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Sri Achadi Nugraheni

Departemen Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro, Semarang

Author-ID : 2403946

Aerospace Engineering Agriculture, Biological Sciences & Forestry Humanities Automotive Engineering Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Civil Engineering, Building, Construction & Architecture Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Electrical & Electronics Engineering Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Mathematics Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Veterinary Other

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Supplementary Feeding Program Evaluation Restoration Malnourished In Children Under Five In The District Wonogiri Seen From Input and Process Aspects Ratna Indriati; Sri Achadi Nugraheni; Apoina Kartini
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Salah satu upaya untuk mengatasi masalah kurang gizi di Kabupaten Wonogiri adalah dengan program PMT-P. Program ini sudah dilakukan sejak tahun 2007 namun belum menunjukkan hasil yang bermakna. Hasil studi pendahuluan menunjukkan masih ada kendala dalam aspek input dan proses dalam pelaksanaan program ini. Tujuan penelitian untuk mengevaluasi pelaksanaan program PMT-P balita kurang gizi. Jenis penelitian observasional analitik dengan metode kualitatif untuk mengevaluasi pelaksanaan program PMT-P oleh TPG dan kuantitatif untuk membandingkan pelaksanaan program PMT-P oleh bidan desa antara puskesmas yang mengalami peningkatan dan penurunan kasus balita kurang gizi. Informan utama 4 TPG dari 4 puskesmas yang mengalami peningkatan dan penurunan kasus balita kurang gizi. Informan triangulasi yaitu 4 kepala puskesmas, Kasi Kesga dan Gizi DKK, 4 bidan desa, 4 kader posyandu, dan ibu balita penerima PMT-P. Subjek penelitian kuantitatif adalah 60 bidan desa yang dipilih secara purposif dari puskesmas tersebut. Pengumpulan data kualitatif melalui wawancara mendalam dan kuantitatif dengan angket. Analisis data kualitatif dengan contentanalysis dan kuantitatif dengan uji statistik Mann Whitney. Pelaksanaan PMT-P di puskesmas yang mengalami penurunan kasus kurang gizi lebih banyak yang optimal (83,3%) dibandingkan puskesmas yang mengalami peningkatan kasus (56,7%). Perbedaan mencolok pada pelaksanaan meliputi sosialisasi ke masyarakat, registrasi sasaran, pemantauan daya terima makanan tambahan, penggunaan kartu pemantauan serta pendampingan bidan terhadap kader lebih banyak dilakukan oleh puskesmas yang mengalami penurunan kasus balita kurang gizi. Pemberian paket PMT-P di puskesmas yang mengalami peningkatan kasus dilakukan pada semua balita dengan rata-rata pemberian selama satu bulan. Selain itu puskesmas kurang melibatkan perangkat desa dan kecamatan dalam PMT-P. Penentuan sasaran dengan tepat dan peningkatan peran serta masyarakat dapat menurunkan kasus kurang gizi. One of efforts to solve undernourishment problems in Wonogiri district was a recovery food supplement distribution (PMT-P) program. This program has been implemented since 2007. However, it had not shown significant results. Preliminary studies showed that there were problems in input and process aspects in the implementation of this program. Objective of the study was to evaluate the implementation of PMT-P program for undernourished under-five children (balita). This was an observational-analytical study. A qualitative method was applied to evaluate the implementation of PMT-P program by TPG. A quantitative method was used to compare the implementation of PMT-P program by midwives in the primary healthcare centers (puskesmas) with increasing and decreasing numbers of undernourished under-five children cases. The main informants were four TPG from four puskesmas that experienced the increase and decrease numbers of undernourished under-five children cases. Triangulation informants were four heads of puskesmas, a head of Kesga and nutrition section of the district health office, four village midwives, four posyandu cadres, and mothers of under-five children who received PMT-P. Subject of the quantitative study were 60 midwives selected purposively from each puskesmas. Qualitative data were collected through in-depth interview; quantitative data were collected using questionnaire. Content analysis was applied for qualitative data analysis, and Mann-Whitney statistic test was applied for quantitative data analysis. Implementation of PMT- P in puskesmas that experienced the decrease of the number of undernourished cases was more optimal (83.3%) than in puskesmas that experienced the increase of the cases (56.7%). Distinct difference that was shown in the implementation included socialization to the community, target registration, monitoring of PMT absorption ability, monitoring card usage. Midwives accompaniment to cadres was conducted more frequent by puskesmas that experienced the decrease of the number of undernourished under-five children cases. PMT-P packages were distributed continually to all under-five children in the puskesmas that experienced the increase of the cases for a month in average. Additionally, puskesmas did not optimally involve village staffs and sub district office staffs in the PMT-P program activities. The implementation of PMT- P in puskesmas that experienced the decrease of undernourished cases is better. Accurate determination of the target and improvement of community involvement should be able to decrease undernourished cases.

