Analisis Implementasi Kebijakan Swasembada Gizi dalam Upaya Pencegahan dan Penanggulangan Stunting di Kabupaten Lampung Selatan

Anita Anita* -  Tanjungkarang Health Polytechnic MOH Republic of Indonesia, Indonesia
Aprina Aprina -  Tanjungkarang Health Polytechnic MOH Republic of Indonesia, Indonesia
Sudarmi Sudarmi -  Tanjungkarang Health Polytechnic MOH Republic of Indonesia, Indonesia
Anggun Rusyantia -  Tanjungkarang Health Polytechnic MOH Republic of Indonesia, Indonesia
Pranajaya Pranajaya -  Tanjungkarang Health Polytechnic MOH Republic of Indonesia, Indonesia
Titi Astuti -  Tanjungkarang Health Polytechnic MOH Republic of Indonesia, Indonesia

ABSTRACT

 

South Lampung Regent's Instruction Number 2 of 2020 through the Gerakan Swasembada Gizi as an effort to reduce stunting in 2018-2021 which must be implemented in all areas of South Lampung Regency. The aim of this research is to analyze the implementation of the Gerakan Swasembada Gizi Policy in efforts to prevent and overcome stunting in the South Lampung district. This was a qualitative descriptive study with a research instrument using a semi-structured interview guide. Data analysis was conducted using a deductive coding approach based on Grindle's theory, namely, policy content and context. In-depth interviews were conducted with eight regional apparatus organization (OPD) participants as key informants. Method triangulation was carried out by conducting Focus Group Discussions (FGD) in three policy-implementing groups at the community health center and sub-district levels with a total of 15 participants, and also an in-depth interview with seven village midwives, posyandu cadres, and parents with children at risk of stunting. The results show that all OPDs have the same understanding of the implementation of the Gerakan Swasembada Gizi policy. Technical instructions for implementing policies at the district level have been prepared well through a good practice book on efforts to accelerate stunting reduction. Obstacles that still arise are the absence of integrated program SOPs to increase a uniform understanding of the main duties and functions, no integration of integrated data from 64 stunting indicators spread across various OPDs, and rejection and perception of stigma among parents with children at risk of stunting, which causes decreased access to health services. Policy recommendations are provided regarding the need for integrated stunting data management, the need to create SOPs related to the integrated Gerakan Swasembada Gizi program, optimizing regional apparatus and cadres in implementing the Gerakan Swasembada Gizi, and optimizing behavior change campaigns.

 

Keywords: Policy, Gerakan Swasembada Gizi, Prevention, Stunting

 

 

ABSTRAK

 

Instruksi Bupati Lampung Selatan Nomor 2 Tahun 2020 melalui Gerakan Swasembada Gizi sebagai upaya penurunan stunting tahun 2018-2021 yang wajib dilaksanakan di seluruh wilayah Kabupaten Lampung Selatan. Tujuan penelitian ini adalah menganalisis implementasi kebijakan Swasembada Gizi dalam upaya pencegahan dan penanggulangan stunting di kabupaten Lampung Selatan. Penelitian ini adalah deskriptif kualitatif dengan instrumen penelitian menggunakan panduan wawancara semi-struktur. Analisis data dengan pendekatan koding secara deduktif berdasarkan teori Grindle yaitu isi dan konteks kebijakan. Wawancara mendalam dilakukan pada 8 partisipan Organisasi Perangkat Daerah (OPD) sebagai informan kunci. Triangulasi metode dilakukan dengan melakukan Focus Group Discussion (FGD) pada tiga kelompok pelaksana kebijakan di tingkat puskesmas dan kecamatan dengan total 15 partisipan, serta wawancara mendalam pada 7 orang perwakilan bidan desa, kader posyandu dan penerima manfaat. Hasil penelitian menunjukkan bahwa seluruh OPD sudah memiliki pemahaman yang sama mengenai pelaksanaan kebijakan swasembada gizi. Petunjuk teknis pelaksanaan kebijakan di tingkat Kabupaten telah disusun dengan sangat baik melalui buku praktik baik upaya percepatan penurunan stunting. Kendala yang masih muncul adalah belum adanya SOP program terintegrasi untuk dapat meningkatkan pemahaman yang seragam terkait tupoksi; belum adanya integrasi data terpadu dari 64 indikator stunting yang tersebar di berbagai OPD; serta masih ada penolakan dan persepsi stigma pada orangtua dengan anak beresiko stunting yang menyebabkan menurunnya akses ke pelayanan kesehatan. Rekomendasi kebijakan diberikan terkait perlu adanya manajemen data stunting yang terintegrasi, perlu dibuatnya SOP terkait program terpadu Swasembada Gizi, mengoptimalkan perangkat daerah beserta kader dalam pelaksanaan gerakan Swasembada Gizi serta mengoptimalkan kampanye perubahan perilaku.

