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Gambaran kematian neonatal di RSUD Dr. M. Haulussy Ambon. Magdalena Paunno
MOLUCCAS HEALTH JOURNAL Vol 1, No 3 (2019): Moluccas Health Journal Edisi Desember 2019
Publisher : Lembaga Penerbitan Fakultas Kesehatan Universitas Kristen Indonesia Maluku

ABSTRACTMost child deaths in Indonesia today occur in the newborn period (neonatal), the first month of life. The probability of a child dying at different ages is 19 per thousand during neonatal mass, 15 per thousand from ages 2 to 11 months and 10 per thousand from ages 1 to 5 years. Delivery assistance by midwives is one of the strategies in reducing maternal and child health problems. In Indonesia the use of delivery assistance by midwives is still low compared to established indicators. One of the efforts to reduce maternal, infant and under-five mortality rates is the provision of Basic Emergency Neonatal Obstetric Services (PONED) facilities in care centers and Comprehensive Emergency Neonatal Obstetric Services (PONEK) in hospitals. This type of research uses descriptive research. The study was conducted on November 4 - December 15, 2019 at Dr. M. Haulussy Ambon. A sample of 51 infants using total sampling techniques. The results of the study found that deliveries performed by health workers more than 50% were performed by mothers, neonatal deaths with a referral system were smaller compared to non-referral neonatal deaths and the age of mothers giving birth 90% were at productive age.Keywords: Neonatal DeathABSTRAK Sebagian besar kematian anak di Indonesia saat ini terjadi pada masa baru lahir (neonatal), bulan pertama kehidupan. Kemungkinan anak meninggal pada usia yang berbeda adalah 19 per seribu selama massa neonatal, 15 per seribu dari usia 2 hingga 11 bulan dan 10 per seribu dari usia 1 hingga 5 tahun. Pertolongan persalinan oleh bidan merupakan salah satu strategi dalam mengurangi masalah kesehatan ibu dan anak. Di Indonesia pemanfaatan pertolongan persalinan oleh bidan masih rendah dibandingkan dengan indikator yang telah ditetapkan. Salah satu upaya untuk menurunkan angka kematian ibu, bayi dan balita adalah penyediaan fasilitas Pelayanan Obstetri Neonatal Emergensi Dasar (PONED) di puskesmas perawatan dan Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) di rumah sakit. Jenis penelitian mengunakan penelitian deskriptif. Penelitian dilakukan pada tanggal 04 November – 15 Desember 2019 di RSU Dr. M. Haulussy Ambon. Sampel sebanyak 51 bayi dengan menggunakan teknik total sampling. Hasil penelitian ditemukan persalinan yang dilakukan oleh tenaga kesehatan lebih dari 50% dilakukan oleh ibu, kematian neonatal dengan sistem rujukan lebih kecil presentasinya dibandingkan dengan kematian neonatal yang bukan rujukan serta umur ibu yang melahirkan 90% berada pada usia produktif. Kata Kunci : Kematian Neonatal

Gambaran Penyebab Kematian Neonatal Di Rumah Sakit Umum Daerah Dr. M. Haulussy Ambon Tahun 2019. Magdalena Paunno; Nenny Parinussa
MOLUCCAS HEALTH JOURNAL Vol 1, No 2 (2019): Agustus
Publisher : Lembaga Penerbitan Fakultas Kesehatan Universitas Kristen Indonesia Maluku

Neonatal mortality rates in Indonesia in 2010 were still high at 228 / 100,000 live births. Neonatal deaths can occur due to infection, asphyxia or low birth weight. While the medical records of RSUD Dr. M Haulussy Ambon is a referral center Hospital that has PONEK services that the number of neonatal deaths in 2013 was 49 cases out of 2633 live births, in 2014 there were 80 cases of 2483 KH while in 2015 in 6 months (January-July) already as many as 51 of 983 births. From the death data obtained in 2015 the causes of neonatal death are: LBW 16; Asphyxia 15; Sepsis / Infection 14; Respiratory Disorders 4; and atresia ani 2. The purpose of this study was to determine the frequency distribution of neonatal deaths and a description of the causes of neonatal death in Dr. M Haulussy Ambon in 2015. The research method is descriptive. The study population was all neonates who died in Dr. M Haulussy Ambon in 2015 recorded a diagnosis of obstetric gynecology specialist in the medical record with a total of 51 neonatal. namely data on the description of birth attendants, referral system, and maternal age less than 20 years with Neonatal death in Dr. M. Haulussy Ambon 2015. The study population was all neonates who died in Dr. M. Haulussy Ambon 2015 starting from January to July 2015 recorded in the medical record with a total of 51 neonates. The sampling technique used is total sampling. The sample in this study must meet the following criteria: neonatal and died at the age of 0-28 days and a diagnosis was given from the doctor who was on duty at the time of death. Research Instrument The instrument in this study used a checklist, which records the condition of patients who experienced neonatal death in the documentation data, namely medical records. Data The results of further research data are processed in a univariate manner, carried out by tabulating data which is then arranged in a table. The results showed that neonatal mortality of childbirth assistants by 39 health workers (76.47%) neonatal consisted of: midwives 29 (56.9%); obstetric gynecology specialist 10 (19.6%); dukun 12 (23.52%); while due to referral 15 (29.41 %%), and mortality due to maternal age <20 years neonatal mortality 5 (9.8%)