Analisis Sistem Program One Student One Client Pendampingan Ibu Hamil oleh Mahasiswa Keperawatan di Kota Semarang Mukhamad Musta'in; Sri Achadi Nugraheni; Untung Sujianto
Jurnal Manajemen Kesehatan Indonesia Vol 5, No 2 (2017): Agustus 2017
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Maternal mortality rate (MMR) and infant mortality rate (IMR) are one of the main indicators of a country's health status. MMR in Semarang was increasing since 2013 (107.95 per 100,000 live birth) become (128.05 per 100,000 live birth) in 2015. Various efforts have been made to handle the increase in maternal mortality rate in Semarang, one of them is OSOC program to accompany pregnant women. However, its implementation has not run optimally and encounters several obstacles. The purpose of the research was to analyze the input, process, and output aspects of the One Student One Client Program to accompany pregnant women by Nursing Students in Semarang. This was qualitative research with descriptive explorative approach through in-depth interview and focus of group discussion. The main informants were; Head of Health Section of Central Java Provincial Health Office and triangulation informant; 2 Heads of Public health services and 2 nurses / midwife coordinator, 2 Head of study program, 2 field supervisors, 14 nursing students and 7 pregnant women / postpartum. Data processed and analysed by content analysis method. The result showed that the input aspect: which was human resources, had been sufficient, but insufficient in funds, infrastructure facilities only in the form of modules, the policy had not been written and there was no memorandum of understanding / MoU between the health office and educational institutions.

Faktor – Faktor yang Berpengaruh Terhadap Praktik Perawat dalam Pelaksanaan Universal Precaution di RSUD Brebes Haris Basuni; Chriswardani Suryawati; Sri Achadi Nugraheni
Jurnal Manajemen Kesehatan Indonesia Vol 7, No 2 (2019): Agustus 2019
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Healthcare Associated Infections/HAIs merupakan persoalan serius di fasilitas kesehatan yang bisa menjadi penyebab kematian pasien dan bertambahnya hari rawat. Universal precaution dirancang di rumah sakit sebagai langkah awal untuk tindakan pencegahan HAIs. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi Praktik Perawat dalam pelaksanaan unversal precaution pencegahan infeksi di RSUD Brebes.Jenis penelitian observasional kuantitatif dengan pendekatan cross sectional. Jumlah sampel 130 perawat, teknik pengambilan sampel dalam penelitian ini menggunakan non probability sampling dengan prosedur convenient/judgement sampling. Pengumpulan data menggunakan kuesioner dan lembar observasi. Analisis data dengan program SPSS menggunakan korelasi rank spearman dan regresi logistik metode enter.Hasil penelitian menunjukkan pengetahuan perawat sebagian besar baik 70,8%, sikap perawat sebagian besar baik 58,5%, praktik perawat sebagian besar baik 50,8%. Uji hubungan rank spearman menunjukkan adanya hubungan antara pengetahuan dan sikap dengan praktik perawat dalam pelaksanaan universal precaution dengan nilai p-value < 0,05. Analisis multivariat regresi logistik menunjukkan pengetahuan dengan nilai rho 5,351 dan sikap dengan nilai rho 6,835 secara bersama-sama berpengaruh terhadap Praktik Perawat dalam pelaksanaan universal precaution. Saran untuk meningkatkan praktik perawat dalam pelaksanaan universal precaution perlu dilakukan usaha untuk meningkatkan pengetahuan dan sikap perawat dengan cara mengadakan pelatihan .

Bottleneck Pelayanan Nifas pada Upaya Penurunan Risiko Kejadian Kematian Ibu di Wilayah Dinas Kesehatan Kota Semarang Ike Johan Prihatini; Sri Achadi Nugraheni; Sutopo Patria Jati
Jurnal Manajemen Kesehatan Indonesia Vol 5, No 3 (2017): Desember 2017
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jmki.5.3.2017.28-35

