PARTICIPATORY TRAINING MODEL DEVELOPMENT IN INCREASING OF
COMPETENCE Cadre TBC IN NORTH SUMATRA
Reni Asmara Ariga1, Siti Zahara Nasution2
1
Faculty of Nursing, University of Sumatera Utara, Medan, 20155 , Indonesia
2
Faculty of Nursing, University of Sumatera Utara, Medan, 20155 , Indonesia
Abstract The high morbidity and mortality of TB patients
has many causes, among others, delays in medical help and low
competence of health cadres. Health workers are citizens
appointed by the community to help people, especially in
health problems such as TB. Ideally health cadres have
standardized capabilities such as knowledge, attitudes and
skills in the treatment of TB. These competencies can be
obtained through participatory training model. Model
Participatory training is training that provides the capability
of knowledge, attitudes and skills to volunteer in the
community, especially its role in assisting in the prevention and
treatment of TB. Development of training materials with the
principles applied integrative androgogi in the unity of the
training program, this research innovative and effective in
improving the competence of health cadres. This training
method can be an added value in training programs, especially
in health. The method used is Reseach and development,
sampling techniques in total by the number of 44 respondents.
The demographic data obtained all of the respondents were
female, largely early adulthood respondents 29 respondents
(66%), with educational backgrounds SMU 30 respondents
(68%), job IRT 38 respondents (86%). Results of research on
get one). The training methods participatory approach to adult
learning has not been applied 2) After the implementation of
participatory training on TB knowledge change for the better;
3) Development of participatory training is suitable for cadres
in order to reduce morbidity and mortality penderta TB in the
community; 4) In the implementation of this training model
can be received by cadres. Development with participatory
training approach is an innovative training model and effective
in improving the competence of health workers about TB so it
is necessary to be applied in other health fields.
Keywords Participatory Training Model, Competence Kader,
TB
I INTRODUCTION
Tuberculosis (TB) is a chronic disease of lung health
problem in the world, including Indonesia. WHO stated that
TB has now become a global threat. An estimated 1.9
billion people or a third of the world's population infected
with the disease. Every year there are about 9 million new
cases of TB with the death of 3 million people. An
estimated 95% of TB cases and 98% of TB deaths in the
world, occur in developing countries. Similarly, female
mortality due to TB are more than the deaths due to
pregnancy, childbirth and postpartum.
In developing countries, mortality accounted for 25% of all
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cases, the disease can be prevented by the discovery of the
TB germ.
Death is generally caused because no detection of cases
and treatment failure. Approximately 75% of TB patients
are the age group most economically productive (15-50
years). It is estimated that an adult TB patients, would lose
an average working time of 3 to 4 months. It resulted in the
loss of annual household income of about 20-30%. If he
died of TB, it will lose revenue of about 15 years. In
addition to adverse economic, TB also negatively impact
other socially stigmatized even ostracized by the
community.
Data Eradication Program Tuberculosis (TB P2) in
Indonesia showed an increase in cases from year to year.
Alleviation and prevention efforts that have been attempted
still not managed to resolve any problems that reduce
morbidity and mortality. The problem encountered was the
difficulty of case detection of pulmonary TB BTA (+),
disorder treatment and drop out of treatment. Untreated TB
cases will continue to be a source of transmission.
Community health volunteers are appointed by the
community to help people, especially in health problems
such as TB.
Health workers should have the competence to carry out
their duties in the community especially the prevention of
tuberculosis. Increased competence of this can be done with
a participatory model of training. Where this training
provides the ability knowledge, attitudes and skills to the
cadres in carrying out his role in society, especially
prevention and assistance in the treatment of TB.
II MATERIALS AND METHODS
The study design development model of participatory
training in improving the competence of cadres of TB in
North Sumatra design using quantitative methods of
training which consists of three stages: the first stage is the
stage of identification of the problem, the second stage of
refreshment cadres and the third stage is evaluation of
activities. Population and sample of this research is the
overall health cadres in the village of Sari Rejo district of
Medan Polonia is still active and willing to participate in
this study as many as 44 people.