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PERSALINAN DI FASILITAS KESEHATAN PADA WILAYAH KERJA PUSKESMAS BENTENG Magdalena Paunno
MOLUCCAS HEALTH JOURNAL Vol 2, No 1 (2020): Moluccas Health Journal Edisi April 2020
Publisher : Lembaga Penerbitan Fakultas Kesehatan Universitas Kristen Indonesia Maluku

ABSTRACT The quality of public health facilities greatly influences the degree of health services. Health facilities are means to provide individual health service (UKP) and public health services (SMEs), either to outpatient or to inpatient services. Utilization of health facility for childbirth is one of the indicators in the health sector strategic plan. Factors that can affect maternal care service include K4 antenatal care visits and access to P4K counseling fees. This is an analytical study using a cross-sectional approach. The study used Simple random sampling with a sample size of 63 women. The data were analyzed using chi-square. The results showed that 46 women (73%) used health facility-based delivery 17 women (27%) used non health facility-based delivery. Based on the results of the bivariate statistical test, the variables associated with labor and delivery at the public health facility were K4 antenatal care visits (p = 0.021), and access costs (p = 0.000), while the non-health facility variable was P4K sticker counseling (p = 0,532). It is, therefore, recommended for women to be more aware and comprehend about the utilization of health facility-based delivery so that the condition of both mother and the fetus can be monitored for the safety and normal delivery. Keywords: Antenatal Care, Cost, Counseling labor in Health Facilities ABSTRAKKualitas sarana pelayanan kesehatan sangat mempengaruhi derajat kesehatan masyarakat. Fasilitas kesehatan merupakan fasilitas yang memberikan pelayanan kesehatan berupa upaya kesehatan perorangan (UKP) maupun upaya kesehatan masyarakat (UKM), berupa pelayanan rawat jalan maupun rawat inap. Persalinan pada fasilitas kesehatan merupakan salah satu indikator kinerja dalam rencana strategi bidang kesehatan. Faktor yang dapat mempengaruhi persalinan di fasilitas kesehatan antara lain : kunjungan antenatal care K4, akses biaya dan konseling P4K. Penelitian ini merupakan jenis penelitian Analitik dengan menggunakan pendekatan cross sectional. Teknik sampling yang digunakan adalah Simple Random Sampling dengan besar sampel sebanyak 63 ibu bersalin. Data dianalisis menggunakan chi-square. Hasil penelitian menunjukkan bahwa persalinan di fasilitas kesehatan sebanyak 46 orang (73%) dan persalinan di Non fasilitas kesehatan sebanyak 17 orang (27%). Berdasarkan hasil uji statistik bivariat didapatkan variabel yang berhubungan dengan persalinan di fasilitas kesehatan yaitu Kunjungan antenatal care K4 (p=0,021), dan Akses biaya (p=0,000). Sedangkan yang tidak mempunyai hubungan yaitu Konseling P4K (p=0,532). Saran bagi ibu bersalin untuk perlu ditingkatkan kesadaran dan pemahaman terkait pemakaian fasilitas kesehatan agar kondisi ibu dan janin dalam kandungan dapat dipantau sehingga kehamilan dan persalinan dapat berjalan aman dan normal.Kata Kunci : Antenatal Care, Biaya, Konseling Persalinan di Fasilitas Kesehatan.