Maternal and child health was a priority of health program in Indonesia. Maternal Mortality Rate in Semarang was ranked second highest in Central Java. The highest proportion of maternal deaths occurred during puerperium. That’s indicates, there was a problem in a process of maternal health services during puerperium period in health facilities. This study was conducted to examine constraints on health systems that limit range of interventions or health services that were important for postpartum, bottlenecks related to postpartum services in Public Health Center (PHC), especially infrastructure, human resources, access to PHC, post partum visits (KF1 and KF3), as well as quality of post partum services on risk reduction of maternal mortality. This case study used a qualitative approach. Data collection through interviews to five midwives as main informants, 5 midwives coordinator and 5 heads of PHC as informant triangulation. Data analsyis used content analysis method, then assigned priority bottleneck through MCUA (Multiple Criteria Utility Assessment) techniques. WHO's scale-up BNA plan to analyze bottleneck causes. Results showed, there was a bottleneck on childbirth services in PHC. The causes of bottleneck risk reduction efforts of maternal mortality incidence in puerperium period has never been analyzed workload of health personnel in PHC, lack of monitoring and evaluation of an availability infrastructure facilities in PHC, there has not been regular training, especially on delivery until puerperium services, and PHC has not received more detailed and operational information about puerperium so their maternal knowledge about puerperium has not increased much and couldn’t raise mother's awareness to do so. Semarang Public Health Office (Dinas Kesehatan Kota Semarang) needs to conduct periodic monitoring and evaluation implementation of postpartum services and improve quality of childbirth services in PHC.Keywords: Bottleneck analysis, health services, post partum, Primary Health Care, Puskesmas, Maternal Mortality Rate

Analysis on the Implementation of Iron Supplementation Program by Midwives at Primary Healthcare Center in South Minahasa District Sjenny Olga Tuju; Sri Achadi Nugraheni; Lucia Ratna Kartika
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Pelaksanaan program pemberian tablet Fe (besi) di Puskesmas Kabupaten Minahasa Selatan masih dibawah target nasional (78,8 %) target Nasional (90 %) walaupun sudah ada kebijakan tentang program pemberian tablet Fe (besi) pada bidan. Survey pendahuluan yang dlakukan oleh 7 bidan di 7 Puskesmas diperoleh informasi bahwa masih ada bidan yang belum melaksanakan sesuai dengan standar operasional prosedur yang sudah ada. Penelitian ini bertujuan untuk menganalisis faktor yang mempengaruhi implementasi program pemberian tablet Fe (besi) oleh bidan di Puskesmas Wilayah Kabupaten Minahasa Selatan. Jenis penelitian merupakan deskriptif observasional analitik dengan pendekatan cross sectional.Pengumpulan data dilakukan wawancara kuesioner dan observasi langsung pada saat bidan memberikan tablet Fe (besi) di polindes/Posyandu. Jumlah sampel 98 orang bidan desa di 17 kecamatan Kabupaten Minahasa Selatan.yang diambil secara Simple Random Sapling. Analisis univariat, bivariat dilakukan dengan chi-square test dan analisis multivariat dengan regresi logistik Bidan sudah melaksanakan kegiatan-kegiatan dengan kategori baik dalam komunikasi (46,9%),Sumberdaya (52%),Disposisi (57,1%) dan Struktur Birokrasi (53,1%). variabel yang berpengaruh terhadap implementasi program pemberian tablet Fe (besi) adalah birokrasi (nilai p=0,24 ) exp ß=2,584.Saran untuk Dinas Kesehatan Kabupaten Minahasa Selatan adalah : memberikan soaialisasi kepada bidan tentang manfaat dari pengunaan Standar Operasional Prosedur (SOP) pemberian tablet Fe(besi). Memberikan insentif bagi bidan yang telah melaksanakan sesuai dengan standar yangmemenuhi cakupan, diberikan Hb Sahli set bagi semua bidan yang bertugas didesa yang belum mempunyai lat tersebutImplementation of iron tablets supplementation program in the primary healthcare centers of South Minahasa district was still below the national target (78.8%) although there was a policy regarding iron supplementation program by midwives. The national target was 90%. Preliminary survey conducted on 7 midwives showed that there were midwives who had not implemented the program according to the existed standard operating procedure. The objective of this study was to analyze factors affecting the implementation of iron tablets supplementation program by midwives in the primary healthcare centers in the area of South Minahasa district. This was an observational analytical study with cross sectional approach. Data collection was done through interview guided by questionnaire and direct observation to midwives when giving iron tablets in a polindes/posyandu. The number of study samples was 98 village midwives in 17 sub districts of South Minahasa district. They were selected using simple random sampling method. Univariate analysis, bivariate analysis with chi square test, and multivariate analysis with logistic regression were applied in the data analysis. Results of the study showed that midwives had implemented the activities with good category incommunication (46.9%), resources (52%), disposition (57.1%), and structured bureaucracy (53.1%).Variable affecting the implementation of iron tablets supplementation program was bureaucracy (p= 0.24), exp â= 2.584.Suggestions for the South Minahasa district health office were to conduct socialization to midwives regarding the benefits of using standard operating procedures of the implementation of iron tables supplementation; to give incentive for midwives who implement the program according to the standard and reaching the target; to provide Hb Sahli set for all midwives who work in the village and they do not have the Hb Sahli set.

