Cost Effectiveness Upaya Penanggulangan Gizi Metode Positif Deviance dan Pemberian Makanan Tambahan di Puskesmas Gekbrong Kabupaten Cianjur 2006

Abstract

The Province of West Java still faces serious malnutrition problem that can be seen in 18.094 cases of under 5 years old children who suffer from malnutrition particularly in districts of Cirebon (4.005), Bandung (2.991), and Cianjur (2.670). In Cianjur it was found that 2.670 (1,3%) cases of severe under-nutrition and 24.447 (11,7%) cases of under-nutrition out of 208.572 children. The objective of this study is to compare the cost effectiveness between positive deviance (PD) and food supplementation (PMT) methods. The data were observed from the provider side using Activity Based Costing (ABC) method. The study shows that the biggest cost component is the operational cost (85%), investment cost (14,5%), and maintenance cost (0,3%). The time frame for PD method (54 days) is shorter than that of PMT method (102 days). The average body weight gain in three months, the PD method (920 grams) is smaller than that of PMT method (650 grams). The monthly average gain in the first, second and third for the PD method (470, 220, and 230 grams) is higher than that of the PMT method (300, 170, and 180 grams). From growth chart (KMS) in three months, below red line (BGM) and under-weight in the PD method (54% and 17%) is lower than the PMT (78% and 22%). The CER value for PD method is Rp 446.828,-/child, lower than that of the PMT method ( Rp 768.887,-/child). It was concluded that PD method is more cost effective than PMT method. Key words: Cost-effectiveness, under-weight, positive deviance, food supplementation