PENGARUH IBU HAMIL PEROKOK PASIF TERHADAP KEJADIAN LAHIR MATI DI KOTA AMBON Magdalena Paunno; Ova Emilia; Abdul Wahab
JURNAL KESEHATAN REPRODUKSI Vol 2, No 3 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.12647

PENGARUH IBU HAMIL PEROKOK PASIF TERHADAPKEJADIAN LAHIR MATI DI KOTA AMBONMagdalena Paunno1, Ova Emillia2, Abdul Wahab3ABSTRACTBackground: Intervention in the care for pregnant women can reduce antenatal mortality until 75%.Antenatal Care (ANC) in Ambon municipality is categorized good if compared from the mean rate ofnational level, that is, Visit 1 (89%) and Visit 4 (87.76%); however, the incidence of stillbirths in Ambonis still considered high. Data about the incidence of stillbirths in three hospitals of Ambon showed thatthere were 44.2 stillbirths per 1000 live births while national data in 2003 showed that there were only9.6 stillbirths per 1000 live births. The direct cause of stillbirth is hypoxia, that is, the lack of oxygenin a pregnant woman’s body due to the exposure of cigarette smoke. In Ambon municipality, 65% ofhouseholds have 1 active smoker and almost all of the smokers (90%) smoke inside the house. This rateof course exceeds the national rate. In addition, other factors causing stillbirth are the quality of antenatalcare, age, parity, anemia and women’s educational level.Objective: To study whether passive smoking during pregnancy is a risk factor of the incidence of stillbirths.Method: This was an observational study with case-control study design. Study sites were in three hospitalsof Ambon municipality, namely Dr. M. Haulussy District Hospital, Al-Fatah Hospital, and Sumber HidupHospital. Subjects were divided into two groups which were case and control with comparison of 1:1 (69stillbirths as case and 69 live births as control) from January to December 2007. Samples were taken usingnon probability sampling which was determined with quota sample. The analysis of quantitative dataused univariable analysis, bivariable analysis with chi-square test (χ²) and stratification, and multivariableanalysis with logistic regression.Result and Discussion: There was a significant relationship between passive smoking during pregnancyand the incidence of stillbirth based on bivariable analysis with OR=3.36 (95% CI=1.20-5.41) while basedon multivariable analysis with OR=2.8 (1.01-7.94). Other risk factors that affected the incidence of stillbirthwere the quality of antenatal care with OR=3.2 (95% CI=1.39-7.52) and anemia during pregnancy withOR=2.3 (95% CI=1.20-5.41). Meanwhile, stratification analysis showed that non anemic women duringpregnancy was significantly related to stillbirths with OR=5.7 (95% CI 1.10-55.22). However, age, parity andeducation were not the risk factors of the incidence of stillbirth in Ambon.Conclusion: Passive smoking during pregnancy was a risk factor of the incidence of stillbirth in Ambonmunicipality. Other factors that caused the incidence of stillbirths were the quality of antenatal care andanemia. However, age, and parity were not the risk factors of the incidence of stillbirths in Ambon.Keywords: pregnant woman, passive smoking, stillbirthINTISARILatar belakang: Intervensi pada perawatan ibu hamil dapat menurunkan kematian perinatal hingga 75%.ANC di Kota Ambon dikategorikan baik, bila dilihat angka rata-rata secara nasional yaitu K1 89%, K4 87,76%namun, kejadian lahir mati sangat tinggi dibanding angka nasional. Salah satu penyebab langsung lahirmati adalah hypokxia yaitu kekurangan oksigen dalam tubuh ibu, akibat dari ibu hamil terpapar asaprokok. Di Kota Ambon, 65% rumah tangga mempunyai 1 orang perokok, dan hampir semua perokok (90%)merokok di rumah. Angka ini lebih tinggi dari angka nasional. Faktor lain menyebabkan lahir mati adalahkualitas antenatal care, umur, paritas anemia ibu selama hamil, pendidikan ibu yang rendah.Tujuan: Penelitian ini untuk mengetahui apakah ibu hamil perokok pasif merupakan faktor risiko kejadianlahir mati.Metode: Penelitian observasional dengan rancangan kasus-kontrol. Lokasi penelitian pada 3 RS di KotaAmbon yaitu: RSUD dr. M. Haulussy, RS. Al-Fatah, RS. Sumber Hidup. Subjek penelitian 1:1 69 lahir mati(kasus) dan 69 lahir hidup (kontrol) pada bulan Januari sampai dengan bulan Desember 2007. Pengambilansampel dengan cara non probability sampling, ditentukan secara quota sample . Analisis data terdiridari analisis univariabel, analisis bivariabel menggunakan uji chi-square (χ²), stratifikasi serta analisismultivariabel menggunakan regresi logistik.Hasil dan Pembahasan: Ada hubungan yang bermakna antara ibu hamil perokok pasif dengan kejadianlahir mati. Analisis bivariabel OR=3,36 (95% CI=1,20-5,41) analisis multivariabel OR=2,8 (1,01-7,94). Faktorrisiko lain yang mempengaruhi kejadian lahir mati adalah: Kualitas antenatal care mempunyai nilai OR=3,2(95% CI=1,39-7,52), ibu hamil anemia OR=2,3 (95% CI=1,20-5,41) dan pendidikan OR=2,42 ( 1,15-5,10).Saat analisis strativikasi, ibu tidak anemia mempunyai hubungan bermakna dengan lahir mati OR=5,7 (95%CI 1,10-55,22). Umur, paritas dan pendidikan bukan merupakan faktor risiko lahir mati di Kota Ambon.Kesimpulan : Ibu hamil perokok pasif merupakan faktor risiko terhadap kejadian lahir mati di Kota Ambon.Faktor lain yang menyebabkan lahir mati adalah kualitas antenatal care dan anemia ibu hamil.Kata kunci: ibu hamil, perokok pasif, lahir mati.1 Air Selobar Community Health Center, Ambon Health Office, Maluku Province2 Obstetric and Gynecology Division, Faculty of Medicine,Gadjah Mada University, Yogyakarta3 Maternal and Child Health-Reproductive Health, Graduate Program,Faculty of Medicine, Gadjah Mada University, Yogyakarta

