkap dapat dilihat pada tabel 54 – tabel 59.

IV.6.2 Sarana KesehatanUntuk mewujudkan pelayanan kesehatan yang optimal bagi

masyarakat perlu didukung oleh adanya sarana kesehatan yang memadai

Profil Kesehatan Kota Semarang Tahun 2007

63

dan memiliki kualitas pelayanan yang baik. Sarana kesehatan dasar yang

ada di Kota Semarang pada tahun 2006 terdiri dari : 15 Rumah Sakit

Umum, 1 Rumah Sakit Jiwa, 4 Rumah Sakit Bersalin, 4 Rumah Sakit Ibu

dan Anak, 37 Puskesmas (11 Puskesmas Perawatan dan 26 Puskesmas

Non Perawatan), 33 Puskesmas Pembantu, 37 Puskesmas Keliling, 264

Balai Pengobatan/Klinik 24 Jam, 316 Apotek, 78 Toko Obat, 20 praktek

dokter bersama spesialis, 2.541 praktek dokter swasta perorangan dan 220

praktek pengobat tradisional. Data secara lengkapnya dapat dilihat pada

tabel 61.

Sarana Pelayanan Kesehatan dengan Laboratorium Kesehatan dan 4 spesialis dasar, dalam upaya meningkatkan mutu pelayanan

kesehatan kepada masyarakat, telah terdapat beberapa sarana pelayanan

kesehatan yang telah dilengkapi oleh fasilitas laboratorium kesehatan dan 4

(empat) spesialis dasar. Kondisi yang ada di Kota Semarang pada tahun

2007, diketahui bahwa sarana kesehatan yang memiliki laboratorium

kesehatan sebanyak 62 buah (100%) dan yang memberikan pelayanan 4

spesialis dasar sebesar 15 buah (24,19%). Sarana kesehatan tersebut

terdiri dari : 15 Rumah Sakit Umum dengan fasilitas laboratorium kesehatan

dan 4 spesialis dasar; Rumah Sakit Khusus 5 buah yang memiliki

laboratorium kesehatan serta 37 puskesmas se-Kota Semarang telah

seluruhnya dilengkapi oleh fasilitas laboratorium kesehatan sederhana

Sarana kesehatan dengan kemampuan gawat darurat yang dapat

diakses oleh masyarakat di Kota Semarang pada tahun 2007 sebanyak 62

sarana kesehatan (58,06%) yaitu 15 Rumah Sakit Umum (100%), 1 RS

Jiwa (100%), 9 RS Khusus (100%) dan 11 puskesmas (29,73%). Data

selengkapnya dapat dilihat pada tabel 29. Apabila dibandingkan dengan

target SPM 2005 (40%), maka jumlah ini sudah mencapai target tersebut.

Desa Siaga, merupakan desa yang penduduknya memiliki kesiapan

sumber daya dan kemampuan serta kemauan untuk mencegah dan

mengatasi masalah-masalah kesehatan secara mandiri. Sebuah desa

dikatakan menjadi desa siaga apabila desa tersebut telah memiliki

sekurang-kurangnya sebuah Pos Kesehatan Desa (Poskesdes). Jumlah

desa siaga yang ada di Kota Semarang Tahun 2007 sebanyak 48 desa.

Kedepan desa siaga akan terus dikembangkan baik dari segi kuantitas

maupun kualitas guna memeratakan pelayanan kesehatan dasar kepada

masyarakat dan pada akhirnya diharapkan dapat mengatasi berbagai

masalah kesehatan yang ada.

IV.6.3. Anggaran KesehatanAlokasi anggaran kesehatan untuk Kota Semarang pada tahun 2007

sebesar Rp. 98.773.163.758,- meningkat dari tahun 2006 yaitu sebesar Rp.

