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All Journal International Journal of Public Health Science (IJPHS) Media Kesehatan Masyarakat Indonesia JURNAL GIZI INDONESIA Jurnal Kesehatan Lingkungan indonesia JURNAL PROMOSI KESEHATAN INDONESIA Media Kesehatan Masyarakat Indonesia Jurnal Kesehatan Masyarakat Media Penelitian dan Pengembangan Kesehatan Jurnal Kebijakan Kesehatan Indonesia Jurnal Kesehatan Masyarakat Jurnal Ilmu Kesehatan Masyarakat LINK Jurnal Riset Kesehatan Jurnal Kesehatan Andalas Jurnal Administrasi Kesehatan Indonesia MEDISAINS Jurnal Kesehatan Masyarakat (JKM) CENDEKIA UTAMA JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education Jurnal Kebidanan Jurnal Ilmu Keperawatan dan Kebidanan Jurnal Manajemen Kesehatan Indonesia Jurnal Ilmiah Mahasiswa Dentino: Jurnal Kedokteran Gigi Public Health of Indonesia IJNP (Indonesian Journal of Nursing Practices) HIGEIA (Journal of Public Health Research and Development) Jurnal Preventia Jurnal Kesehatan Jurnal Bahasa Rupa Promotif: Jurnal Kesehatan Masyarakat Jurnal Penelitian Pendidikan IPA (JPPIPA) Jurnal Kesehatan Vokasional Syntax Literate: Jurnal Ilmiah Indonesia JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Jurnal SOLMA Jurnal Keperawatan Silampari Jurnal Epidemiologi Kesehatan Komunitas Journal of Public Health for Tropical and Coastal Region Al-sihah: The Public Health Science Journal Journal of Maternal and Child Health Amerta Nutrition Holistik Jurnal Kesehatan Manuju : Malahayati Nursing Journal Unnes Journal of Public Health Jurnal Kesehatan Indonesia Bhamada: Jurnal Ilmu dan Teknologi Kesehatan (E-Journal) Contagion: Scientific Periodical Journal of Public Health and Coastal Health Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal PREPOTIF : Jurnal Kesehatan Masyarakat Management Studies and Entrepreneurship Journal (MSEJ) Jurnal Ners Jurnal Aisyah : Jurnal Ilmu Kesehatan BALABA (JURNAL LITBANG PENGENDALIAN PENYAKIT BERSUMBER BINATANG BANJARNEGARA) Indonesian Journal of Global Health research Jurnal Kesehatan Pasak Bumi Kalimantan Jurnal Mandala Pengabdian Masyarakat Diversity: Disease Preventive of Research Integrity MAHESA : Malahayati Health Student Journal Journal of Community Development Devotion: Journal of Research and Community Service Madu : Jurnal Kesehatan Narra J Interdisciplinary Social Studies Media Publikasi Promosi Kesehatan Indonesia (MPPKI) International Journal of Science and Society (IJSOC) Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Jurnal Multidisiplin Madani (MUDIMA) Medical Sains : Jurnal Ilmiah Kefarmasian Jurnal Locus Penelitian dan Pengabdian Jurnal Pengabdian Vokasi Berita Kedokteran Masyarakat Jurnal Indonesia Sosial Teknologi Jurnal Pendidikan Indonesia (Japendi) Eduvest - Journal of Universal Studies Jurnal Keperawatan Journal of Public Health and Pharmacy JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Borneo Journal of Pharmacy Medical Sains : Jurnal Ilmiah Kefarmasian Malahayati International Journal of Nursing and Health Science Holistik Jurnal Kesehatan Bhamada: Jurnal Ilmu dan Teknologi Kesehatan (E-Journal) Proceeding Mulawarman International Conference on Tropical Public Health Jurnal Info Kesehatan