PENGARUH PERAWATAN KEHAMILAN DAN PERSALINAN DENGAN KEJADIAN KEMATIAN NEONATAL. Magdalena Lena Paunno
JURNAL KESEHATAN REPRODUKSI Vol 8, No 3 (2021)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.61550

AbstractBackground: Maternal care interventions (ANC) can reduce perinatal mortality by up to 75%. Neonatal mortality is closely related to the first 100 days of life starting from conception, the intra-uterine period, or in the womb for 230 days. Neonatal mortality can also be caused by various factors based on the cause, namely: Direct causes related to complications during the newborn and indirect causes related to the mother are hypertension, anemia in pregnancy, quality of care during pregnancy and/or delivery, and maternal mortality. Maternal mortality has some characteristics, such as Condition 4 is categorized as too much (namely too young; too old; too close range; and too much), while Condition 3 is categorized as delay, (being late to recognize the danger signs of childbirth; being late in making decisions; being late in handling by health workers in health facilities). Neonatal mortality refers to death in the 1st 28 days of life. Neonatal deaths are divided into two types, such as early neonatal mortality refers to death before 7 days or 0-6 days, and late neonatal mortality to death on days 7-28. The highest rate of neonatal deaths is perinatal mortality, where intrauterine fetal death occurs from 28 weeks of gestation to the 1st 7 days of life.Objective: This study was to determine the risk of neonatal death associated with prenatal care and delivery, as well as other factors.Research Methods: This type of observational research with a quantitative approach is a case-control research design. In this study, the case was neonatal mortality and the exposure was pregnancy care and delivery care. Calculation of the case-control sample size without matching by considering previous studies with a minimal sample studied for 1:1 control cases. Thus, the total number of samples is 86 people. By taking non-probability sampling, it is determined by quota sample.Results and Discussion: There is a relationship between Neonatal mortality with a P-value of 0.3150, which means being late in recognizing danger signs has a risk of 3.150 times The Asymptotic Significance (2-sided) value shows a P-value = 0.011 which means that <0.05 then the OR value declared significant or meaningful. While 95% CI showed a value of 1.306-7.600. There is a relationship between age and Neonatal mortality with the Odds value of Haenszel's Mantel Ratio indicated by the Estimate value, which is 3,496, which means that age in the risk category <25 years and >35 years has a risk of 3.496 times that of the age with no risk category 25-35 years. The Asymptotic Significance (2-sided) value shows a P-value = 0.006 which means that <0.05, the OR value is declared significant or significant. While the 95% CI showed a value of 1.438-8.498. There is a relationship between danger signs and Neonatal Mortality, the Odds value of the Haenszel Coat Ratio is indicated by the Estimate value, which is 3.150, which means that the variable late recognizes danger signs has a risk of 3.150 times that of not recognizing danger signs late. The Asymptotic Significance (2-sided) value shows a P-value = 0.011, which means that <0.05, the OR value is declared significant or significant. While 95% CI showed a value of 1.306-7.600.Conclusion: Pregnancy care and other factors, such as age and danger signs, have a risk of neonatal death compared to delivery care. Pregnant women of reproductive age have a higher risk than the group of live neonates. In the stillbirth group, pregnant women who were late in recognizing danger signs were higher than in the live neonates