Upaya Pengendalian Malaria Dalam Rangka Pre-Eliminasi di Kabupaten Garut: Sebuah studi kualitatif

Abstract

Indonesia is one of the malaria-endemic countries commits to eliminate malaria in 2030. The implementation of malaria control program policy is a determinant to achieve the goal. This research was qualitative that described the implementation of malaria control program policy in Garut Regency, West Java Province. The data collected through in-depth interviews and documents’ review. The implementation of malaria control had referred to guidelines from the Ministry of Health, Republic of Indonesia. This control was also technically adjusted to regional conditions. Case detection of malaria was conducted such as a mass blood survey, rapid diagnostic tests and a microscopic laboratory test both passive and active. The malaria case surveillance has already accomplished. However, the vector was left. The malaria vector control focused on the distribution of insecticide-treated nets and the insecticide spray by the Indoor Residual Spraying (IRS) technique. The analysis indicated that the cross-program cooperation at the central government was well coordinated. However, at the level of the district, this cooperation has to be tightened. Moreover, malaria control budget was still the under district level, so that controlling malaria program did not cover all aspects of the implementation. Abstrak Indonesia sebagai salah satu negara endemis malaria, berkomitmen melakukan eliminasi di tahun 2030. Implementasi kebijakan program pengendalian malaria menjadi determinan keberhasilan eliminasi. Tujuan penelitian ini memberikan gambaran pelaksanaan program pengendalian malaria di Kabupaten Garut, Provinsi Jawa Barat. Pengumpulan data dilakukan dengan wawancara mendalam pada pengelola Program Penanggulangan Malaria serta telaah dokumen dan data dianalisis secara kualitatif. Hasil penelitian menunjukkan bahwa kebijakan pelaksanaan program pengendalian malaria di Kabupaten Garut, Provinsi Jawa Barat sudah merujuk pada pedoman Kementerian Kesehatan RI, secara teknisnya disesuaikan dengan kondisi wilayah. Penemuan penderita dilakukan secara pasif maupun aktif melalui Mass Blood Survey (MBS), dengan pemeriksaan menggunakan Rapid Diagnostic Test (RDT) dan laboratorium secara mikroskopis, Surveilans yang dilakukan oleh Puskesmas hanya terfokus pada surveilans kasus dan belum dilakukan surveilans vektor malaria. Pengendalian vektor malaria yang dilakukan berupa pembagian kelambu dan penyemprotan insektisida dengan metode Indoor Residual Spraying (IRS).  Kerjasama lintas program berjalan dengan baik, namun kerjasama lintas sektor terutama pada tingkat kabupaten masih perlu dilakukan dan ditingkatkan. Pembiayaan program pengendalian malaria hanya dari pemerintah daerah dan belum dapat mengakomodir kegiatan pengendalian secara keseluruhan.