Ayun Sriatmi

Fakultas Kesehatan Masyarakat, Universitas Diponegoro, Semarang

Author-ID : 3091490

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Factors Associated to the Work Performance of Midwives in the Implementation of Village Allertness Program in the Boyolali District Asih Dwi Astuti; Laksmono Widagdo; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) di Kabupaten Boyolali masih tinggi, terlihat pada AKI tahun 2010 sebesar 114,80/10.000 KH dan pada tahun 2011 sebesar 116,23/100.000 KH sedangkan pada AKB tahun 2010 sebesar 9,18/1.000 KH dan pada tahun 2011 sebesar 12,27/1.000 KH. Dalam rangka mempercepat penurunan AKI dan AKB maka diperlukan intervensi pelayanan kesehatan yang berdasarkan pada kebutuhan dan kemampuan masyarakat, maka Dinas Kesehatan Kabupaten Boyolali melakukan pengembangan Desa Siaga. Akan tetapi keberlangsungan Desa Siaga masih belum maksimal, salah satu penyebabnya adalah rendahnya kinerja bidan dalam pengembangan Poliklinik Kesehatan Desa (PKD). Tujuan penelitian ini adalah menganalisis rendahnya kinerja bidan dalam pelaksanaan Desa Siaga yang meliputi ketrampilan dan kemampuan, motivasi, kepemimpinan dan imbalan. Penelitian ini merupakan penelitian analitik dengan metode pendekatan waktu cross sectional. Populasinya adalah seluruh bidan desa yang berada di Boyolali sebanyak 267 bidan, sempel diambil dengan cara propotional random sampling dengan jumlah 75 responden, analisis univariat dengan frekuensi, bivariat dengan uji Chi Square dan analisis multivariate dengan regresi binary logistic. Hasil analisis peneitian bivariat menunjukkan ada hubungan yang siknifikan antara kemampuan dan ketrampilan dengan kinerja (p=0,032), motivasi dengan kinerja (p=0,001), kepemimpinan dengan kinerja (p=0,002), dan imbalan dengan kinerja (p=0,001). Secara bersama-sama variabel kepemimpinan dan motivasi berpengaruh terhadap kinerja. Disarankan kepada Kepala Dinas Kabupaten Boyolali untuk memberikan pelatihan Asuhan Persalinan Normal (APN), kegawatdaruratan dalam rangka peningkatan kinerja bidan desa , perbaikan PKD, serta bantuan kegiatan Desa Siaga. Bagi Kepala bidan koordinator untuk melakukan pembinaan, pendampingan program.Maternal mortality rate (AKI) and infant mortality rate (AKB) in Boyolali district were still high. Facts showed that AKI in 2010 was 114.80/10000 live-births, and in 2011 was 116.23/100.000 live-births; AKB in 2010 was 9.18/1000 live-births, and in 2011 was 12.27/1000 live-births. To accelerate the decrease of AKI and AKB, health service intervention based on community need and capacity is required. Boyolali district health office had answered this challenged by developing alert village program. However, the continuity of this alert village program was not maximal. One of reasons of this condition was inadequacy of midwives work performance in the development of village health polyclinic (PKD). Objective of this study was to analyze the inadequacy of midwives work performance in the implementation of alert village such as skill, ability, motivation, leadership, and compensation. This was an analytical study with cross sectional approach. Study population was all 267 village midwives in the district of Boyolali. Samples were 75 village midwives selected using proportional random sampling method. Frequency distribution for univariate analysis, Chi square test for bivariate analysis, and binary logistic regression for multivariate analysis were applied in the data analysis. Results of the study showed that there were significant associations between ability, skill and midwives work performance (p= 0.032); motivation and midwives work performance (p= 0.001); leadership and midwives work performance (p= 0.002); compensation and midwives work performance (p= 0.001). Variables, in common, affecting work performance of midwives were leadership and motivation. Suggestions for the head of Boyolali district health office were to provide trainings on normal delivery care (APN) and emergency to improve village midwives work performance, to improve PKD, to provide assistance for alert village program activities. Suggestion for chief of coordinator midwives was to do program supervision and assistance.

Factors Related to the Work Performance of Private Midwives in Using the “Poedji Rochjati” Scores for Early Detection of High Risk Pregnancy in Gresik Regency Sri Rulihari; Martha Irene Kartasurya; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakSkor “Poedji Rochjati” merupakan salah satu metode yang digunakan di provinsi Jawa Timur dalam mendeteksi resiko tinggi kehamilan. Bidan Praktek Swasta (BPS) ternyata tidak melakukan upaya deteksi resiko tinggi dengan skor “Poedji Rochjati” secara optimal dan hanya melakukannya bila ada indikasi tertentu saja. Tujuan penelitian mengetahui faktor yang mempengaruhi kinerja BPS dalam penggunaan skor “Poedji Rochjati” dalam deteksi resiko tinggi ibu hamil. Jenis penelitian observasional analitik dengan pendekatan belah lintang. Pengumpulan data dengan metode angket. Populasi adalah BPS di Kabupaten Gresik dengan subyek sejumlah 90 orang. Data dianalisis bivariat dengan chi-square dan multivariat dengan regresi logistik berganda.Hasil penelitian menunjukkan sebesar 56,67% BPS mempunyai kinerja baik dalam penggunaan skor “Poedji Rochjati”. Variabel yang berhubungan dengan kinerja adalah pengetahuan (p=0,04), sikap (p= 0,001), motivasi (p=0,000), persepsi supervisi Dinas Kesehatan (p=0,000) dan persepsi supervisi IBI (0,003). Variabel beban kerja terbukti tidak berhubungan dengan kinerja (p=0,443). Sikap dan motivasi secara bersama-sama berhubungan dengan kinerja.Dinas Kesehatan dan IBI perlu meningkatkan kualitas supervisi dan pembinaan bagi BPS dalam penggunaan skor “Poedji Rochjati” serta memberikan refreshing rutin sehingga meningkatkan pengetahuan, sikap dan motivasi BPS dalam deteksi resiko tinggi sebaik-baiknya. AbstractPoedji Rochjati score was a method used in East Java province to detect high risk pregnancy. Private practice midwives (BPS), surprisingly, did not optimally detect high risk pregnancy using ‘Poedji Rochjati’ score; they only used the score when there was a certain indication. Objective of this study was to identify factors affecting work performance of BPS in utilizing ‘Poedji Rochjati’ score to detect pregnancy risk. This was an observational analytical study with cross sectional approach. Data were collected using questionnaire. Study population was BPS in Gresik district, and 90 of them were selected as study subjects. Chi square was applied in the bivariate analysis, and multiple logistic regressions were applied in the multivariate analysis. Results of the study showed that 56.67% of BPS had good work performance in utilizing ‘Poedji Rochjati’ score. Variables related to work performance were knowledge (p= 0.04), attitude (p= 0.001), motivation (p < 0.001), perception on IBI supervision (p= 0.003). Workload was not significantly associated with work performance (p= 0.443). Attitude and motivation together were associated with work performance. District health office and IBI are suggested to improve the quality of supervision and guidance to BPS in utilizing ‘Poedji Rochjati’ score; to give routine refreshing to improve knowledge, attitude, and motivation of BPS in conducting proper detection of high risk pregnancy.