This research has been conducted for 6 (six) months
from July to September 2016. The reason the researchers
chose Sarirejo Village district of Medan Polonia as a
research site because this location is densely populated
 locations that have the citizens of TB patients, has posyandu The demographic data of respondents include age,
and health volunteers active in each activities and health gender, occupation, and education. Results of research on
training in community health active in the environment in demographic data obtained early adulthood 29 respondents
community activities, and work together in an effort to (66%) and late adulthood as much as 15 respondents (34%),
clean and healthy life behavior and one of the land practice all respondents were female (100%), with educational
the profession of nursing students nursing Faculty USU backgrounds SD 1 respondents (3%), SMP 13 respondents (
community. 29%) and the SMU 30 respondents (68%), job IRT 38
The research instrument a questionnaire on demographic respondents (86%) and the self-employed 6 respondents
data and questionnaire development model of participatory (14%).
training in improving the competence of cadres of TB has 2. Participatory health workers about TB
been on the validity and realibilitasnya specialist in TB The results showed all Participatory health cadre of TB
midwife with good results, ie reliability test results obtained in 44 respondents in both categories (100%).
was 0,813. The following is a matrix of the Research 3. Health Cadre knowledge about TB
Process steps shown in the table 1. Result of this observation is knowledge of health cadre
Activity Inform Secondary Data gatherer Result are in a good range, as many as 39 (89%) and enough range
ant Data of 5 repondents (11%).
Early identification of PHC document Observation A general
health Kader of PHC Participation descriptio Education is basically an attempt to develop the
Deep interview n of the potential of human resources, making it more functional in
Study documents health answering all of the stimulation coming at him. Training is a
cadre systematic process to change the behavior of employees to
The collection of data matrix Observation City of
and document training training participation cadre
achieve organizational goals. Training related to the
of health workers on Group discussion training expertise and ability of employees to perform their duties
TB focused and and improve performance in accordance with
Interview activities pekerjaannya.Orientasi in adult training program is to assist
Study documents
employees / employee / driver of the organization to achieve
Mapping capabilities Document Interview Model
cadres the Focus Group training
specific skills and abilities, in order to succeed in doing his
characterist Discussion Expert job. On the issue of maternal and child health is required
ics of the contribution of Non-Formal Education (PNF), because of
training health problems of women starting from conception to old
process
Pre test on Cadre An questionnaire The
age, and in which there are problems of equality of
participatory health understandi ability of treatment of women or gender.
workers about TB and ng of TB cadres Improving knowledge and skills of human resources
knowledge about TB development needed khususny cadres training model of
health workers
effective, efficient and sustainable .Where community,
Socialization of TB Resear Material Presentation Improvin
cher about TB Discussion g the especially the cadres involved from the start of program
ability of planning, implementation, until the evaluation phase, it is so
cadres that the cadres have a high responsibility towards success
Post test on Cadre Pemahan questionnaire The training program. Training approach is implemented top-
participatory cadres about TB ability of
and knowledge about cadres down without meaningful public participation did not
TB health workers produce the results effectively and efficiently. Just as in the
about TB case of cadre training model that is implemented by the
Exposure results Resear An Test results socializati government in solving the problems of lack of competence
cadres understanding cher understandi on
about TB ng of TB
kadertentang tuberculosis.