74.573.915.000,-. Alokasi dana ini terbagi atas: sumber APBD Kota

Semarang sebesar Rp. 94.073.730.300,- (95,24%); sumber APBD Propinsi

Rp. 276.500.500,- (0,28%); sumber APBN sebesar Rp. 3.404.463.000,-

(3,44%). Total APBD Dinas Kesehatan dari total APBD Kota Semarang

sebesar Rp. 1.326.309.254.272,- yaitu 7,09%. Data secara lengkap dapat

dilihat pada tabel 60.

Profil Kesehatan Kota Semarang Tahun 2007

65

BAB VKESIMPULAN

Berbagai upaya yang telah dilaksanakan dalam pembangunan

kesehatan, antara lain upaya peningkatan dan perbaikan terhadap derajat

kesehatan masyarakat, upaya pelayanan kesehatan, sarana kesehatan dan

sumber daya kesehatan. Hasil-hasil kegiatan pembangunan kesehatan di 16

kecamatan di Kota Semarang selama periode 1 (satu) tahun tergambar dalam

Profil Kesehatan Kota Semarang tahun 2007.

Secara umum upaya-upaya yang telah dilakukan dalam

pembangunan kesehatan telah menunjukkan hasil yang cukup baik, namun

masih ada beberapa program kesehatan yang belum mencapai hasil yang

optimal. Keberhasilan maupun kekurangan dalam pencapaian upaya-upaya

pembangunan kesehatan di Kota Semarang selama tahun 2007 adalah

sebagai berikut :

a. Berdasarkan hasil Survei Kesehatan Daerah (SURKESDA) jumlah

kematian bayi yang terjadi di Kota Semarang Tahun 2007 sebanyak 466

dari 24.746 kelahiran hidup,sehingga didapatkan Angka Kematian Bayi

(AKB) sebesar 18,8 per 1.000 KH. Sedangkan untuk kematian Balita di

Kota Semarang Tahun 2007 sebanyak 113 anak sehingga Angka Kematian

Balita (AKABA) Kota Semarang diperoleh sebesar 4,6 per 1.000 KH.

b. Berdasarkan laporan Puskesmas dan Rumah Sakit jumlah kematian ibu

maternal di Kota Semarang pada tahun 2007 sebanyak 20 orang dengan

jumlah kelahiran hidup sebanyak 24.746 orang.

c. Penyakit DBD di Kota Semarang pada tahun 2007 mengalami peningkatan

dari tahun sebelumnya yaitu dari 1.845 kasus menjadi 2.924 kasus

sehingga diperoleh angka kesakitan DBD sebesar 19,64 per 10.000

penduduk.

d. Berdasarkan laporan Puskesmas, jumlah kasus malaria pada tahun 2007

ditemukan 34 orang (API = 0.02 pddk) meningkat dari tahun sebelumnya

yaitu 27 orang (API = 0.02 pddk).

e. Berdasarkan data laporan triwulan (Puskesmas, BP4 dan Rumah Sakit)

penemuan penderita TB Paru BTA positif pada tahun 2007 sebanyak 747

orang mengalami penurunan bila dibandingkan tahun 2006 (901 orang)

f. Penderita diare di Kota Semarang pada tahun 2007 sebanyak 29.943

penderita dengan angka kesakitan sebesar 20,11 per 1.000 penduduk,

dimana terdapat peningkatan dari tahun sebelumnya.

g. Kasus pneumonia di Kota Semarang pada tahun 2007 mencapai 3.230

penderita, meningkat dari tahun 2006 yang hanya mencapai 2.286

penderita, sehingga diperoleh IR untuk tahun 2007 sebesar 219,88 per

10.000 balita

h. Pada tahun 2007, penderita kusta di Kota Semarang yang dilaporkan dari

16 kecamatan sebanyak 34 orang mengalami peningkatan dari 14 orang

pada tahun 2006, yaitu terdiri dari penderita Kusta tipe MB = 27 orang dan

PB = 7 orang.