Analysis on the Implementation of Nutrition Services in Tugurejo General Hospital Semarang Emy Shinta Dewi; Martha Irene Kartasurya; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKGizi merupakan faktor penting dalam upaya perawatan dan penyembuhan pasien. Hasil evaluasi Unit Litbang Gizi RSUD Tugurejo pada tahun 2011 menunjukkan bahwa sisa makan pasien masih di bawah Standar Pelayanan Minimal. Tujuan penelitian ini adalah melakukan analisis terhadap implementasi pelayanan gizi di RSUD Tugurejo Semarang. Penelitian dilakukan secara kualitatif dengan informan utama 4 ahli gizi, 8 pramumasak dan 8 pramusaji. Informan triangulasi adalah Kabid Penunjang, Ka. Instalasi Gizi, Ka. Ruang Perawatan dan 6 orang pasien dari kelas 1, 2 dan 3 dengan diit biasa dan diit khusus. Pengumpulan data melalui indepth interview, focus group discussion dan observasi. Pengolahan data dengan metode content analysis. Hasil penelitian menunjukkan bahwa implementasi pelayanan gizi belum optimal. Komunikasi kebijakan pelayanan gizi belum jelas dan konsisten. Sumberdaya belum mencukupi dengan latar belakang pengetahuan dan ketrampilan kurang mendukung. Usulan sarana terpenuhi namun tidak tersedia tepat waktu. Petugas menunjukkan sikap kurang mendukung kegiatan pengolahan dan distribusi diit. Tugas dan wewenang kurang dipahami oleh pramusaji, SOP kurang jelas dan kurang dipahami oleh petugas serta mekanisme pertanggungjawaban tugas distribusi diit belum berjalan. Pasien menyatakan bahwa makanan sudah baik, alat makan lengkap dan bersih namun belum mendapatkan penjelasan tentang diit yang diberikan. Hasil observasi menunjukkan bahwa sisa nasi, lauk nabati dan sayur pasien masih cukup banyak. Disimpulkan bahwa implementasi pelayanan gizi belum optimal berkaitan dengan komunikasi kebijakan tidak jelas/tidak konsisten, tugas, wewenang, SOP dan mekanisme pertanggungjawaban tugas tidak jelas/tidak dipahami oleh petugas. Disarankan kepada rumah sakit untuk mengevaluasi kebijakan, memperbaiki hubungan antar petugas dengan family gathering/outbond dan koordinasi serta menata ulang tupoksi SDM.Kata kunci : Implementasi, Pelayanan Gizi, Rumah SakitABSTRACTNutrition was an important factor for patient care and cure. Results of an evaluation by nutritional research and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated that food remains of patient were still below the minimal standard of service. Objective of this study was to analyze the implementation of nutritional service in the RSUD Tugurejo Semarang. This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as main informants. Triangulation informants were a head of supporting unit, a head of nutritional installation, a chief of nursing room, and 6 patients from 1,2,3 classes with ordinary and special diet. Data were collected through in-depth interview, focus group discussion, and observation. Content analysis was applied in the data management. Results of the study showed that nutritional service implementation was not optimal. Nutritional service policy communication was not clear and consistent. Human resources were insufficient, and they had inadequate educational and skill backgrounds. Facilities were sufficient, but it was not provided on time. Workers did not fully support processing and diet activities. Tasks and responsibilities were not understood by waitresses. Standard operating procedure (SOP) was not clear, and it was not understood by the workers. Job responsibility mechanism of diet distribution was inadequate. Patients stated that the food was good, utensils were complete and clean. They did not get explanation regarding diet that they had received. Results of the observation showed that rice remains and vegetable site dish of the patients were sufficient. In conclusion, the implementation of nutritional service was not optimal. It was related to unclear or inconsistence of policy communication, task, authority, and SOP. The workers did not understand the job responsibility mechanism. Hospital workers are suggested to evaluate the policies, to improve relationship among workers by conducting family gathering or outbound, to coordinate and re-arrange functional main tasks (tupoksi) of human resource.Keywords : Implementation, nutritional service, hospital

Analysis on Factors Associated with the Implementation of the Pulmonary Tuberculosis Care Finding in Tuberculosis Control Program at Primary Healthcare Center in Semarang Rosmila Tuharea; Anneke Suparwati; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakKeberhasilan penanggulangan tuberkulosis di kota Semarang sangat bervariatif berdasarkan angka penemuan pasien TB Paru dari 37 Puskesmas yang ada di Kota Semarang hanya terdapat dua Puskesmas yang mencapai target >55% yaitu Puskesmas Karangdoro (76,67%) dan puskesmas Ngesrep (63,89%), sedangkan 35 puskesmas diantaranya belum mencapai target. Penelitian ini bertujuan untuk Mengetahui faktor-faktor yang berhubungan dengan implementasi penemuan pasien TB Paru dalam program penanggulangan TB di puskesmas Kota Semarang.Jenis penelitian adalah Explanatory Research dengan pendekatan Cross Sectional. Populasi dalam penelitian ini adalah seluruh koordinator TB Paru di Puskesmas kota Semarang sebanyak 37 orang. Analasis data dilakukan secara univariat dan bivariat.Hasil penelitian dengan uji statistik menunjukkan bahwa ada hubungan yang bermakna antara faktor komunikasi dengan penemuan pasien TB Paru (p= 0,009 <0,05), ada hubungan yang bermakna antara faktor sumberdaya dengan penemuan pasien TB Paru (p = 0,010<0,05), ada hubungan yang bermakna antara faktor disposisi dengan penemuan pasien TB Paru (p = 0,016 <0,05), dan ada hubungan yang bermakna antara faktor SOP dengan penemuan pasien TB Paru (p= 0,012<0,05).Untuk meningkatkan komunikasi yang baik dinas kesehatan perlu mengikutkan sertakan petugas yang belum mendapat pelatihan, memudahkan prosedur pelaporan pertanggung jawaban dana, pengadaan alat-alat laboratorium yaitu mikroskop terhadap puskesmas satelit, melakukan verifikasi laporan secara rutin 3 bulan sekali supaya tidak terjadi over reporting dan under reporting data TB Paru agar cakupan yang didapatkan akurat, pelaksanaan supervisi oleh dinas kesehatan dengan menggunakan daftar tilik, dan membuat dokumen perencanaan penemuan pasien TB Paru secara tertulis dengan melibatkan kepala puskesmas dan atau koordinator TB Paru di puskesmas.Kepala puskesmas melakukan pemantauan kepada koordinator TB Paru untuk selalu ikut sertadalam pertemuan koordinator TB Paru yang dilaksanakan setiap bulan, melakukan perencanaan puskesmas dalam penemuan pasien TB Paru serta perencanaan pengadaan alat laboratorium yaitu mikroskopis untuk mempermudah petugas dalam pemeriksaan dahak suspek TB Paru dan mengikutsertakan petugas TB Paru dalam pelatihan yang dilakukan baik oleh dinas kesehatan kota maupun dinas kesehatan propinsi. AbstractSuccess of tuberculosis (TB) control in Semarang city varied. Based on the case detection of pulmonary TB among 37 primary health centers (puskesmas) in Semarang city, only 2 puskesmas reached the target of 55% or more. Those Puskesmas were Karangdoro (76.67%) and Ngesrep (63.89%). The other 35 puskesmas had not reached the target. The objective of this study was to identify factors related to the implementation of pulmonary TB case detection in TB control program at Puskesmas in Semarang city. This was an explanatory research with cross sectional approach. Study population was all pulmonary TB coordinators at puskesmas in Semarang city with the total number of 37 persons. Bivariate and multivariate methods were implemented for analyzing the data. Results of the study using statistical test indicated significant association between communication factor and pulmonary TB case detection (p: 0.009), resource factor and pulmonary TB case detection (p: 0.010), disposition factor and pulmonary TB case detection (p: 0.016) and SOP factor and pulmonary TB case detection (p: 0.012) To improve a good communication, Health Office needs to include untrained workers to make the procedure of budgeting report easier, to provide laboratory facilities such as microscope to satellite puskesmas, to do routine report verification every 3 months to avoid over reporting and under reporting pulmonary TB data in order to obtain valid coverage, to do supervision by health office staffs using check list, to write pulmonary TB case detection planning documents by involving head of puskesmas and/or puskesmas pulmonary TB coordinators. Heads of puskesmas have to monitor their pulmonary TB coordinators to be involved in the pulmonary TB coordinator meeting every month, to make puskesmas planning on the pulmonary TB case detection and planning on providing the laboratory instrument that is microscopic to make it easier for laboratory workers to examine sputum of pulmonary TB suspects and to involve pulmonary TB workers in the training conducted by either district or provincial health office.