 

Kata Kunci: Kebijakan, Swasembada Gizi, Pecegahan, Penanggulangan, Stunting

  1. Andrew, S. A., & Arlikatti, S. (2020). Ebola crisis response in the USA: Communication management and SOPs. International Journal of Disaster Risk Reduction, 31(2018), 243–250. https://doi.org/https://doi.org/10.1016/j.ijdrr.2018.04.028
  2. Bappenas. (2018). Pedoman PelaksanaanIntervensi Penurunan Stunting Terintegrasi di Kabupaten/Kota.
  3. Bender, G. W. (2022). Strategi Komunikasi Kampanye Sadar Stunting 2021 Melalui Kol. Jurnal Pariwara, 1(1), 14–24. https://jurnal.bsi.ac.id/index.php/pariwara
  4. Bullock, H. L., & Lavis, J. N. (2019). Understanding the supports needed for policy implementation: A comparative analysis of the placement of intermediaries across three mental health systems. Health Research Policy and Systems, 17(1), 1–13. https://doi.org/10.1186/s12961-019-0479-1
  5. Errida, A., & Lotfi, B. (2021). The determinants of organizational change management success: Literature review and case study. International Journal of Engineering Business Management, 13, 1–15. https://doi.org/10.1177/18479790211016273
  6. Fereday, J., & Muir-Cochrane, E. (2006). Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development. International Journal of Qualitative Methods, 5(1), 80–92. https://doi.org/10.1177/160940690600500107
  7. Grindle, M. S. (1980). Politics and Policy Implementation in the Third World. Princeton University Press.
  8. Gunawan, I. (2019). Pengaruh Daya Tanggap dan Kinerja Pegawai Terhadap Kepuasan Masyarakat Kecamatan Metro Kibang Kabupaten Lampung Timur. Jurnal Simplex, 2(April), 33–40. https://fe.ummetro.ac.id/ejournal/index.php/JS/article/view/329/222
  9. Hamadamin, H. H., & Atan, T. (2019). The impact of strategic human resource management practices on competitive advantage sustainability: The mediation of human capital development and employee commitment. Sustainability (Switzerland), 11(20). https://doi.org/10.3390/su11205782
  10. Harapan, H., Itoh, N., Yufika, A., Winardi, W., Keam, S., Te, H., Megawati, D., Hayati, Z., Wagner, A. L., & Mudatsir, M. (2020). Coronavirus disease 2019 (COVID-19): A literature review. Journal of Infection and Public Health, 13(5), 667–673. https://doi.org/10.1016/j.jiph.2020.03.019
  11. Hudson, B., Hunter, D., & Peckham, S. (2019). Policy failure and the policy-implementation gap: can policy support programs help? Policy Design and Practice, 2(1), 1–14. https://doi.org/10.1080/25741292.2018.1540378
  12. Kemenkes RI. (2021). Modul Pelatihan Komunikasi Antar Pribadi (KAP) Bagi Tenaga Kesehatan Di Puskesmas Dalam Percepatan Pencegahan Stunting Di Indonesia. 1–175. https://siakpel.kemkes.go.id/upload/akreditasi_kurikulum/modul-1-34353134-3730-4434-b639-323032393434.pdf
  13. Kemenkes RI. (2023). Hasil Survei Status Gizi Indonesia (SSGI). In Kementerian Kesehatan Republik Indonesia. https://promkes.kemkes.go.id/materi-hasil-survei-status-gizi-indonesia-ssgi-2022
  14. Kementerian PPN/ Bappenas. (2018). Pedoman Pelaksanaan Intervensi Penurunan Stunting Terintegrasi di Kabupaten/Kota (Issue November). https://www.bappenas.go.id
  15. Lailia, I., Kismartini, K., & Rahman, A. Z. (2020). Peran Stakeholders dalam Implementasi Kebijakan Intervensi Gizi Sensitif di Kota Semarang. Journal Of Public Policy And Management Review, 10(3), 1–23. https://doi.org/10.14710/jppmr.v10i3.31228
  16. Mantzari, E., Reynolds, J. P., Jebb, S. A., Hollands, G. J., Pilling, M. A., & Marteau, T. M. (2022). Public support for policies to improve population and planetary health: A population-based online experiment assessing impact of communicating evidence of multiple versus single benefits. Social Science and Medicine, 296(April 2021), 114726. https://doi.org/10.1016/j.socscimed.2022.114726
