Anneke Suparwati
Fakultas Kesehatan Masyarakat Universitas Diponegoro

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Analysis of the Difference between Iron Supplementation Program and Primary Healthcare Center in Kendal Vepti Triana Mutmainah; 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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (660.77 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakBerdasarkan SDKI survei terakhir tahun 2007 AKI Indonesia sebesar 228 per 100.000 Kelahiran Hidup. Salah satu penyebabnya adalah anemia. Untuk mengatasi masalah anemia kekurangan zat besi pada ibu hamil pemerintah Depkes RI sejak tahun 1970 telah melaksanakan suatu program pemberian tablet zat besi pada ibu hamil di seluruh Puskesmas dan Posyandu. Kenyataannya program tersebut sulit dilaksanakan, ditunjukan dengan hasil cakupan di Kendal 53,2 %. Berdasarkan hasil prasurvey disampaikan bahwa satu tahun terakhir belum ada monitoring program, Standar operasional prosedur belum ada, dana yang disediakan untuk program belum mencukupi, baru 40% dana yang tersedia. Tujuan penelitian ini adalah untuk menganalisis implementasi program suplementasi tablet besi ibu hamil di puskesmas wilayah Dinas Kesehatan Kendal.Penelitian ini termasuk penelitian deskriptif eksploratif yang dilakukan dengan metode kualitatif dan menggunakan analisis konten. Informan utama yaitu 4 orang petugas gizi di Puskesmas dan informan triangulasi yaitu 4 orang Pimpinan Puskesmas, 2 orang pembuat kebijakan dari DKK Semarang dan 4 orang ibu hamil.Hasil penelitian menunjukkan bahwa implementasi program suplementasi tablet besi ibu hamil di puskesmas dengan cakupan tinggi dan rendah tidak ada perbedaan yang signifikan. Demi kesinambungan program dan mencapai tujuan perlu adanya pembahasan permasalahan dan selanjutnya keputusan di SK kan dan disosialisasikan. AbstractBased on the last SDKI survey in 2007, Indonesian maternal mortality rate (AKI) was 228/100000 live-births. One of causes of maternal death was anemia. To solve iron deficiency anemia problems on pregnant women, Indonesian Ministry of Health had implemented iron tablet distribution program to pregnant women in all puskesmas (primary healthcare center) and posyandu (integrated health services post) since 1970. In reality, that program was difficult to implement; it was shown by the fact that coverage of iron tablet distribution in Kendal was only 53.2%. Results of preliminary survey showed that no monitoring program was performed during the last year, no standard operating procedure was formulated, and funding provided for the program was insufficient; the available funding was only 40%. Objective of this study was to analyze the implementation of iron tablet supplementation program for pregnant women in the work area of Kendal district health office. This was a descriptive-explorative study with qualitative method, and using content analysis method. Main informants were 4 nutritional staffs in puskesmas. Triangulation informants were 4 heads of puskesmas, 2 policy makers from Semarang city health office, and 4 pregnant women. Results of the study showed that implementation of iron tablet supplementation for pregnant women in the puskesmas with high and low iron tablet coverage indicated no significant difference. For the continuity of the program and to attain the objective, discussions on the problems are needed; then decisions are legitimated by issuing decrees and conducting socialization.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (748.291 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

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.