i. Jumlah kasus Infekasi Menular Seksual (IMS) di Kota Semarang pada

tahun 2007 berdasarkan laporan Puskesmas mencapai 550 kasus. Jumlah

kasus HIV (+) yang ditemukan tahun 2007 sebanyak 18 orang dan dari

hasil kegiatan VCT tahun 2007 ditemukan 195 kasus (120 orang dari klinik

VCT, 42 orang BP4 dan 33 orang dari LSM). Sedangkan untuk kasus AIDS

ditemukan sebanyak 33 kasus meningkat dari tahun 2006 yang mencakup

25 kasus.

j. Kasus AFP yang ditemukan di Kota Semarang tahun 2007 sebanyak 11

kasus, meningkat dari tahun sebelumnya sebanyak 8 kasus, terbanyak

pada golongan umur 5 -15 thn sebanyak 6 kasus, 1-4 thn sebanyak 5 kasus

sehingga untuk tahun 2007 diperoleh AFP rate sebesar 2,75 per 100.000

( target ≥ 2/100.000 penduduk )

k. Jumlah kasus penyakit menular yang dapat dicegah dengan imunisasi

tertinggi yaitu Campak 343 kasus, dan Difteri 29 kasus,Hepatitis B 457

kasus sedangkan untuk penyakit lainnya seperti Pertusis, Tetanus, Tetanus

Neonatorum dan Polio di Kota Semarang Tahun 2007 tidak ditemukan

adanya kasus.

l. Data kasus penyakit tidak menular tahun 2007 di Kota Semarang : Kasus

penyakit kanker yang ditemukan sebanyak 10.171 kasus ( Kanker

Payudara 4.844 kasus, Kanker Serviks 4.537 kasus, Kanker Hepar 434

kasus, Kanker Paru 256 kasus) ; Diabetes Mellitus sebanyak 50.129 kasus ;

kasus Penyakit Jantung dan Pembuluh Darah ( Angina Pektoris 3.807

kasus, AMI 2.088 kasus, Hipertensi 54.780 kasus dan Stroke 2.958 kasus )

m. Dilaporkan pada tahun 2007 di Kota Semarang terjadi Kejadian Luar Biasa

(KLB) sebanyak 33 kejadian yaitu : Difteri (26 kejadian), Keracunan

Makanan (5 kejadian), Meningitis ( 1 kejadian) dan Campak (1 kejadian).

Profil Kesehatan Kota Semarang Tahun 2007

67

Dari kasus KLB yang ada, terjadi kematian akibat KLB Difteri (1 orang).

n. Pada tahun 2007 di Kota Semarang menunjukkan jumlah Bayi Lahir Hidup

sebanyak 24.746 bayi dan jumlah Balita yang ada (S) sebesar 115.400

anak. Untuk kasus bayi dengan Berat Badan Lahir Rendah (BBLR) pada

tahun 2007 yaitu sebanyak 137 bayi (0,55%), meningkat dari tahun

sebelumnya yaitu 133 bayi (0,53%). Sedangkan jumlah Balita yang datang

dan ditimbang (D) di posyandu dari seluruh balita yang ada 115.400 anak

(S) yaitu sejumlah 93.272 anak (80,82%) dengan rincian jumlah balita yang

naik berat badannya sebanyak 74.775 anak (80,17%) dan Bawah Garis

Merah (BGM) sebanyak 897 anak (0,96%)

o. Berdasarkan hasil laporan puskesmas tahun 2007, pemberian ASI

Ekslusif mengalami penurunan dari tahun 2006 40,07% (9.129 bayi ) yang

hanya mencapai 4.281 bayi (38,44%).

p. Pada tahun 2007 di Kota Semarang dari sampling 84.480 rumah tangga

yang diperiksa diperoleh hasil yaitu Rumah Tangga yang berperilaku hidup

bersih dan sehat sebanyak 68.67%, terdiri dari strata utama 63.083 RT

(75%) strata paripurna 4.725 RT (5,59%)

q. Posyandu yang ada di Kota Semarang berjumlah 1.464 buah, terdiri dari

639 posyandu purnama (43,65%) dan 307 Posyandu mandiri (20,97%)

sehingga jumlah total posyandu yang tergolong purnama dan mandiri

adalah 946 posyandu (64,61%)

r. Berdasarkan laporan puskesmas, jumlah penduduk yang tercakup dalam

dalam berbagai JPK (Jaminan Pemeliharaan Kesehatan) sebesar 254.869

jiwa (20,62%) dari total jumlah penduduk , dengan perincian :