Implementation on the Referral System of High Risk Pregnant Women from Villages Midwives to Primary Healthcare Center with Basic Obstetric and Neonatal Emergency Care in Banjar District, South Kalimantan (a Case Study in Sungkai Primary Healthcare Center) Adriana Palimbo; Ayun Sriatmi; Tjahjono Kuntjoro
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Kualitas pelayanan rujukan kebidanan tidak bisa terlepas dari system rujukan yang dilaksanakan oleh bidan desa sebagai pos pelayanan terdepan di masyarakat. Selain karena faktor sistem penanganan kasusnya yang kurang sesuai dengan prinsip dasar merujuk, diduga juga karena keterlambatan menganal tanda bahaya dan mengambil keputusan dan terlambat mendapat pelayanan di fasilitas kesehatan. Tujuan penelitian adalah menjelaskan pelaksanaan sistem rujukan ibu hamil risiko tinggi oleh bidan desa ke Puskesmas PONED Kabupaten Banjar tahun 2011. Penelitian ini adalah penelitian observasional menggunakan rancangan deskriptif kualitatif, dalam bentuk studi kasus untuk menggambarkan dan memahami fenomena yang berkaitan dengan pendekatan crossectional. Instrumen penelitian adalah bidan desa Puskesmas Sungkai yang melakukan rujukan kasus ibu hamil risiko tinggi ke Puskesmas PONED. Data dikumpulkan dengan wawancara mendalam dan dianalisis dengan teknik kualitatif. Hasil penelitian menunjukkan bahwa masih ada bidan desa yang melakukan stabilisasi diluar kewenangan. Sebagian besar masyarakat menggunakan pembiayaan Jamkesmas, tetapi dari biaya dan ketersediaan transportasi/ambulan desa dan keperluan lain masih masih kurang memadai bagi pasien Jamkesmas. Selama proses pendampingan bidan sebagian besar hanya mendampingi jika pasien dirujuk ke RS swasta, tetapi hal sama tidak dilakukan pada pasein Jamkesmas. Dalam merujuk ibu hamil ke puskesmas PONED bidan desa tidak membawa surat pengantar rujukan, tetapi hal sama juga tidak dilakukan saat merujuk ke RS swasta. Bidan menyertakan surat dan lampiran buku KIA jika ke RS umum untuk tujuan klem Jamkesmas. Berdasarkan hasil penelitian tersebut disarankan kepada Dinas Kesehatan untuk melengkapi jumlah tenaga bidan desa dan kualifikasinya, serta kecukupan alat/obat/bahan di Polindes/Poskesdes. Bagi Puskesmas untuk melakukan pembinaan dan supervisi bidan di desa dan ada pembagian tugas yang jelas untuk bidan desa di wilayah kerjanya. Quality of obstetrical referral service could not be separated from referral system done by village midwives as a front health service post in the community. Obstetric case management that was not fully follow a basic principle of referral, delays to identify signs of dangerous pregnancy condition, delay to make decision, and delay to obtain services in the health facility were factors related to the quality of obstetrical referral service. The objective of this study was to explain the implementation of high risk pregnancy referral system by village midwives to PONED primary healthcare center Banjar district, 2011. This was an observational study using descriptive qualitative design. This study was in the form of a case study to describe and to comprehend related phenomena using cross sectional approach. Study instrument was village midwives from Sungkai primary healthcare center who referred high risk pregnant women to PONED primary healthcare center. Data were collected by conducting in-depth interview. Qualitative technique was applied to analyze the data. Results of the study showed that village midwives still performed stabilization beyond their authority. Majority of people in the community used Jamkesmas (community health insurance) funding; however, funding and transportation or village ambulance availability and other needs were insufficient for Jamkesmas patients. During midwives accompaniment, most of them only accompanied when the patient was referred to the private hospital, and they did not do that for Jamkesmas patients. Midwives did not bring reference letter to PONED primary healthcare centers when they were referring pregnant women; it was also done when they were referring pregnant women to private hospitals. Midwives included a letter and KIA book as an enclosure when they referred the patient to the general hospital for Jamkesmas claim purpose. Based on the study results, suggestions given to the head of district health office were to provide additional number of village midwives with its qualification; to assure the availability and sufficiency of instrument, medicine and materials in Polindes or Poskesdes; Suggestions for primary healthcare office were to conduct guidance and supervision for village midwives, to distribute clearly the job assignments to village midwives in their work areas.

