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Abstract

Keberhasilan program KB mengendalikan tingkat kelahiran di Indonesia selama lebih dari tiga dekade tidak terlepas dari peran petugas Penyuluh Keluarga Berencana (PKB). Di Rwanda, keaktifan penyuluhan oleh PKB dapat meningkatkan prevalensi kesertaan akseptor hingga 29%. Sejak tahun 2004, pascakebijakan desentralisasi di Indonesia, jumlah PKB menurun drastis hingga menyisakan dua pertiga dari jumlah awal sekitar 3.500 petugas. Dampak perubahan tersebut tercermin pada angka fertilitas total (TFR) Indonesia berdasarkan data SDKI 2007 yang bertahan sama dengan data SDKI 2002-2003 (2,6 anak per wanita). Hal tersebut dikhawatirkan dapat semakin meningkat apabila kinerja program KB termasuk kinerja petugas PKB tidak mendapat perhatian. Peningkatan TFR mengancam ledakan penduduk yang dapat menghabiskan sumber daya alam yang terbatas dengan segala konsekuensi negatif. Hal tersebut juga dapat memperberat sasaran BKKBN mencapai pertumbuhan penduduk yang seimbang pada tahun 2015. Direkomendasikan untuk menciptakan iklim kerja yang kondusif dalam lingkungan strategis yang terus berubah sejak kebijakan desentralisasi program KB, antara lain melalui sistem reward dan model pelaporan berbasis teknologi informasi.

The success of Family Planning (FP) program in controlling fertility level in Indonesia over the last three decades has been associated with the role of FP field workers. A study from Rwanda indicated that activity of the FP field workers to deliver counseling has increased contraceptive prevalence rate until 29% points. However, since decentralization policy has been adopted and implemented in Indonesia in 2004, later in 2009 it was found that the total number of FP field workers has been decreased to remain two-thirds from the previous number i.e. 35 thousands workers before desentralization took place. A reflecting impact from this dynamic situation is a stagnant level of Indonesia’s total fertility rate (TFR) based on IDHS 2007 data that has been similar to that in IDHS 2002-2003, accounted for 2.6 children per woman. A stagnant TFR trend may stimulate fear of increasing TFR after then, when the FP program performance including that the performance of FP field workers are neglected. Increasing TFR would lead to a baby booming that threatens excessive utilization of natural resources that is already limited. This also worsens BKKBN efforts to achieve a zero growth population stage or replacement fertility level by year 2015. It is recommended that an optimum working climate should be pursued to yielding a maximum performance of FP field workers within these dynamic changes since decentralization policy has been applied. The recommendation includes establishing a reward system and recording reporting system with information technology basis.

References

  1. Koalisi Kependudukan. Population of Indonesia: venturing into the future. Jakarta: BKKBN; 2007.
  2. BPS, Bappenas, UNFPA. Proyeksi penduduk Indonesia. Jakarta: BPS; 2005.
  3. BAPPENAS, UNDP, BPS. Indonesia human development index 2004. Jakarta: BPS; 2004.
  4. BPS. Survei demografi dan kesehatan Indonesia 2002-2003. Jakarta: BPS; 2003.
  5. BPS. Survei demografi dan kesehatan Indonesia 2007. Jakarta: BPS; 2008.
  6. BKKBN. Laporan pertemuan pengembangan konsep reposisi PKB sebagai leader dalam program KB nasional di lapangan. (Prosiding Pertemuan di Bandung 13-15 Desember 2000). Jakarta: BKKBN; 2000.
  7. BKKBN. Pedoman pembinaan PKB. Jakarta: BKKBN; 1986.
  8. Bulatao RA. Family planning: the unfinished revolution. Finance and Development. 1992; 29 (4): 8.
  9. Saha UR. Determinants of pill failure in rural Bangladesh. Journal of Biosocial Sciences Cambridge University Press. 2004; 36: 39.
  10. Rogers EM. Diffusion of innovations. Fourth Edition. New York: Free Press; 1995. p.335-66.
  11. Levin PF. Test of the fishbein and ajsen models as predictors of health care. Research in Nursing and Health. 1999; 22: p. 295-307.
  12. Kamal N. Role of government’s family planning field workers and health centers as determinants of contraceptive use in Bangladesh. Asia-Pacific Population Journal. 1994; 9 (4): 59.
  13. Lerman C, Molyneaux JW, Pangemanan S, Iswarati. Determinants of contraceptive methods and service point choice. Jakarta: LD FE-UI & BKKBN; 1990.
  14. Samosir OB. Contraceptive use in Indonesia [dissertation]. Department of Social Statistics, Faculty of Social Sciences, University of Southampton; 1994. p. 50-5.
  15. BKKBN. Studi pelaksanaan program KB era desentralisasi melalui pemanfaatan peran pengganti PKB. Jakarta; PUSRA: 2005.
  16. BKKBN. Buku pegangan penyuluh KB. Jakarta: BKKBN Pusat; 2007.
  17. Pratomo H. Communication aspects and their implications on the IEC strategy of the FP program in Indonesia: a further analysis of the Indonesia fertility survey [disertasi]. Lousiana: The School of Public Health & Tropical Medicine New Orleans; 1982. p.26.
  18. Trisnantoro L. Desentralisasi kesehatan di Indonesia dan perubahan fungsi pemerintah tahun 2001-2003: apakah merupakan periode uji coba? Yogyakarta: Gadjah Mada University Press: 2005.
  19. Mills A. Health system decentralization: concepts, issues, and country experience. Geneva: World Health Organization Headquarters, Switzerland; 1990.
  20. Ribot JC. African decentralization: local actors, powers, and accountability. Democracy, Governance, and Human Rights, United Nations Research Institute for Social Development. 2002; 8.
  21. Saud HN. Mekanisme operasional lini lapangan dalam kaitan reposisi PKB sebagai leader program KB lapangan. Disajikan dalam Pertemuan Pengembangan Konsep Reposisi PKB sebagai Leader dalam Program KB Nasional di Lapangan, di Bandung 13-15 Desember 2000. Jakarta: BKKBN; 2003.
  22. United Nations Populations Fund & BKKBN. Ledakan penduduk mengancam bangsa. (Fact Sheet). Jakarta: UNFPA; 2006.
  23. BKKBN. Sambutan kepala BKKBN pada pembukaan rapat kerja nasional program KB tahun 2008, tanggal 18 Februari 2008. Jakarta: BKKBN; 2008.

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