• Peserta ASKES : 239.482 jiwa (19,92%)

• Peserta BAPEL : 35.972 jiwa (2,99%)

• Peserta JAMSOSTEK : 65.237 jiwa (5,43%)

• Peserta Dana Sehat : 15.380 jiwa (1,28%)

s. Di Kota Semarang sampai dengan tahun 2007 terdapat masyarakat miskin

dan yang memiliki kartu ASKESKIN baru mencapai 175.716 jiwa (69,75%)

dari 252.579 masyarakat miskin yang ada

t. Pada tahun 2007 Kota Semarang jumlah rumah yang ada sebanyak

294.351 buah, sedangkan kategori rumah yang memenuhi syarat

kesehatan sebanyak 33.846 rumah (82,77%) dari 40.892 rumah yang

dilakukan pemeriksaan

u. Jumlah tempat - tempat umum dan tempat pengelolaan makanan di Kota

Semarang Tahun 2007 sebanyak 2.081 buah, jumlah diperiksa 1.538 buah

dan jumlah yang sehat 1.258 buah atau 81,79%.

v. Keluarga dengan kepemilikan sarana sanitasi dasar yaitu : persediaan air

bersih sebanyak 327.902 KK (92,91 %) dari 352.929 KK yang ada; 46.936

KK telah memanfaatkan jamban keluarga dan 44.191 KK telah memenuhi

syarat jamban yang sehat (94,15%) dari 49.324 KK yang dilakukan

pemeriksaan; Pengelolaan limbah di rumah tangga yang diperiksa

sebanyak 46.649 KK dan yang memenuhi syarat kesehatan sebanyak

41.487 KK (88,93%);

w. Pada tahun 2007 di Kota Semarang jumlah penduduk yang memanfaatkan

pelayanan kesehatan rawat jalan di Puskesmas sebanyak 18.387 per

100.000 penduduk, sedangkan untuk rawat inap Puskesmas yaitu sebesar

296 per 100.000 penduduk. Sedangkan pemanfaatan pelayanan kesehatan

rawat jalan di Rumah Sakit yaitu sebanyak 24.437 per 100.000 penduduk

dan rawat inap 10.277 per 100.000 penduduk. Untuk cakupan rawat jalan di

Kota Semarang pada tahun 2007 yaitu sebesar 42,82%. Sedangkan untuk

cakupan rawat inap (kunjungan pasien baru) di sarana pelayanan

kesehatan pada tahun 2007 yaitu sebesar 10,57%.

x. Pencapaian hasil kinerja Rumah Sakit di Kota Semarang meliputi : BOR

(67,20) ; LOS (5,60) ;TOI (2,7) ; GDR (3,5) ; NDR (2,00).

y. Pelayanan kesehatan Ibu dan Anak :

• Cakupan kunjungan ibu hamil K4 Kota Semarang pada tahun 2007

adalah 24.274 bumil (89,04%)

• Cakupan pemberian tablet (Fe)1 sebanyak 28.069 bumil (102,96%)

dan cakupan untuk tablet (Fe)3 sebanyak 24.240 bumil (88,91%)

• Pemberian imunisasi TT pada Bumil mencakup TT1 sebesar

20.090 bumil (71,86%), imunisasi TT2 sebesar 18.189 bumil

(65,06%), imunisasi TT3 sebanyak 2.543 bumil, imunisasi TT4

sebanyak 1.926 (6,98%) dan imunisasi TT5 mencapai 1.108 bumil

(3,96%)