Evaluasi Penerimaan Sistem Informasi Pelayanan Kesehatan Ibu Dengan Metode Tam Di Dinas Kesehatan Kabupaten Bungo Martunus Martunus; Farid Agushybana; Sri Achadi Nugraheni
Jurnal Manajemen Kesehatan Indonesia Vol 7, No 3 (2019): Desember 2019
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jmki.7.3.2019.212-216

Berdasarkan hasil studi pendahuluan didapatkan bahwa pengumpulan data kesehatan ibu pada dinas kesehatan Kabupaten Bungo sering mengalami keterlambatan pengumpulan, kurang lengkapnya pengisian data dan membutuhkan waktu yang lama untuk menyajikan data yang diperlukan. Salah satu model evaluasi yang dapat digunakan untuk menilai penerimaan dan penggunaan sebuah sistem teknologi informasi adalah evaluasi dengan menggunakan metode model penerimaan teknologi (Technology Acceptance Model atau TAM). Metode pada penelitian ini ialah oobservasional anallitik, menggunakan analisis regresi linear berganda untuk mengetahui hubungan antara variabel persepsi terhadap kemudahan, persepsi terhadap kemanfaatan dengan variabel sikap dan minat untuk menggunakan sistem informasi kesehatan ibu. Tujuan penelitian ini adalah Menerapkan evaluasi penerimaan sistem informasi pelayanan kesehatan ibu dengan menggunakan metode TAM di dinas kesehatan Kabupaten Bungo. Jenis penelitian yang digunakan adalah Kuantitatif. Subyek penelitian yaitu, bidan desa dan bidan koordinator di 19 puskesmas sejumlah 38 orang. Variabel persepsi terhadap kemudahan berpengaruh terhadap sikap untuk menggunakan SIK dengan nilai P-Value=0,000. Variabel persepsi terhadap kemudahan berpengaruh terhadap minat untuk menggunakan SIK dengan nilai P-Value=0,002. Variabel persepsi terhadap kemanfaatan berpengaruh terhadap sikap untuk menggunakan SIK dengan nilai P-Value=0,003. Variabel persepsi terhadap kemanfaatan berpengaruh terhadap minat untuk menggunakan SIK dengan nilai P-Value=0,002. Perlunya ada pelatihan yang berkelanjutan terkait Sistem Informasi Kesehatan Ibu sehingga dapat meningkatkan keterampilan dan menambah kepercayaan diri bidan dalam menggunakan Sistem Informasi Pelayanan Kesehatan Ibu.

Analisis Implementasi Program Perawatan Metode Kanguru (PMK) Dan Partisipasi Pasien Pada Pelayanan Kesehatan Bayi Berat Lahir Rendah (BBLR) (Studi pada Pasien di Rumah Sakit Mardi Rahayu Kudus) Nur Sri Atik; Sri Achadi Nugraheni; Kusyogo Cahyo
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Kangaroo Mother Care (KMC) varies in each hospital. This condition can be viewed from the aspects of types of services, competency of human resource, facilities, and means. Implementation is a crucial step in the process of policy. Readiness and participation of parents will support the success of the KMC implementation. A role of family such as attitude, behaviour, and family participation is as a desire to protect a family member who is sick. This research aimed to identify the implementation process of factors of communication, disposition/attitude, resource, bureaucratic structure, and participation of patients and their families in KMC at Mardi Rahayu Hospital. This was qualitative research using in-depth interview and direct observation. Main informants encompassed 4 mothers who had Low Birth Weight (LBW) Babies. Meanwhile, informants for triangulation purpose encompassed 3 trained midwives, 3 trained nurses, and 3 trained paediatricians, nursing manager, and director of medical services. Furthermore, data were analyzed using thematic analysis in which data as the result of in-depth interview were analyzed in accordance with a theme. The implementation of KMC had not been done optimally. Regarding communication, there was no socialization of the program. Therefore, information of the KMC program was unclear, inconsistent. Regarding attitude/disposition of the program implementer, there was not only lack of support from all implementers in implementing the program but also lack of commitment. Regarding resource, there was lack of trained health workers, lack of facilities, and no sustainable fund for the program. Regarding bureaucratic structure, Standard Operating Procedure was needed to be revised and no clear job-sharing in KMC. Mothers had not participated in making decision, implementing, taking benefits, and evaluating yet. This was due to lack of information. As suggestions, the hospital needs to improve socialization of the program, provide implementation guidelines, and implement KMC followed by monitoring and supervising. In addition, the hospital needs to improve communication, information, education (CIE) for mother/family and provide opportunity for clients to implement KMC at the hospital before going home.