  17. Novianti, R., Paselle, E., & Susilowati, T. (2021). Implementasi Peraturan Bupati Kutai Kartanegara No. 38 Tahun 2019 Tentang Gerakan Masyarakat Hidup Sehat (Studi Kasus Intervensi Penanganan Stunting Oleh Dinas Kesehatan di Desa Bakungan Kecamatan Loa Janan). Administrasi Publik, 9(1), 27–33.
  18. Obi, J. (2015). Effective Human Resources Management Practices As the Key To Organizational Performance. International Journal of Educational Research, 3(1), 1–26.
  19. Permanasari, Y., Permana, M., Pambudi, J., Rosha, B. C., Susilawati, M. D., Rahajeng, E., Triwinarto, A., & Prasodjo, R. S. (2020). Tantangan Implementasi Konvergensi pada Program Pencegahan Stunting di Kabupaten Prioritas. Media Penelitian Dan Pengembangan Kesehatan, 30(4), 315–328. https://doi.org/10.22435/mpk.v30i4.3586
  20. Pollack Porter, K. M., Rutkow, L., & McGinty, E. E. (2018). The Importance of Policy Change for Addressing Public Health Problems. Public Health Reports, 133(1), 9S-14S. https://doi.org/10.1177/0033354918788880
  21. Ribka, A., & Wijaya, A. F. (2013). Role of Actors in Policy Formulation Process in Development Plan for Land Transport Study Case in Tuban Regency. Jurnal Pembangunan Dan Alam Lestari, 4(2), 1–9.
  22. Shauma, U. N., & Purbaningrum, D. G. (2022). Implementasi Kebijakan Percepatan Pencegahan Stunting. Jurnal Kebijakan Publik, 13(2), 200–207.
  23. Suandi. (2019). Analisis Kepuasan Masyarakat terhadap Pelayanan Publik Berdasarkan Indeks Kepuasan Masyarakat di Kantor Kecamatan Belitang Kabupaten OKU Timur. Jurnal Ilmu Administrasi Dan Studi Kebijakan, 1(2), 13–22. https://doi.org/10.48093/jiask.v1i2.8
  24. Sugianti, E. (2017). Evaluasi Pemberian Makanan Tambahan Pemulihan (PMT-P) Pada Balita Kurang Gizi Di Kabupaten Tuban. Cakrawala, 11(2), 217–224. https://doi.org/10.32781/cakrawala.v11i2.20
  25. Sunaryo, D. R., Candradewini, & Arifianto, R. (2021). Implementasi Kebijakan Percepatan Pencegahan dan Penanggulangan Stunting di Kabupaten Bandung. Jurnal Pemikiran Dan Penelitian Bidan Administrasi, Sosial, Humaniora Dan Kebijakan Publik, 04(04), 205–213.
  26. Surbakti, E., Sulaeman, A., Alamsyah, N., & Kartini, D. S. (2021). Implementation on financial assistance policy of political parties in 2015-2018. Utopía y Praxis Latinoamericana, 26(2), 313–322.
  27. Sutyawan;, Novidiyanto;, & Wicaksono, A. (2022). Optimalisasi Pemanfaatan Pangan Lokal yang Aman dan Bergizi dalam Upaya Pencegahan Stunting di Desa Ibul Kabupaten Bangka Barat. Jurnal Panrita Abdi, 6(3), 565–577.
  28. Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and Implementing Value-Based Health Care: A Strategic Framework. Academic Medicine, 95(5), 682–685. https://doi.org/10.1097/ACM.0000000000003122
  29. Tolley, E. E., Ulin, P. R., Mack, N., Robinson, E. T., & Succop, S. M. (2016). Qualitative methods in public health : a field guide for applied research (Second edi). Jossey-Bass & Pfeiffer Imprints, Wiley.
  30. Vela, L. R., & Sjaaf, A. C. (2020). Policy Implementation in Achieving Basic Complete Immunization and Universal Child Immunization Indicators in Kapuas District in 2018. Journal of Indonesian Health Policy and Administration, 5(1), 14–19. https://doi.org/10.7454/ihpa.v5i1.3150
  31. Wardani, R. (2014). Analisis Penetapan Prioritas Program Upaya Kesehatan Dasar Puskesmas Pada Tingkat Pemerintah Daerah (Studi Eksploratif di Kota Bogor Tahun 2013). Jurnal Kebijakan, 03(04), 199–212.
  32. Wendt, J., Scheller, D. A., Banik, A., Luszczynska, A., Forberger, S., Zeeb, H., Scheidmeir, M., Kubiak, T., Lien, N., Meshkovska, B., Lobczowska, K., Romaniuk, P., Neumann-Podczaska, A., Wieczorowska-Tobis, K., Steinacker, J. M., & Mueller-Stierlin, A. S. (2023). Good practice recommendations on implementation evaluation for policies targeting diet, physical activity, and sedentary behaviour. BMC Public Health, 23(1), 1–14. https://doi.org/10.1186/s12889-023-15775-9
  33. Weny, I. (2022). Implementasi Program Penurunan Stunting di Kabupaten Alor Provinsi Nusa Tenggara Timur. Institut Pemerintahan Dalam Negeri.