• Cakupan TT bagi Wanita Usia Subur (WUS) yaitu TT1 2.943 orang

(10,53%), TT2 1.552 orang (5,55%), TT3 309 orang (1,11%), TT4

256 orang (0,92%) dan TT5 384 orang (1,37%) dari 27.958 WUS

yang ada

Profil Kesehatan Kota Semarang Tahun 2007

69

• Jumlah persalinan dengan pertolongan tenaga kesehatan di Kota

Semarang pada tahun 2007 sebesar 22.155 (85,14%) dari jumlah

perkiraan persalinan sebesar 26.021 kelahiran

• Pada tahun 2007 ibu hamil risiko tinggi/ komplikasi yang ditemukan

di Kota Semarang sebesar 3.366 orang dan bumil risti/ komplikasi

yang dirujuk yaitu sebanyak 885 orang (26,29%)

• Cakupan pemberian suplementasi kapsul Vitamin A dosis tinggi

pada bayi sebanyak 28.634 bayi (100%), Balita sebanyak 93.600

anak (100%) serta Bufas 25.178 orang (96,76%).

• Cakupan kunjungan neonatus tingkat Kota Semarang tahun 2007

sebesar 23.643 (95,54%)

• Hasil cakupan kunjungan bayi di Kota Semarang pada tahun 2007

sebesar 22.987 (92,89%)

• Hasil cakupan deteksi dini tumbuh kembang (DDTK) anak balita dan

pra sekolah di tingkat Kota Semarang pada tahun 2007 yaitu

68,91%.

z. Cakupan bayi yang diimunisasi DPT3 pada tahun 2007 sebesar 23.472

anak (92,37%), Polio 4 sebanyak 21.864 anak (86,04%) dan bayi yang

telah memperoleh imunisasi campak sebesar 23.274 (91,59%) dari sasaran

sejumlah 25.412 bayi

Hasil kegiatan pelayanan kesehatan Pra Usila dan Usila di Kota Semarang

pada tahun 2005 sebesar 19.321 (41,61%) terdiri atas pra usila (45 – 59

thn) sebanyak 9.665 (39,99%) dan Usila (≥ 60 thn) sebanyak 9.656

(43,39%)

aa. Pada tahun 2007, jumlah PUS yang ada sebanyak 243.194. Yang menjadi

peserta KB baru sebanyak 33.874 (13,93%). Sedang jumlah peserta KB

aktif yang telah dibina sebesar 188.309 (77,43%)

bb. Cakupan pelayanan kesehatan pekerja pada industri formal di Kota

Semarang pada tahun 2007 sebanyak 240.753 orang (79,14% dari 304.196

pekerja formal yang ada). Sedangkan untuk pelayanan kesehatan pada

pekerja sektor informal dari 665.530 pekerja yang terdata, yang

mendapatkan pelayanan kesehatan sebanyak 551.838 pekerja (82,92%)

cc. Cakupan pelayanan NAPZA pada tahun 2007 berupa kegiatan penyuluhan

NAPZA oleh tenaga kesehatan, baru mencapai 375 kegiatan (21,61%) dari

1.735 kegiatan penyuluhan keseluruhan

dd. Hasil cakupan pelayanan kesehatan pada anak sekolah (siswa TK, SLTP

dan SLTA)pada tahun 2007 di Kota Semarang mencapai 99.729 siswa

(97,08%

ee. Sarana kesehatan dengan kemampuan gawat darurat yang dapat diakses

oleh masyarakat di Kota Semarang pada tahun 2007 sebanyak 62 sarana

kesehatan (58,06%) yaitu 15 Rumah Sakit Umum (100%), 1 RS Jiwa

(100%), 9 RS Khusus (100%) dan 11 puskesmas (29,73%)

ff. Pelayanan kesehatan jiwa pada Puskesmas dan Rumah Sakit di Kota

Semarang pada tahun 2007 menunjukkan pencapaian sebesar 0,42%.