Analysis on the Implementation System of Early Breastfeeding Initation by Village Midwives in Pati District Mamik Aryani; Sri Achadi Nugraheni; Anneke Suparwati
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakPada tahun 2010 Kabupaten Pati berada pada urutan 16 tertinggi dari 35 kabupaten di Jawa Tengah yaitu masih >10 per 1.000 KH masih diatas target tahun 2013 Jawa Tengah sebesar 8,9 per 1.000 KH. Dengan IMD dapat menyelamatkan bayi karena Skin-to-skin akan memberikan kehangatan dan perlindungan pada bayi dan colustrum merupakan imunisasi pertama bagi bayi yang mengandung zat-zat kekebalan tubuh yang tidak tergantikan. Keberhasilan pelaksanaan inisiasi menyusui dini (IMD) sangat di pengaruhi oleh pengetahuan, sikap dan motivasi bidan atau penolong persalinan itu sendiri.Jenis penelitian adalah observasional kualitatif. Informan penelitian adalah 8 Bidan desa yang dipilih dari 2 Puskesmas, masing-masing 4 orang. Informan triangulasi adalah 8 pasien, 2 bidan koordinator dan 2 kepala Puskesmas. Data dikumpulkan dengan wawancara mendalam dan observasi terhadap pelaksanaan IMD. Pengolahan metode content analysis.Hasil penelitian menunjukkan 4 dari 8 bidan desa di polindes tidak sealu melaksanakan IMD karena pasien tidak menghendaki untuk dilakukan IMD, dan dalam pelaksanaan IMD dengan cara yang tidak tepat, kemampuan kognitif semua informan utama tentang IMD masih kurang. Dapat dilihat dari semua jawaban informan utama kurang tepat dalam menjawab tentang pengertian, manfaat dan langkah-langkah pelaksanaan IMD karena semua bidan hanya berbekal peltihan APN dan belum pernah mengikuti pelatihan manajemen laktasi karena terhambat pada dana.Pelaksanaan IMD dipolindes oleh bidan desa tidak tepat. Terdapat 7 Langkah IMD yang di keluarkan oleh Kementrian Kesehatan Republik Indonesia yang seharusnya di dilaksanakan namun oleh bidan desa dalam pelaksanaan IMD tidak dilaksanakan. Diharapkan khususnya bidan desa selalu melaksanakan IMD pada setiap menolong persalinan. AbstractInfant mortality rate (IMR) in Pati district, in 2010, was > 10 per 1000 live births. It was the highest 16 th among 35 districts in Central Java province, and it was above the target of Central Java province, 8.9 per 1000 live births. Early breastfeeding initiation (IMD) could save infants due to skin-to-skin contact (contact between mother and child skins). Skin-to-skin contact gave warmness and protection to the infants. In addition, colostrum (the first breast milk being expressed) was a first immunization for infant. It contained irreplaceable body immune elements. Successfulness of IMD was influenced by knowledge, attitude, and motivation of midwives or delivery assistants. Results of a preliminary study showed that the IMD implementation was still inadequate. Village midwives did not implement IMD when they assisted deliveries because they were not patient to wait to implement IMD. The implementation of IMD was influenced by system that included input, process, and output. This system could determine the success of IMD. Objective of this study was to analyze early breastfeeding initiation system in the village maternity policlinics (polindes) by village midwives in Pati district. This was an observational qualitative study. Study informants were 8 village midwives selected from 2 primary healthcare centers (puskesmas); 4 informants were selected from each puskesmas. Triangulation informants were 8 patients, 2 midwives coordinators, and 2 heads of puskesmas. Data were collected by conducting in-depth interview and observation toward IMD implementation. Content analysis method was applied in the data management. Results of the study showed that four of eight village midwives in the polindes did not implement IMD continuously because patients did not want to do IMD; implementation of IMD was not done properly; cognitive ability of the main informants regarding IMD was insufficient. The main informants did not answer properly questions regarding definition, benefits, and steps to do IMD. All midwives were only equipped with knowledge from APN training, and they did not receive training regarding lactation management due to funding constraint. The implementation of IMD in the polindes by village midwives was not proper. Seven steps to implement IMD issued by Ministry of Health of the Indonesian Republic were not done by village midwives. Village midwives are suggested to always implement IMD when they assist a delivery.

