Niniek Lely Pratiwi
Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

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Dinamika Jender terhadap Akses Pelayanan Kesehatan Maternal Sembilan Etnis di Indonesia Isfandari Siti; Selma Siahaan; Grace Wanggae; Ratna Widyasari; Aan Kurniawan; Ni Ketut Aryastami; Niniek Lely Pratiwi
Buletin Penelitian Sistem Kesehatan Vol 22 No 1 (2019): Buletin Penelitian Sistem Kesehatan
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (249.916 KB) | DOI: 10.22435/hsr.v22i1.652

Abstract

This is a review of maternal mortality risk due to preference of non skilled health worker delivery assistance among 9 ethnics applying gender analysis. Data obtained from 9 ethnograpic studies reports conducted by Pusat Humaniora. Estimation of maternal mortality rate (MMR) in Indonesia is between 305 (Supas) – 359 (Susenas) per 100.000 live birth. There is no single cause of maternal death. The greatest contributors 75% are due to direct cause namely bleeding, infection, hypertension, delivery complication and unsafe abortion. Government intervention prioritizes to prevent direct cause of maternal death through health service delivery improvement. Among them are midwives in village, PONEK, PONED. However MMR is still high. Social factors as Indirect causes such as poverty, distance, information, inadequate service and culture have not yet considered as important. In fact contribution of social factors cannot be neglected. This review explores gender dynamics of preferences on non skilled health worker delivery assistance from 9 ethnic in Sumatra, Jawa and NTT. The results showed each ethinc had different gender dynamics. Among which are gender relation in each culture. Some ethnic shows gender equity, while others believe woman have full responsibility of her pregnancy and delivery without assistance from others. Powerlessness of woman is indicated by preference of traditional birth attendant for delivery due to culture and comfort. Even the pregnant women herself did not aware that delivery is a life risk. However the studies showed there is no sharp inequity with strong preference to boy over girl. Accessibility, education, comfort perceived culture, and economy are important for delivery assisted by health providers.
Ibu Hamil “Kemel” Pada Etnis Gayo Di Kecamatan Blang Pegayon Kabupaten Gayo Lues, Aceh Niniek Lely Pratiwi; Yunita Fitrianti; Syarifah Nuraini; Tety Rachmawati; Agung Dwi Laksono
Buletin Penelitian Sistem Kesehatan Vol 22 No 2 (2019): Buletin Penelitian Sistem Kesehatan
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1601.917 KB) | DOI: 10.22435/hsr.v22i2.1693

Abstract

The unique and enormous culture of concealed pregnancy or “Kemel” in Gayo ethnic, low coverage of antenatal care for pregnant women in health workers and high numbers of neonatal mortality, and infection in infants with low birth weight were social determinants of health issues existing in Aceh. These were urgently observed to fi gure out solution in reducing low examination of antenatal care by pregnant women in Gayo. Increasing the interest of researchers to conduct this research. This descriptive study was based on socio-cultural phenomena that aff ect a “Kemel” pregnant woman. The results showed ‘Kemel’ vulnerability perceptions were indicated by keeping the pregnancy as a secret in case of being used by those who do not like their pregnancies. ’Kemel’ perceived severity aff ects the safety of women pregnancies. Pregnant women may get some threats such as: malnutrition, lack of calorie energy, anemia, newborn with low birth weight, premature newborn, and infectious diseases. “Kemel” cues to action, pregnant women check theirpregnancies after 5 months pregnancy to a traditional birth attendant. Soon after TBA claimed their pregnancies, they refer to midwives. This the reason why examination of antenatal care were very low. Family role in the social structure, the culture of the Gayo, parents-in-law and parents of pregnant women, have a great contribution in making decisions such as pregnancy, childbirth and postpartum cares. A marriage tradition of the Gayo, was when a woman pawned into a part of male family, she must follow its habits and traditions. Thus, intervention by forming an agent of change are highly recommended by involving parent in law. Abstrak Tingginya budaya merahasiakan kehamilan/”Kemel”pada etnis Gayo, rendahnya cakupan antenatal care ibu hamil pada petugas kesehatan dan tingginya kematian neonatal, infeksi pada bayi dengan Berat badan lahir rendah, menambah ketertarikan peneliti untuk melakukan penelitian ini. Metode penelitian adalah kualitatif, peneliti menganalisis berdasarkan fenomena sosial budaya yang dapat mempengaruhi seorang ibu hamil “Kemel”. Hasil menunjukkan Persepsi kerentanan ‘Kemel’, dengan merahasiakan kehamilannya, takut diguna-guna orang lain yang tidak suka kehamilannya. Perceived severity Kemel mempengaruhi keselamatan kehamilannya, ancaman pada ibu hamil: gizi kurang, Kurang Energi Kalori, anemia dan bayi dengan Berat Badan Lahir Rendah/BBLR, bayi lahir prematur dan serangan penyakit infeksi pada ibu hamil. Cues To Action Kemel, periksa kehamilan saat kehamilan berusia 5 bulan pada bidan kampong, setelah bidan kampong menyatakan hamil ia baru pergi ke bidan, hal inilah yang menjadi salah satu penyebab rendahnya pemeriksaanantenatal care pada ibu hamil. Peran keluarga dalam struktur sosial, budaya masyarakat Gayo, Mertua dan orang tua bumil sangat besar dalam menentukan keputusan segala sesuatu yang berkaitan dengan keputusan dalam perawatan kehamilan, persalinan dan perawatan nifas. Suatu tradisi perkawinan masyarakat Gayo, perempuan sudah tergadai menjadi bagian besar keluarga pihak laki laki, ia mengikuti kebiasaan dan tradisi keluarga laki laki, sehingga bila membentuk agen perubahan perlu mempertimbangkan peran mertua.