Observation / PHC patient data Observation / data at number a. Education
identification number health centers of Education is essentially an attempt to develop the
of people with TB patients potential of human resources, making it more functional in
answering all of the stimulation coming at him. This effort
is expressed in learning activities, followed by everyone
III RESULTS AND DISCUSSION who membutuhkannya.Melalui educational activities, a
Presentation of data includes demographic data person acquires the knowledge, attitudes and skills, so as to
description, participatory health workers about TB and TB improve the ability to bear behavior in the act, in addition to
knowledge about the health cadre in North Sumatra with a the spark of hope, because hope is found in education.
total sample size is 44 people. The following is an analysis The national education system explains that education is
of the results obtained from the research that has been done a conscious and deliberate effort to create an atmosphere of
before. learning and the learning process so that learners are
1. Distribution of respondents by demographic data actively developing the potential for him to have kekutan
religious spiritual, self-control, personality, intelligence,

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good values, and skills needed him, society, nation and
country.
Education can be implemented through three channels,
namely formal education, non-formal education and
informal education. Non-formal education is any activity
organized and systematic, beyond the school system is
structured and conducted independently established or an
important part of broader activities, which deliberately
made to serve specific learners in achieving learning goals.
Developing non-formal education on four principles,
namely the principles of necessity, the principle of lifelong
education, the principle of relevance to the development of
society and the principle of insight into the future.
b. Education cadres
Cadre education is organized educational activities with
the aim of fostering and improving the ability of cadres.
Training is a systematic process of changing the behavior of
cadres to achieve the goal of reducing the incidence and
mortality of TB patients. Orientation in the adult training
program is to help health workers about TB to achieve
specific skills and abilities, in order to succeed in carrying
out his job.
For training in accordance with the planned objectives, it
is necessary dilakuakn planned and systematic way in
accordance with the concept of adult learning, through an
agent - an agent change reliable involving institutions -
social institutions in the community, for the community's
support in the implementation of these innovations, in order
to repair social issues related to the health of patients
TB.Seperti expressed by Mangkunagara (2005: 49) sees
each stage of the training require - as put forward that
stages: stages - stages in the training and development
include: (1) identify training needs; (2) establish goals and
objectives of training; (3) establish criteria of success by the
means of measurement; (4) training methods; (5)
conducting experiments (try out) and the revision and (6)
implement and evaluate.
Previously communicated training purposes by the
Prabu, A (2000: 45), namely (a) increase the productivity of
labor, (b) improve the quality of work; (C) To improve the
provision of human resource planning (d) improve moral
attitudes and morale (e) increase the stimulation so that
employees would perform optimally (f) improving
occupational health and safety (g) reduce waste and (h)
improving employee development.
Results of research on get one). The training methods
participatory approach to adult learning has not been
applied 2) After the implementation of participatory training
changes in knowledge, attitudes and actions of cadres on TB
for the better; 3) Development of participatory training is
suitable for cadres in order to reduce morbidity and
mortality penderta TB in the community; 4) In the
implementation of this training model can be received by
cadres. Development with participatory training approach is
an innovative training model and effective in improving the
competence of health workers about TB so it is necessary to
be applied in other health fields.
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IV CONCLUSION
Conclusions obtained are as follows. The demographic
data of all respondents were female, largely early adulthood
respondents 29 respondents (66%), with educational
backgrounds SMU 30 respondents (68%), job IRT 38
respondents (86%). The training methods participatory
learning approaches of adults have not been applied, once
implemented participatory training there is a change of
knowledge about TB to be better.
The development of participatory training is suitable for
cadres in order to reduce morbidity and mortality of TB in
masyaraka penderta In the implementation of this training
model can be received by cadres. Development with
participatory training approach is an innovative training
model and effective in improving the competence of health
workers about TB so it is necessary to be applied in other
health fields.
ACKNOWLEDGEMENT
This research is part of the Doctoral Dissertation Grant. The
authors thank to the Directorate General of Higher
Education, Ministry of National Education, Republic of
Indonesia that has funded this research..
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Author : Reni Asmara Ariga

Institute : Faculty of Nursing, University of Sumatera Utara
Street : Jl. Prof, Maas Number 3, University of North
Sumatera
City : Medan
Country : Indonesia
Email : ariga_reni@yahoo.com

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