Analisis Penerimaan Sistem Informasi Manajemen Rumah Sakit menggunakan Technology Acceptance Model di RSUD Kajen Kabupaten Pekalongan Imaniar Sevtiyani; Eko Sediyono; Sri Achadi Nugraheni
Jurnal Manajemen Kesehatan Indonesia Vol 6, No 1 (2018): April 2018
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jmki.6.1.2018.14-21

Implementasi SIM RS di Indonesia diatur dalam Permenkes No.1171 tahun 2011 dan UU No.14 tahun 2008. Salah satu faktor penting dalam kesuksesan implementasi SIM RS adalah kesiapan pengguna. RSUD Kajen Kabupaten Pekalongan telah mengimplementasikan SIM RS sejak tahun 2015, namun implementasi SIM RSUD Kajen belum berjalan optimal. Tujuan penelitian ini adalah meganalisis SIM RSUD Kajen Kabupaten Pekalongan dengan metode Technology Acceptance Model (TAM).Penelitian ini merupakan penelitian kuantitatif korelasional dengan pendekatan cross sectional. Responden penelitian adalah 44 staff RSUD Kajen yang menggunakan SIM RSUD Kajen sesuai dengan kriteria yang ditentukan yang dipilih dengan metode sensus. Pengumpulan data dilakukan dengan kuesioner. Analisis data dilakukan menggunakan Structural Equation Modelling (SEM) dengan software smartPLS.Hasil penelitian implementasi SIM RSUD Kajen menunjukkan norma subjektif berpengaruh langsung dan signifikan terhadap niat menggunakan SIM RSUD Kajen (T=3,275), kepercayaan diri responden berpengaruh secara langsung dan signifikan terhadap persepsi kemudahan penggunaan SIM RSUD Kajen (T=7,857), persepsi responden terkait kemudahan penggunaan SIM RSUD Kajen berpengaruh secara langsung dan signifikan terhadap persepsi responden terkait manfaat SIM RSUD Kajen (T=3,227) dan niat menggunakan SIM RSUD Kajen (T=2,034). Rekomendasi untuk perbaikan SIM RSUD Kajen adalah pembuatan kebijakan penggunaan SIM RS, peningkatan pengetahuan dan keterampial staff serta monitoring dan evaluasi berkala penggunaan SIM RS.

