Latar belakang : Penyakit anjing gila (rabies) merupakan penyakit akut (bersifat zoonosis) menyerang susunan saraf pusat yang disebabkan oleh virus. Kasus gigitan hewan penular rabies (HPR) tersebar di 21 kabupaten/kota di Provinsi Aceh dan kasus tertinggi terjadi di Kabupaten Aceh Tengah selama 4 (empat) tahun terakhir. Pada tahun 2008 gigitan HPR sebanyak 132 kasus, tahun 2009 sebanyak 197 kasus, tahun 2010 sebanyak 205 kasus, dan tahun 2011 sebanyak 219 kasus. Mengingat ancaman terhadap kesehatan, keselamatan dan ketentraman masyarakat karena dampak buruk rabies yang selalu diakhiri dengan kematian, maka usaha pengendalian penyakit berupa pencegahan, penanggulangan dan penatalaksanaan kasus gigitan HPR harus untuk dilaksanakan seintensif mungkin agar Kabupaten Aceh Tengah dapat bebas rabies. Berbagai upaya telah dilaksanakan yakni vaksinasi dan eliminasi HPR, penatalaksanaan kasus gigitan, dan membentuk 7 rabies center yang tersebar di 14 kecamatan. Pada akhir tahun 2012 dinas kesehatan menambah 1 rabies center untuk meningkatkan pelayanan rabies kepada masyarakat di Kabupaten Aceh Tengah. Tujuan : Untuk mengevaluasi pelaksanaan program rabies melalui upaya pencegahan, penanggulangan dan penatalaksanaan kasus gigitan HPR di Kabupaten Aceh Tengah Provinsi Aceh. Metode : Jenis penelitian ini adalah kualitatif, dengan rancangan studi kasus. Subjek berjumlah 20 orang dari Dinas kesehatan, Dinas Peternakan dan perikanan, puskesmas rabies center, dan poskeswan. Data diperoleh melalui wawancara mendalam, observasi, dan pemanfaatan dokumentasi. Data dianalisis dengan langkah: reduksi data, koding, kategorisasi, sintesis, dan interprestasi data. Hasil dan Pembahasan : Implementasi program rabies belum terkoordinasi dengan lintas sektor secara baik, karena tim koordinasi di tingkat kecamatan maupun di kabupaten belum terbentuk. Upaya pencegahan, dan penanggulangan kasus gigitan HPR belum berjalan dengan baik. Belum adanya komitmen daerah dalam melaksanakan kebijakan dan pengembangan strategi program rabies (vaksinasi, eliminasi, penatalaksanaan kasus, promosi dan pemberdayaan masyarakat). Sumber daya manusia sebagai pelaksana program rabies di rabies center dan poskeswan sudah sesuai berdasarkan jumlah dan tingkat pendidikan namun belum efektif karena masih tingginya beban kerja bagi petugas program rabies, dan perlu peningkatan upaya pendidikan dan pelatihan SDM secara berkesinambungan. Alokasi anggaran tidak memadai baik dalam pelaksanaan upaya pencegahan, penanggulangan dan penatalaksanaan kasus gigitan HPR. Sarana dan prasarana dalam pelaksanaan program rabies yang sangat terbatas. Kesimpulan : Implementasi program rabies di Kabupaten Aceh Tengah belum berjalan dengan baik, karena belum adekuatnya komitmen daerah dalam pendanaan program, sarana prasarana, sumber daya manusia, dan lemahnya koordinasi pelaksanaan program. oleh karena itu direkomendasikan agar meningkatkan komitmen bersama dari pihak terkait dalam meningkatkan upaya pencegahan, penanggulangan dan penatalaksanaan kasus gigitan HPR di Kabupaten Aceh Tengah.

Background : Rabies is an acute disease (zoonotic) attacking the central nervous system caused by virus. A bite case of rabies animal transmitter (HPR) spreads in 21 regencies/city in Province of Aceh and the highest case has been in Regency of Central Aceh for 4 (four) last years. In the year 2008 as many bites HPR 132 cases, year 2009 as many as 197 cases, as many as 205 cases year 2010, and year 2011 as many as 219 cases. Given the threat to the health, safety and peace of the community due to adverse rabies are always terminated by death, disease control efforts in the form of prevention, mitigation and management of bite cases HPR had to be carried out as intensively as possible in order to free Central Aceh District rabies. Various efforts has been conducted such as vaccination and elimination of HPR, management of bite case and forming 7 rabies centers spreading over 14 disctricts. In the end of 2012, Health Service added 1 rabies center to improve rabies service to public in Regency of Central Aceh Objective: To evaluate the implementation of rabies program through prevention, control and management over a bite case on HPR in Regency of Central Aceh, Province of Aceh. Method: The study type was qualitative with case study design. The subject was 20 people from Health Service, Husbandry and Fishery Service, public health center of rabies center, and animal health post. The data were obtained through in depth interview, observation, and documentation. Data were analyzed with following steps: data reduction, coding, categorization, synthesis, and data interpretation. Results: The implementation of rabies program had not been well coordinated yet with cross – sectors since team of coordination either in district or regency had not been formed. The prevention and control on bite case of HPR had not been run well. There was no local commitment in conducting the liability and development of rabies strategy program (vaccination, elimination, case management, promotion, and public empowerment). Human resource as the executor of rabies program in rabies center and animal health post had been in accordance with number and education background, however it had not been effective since there was a higher work liability for the officer of rabies program, and it was necessary to improve Human Resource training and education sustainability. The budget allocation was not sufficient in the implementation of prevention, control and management over a bite case on HPR. Infrastructure in the implementation of rabies program was highly limited. Conclusion: The implementation of rabies program in Regency of Central Aceh had not run well because there was a limitation of financial, infrastructure, human resource, and weak coordination in the program implementation. Therefore, it is recommended to improve joint commitment from related party.

Kata Kunci : Program pencegahan, penanggulangan dan penatalaksanaan kasus gigitan HPR, rabies center, pos kesehatan hewan (Poskeswan)