Analysis on Determinants of Pulmonary Tuberculosis Officer Motivations In Tuberculosis Case Invention in Semarang Regency (A Case Study in Several Primary Health Care Centers) Joyo Minardo; Ayun Sriatmi; Septo Pawelas Arso
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Penderita Tuberkulosis dengan status Basil Tahan Asam (BTA) positif dapat menularkan ke 1015 orang lain setiap tahunnya, sehingga penemuan kasus penting dilaksanakan. Cakupan penemuan kasus tuberkulosis dengan BTA positif di Kabupaten Semarang tahun 2009 jauh di bawah cakupan nasional. Rendahnya disebabkan karena motivasi petugas yang kurang. Tujuan penelitian ini untuk menganalisis faktor yang dapat menurunkan motivasi petugas TB dalam penemuan kasus di Kabupaten Semarang. Penelitian dilakukan dengan metode kualitatif. Pengumpulan data primer dilakukan dengan wawancara mendalam, dan data sekunder dengantelaah dokumentasi. Subjek penelitian adalah petugas Tuberkulosis Paru di Puskesmas. Pemilihan subjek dilakukan secara purposive. Informan utama berjumlah 18 orang, terdiri dari 6 orang perawat, 6 orang Analis dan 6 orang dokter kepala Puskesmas. Informan triangulasi adalah 6 orang petugas BP, dan satu orang Kasie P2M Dinkes Kabupaten Semarang. Analisis data dilakukan dengan content analysis. Hasil penelitian menunjukkan bahwa motivasi petugas rendah karena pekerjaannya merupakan penunjukkan pimpinan Puskesmas dan membutuhkan waktu yang lama serta berisiko tertular oleh penderita. Tanggung jawab dalam menyelesaikan pekerjaan kurang karena beban pekerjaan yang banyak, bekerja tanpa target dan motivasi. Petugas tidak mendapatkan kompensasi, membutuhkan dukungan dari pimpinan untuk mengeluarkan ide dan gagasan dalam penemuan kasus. Sarana transportasi untuk penemuan kasus tidak ada. Puskemas tidak memiliki rencana implementasi kebijakan program penemuan kasus, dan sistem supervisi terhadap cakupan penemuan kasus belum optimal. Disimpulkan bahwa motivasi petugas Tuberculosis Paru dalam penemuan kasus masih rendah, karena belum ada dukungan dan tanggung jawab masih kurang serta sistem kompensasi dan supervisi yang belum ada. Tuberculosis patients with positive acid fast bacilli (BTA) were able to infect 10-15 other people every year; therefore case detection was important to be implemented. Detection coverage of tuberculosis cases with positive BTA in Semarang district was far below national coverage. This low coverage could be caused by low motivation of tuberculosis (TB) health workers. Objective of this study was to analyze factors that decreased motivation of TB workers in conducting case detection in Semarang district. This was a qualitative study. Primary data collection was done by conducting in-depth interview; secondary data collection was done by conducting documentation review. Study subjects were lung tuberculosis workers in the primary healthcare centers. Subjects were purposively selected. The number of main informants was 18 people. The main informants were six nurses, 6 analysts, and six heads of primary health care centers. Triangulation informants were six polyclinic health workers, and one head of communicable disease control unit of Semarang district health office. Content analysis method was applied in the data analysis. Results of the study showed that motivation of TB workers was low due to the works were assigned by the primary healthcare centers leader, the work took longer time, and workers were at risk to get infection from patients. Responsibility to finish the works was low due to high amount of workload, work without target and motivation. TB workers did not get compensation; they needed support from the leader to express their ideas in the case detection. Transportation facility for case detection was not provided. The primary healthcare centers did not have planning to implement case detection program policy. Supervision system on case detection coverage was not optimal. In conclusion, motivation of lung tuberculosis workers in case detection was low. It was caused by no supports, insufficient responsibility, and no compensation and supervision.

Analisis Hubungan Faktor Internal Dan Eksternal Dengan Kinerja Bidan Desa Dalam Deteksi Dini Dan Penanganan Ibu Hamil Kekurangan Energi Kronik (KEK) di Kabupaten Grobogan Tahun 2015 Rosmala Kurnia Dewi; Sri Achadi Nugraheni; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Chronic Energy Deficiency (CED) is one of the causes of maternal and infant mortality indirectly. Maternal Mortality Rate (MMR) in Grobogan District increased gradually during the period of 2011 – 2012 from 26 cases (114.03/100,000 live births) to 34 cases (151.15/100,000 live births), and decreased sharply to be 22 cases (102.03/100,000 live births) in 2013. Meanwhile, Infant Mortality Rate (IMR) was 194 cases in 2011, rose dramatically in 2012 to be 240 cases, and declined sharply in 2013 to be 166 cases. Low Birthweight Babies (LBWB) was one of the causes of infant mortality because pregnant women suffered from CED during their pregnancies. The aim of this study was to analyse internal and external factors with performance of village midwives in conducting early detection and handling pregnant women with CED. This was an observational-analytic study using cross-sectional approach. Data were collected using structured questionnaires. Population was 243 village midwives at health centres in Grobogan District. As many as 71 village midwives were selected randomly using a technique of stratified random sampling. Data were analysed using analyses of bivariate (chi square test) and multivariate (logistic regression test). The results of this research showed that most of the respondents aged ranging from 20-35 years old (76.1%), had working period less than or equal to 6 years (53.5%), ever handled CED (81.7%). Variables of health facilities (p=0.001), fellow worker support (p=0.016), community support (p=0.001), leader support (p=0.0001) had significant relationship with the performance of village midwives in conducting early detection of pregnant women with CED. Factors jointly influencing the performance were health facilities (p=0.000; Exp(B)=25.395), and leader support (p=0.001; Exp(B)=10.278). As suggestions, health centres and District Health Office need to provide complete health facilities to improve performance of health workers in providing services.