Analysis on the Implementation of Exclusive Breastfeeding in Working Area of Remu Primary Healthcare Center in Sorong, Papua Barat Daud Rumangun; Sri Achadi Nugraheni; Martha Irene Kartasursya
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ASI eksklusif merupakan bagian penting dalam pemenuhan nutrisi bayi untuk mencapai pertumbuhan perkembangan optimal pada awal kehidupan dan masa pertumbuhan berikutnya. Kesepakatan Innocenti di Roma tahun 1990 mengamanatkan pencapaian ASI eksklusif 80%, sehingga target Standar Pelayanan Minimal (SPM) tahun 2003 di Indonesia ditetapkan 80%. Data SDKI tahun 1994 menunjukkan ibu-ibu memberikan ASI eksklusif baru mencapai 47%. Metode penelitian adalah kualitatif. Subjek penelitian adalah tenaga Gizi dan Bidan KIA Puskesmas Remu. Sebagai Triangulasi adalah Pimpinan Puskesmas, Kepala Seksi Kesehatan Ibu dan Anak Dinas Kesehatan Kota Sorong serta ibu yang memiliki bayi usia kurang dari 6 bulan. Pengumpulan data dilakukan melalui wawancara mendalam dan studi dokumentasi . Hasil penelitian menunjukkan bahwa pelaksanaan program ASI ekslusif di Puskesmas Remu belum berjalan baik. Petunjuk teknis atau SOP tesedia di Puskesmas, namun dalam pelaksanaan program belum sesuai. Pelaksanaan program yang sering dilakukan berupa penyuluhan saat posyandu, ANC dan persalinan. Sosialisasi aktif dari puskesmas oleh bidan, dari bagian gizi di Puskesmas belum dilaksanakan. Dari DKK tidak mempunyai jadwal tetap. Sosialisasi dipaketkan saat ANC, posyandu, minilokakarya, saat evaluasi program dan menempelkan pamflet di Puskesmas. Sosialisasi hanya berupa penyuluhan tanpa dilengakapi alat peraga yang memadai. Ketersediaan dan kualitas tenaga di Puskesmas masih kurang, belum mendapat pelatihan sehingga dibantu perawat yang belum dilatih. Dana yang tersedia langsung diserahkan ke ahli gizi Puskesmas untuk dikelola. Dana tersendiri untuk pelaksanaan program ASI ekslusif belum ada. Alat peraga kurang, hanya leaflet, namun sudah tidak layak pakai. Kendaraan yang tersedia hanya motor. Jumlah peralatan belum mencukupi. Klinik khusus laktasi belum tersedia. Watak atau sikap petugas yakni respon, komitmen dan pemahaman dalam program ASI ekslusif di Puskesmas Remu masih baik. Pelaksanaan program ASI ekslusif dapat berjalan dengan baik dengan menjalankan SOP/petunjuk teknis oleh seluruh pelaksana program, menyiapkan tenaga gizi di tiap Puskesmas, meningkatkan sosialisasi, membuat job description dengan jelas, penyediaan reward dan insentif sesuai beban kerja dan kompetensi, keuangan tersendiri untuk program ASI ekslusif, monitoring dan koordinasi pelaksanaan program ASI ekslusif dan pendokumentasian kegiatan secara benar Exclusive breastfeeding was an important part in fulfilling infant nutrition to gain optimum growth and development in the early live and in the next growth period. Innocenti agreement in Rome in 1990 mandated that the exclusive breastfeeding coverage was 80%. Therefore, the minimum service standard (SPM) coverage for exclusive breastfeeding in 2003 for Indonesia was established to be 80%. Data of SDKI in 1994 indicated that exclusive breastfeeding coverage was still 47%. This was a qualitative study. Study subjects were nutrition field workers and maternal and child health (KIA) midwives of Remu primary healthcare centre. Triangulation respondents were the head of primary healthcare centre, head of maternal and child health section of Sorong city health office, and mothers of infants less than 6 months. Data were collected by conducting in-depth interview and documentation study. Results of the study showed that the implementation of exclusive breastfeeding program in Remu primary healthcare center was still inadequate. Standard operating procedure was provided in the primary healthcare center, but the program was not implemented according to the standard. Programs frequently implemented were giving education in the posyandu, ANC and delivery process. Active socialization by midwives and nutrition section workers from primary healthcare center had not done yet. District health office did not have routine schedule. Socialization was attached in the ANC, posyandu, mini workshops, and evaluation sessions. In addition, it was also done by putting pamphlets in the primary healthcare center. Socialization was only in the form of giving education without sufficient visual aids. The availability and quality of human resource in the primary healthcare was still insufficient; they had not been trained, and they were accompanied by untrained nurses. The available funding was given directly to the primary healthcare nutritionist to manage it. No special funding was available for exclusive breastfeeding program. Visual aids or models were insufficient; only leaflets with unfeasible condition were used. The available transportation vehicle was only motor cycle. The number of instruments was insufficient. No lactation clinic was available. Character and attitude of the workers such as giving response, commitment and understanding on the exclusive breastfeeding in Remu primary healthcare center were good. The implementation of exclusive breastfeeding program will be good by implementing the standard operating procedure or technical guidance, assigning nutritional field workers in every primary healthcare centre, improving socialization, formulating clear job description, providing rewards and incentive according to workload and competence, separating finance for exclusive breastfeeding program, monitoring and coordinating the implementation of exclusive breastfeeding program, and having an adequate documentation of the activities.