gg. Kegiatan pelayanan kesehatan gigi dan mulut yang dilaksanakan di

puskesmas pada tahun 2007 yaitu tumpatan gigi tetap sebanyak 9.590

dengan rata-rata per bulan sebesar 799 tindakan dan pencabutan gigi tetap

sebanyak 10.250 dengan rata-rata per bulan sebesar 854, dengan rasio

untuk tambal dibandingkan pencabutan gigi sebesar 0,94

hh. Hasil kegiatan pelayanan transfusi darah di Kota Semarang pada tahun

2007 sebesar 66.489 (92,96%) kantong darah dari kebutuhan 71.526

kantong darah

ii. Data ketersediaan obat pada tahun 2007 bersumber dari laporan 37

Puskesmas se-Kota Semarang, jumlah jenis obat yang dibutuhkan oleh

Puskesmas rata-rata 129 item, sedangkan jenis obat yang tersedia di

Puskesmas rata-rata 145 item sehingga diperoleh ketersediaan obat secara

keseluruhan sebesar 112,87%. Untuk obat generik, kebutuhan total jenis

obat generik seluruh Puskesmas Tahun 2007 adalah rata-rata 131 item.

Sedangkan jumlah total jenis obat generik yang tersedia sebanyak 145

item, sehingga diperoleh pemenuhan sebesar 110,55%.

jj. Jumlah penulisan resep obat generik di fasilitas sarana kesehatan tersebut

sebesar 52.816 (55,81%) dari total penulisan resep yang ada yaitu

sejumlah 94.639 resep.

kk. Jumlah seluruh kebutuhan obat narkotika dan psikotropika di Kota

Semarang tahun 2007 yaitu rata-rata 3 item per Puskesmas sedangkan

untuk ketersediaan obat narkotika dan psikotropika yaitu sebesar 4 item

ll. Rasio tenaga kesehatan Kota Semarang (puskesmas, Rumah Sakit dan

Dinas Kesehatan Kota Semarang) dibandingkan dengan jumlah penduduk

kota Semarang tahun 2007 dapat diperoleh data sebagai berikut:

• jumlah Dokter Umum sebesar 107 per 100.000 penduduk

Profil Kesehatan Kota Semarang Tahun 2007

71

(target IS 2010 : 40/100.000 penduduk)

• jumlah Dokter Spesialis sebesar 46 per 100.000 penduduk

(target IS 2010 : 6/100.000 penduduk)

• jumlah Dokter Gigi sebesar 30 per 100.000 penduduk

(target IS 2010 : 11/100.000 penduduk)

• jumlah Perawat sebesar 175 per 100.000 penduduk

(target IS 2010 : 117,5/100.000 penduduk)

• jumlah Bidan sebesar 37 per 100.000 penduduk

(target IS 2010 : 100/100.000 penduduk)

• jumlah Tenaga Farmasi sebesar 57 per 100.000 penduduk

(target IS 2010 : 10/100.000 penduduk)

• jumlah Tenaga Gizi sebesar 11 per 100.000 penduduk

(target IS 2010 : 22/100.000 penduduk)

• jumlah Tenaga Kesehatan Masyarakat sebesar 8 per 100.000

penduduk

(target IS 2010 : 40/100.000 penduduk)

• jumlah Tenaga Sanitasi sebesar 4 per 100.000 penduduk

(target IS 2010 : 40/100.000 penduduk)

• jumlah tenaga teknisi medis sebesar 28 per 100.000 penduduk

mm.Sarana kesehatan dasar yang ada di Kota Semarang pada tahun 2007

terdiri dari : 15 Rumah Sakit Umum, 1 Rumah Sakit Jiwa, 4 Rumah Sakit

Bersalin, 4 Rumah Sakit Ibu dan Anak, 37 Puskesmas (11 Puskesmas

Perawatan dan 26 Puskesmas Non Perawatan), 33 Puskesmas Pembantu,

37 Puskesmas Keliling, 264 Balai Pengobatan/Klinik 24 Jam, 316 Apotek,

78 Toko Obat, 20 praktek dokter bersama spesialis, 2.541 praktek dokter

swasta perorangan dan 220 praktek pengobat tradisional

nn. Alokasi anggaran kesehatan untuk Kota Semarang pada tahun 2007

sebesar Rp. 98.773.163.758 meningkat dari tahun 2006 yaitu sebesar Rp.

74.573.915.000,-.