Prevention Program Performance Improvement Strategy and Control of Non-Communicable Diseases at Blega Health Center, Bangkalan District

The increase in cases of Non-Communicable Diseases (NCDs) will significantly increase the burden on society and the government because handling them requires a short time, large costs, and high technology. NCD cases are not transmitted but are deadly and result in individuals becoming less or less productive but NCDs can be prevented by controlling risk factors through early detection. Overall, this residency was carried out to provide an overall picture of the Strategy for Improving the Performance of the Non-Communicable Disease Prevention and Control Program at the Blega Health Center, Bangkalan Regency . In this article, the method used is the residency method, which is the process of exploring the place, condition, and situation of the residency and determining problems using the Fishbone method Implementation and strategies in improving services The Non-communicable disease program has been carried out well, but there are still some weaknesses, namely restrictions on activities in the Covid-19 pandemic, the program coordinator is still new, Program regulation is still partial, budget constraints and lack of community participation.


INTRODUCTION
Indonesia is currently facing a double burden of diseases, namely communicable diseases and non-communicable diseases. Changes in disease patterns are strongly influenced by environmental changes, people's behavior, demographic transitions, technology, economy, and socio-culture. The increase in the burden of NCDs is in line with the increase in risk factors which include increased blood pressure, blood sugar, body mass index or obesity, unhealthy eating patterns, lack of physical activity, and smoking and alcohol.
The significant increase in PTM cases is expected to add to the burden on society and the government because handling them requires a lot of money and requires high technology. This can be seen from the data from the Health Social Security Administration Agency (BPJS) in 2017, as many as 10,801,787 million people, or 5.7% of JKN participants received services for catastrophic illnesses and spent health costs of 14.6 trillion rupiahs or 21.8% of all health service costs with a rating composition of heart disease of 50.9% or 7.4 trillion, chronic kidney disease of 17.7% or 2.6 trillion rupiahs.
The increase in cases of Non-Communicable Diseases (PTM) will significantly add to the burden on society and the government because handling them requires a lot of time, a lot of money, and high technology. PTM cases are indeed not transmitted but are deadly and result in individuals becoming unproductive or less productive. However, PTM can be prevented by controlling risk factors through early detection.
Services for the Prevention and Control of Non-Communicable Diseases at the Blega Health Center have been implemented, but the results tend to decrease compared to last year.

Results of Performance Evaluation of Prevention and Control of Non-Communicable Diseases at the Blega Health Center in 2021
Reducing PTM cases through controlling PTM risk factors in the community, requires equal effort and understanding of the division of roles and management support for PTM control programs, increasing the knowledge of program coordinators, compiling program regulations, allocating sufficient funds, and increasing community participation.

METHODS
In this article, the method used is the residency method, which is a process of exploring places, conditions, and residency situations and determining problems using the fishbone method or fish skeleton. A fishbone diagram is a tool that makes quality control easier. Fishbone is used as a tool to find the root cause of a result that occurs.

A.
Description of Location and Population UPT Puskesmas Work Area Blega is the only Public health center parent in the District Blega and UPT Puskesmas Blega is in the village area Blega. UPT Health Center Blega was Established in 1976 and initially _ built following standard Public health center take-care stay One floor in the later 1980s experience renovation into two floors and added take-care stay and PONED in 2007. UPT Puskesmas Blega based on a permit operational Public health center Number: 503/02/433.114/XI/2019. Administrative boundaries are as follows: Next Northwith Subdistrict Konang , Southside with Subdistrict Modung , East of Sampang district, West side with Subdistrict Galis with an area of 102.27 Km2 and a total population of 5382) people, meanwhile based on card 14599 families. Table  No Component Amount The results of the analysis above, it was found the cause of the problem: 1.

Population
No exists treatment 2.
PTM Program Coordinator is still new 3.
Knowledge public Still not enough 4.
Lack of role as well as public 5.
Lack of promotional media management 6.
Lots of broken equipment 7.
Coordinator Not yet understand compile regulation 8. medium no follow development 9.
Lack of coordination across programs 10.
No exists stimulation treatment 11.
Wait for Procurement of promotional media 12.
Procurement material limited 13. Place Integrated Healthcare Center moving around 14.
No understands the importance of educational media IE Metrics Analysis (Internal-External Matrix )

SWOT Analysis Results
Based on the results of the analysis, it can be seen that the Blega Community Health Center is located in quadrant I, meaning a fast/aggressive growth strategy. Quadrant I is a favorable situation because the Blega Health Center has good opportunities and strengths and can be optimized by minimizing all weaknesses and threats.
The strategy used is to support an aggressive strategy that aims to advance the program and minimize weaknesses that come from human resources. The methods used include: 1.

CONCLUSION
The implementation and strategies for improving services for the Non-communicable Diseases Program have been implemented well, but there are still several weaknesses, namely restrictions on activities during the Covid-19 pandemic, program coordinators are still new, program regulations are still partial, budget constraints and lack of community participation Efforts to improve services for Non-communicable Diseases have been carried out, including a common understanding of the division of roles and support for the management of PTM control programs, increasing the knowledge of program coordinators, drafting program regulations, allocating sufficient funds, and increasing community participation.