EVALUASI PELAYANAN PREVENTION OF MOTHER TO CHILD HIV TRANSMISSION PADA IBU HAMIL HIV SELAMA MASA PANDEMI COVID – 19 DI KABUPATEN DEMAK
Authors: Astutik Siti Waghisatul , Suryoputro Antono , Shaluhiyah Zahroh 
Published: February 2022

AbstrakBerdasarkan data jumlah kasus HIV/ AIDS pada ibu hamil dari Dinas Kesehatan Kabupaten Demak pada tahun 2020 yaitu dari 21.980 ibu hamil yang dilakukan pemeriksaan sebanyak 17.045 (77%). Didapatkan hasil bahwa Jumlah kasus HIV/ AIDS pada ibu hamil di Kabupaten Demak tahun 2020 adalah sebanyak 13 orang (16,3%). Sejak masa pandemi COVID-19 tahun 2019 kasus HIVAIDS pada ibu hamil sebanyak 5 orang (9,8%) dan tahun 2020 lebih banyak menjadi 13 orang (16,3%) yang tersebar di 9 Puskesmas. Sedangkan pada tahun 2021 dalam kurun waktu 5 bulan pertama ditemukan kasus baru HIV pada ibu hamil sebanyak 5 orang yang tersebar di 4 puskesmas. Berdasarkan data penularan HIV pada ibu kepada bayi diperoleh bahwa terdapat penularan HIV pada ibu kepada bayi pada tahun 2020 terdapat 2 bayi. program PMTCT di Kabupaten Demak dilakukan melalui 4 prong. Selama masa pandemi Covid-19 ini, dalam kurun waktu tahun 2019 hingga 2021 kurang maksimal, sehingga diperlukan penguatan program baik dari segi health promotion, konteks, input, proses, dan output. Tujuan penelitian ini menjelaskan untuk mengevaluasi Pelaksanaan Pelayanan Kegiatan PMTCT Pada Ibu Hamil dengan HIV di wilayah kerja Dinas Kesehatan Kabupaten Demak. Metode dalam penelitian ini adalah studi kualitatif dengan rancangan studi kasus. Subjek dalam penelitian ini merupakan petugas yang terlibat dalam pelayanan PMTCT pada ibu hamil dengan HIV dan sudah mendapatkan pelatihan PDP meliputi 6 Puskesmas yang terdapat kasus ibu hamil HIV positif dalam kurun waktu 2020 hingga 2021. Pengumpulan data menggunakan wawancara mendalam pada informan utama pemegang program HIV dari 6 puskesmas, dan informan triangulasi Kepala puskesmas, Pemegang program HIV Dinas Kesehatan Kabupaten Demak, pemegang program Kesehatan Ibu Dinas Kesehatan, Bidan Koordinator Rumah Sakit, dan ibu hamil HIV. Hasil penelitian yang dilakukan menunjukkan sebagian besar pelayanan PMTCT masih berjalan meskipun ditemukan beberapa kendala, hal ini dapat dilihat berdasarkan variabel health promotion, media promosi yang kurang menarik dan belum maksimalnya kunjungan rumah oleh petugas di masa pandemi dalam melakukan promosi kesehatan sehingga ibu hamil kurang mengerti. Pada variabel konteks masih adanya stigma negative terhadap ibu hamil HIV. Pada variabel input yang terdiri dari sumber daya manusia masih ditemukannya petugas yang berpindah tempat kerja sehingga petugas yang baru belum mendapatkan pelatihan, pada aspek money berasal dari dana BOK yang penganggarannya tergabung dengan program TB dan penyerapannya belum maksimal, pada aspek sarana dan prasarana mengenai ketersediaan reagen mengalami keterlambatan dalam pendistribusiannya, pada aspek method masih ditemukan pada beberapa puskesmas yang belum memiliki SOP. Pada aspek pencatatan dan pelaporan sering terjadi keterlambatan dalam mengirimkan laporan selama masa pandemi Covid – 19. Pada variabel produk masih ditemukan adanya penularan HIV dari ibu ke anak sebanyak 1 orang. Dengan demikian, perlu adanya perencanaan pelayanan PMTCT baik dari tingkat puskesmas maupun Dinas Kesehatan kabupaten Demak sehingga tidak ditemukan adanya penularan HIV dari ibu ke anak.Kata Kunci: Evaluasi, PMTCT, ibu hamil, Pandemi COVID – 19 AbstractBased on data on the number of HIV/AIDS cases in pregnant women from the Demak District Health Office in 2020, from 21,980 pregnant women, 17,045 (77%). The results showed that the number of HIV/AIDS cases in pregnant women in Demak Regency in 2020 was 13 people (16.3%). Since the 2019 COVID-19 pandemic, there were 5 cases of HIV-AIDS in pregnant women (9.8%) and in 2020 there were 13 people (16.3%) spread over 9 public health centers. Meanwhile, in 2021, within the first 5 months, 5 new cases of HIV were found in pregnant women spread over 4 public health centers. Based on data on HIV transmission from mother to baby, it was found that there were 2 babies transmitting HIV from mother to baby in 2020. PMTCT program in Demak Regency is carried out through 4 prongs. During the Covid-19 pandemic, the period from 2019 to 2021 was not optimal, so program strengthening is needed both in terms of health promotion, context, input, process, and output. The purpose of this study is to evaluate the implementation of PMTCT activities for pregnant women with HIV in the working area of the Demak District Health Office. The method in this research is a qualitative study with a case study design. The subjects in this study were officers who were involved in PMTCT services for pregnant women with HIV and had received PDP training covering 6 public health centers with cases of HIV positive pregnant women from 2020 to 2021. Data collection used in-depth interviews with key informants holding HIV programs from 6 public health centers, and triangulation informants from the Head of public health centers, HIV program holders from the Demak District Health Office, holders of the Maternal Health program at the Health Office, Hospital Coordinator Midwives, and HIV pregnant women. The results of the research conducted showed that most of the PMTCT services were still running even though several obstacles were found, this could be seen based on the health promotion variable, promotional media that were less attractive and home visits by officers during the pandemic were not maximal in conducting health promotion so that pregnant women did not understand. In the context variable, there is still a negative stigma against HIV pregnant women. In the input variable consisting of human resources, there are still officers who change places of work so that new officers have not received training, in the money aspect it comes from BOK funds whose budgeting is combined with the TB program and the absorption has not been maximized, in the aspect of facilities and infrastructure regarding the availability of reagents experienced delays in its distribution, in the method aspect it was still found in several health centers that did not yet have SOPs. In the aspect of recording and reporting, there are often delays in submitting reports during the Covid-19 pandemic. In the product variable, it is still found that there is 1 person transmitting HIV from mother to child. Thus, there is a need for planning for PMTCT services from both the public health centers level and the Demak district health office so that there is no mother-to-child transmission of HIV. Keywords: Evaluation, PMTCT, pregnant women, Covid-19 pandemic