Mengapa Program Pelayanan Kesehatan Peduli Remaja (PKPR) di Puskesmas Kota Magelang tidak Optimal? Ratna Nur Pujiastuti; Ayun Sriatmi; Nurhasmadiar Nandini
Jurnal Manajemen Kesehatan Indonesia Vol 9, No 1 (2021): April 2021
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jmki.9.1.2021.28-37

Adolescents are particularly vulnerable to a variety of health risks, especially about sexual promblems and reproductive health problems. The government develops adolenscent health programs in Indonesia by using the Adolenscent Friendly Health Service (PKPR) at the health care level. Adolescent health programs in 2019 at Magelang city has not achieved performance targets, so that it becomes attention to optimizing the PKPR program. This research is to find out cause the implementation of the PKPR program in Magelang Tengah health center which is not optimal with influencing factors. The method of research was qualitative with descriptive approach. The technique of collecting data was through in-depth interviews with subject sellection with purposive sampling criteria. Data analysis used content analysis. Analyzed variables were communication, resources, dispositions or attitudes, and bureaucratic structure. The results showed that implementation of PKPR in health center has not been optimal because have some constraints which influenced by several factors, such as the lack of communication between PKPR teams in coordinating scheduling activities, the understanding and clarity about PKPR program owned by officers was limited, the function of public service room in health center has not been optimal to provided service to adolescent, and monitoring and evaluation was limited. Therefore, it needs to communication and coordination was scheduled regularly so that has a good team management, and needs to monitoring and assessment of SNPKPR by Department of Health regularly in order to know the achievement and factors which influence the unoptimability of implementation PKPR program in the health center.

Analisis Pelaksanaan Program Kemitraan Bidan dan Dukun Ditinjau Dari Aspek Input, Proses dan Output di Wilayah Dinas Kesehatan Kabupaten Fakfak Provinsi Papua Barat Elzina De Fretes; Hardi Warsono; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 3 (2016): Desember 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Number of midwives in Fakfak District in 2012 was 108 persons. Number of Traditional Birth Attendants (TBAs) was 191 persons consisted of 79 (41%) trained TBAs and 112 (59%) untrained TBAs. The TBAs had an important role in delivery process because number of them was higher than number of midwives. Therefore, coverage of delivery process helped by health workers had not achieved the target. This research aimed to analyze the implementation of the partnership program between midwives and TBAs viewed from the aspects of input, process, and output at Fakfak District Health Office. This was qualitative research with descriptive-explorative approach by conducting indepth interview. Subjects were midwives and TBAs who had been partnering. Data were analysed using a content analysis. The input aspect showed that: 1) Implementers, midwives and TBAs only knew partnership in helping delivery; 2) Specific allocation funds for the program was not available. The funds was from Operational Support for Health but it was still not sufficient; 3) Specific means for the program was not available. The current means is from health center and village polyclinic but it is still limited. Furthermore, the process aspect revealed that: 1) Program planning, midwives and TBAs collected data of pregnant women, maternal, postpartum women, and number of TBAs; 2) The implementation was not good because midwives were not available when needed by TBAs and there was difficult to access. Socialization for cross-program (community leaders and religious leaders) and internship for TBAs had not been done yet due to insufficient fund; 3) Recording and reporting especially about partnership activities had not been done yet and only used a form on a Maternal and Child Health report. Regarding the output aspect, as many as 195 (89%) from 219 TBAs had not been partnered. Coverage of K1, K4, and delivery process helped by health workers from 2011 to 2012 decreased gradually. As a suggestion, District Health Office and Health Center need to maintain partnership by recruiting midwives, providing means, allocating fund, socializing to community leaders, and funding TBAs’ daughter or grandchild to study midwifery.