group. Keywords: Neonatal Death; Pregnancy and Delivery Care; RSUD dr. Haulussy Ambon.AbstrakLatar Belakang Intervensi perawatan ibu hamil (ANC) dapat menurunkan kematian perinatal hingga 75%. Kematian neonatal berkaitan erat dengan100 hari pertama kehidupan yang dimulai sejak konsepsi, masa intra uteri atau dalam kandungan selama 230 hari. Kematian neonatal juga dapat disebabkan oleh berbagai faktor berdasarkan penyebab yaitu: Penyebab langsung berhubungan dengan komplikasi saat bayi baru lahir dan penyebab tidak langsung berhubungan dengan ibu adalah hipertensi, anemia dalam kehamilan, kualitas perawatan selama hamil, persalinan dan karakteristik ibu meliputi keadaan 4 terlalu (terlalu: muda; tua; jarak dekat; banyak) dan keadaan 3 terlambat yaitu terlambat mengenal: tanda bahaya; mengambil keputusan; terlambat ditolong. Kematian Neonatal adalah kematian terjadi saat bayi baru lahir sampai 28 hari. Kematian neonatal dibagi menjadi 2, yaitu kematian neonatal dini yang terjadi selama minggu pertama kehidupan umur 0-6 hari setelah lahir dan kematian neonatal lanjut yang terjadi umur 7-28 hari setelah lahi. Penyumbang kematian neonatal adalah kematian perinatal perinatal dimana tefjadi kematian janin intra uteri mulai dari kehamilan 28 minggu sampai 7 hari pertama kehidupan.Tujuan: Penelitian ini untuk mengetahui risiko kematian neonatal yang berhubungan dengan perawatan kehamilan dan persalinan, serta faktor lainnya.Metode :Jenis penelitian observasional dengan pendekatan kuantitatif adalah rancangan penelitian Kasus-Kontrol. Dalam penelitian ini sebagai kasus adalah kematian neonatal dan paparan adalah perawatan kehamilan dan perawatan persalian. Perhitungan besar sampel kasus kontrol tanpa matching dengan mempertimbangkan penelitian sebelumnya dengan sampel minimal yang diteliti untuk kasus kontrol 1:1. sehingga jumlah sampel total adalah 86 orang. Dengan Cara pengambilan non probability sampling, ditentukan secara quota sample.Hasil dan Pembahasan: Adanya hubungan antara kematian Neonatal dengan nilai Pvalue 0,3150 yang artinya terlambat mengenal tanda bahaya mempunyai risiko sebesar 3,150 kali lipat Nilai Asymptotic Significance (2-sided) menunjukkan nilai Pvalue=0,011 yang berarti bahwa <0,05 maka nilai OR dinyatakan signifikan atau bermakna. Sedangkan 95% CI menunjukkan nilai 1,306-7,600. Ada hubungan antara umur dengan kematian Neonatal dengan atas nilai Odds Rasio Mantel Haenszel ditunjukkan dengan nilai Estimate yaitu 3,496 yang artinya umur dengan kategori beresiko <25 tahun dan >35 tahun mempunyai resiko sebesar 3,496 kali lipat dari pada umur dengan kategori tidak beresiko 25-35 tahun. Nilai Asymptotic Significance (2-sided) menunjukkan nilai Pvalue=0,006 yang berarti bahwa <0,05 maka nilai OR dinyatakan signifikan atau bermakna. Sedangkan 95% CI menunjukkan nilai 1,438-8,498. Ada hubungan tanda bahaya dengan Kematian Neonatal nilai Odds Rasio Mantel Haenszel ditunjukkan dengan nilai Estimate yaitu 3,150 yang artinya variabel terlambat mengenal tanda bahaya mempunyai resiko sebesar 3,150 kali lipat dari tidak terlambat mengenal tanda bahaya. Nilai Asymptotic Significance (2-sided) menunjukkan nilai Pvalue=0,011 yang berarti bahwa <0,05 maka nilai OR dinyatakan signifikan atau bermakna. Sedangkan 95% CI menunjukkan nilai 1,306-7,600.Kesimpulan: perawatan kehamilan serta faktor lainnya yaitu umur dan tanda bahaya memiliki risiko 1kali beriko terhadap kematian Neonatal dibandingkan dengan perawatan Persalinan. lebih besar ibu hamil umur reproduksi beresiko di bandingkan dengan kelompok neonatal hidup.Pada kelompok lahir mati lebih besar ibu hamil yang terlambat mengenal tanda bahaya di banding kelompok neonatal hidup. Kata kunci: Kematian Neonatal; Perawatan kehamilan dan persalinan; RSUD dr. Haulussy Ambon.