Co-Authors Afni, Erina Nur Afni, Erina Nur Afra Dhiya Fadillah Agus Sabdono Ahmad Syauqy Ahmad, Nurul Fauziah Alawiyah, Winda Astuti Ambari, Reni Pawestuti Ani Margawati Ani Margawati Anik Iriyanti Anneke Suparwati Annisa Fadillah Antono Suryoputro Apoina Kartini Aqilatul Munawaroh Arenda Reka Narima Septyasih Aris Puji Widodo Aris Puji Widodo Arum, Rzky Atik Mawarni Awaliya, Henu Bey Putri Ayu Silvia Ayun Sriatmi Bagoes Widjanarko Bekti Putri Harwijayanti Bhernia Indri Setyowati Bhernia Indri Setyowati Cahya Tri Purnami Cahyani, Anggoro Dwi Chairunnisa, Syifa Al Janna Choirunissa, Risza Daramusseng, Andi Darmanto Darmanto Darussalam, Miftafu Daud Rumangun Dea Amarilisa Adespin Dewi Laila Mahligai Putri Dharminto Dharminto Dhea Salisa, Merisha Dian Indriani Hidayat Diki Retno Yuliani, Diki Retno Dilla Fitriana Salekha Dina Apriana Dina Rahayuning Pangestuti, Dina Djati, Isti Sulistyana Djoko Nugroho Dustar, Ghinanissa Azzahra Dwi Pudjonarko Dwi Pudjonarko Eko Sediyono Elsa Nur Aini Elvia Raissa Vania Elviera Gamelia Erna Kusuma Wati Erni Gustina Eti Rimawati Eti Rimawati Etika Ratna Noer Fani Rizky Nugraheni Faqihatin Afifa Farid Agushybana Farid Farid Agushybana Faridah Faridah Fariza Aqmar Adelia Ferry Rachmawatie Suryaningtyas Fifiantyas Amalia Fristiwi, Pingkan Haida Meytania Utami Handung Nuryadi Handung Nuryadi Harahap, Ana Pujianti Haris Basuni Hartuti Purnaweni Heni Irawati Heri Purwanto Heri Purwanto HERI PUSPITO Herinawati, Herinawati Herlina Tri Damailia, Herlina Tri Herlinda Christi Hidayat, Dian Indriani Ida Nurmawati Ifa Nurchumaida Ika Paryanti Ike Johan Prihatini Imaniar Sevtiyani Imaroh, Istiana Islahul Indah Budiastutik Irmawati Irmawati Isti Sulistyana Djati Istiqomah, Dedeh Jerry Ferdinand Haposan Saragih Jerry Ferdinand Haposan Saragih Johan, I Joni Periade Karbito Karbito Karbito Karbito, Karbito Kartasurya, M I Kasriatun Kasriatun Kertasurya, Martha Irene Khoirunisa Triavi Sefaya Kunarsih Fitriana Kusyogo Cahyo Laksmi Widajanti Laksmi Widajanti Laksmi Widajanti Legawati Legawati, Legawati Lia Anjar Nur Zhamaroh Lia Kurniasari Lia Kusmita Lia Kusmita Liena Sofiana Lucia Ratna Kartika Lucya Lede Lusiana, Dikta Ayu May M. Zen Rahfiluddin Maharani Widya Purnama sari Maharani, Virgi Mayang Mamik Aryani Martha Irene Kartasursya Martha Irene Kartasurya Martini Martini Martunus Martunus Mateus Sakundarno Adi Mateus Sakundarno Adi, Mateus Sakundarno Melinda Renssca Inas Merisha Dhea Salisa Miftahuddin M Khoeri Miftahuddin Majid Khoeri Mohammad Zen Rahfiludin Muh. Ridha Setiawan Salam Mukhamad Musta'in Muniroh, Muflihatul Nafisah - - Naintina Lisnawati Naluri Widyaningsih Syamsiedi Nova Adiani Priastari novia nursetiya utomo Novita Wulandari Nugraheni, Anastasia Natalia Sonia Nur Endah Wahyuningsih Nur Indah Rahmawati Nur Siyam Nur Sri Atik Nurchumaida, Nurchumaida Nurul Khatimah Ismatullah Ocky Karna Radjasa Onny Setiani Panjaitan, Arip Ambulan Panjaitan, Arip Ambulan Perdanawati, Mia Prastika Yulianasari Pratiwi Juhanida Lestari Pratiwi, Aulia Dewi Puja Anggun Febiani PUJI LESTARI Putri Lili Heldawati Putri, Rachel Novelia Putri, Rezkia Nadia Rafika Farianita Rahayu Widaryanti Rahfiludin , Mohammad Zen Ratna Indriati Riani, Risky Ika Rieny, Elzha Geniz Rifha Asti Hardinawanti Rika Andriani Rimawati, Eti Risky Ika Riani Roisah, Roisah Romilian, Agung Ronny Aruben Rosmala Kurnia Dewi Rukman, Pingkan Fristiwi S. Sulistiyani Sandyaga Ghaffar Purwanto Sarman Seno, Vena Pebriyanti Sheila Mahardini Silfia Addina Siti Aisyah Kurniasih Siti Fatimah Pradigdo Sjenny Olga Tuju Sri Andriani Sri Desi Juliana Silaban Sri Madinah Sri Suwitri Sri Winarni Suci Musvita Ayu Suhartono, Suhartono Suharyo Hadisaputro Sulistiawati, E SULISTIYANI SULISTIYANI Sulistyana Djati, Isti Sulistyaningsih, Sulistyaningsih - Sumarah Sumarah, Sumarah Sutopo Patria Jati Sutriyawan, Agung Suyatno Suyatno Syamsulhuda BM Syamsulhuda Budi Musthofa Triwahyuningsih, Ria Yulianti Triwahyuningsih, S.ST.,M.Kes, Ria Yulianti Untung Sujianto Vepti Triana Mutmainah, Vepti Triana Virgi Mayang Maharani Virgi Mayang Maharani Wahyu Indri Susanti Wahyu Ratri Sukmaningsih Wahyuningtyas, Miranda Gita Waskito, Agung Winda Astuti Alawiyah Yoga Adhi Dana, Yoga Adhi Yuliana, Aniestia Yulinar Tri Pamungkas Yustin Widyastuti Zahroh Shaluhiyah Zakiyah Islamiaty Oktaviani

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