Analysis on Low Rate Utilization of Delivery Services by Health Workers at Wakaokili Community Health Center in Buton Regency Ira Yusnita; Chriswardani Suryawati; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Pemanfaatan layanan persalinan tenaga kesehatan di Indonesia masih rendah terutama di daerah pedesaan. Kondisi ini juga terjadi pada masyarakat di wilayah kerja Puskesmas Wakaokili Kabupaten Buton, dimana pada saat hamil sebagian besar ibu memeriksakan diri ke bidan tetapi saat bersalin lebih memilih dukun. Pemerintah telah melakukan berbagai upaya meningkatkan minat masyarakat untuk bersalin pada tenaga kesehatan namun sampai saat ini belum mencapai hasil yang diinginkan. Untuk itu penelitian ini dirancangan dengan pendekatan kualitatif, metode studi kasus guna memahami alasan yang melatar belakangi rendahnya pemanfaatkan layanan persalinan oleh masyarakat. Pengumpulan data dengan wawancara menggunakan pedoman wawancara dan observasi langsung pada layanan kesehatan. Jumlah informan utama 36 orang terbagi dalam 2 kelompok yaitu kelompok sasaran langsung program meliputi ibu bersalin oleh bidan, dukun dan oleh keluarga beserta para suami. Serta kelompok sasaran tidak langsung program yaitu Toma/Toga dan kader kesehatan. Adapun informan triangulasi bidan, dukun dan kepala Puskesmas Wakaokili serta Kabid Kesga DKK Buton. Hasil penelitian diketahui bahwa alasan yang melatarbelakangi rendahnya pemanfaatkan layanan persalinan tenaga kesehatan yaitu karena mereka tidak mengenal bidan di desa, karena tidak memahami manfaat persalinan oleh tenaga kesehatan, biaya di dukun lebih terjangkau dan karena bidan tidak selalu ada saat dibutuhkan. Selain itu adanya kepercayaan masyarakat bahwa lancar tidaknya persalinan bukan ditentukan oleh penolong persalinan tetapi oleh perbuatan ibu semasa hamil. Juga adanya keyakinan terhadap doa-doa yang dimiliki oleh dukun atau suami menyebabkan masyarakat selalu menyertakan dukun dalam kehamilan dan persalinan guna kelancaran proses persalinan. Untuk itu diharapkan bidan lebih aktif melakukan pendekatan pada warga binaanya. Juga puskesmas dan kepada Dinas Kesehatan untuk melakukan upaya peningkatan pengetahuan masyarakat, kapasitasi dan pembinaan dukun dan juga mengkaji ulang insentif bagi bidan dalam rangka peningkatan kunjungan pada bumil baik di rumah maupun yang di kebun. Utilization of delivery service by health workers in Indonesia was still low especially in rural areas. This condition occurred in communities in the work area of Wakaokili primary healthcare center (puskesmas) Buton district. Most of pregnant women in this community did antenatal care to midwives, however they chose traditional delivery assistant (dukun bayi) to assist their delivery process. Government had done many efforts to increase community interest to give birth with health workers assistance. However, this effort had not reached what was expected. This was a case study with qualitative approach. Objective of the study was to understand the background for low utilization of delivery services by the community. Data were collected through interview guided by interview guideline, and direct observation in the health services. The number of main informants was 36 people. They were divided into 2 groups. Those groups were direct target program group that included post-delivery women assisted by midwives, dukun bayi, and house member including husbands; indirect target program group consisted of community leaders and cadres. Triangulation informants were midwives, dukun bayi, the head of Wakaokili primary healthcare center, and the head of family health department of Buton district health office. Results of the study showed that background for the low utilization of delivery services by health workers was that community did not know village midwives; community did not understand benefits of giving birth assisted by health workers; the cost of giving birth assisted by dukun bayi was affordable; midwives were not always ready when needed. In addition, there was a stigma that smoothness of delivery process was not determined by who assisted the delivery but by what had been done by the mothers during pregnancy. Furthermore, there was a belief towards praying words spoken by dukun bayi or husbands; this was one of reasons why dukun bayi was included in the delivery process. They believed that dukun would make the delivery process success. Midwives are expected to be more active to approach their supervised community. Primary healthcare center and district health office are suggested to do efforts to improve community knowledge, to train and assist dukun, and to review the incentive for midwives in order to be able increase the number of visits to pregnant women in their house or in the field.

