<![CDATA[Abstract: This Study was Conducted to describe the process of implementing pregnant ang laboring women referral system and factors that support or hinder the process of it. Research design was qualitative case study. Data collection technique use were interview, documentation and focus group discussion. Informant in this study consist of the head community health center, the midwife and patients. The sampling technique used was purposive sampling. The data was analyzed using content analyze techniques. The result illustrate that the number of referral was pretty much, standart operating procedure was available. Health service as referral destination were public and private health services. Cases was referred based on 18 refferal maternal indicators screening standart. Midwife brought midwifery tool and medication based on the case. Refferal patways village maternity clinics, community health centers, hospital. When reffered patients will be accompanied by midwife, family and drver. Patient and family have to prepare mother and baby kit, money and administrative requirement before reffered. Transportation used were owned privately, midwifes car, village ambulance, community health center ambulances or hospital ambulance. Refferal cost can be paid cash or by insurance. Factors that affect the referral process: cost, patient, decision maker, hospital as referral destination, transportation, midwife competency, patienst’s residence and community trust. Keywords: Refferal system, midwife, village maternity clinic Anstrak: Penelitian ini dilakukan untuk mendiskripsikan proses implementasi sistem rujukan ibu hamil dan ibu bersalin oleh bidan Polindes di wilayah Kecamatan Dampit dan faktor – faktor yang mendukung dan menghambat pada proses tersebut. Penelitian ini merupakan jenis penelitian kualitatif dengan pendekatan studi kasus. Tehnik pengumpulan data menggunakan wawancara, dokumentasi dan focus group discussion. Informan terdiri atas Kepala Puskesmas, Bidan dan pasien. Pengambilan sampel dengan tehnik purposive sampling. Analisa data dengan analisa isi. Hasil penelitian menggambarkan bahwa jumlah rujukan cukup banyak, SOP sudah tersedia. Tujuan rujukan adalah Puskesmas/Rumah Sakit dan dokter spesialis. Kasus yang dirujuk mengacu pada standar penapisan 18 indikasi rujukan ibu bersalin. Perlengkapan yang dibawa bidan adalah set alat dan obat. Jalur rujukan dari polindes ke Puskesmas, ke Rumah sakit, ke dokter spsesialis, ke Puskesmas lalu ke rumah sakit. Pendampingnya bidan, keluarga dan sopir. Persiapan sebelum dirujuk adalah perlengkapan ibu, perlengkapan bayi, uang dan syarat-syarat administrasi. Alat transportasi menggunakan kendaraan milik pribadi, milik bidan, ambulan desa, ambulan Puskesmas, ambulan Rumah Sakit. Biaya menggunakan asuransi atau membayar tunai. Faktor-faktor yang mempengaruhi proses rujukan meliputi: biaya, pasien, pengambilan keputusan, rumah sakit yang dituju, transportasi, kompetensi bidan, status domisili pasien dan kepercayaan masyarakat.]]>