Co-Authors - Rudiansyah Ade Kurniasari Adi Nugroho Adi, Mateus S. Adilah, Annida Nur Aditya Kusumawati, Aditya Adriana Egam Adriana Palimbo afiyah hidayati Agushybana , Farid Ahmad Saroni Aina, Sitta Nur Ajeng Retno Yunita Albrina Roza Rezkillah Alifa Rizqia Rachmawati Alimah, Ulya Alvira Putri Calista Amalia Ninggar Amalia Shabrina Fitri Amini, Musdalifah Nor Ana Puji Astuti Ana Pujianti Harahap Ananda Suryo Adi Prayogo Anastasia Wulandari Andini Aridewi ANDRI PURNOMO Anggi Septia Irawan Anjelika, Ratna Anneke Suparwati Anneke Suparwati ANNISA RAHMAWATI Antonia Novika Siswati Antono Surjoputro Antono Suryoputro Antono Suryoputro Apoina Kartini Apriliana Susilowati, Apriliana Arie Sulistiyoningrum Arie Sulistiyoningrum Arina Noor Eka Rachmawati Arinta Riza Andriani Arista, Herlin Ika Yuni Arman Wokas Armunanto, Armunanto Arnia Dian Kusuma Devi Arsita, Alma Nofia Mega Arum Prihatiningsih Arum Rohana Aryani Pujiyanti Asfiya, Nissa Atul Asih Dwi Astuti Astuti, Eka Kristia Ayu Astutik, Risa Septi Atik Mawarni Atik Mawarni Aulia Nur Hidayati Bagoes Widjanarko Bahtiar Bahtiar Bina Kurniawan Bintang Agustina Pratiwi BUDIYONO Budiyono Budiyono Budiyono Budiyono Cahya Tri Purnami Cahya Tri Purnami Cahya Tri Purnami, Cahya Cahyaningsari, Brillian Ayu Camellia, Arta Celica Triulfah Maharani Chairunnisa Putri, Nabilla Cicilia Ninik S Desyana Indira Putri Deviana, Dika Deviani Saskia Putri Dewi Susilowati Dewi, Bella Rossana Dewi, Fitriana Tungga Dian Hasanah Ramli Diana Andriyani Pratamawati Dianti Oktadevi Dianti Oktadevi Didik Ariwibowo Djati, Isti Sulistyana Dwi Ayu Tirtaningrum Eka Kristia Ayu Astuti Eka Yunila Fatmasari Eka Yunila Fatmasari Eka Yunila Fatmasari, Eka Yunila Elisabeth Samaran Elzina De Fretes Emi Widiarti Cahyati Emy Shinta Dewi Erlin Friska Fachrudin, Nur Millati Hanifah Falentine Lidya Telussa Fara Aulia Oktaviani Farid Agushybana Farid Farid Agushybana Fatmasari, Yunila Fatwa Firdhaus, Oki Ino Feby Rahmawati, Feby Firdhaus, Oki Ino Fatwa Firdiah, Mutia Rizqa Firmansyah Kholiq Pradana PH Friska, Erlin Hamida H. Siregar Handayani, Novia Handayani, Novia Hapsari, Kanya Harahap, Ana P. Harahap, Ana Pujianti Hardi Warsono Hardiyanti, Tutut Okta Hartini Hartini Hartono Hartono Henry Setyawan Susanto Henry Setyawan Susanto Henry Setyawan Susanto Hermawati Hermawati Husnan Khair, Muhammad Dyas I Nyoman Agus Suarya Putra INDAH KURNIAWATI Indana Aziza Putri Inna Maulina Insani, Rachel Ivonieta Intan Rahayu Utami, Intan Rahayu Ira Yusnita Irana Eka Wardana Irmawati Irmawati Isti Sulistyana Djati Iwamizu, Yuko Iwan Yunianto Jauhanita, Denisa Jhovia Aloedya Pramana Joyo Minardo Juli Mrihardjono Karimah, Nadzar Akhlaqul Karyono Karyono Khalishah, Jihan Nurul Qamariah Khasna Fikriya Krisnamurti Krisnamurti Kunsianah Kunsianah Laily Maghfira Noor Ridarsyah Laksmono Widagdo Lathifah Safaatul Uzhma Lestari, Marselli Widya Lina Dwi Yoga Pramana Linda Ismawati Lolita Indah Pradini Lucia Ratna Kartika Wulan M. Abdurrahman Shidiq Mabrukah, Aina Manurung, Togar Hasudungan Margaretha Inadyas Verganza Margaretha Triana Martha Irene K Martha Irene Kartasurya MARTINI Martini Martini Mateus Sakundarno Adi, Mateus Sakundarno Maynisa Puspita Kusuma Wardani Mela Nofitri Melinda Novitasari Meytri Saraswati Miftahul Mualimah Mohamad Endy Y Yulianto Mohd Ridwan Muhammad Dyas Husnan Khair Mumpuni Sari Kusumastuti Muslimah Muslimah Mustofa, Syamsulhuda Budhi Mya Rosiana Naintina Lisnawati Nikie Astorina Yunita Dewanti Nikie Astorina Yunita Dewanti Nikie Astorina Yunita Dewanti Nikie Astorina Yunita Dewanti Nila Nafisatul Izzah Ninik S, Cicilia Nirwesti, Wahyu NOVA LISTIANA Nur Khafidhoh, Nur Nur Laili Agustin Nur Setiawati Dewi Nurfrida Pratomo Putri Nurhasmadiar Nandini Nurhasmadiar Nandini Nuridzin, Dion Zein Nurjazuli Nurjazuli Nurrachma, Adennisa Yunitasari Okta Hardiyanti, Tutut Oktadevi, Dianti Pangestika, Windiana Wahyu Paramita, Nadinda Maretta Diah Petosutan, Kenny Pramono Apriawan Wijayanto Pramono Apriawan Wijayanto Pratiwi , Setyo Endah Pratiwi, Setyo Endah Prihatiningsih, Arum Prisma Armaya Puji Hastuti PUJI LESTARI Pujianti Harahap, Ana Purnami, Cahya T. Purwanto, Edy Dwi Putri Asmita Wigati Putri Asmita Wigati Putri, Nabilla Chairunnisa Rahfiluddin, Mohammad Zen Rani Tiyas Budiyanti Ratna Nur Pujiastuti Retno Hestiningsih Retno Mariani Reza Fadly, Teuku Rezkillah, Albrina Roza Rida Krita Imaroh Rika Rejeki Rini Oktaviani Handayani Risa Rahayu Risa Tri Anggraeni Riski Malimpa Rizani Shofi RIZCARACHMAKURNIA, NAFIZTA Rizka Laila Rachmawati Ronald Mahudin Rosalinda Trajuningtyas Rosmala Kurnia Dewi Rosmila Tuharea S.A. Nugraheni Sabrilla Putri Gotama Santosa, Damai Saputro, Wisnu Adhi Sari , Lisnia Sari Ningsih Sari Ningsih Sasi, Erlina Nawang Seno Darmanto Seno Darmanto Septo Pawelas Arso Setyaningrum, Dian Sinta Wati Siti Alfani Siti Alfani Sokhiyatun Sokhiyatun Sri Achadi Nugraheni SRI RAHAYU Sri Rulihari Sri Suwitri Sri Widuri Retnoningrum Utami Jatiputri Sri Winarni Sri Yuliawati Suhartono Suhartono Suhartono, Suhartono Sulastri Sulastri SULISTIYANI SULISTIYANI Sulistyana Djati, Isti Surjoputro, Antono Sutopo Patria Jati Syahidah, Putri Nadya Syamsulhuda BM Tianto, Albert Tio Dora Ultaria S. Tjahjono Kuntjoro Tjahjono Kuntjoro Togar H Manurung Togar Hasudungan Manurung Togar Hasudungan Manurung Trianita Eka Pamundhi Tungga Dewi, Christin Hiyana Tunggal, Indayah Dewi Unzila, Erliana Ustriyaningsih, Ustriyaningsih Viona Febya Pangestika Vivin Fitria Anggraeni WATI, DEWI KUSUMA Widyaputri, Anak Agung Ayu Wanda Wijayanto, Pramono Apriawan Wiranti Wiranti Wiwid Novitaria Wiwik Trapsilowati Wulan Kusumastuti Wulan Kusumastuti Wulan Kusumastuti Yokbeth Kareth Youke A. Supit Yulfiana Yulfiana, Yulfiana Yuliati, Erni Yuniarto Yuniarto, Yuniarto Zahroh Shaluhiyah

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