Determinan Ruptur Perineum Ibu Inpartu Kala II Persalinan di Ruang Bersalin Srumah Sakit Sumber Hidup Kota Ambon Tahun 2019 Magdalena Clara Paunno; Wilma Mamuly
2-TRIK: TUNAS-TUNAS RISET KESEHATAN Vol 10, No 2 (2020): Mei 2020
Publisher : FORUM ILMIAH KESEHATAN

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/2trik10208

Labor and delivery are normal physiological events. Childbirth often results in birth canal injury. Perineal tears occur in almost all first deliveries and are not uncommon in subsequent deliveries. Dangers and complications of perineal rupture include bleeding, infection and dyspareunia (pain during sexual intercourse). The general objective of this study was to determine the Determinant of Perineum Ruptur for Second Part of Inpartu Mother Delivery in the Birth Room of Sumber Hidup Hospital, Ambon City in 2019. This research was a descriptive analytic cross sectional approach. with the proportion of each variable to be examined, bivariate analysis using Method X 2 using categorical data (nominal and ordinal). The results of the bivariate analysis found a relationship between baby weight (p = 0.003), position of being stranded (p = 0.000), punctuality of time (p = 0.000), education of maternal weight gain during pregnancy (p = 0.000) with the degree of rupture, and there was no relationship between education on pregnancy exercise (p = 0.768), mother's age (p = 0, 640) with the degree of rupture. Keywords: determinant perineal rupture; second stage of labor ABSTRAK Persalinan dan kelahiran merupakan kejadian fisiologi yang normal. Persalinan seringkali mengakibatkan perlukaan jalan lahir. Robekan perineum terjadi pada hampir semua persalinan pertama dan tidak jarang pada persalinan berikutnya. Bahaya dan komplikasi ruptur perineum antara lain perdarahan, infeksi dan dyspareunia (nyeri selama berhubungan seksual). Tujuan umum dari penelitian ini adalah untuk mengetahui Determinan Ruptur Perineum Ibu Inpartu Kala II Persalinan Di Ruang Bersalin Rumah Sakit Sumber Hidup Kota Ambon Tahun 2019. Penelitian ini merupakan penelitian deskriptif analitik pendekatan cross sectional Studi design penelitian ini dilakukan dengan cara Analisa univariat untuk mengetahui distribusi frekuensi dengan proporsi dari masing-masing variabel yang akan diteliti, Analisa bivariat dengan menggunakan Metode X 2 menggunakan data kategorik (nominal dan ordinal). Hasil analisis bivariat didapatkan adanya hubungan antara berat badan bayi ( p= 0 ,003), posisi meneran ( p= 0 ,000), ketepatan waktu meneran ( p= 0 ,000), edukasi penambahan berat badan ibu saat hamil ( p= 0 ,000) dengan derajat ruptur, dan tidak ada hubungan antara edukasi senam ibu hamil ( p= 0 ,768), umur ibu (p= 0 ,640) dengan derajat ruptur. Kata kunci: determinan ruptur perineum; kala II persalinan

Upaya Peningkatan Peran Kader Posyandu dalam Pelaksanaan Lima Program Terpadu Melalui Implementasi Sistem Lima Meja Magdalena Paunno; Lea Mediatrix Janwarin
Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) Vol 5, No 5 (2022): Volume 5 No 5 Mei 2022
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jkpm.v5i5.5537

ABSTRAK Pos pelayanan terpadu (Posyandu) adalah perpanjangan tangan Puskesmas yang memberikan pelayanan dan pemantauan kesehatan yang dilaksanakan secara terpadu. Posyandu merupakan salah satu bentuk upaya kesehatan bersumber daya masyarakat (UKBM) dengan sasaran seluruh masyarakat/keluarga, utamanya adalah bayi baru lair, bayi, balita, ibu hamil, ibu menyusui, ibu nifas, dan pasangan usia subur (PUS). Posyandu Balita Namakoli terletak di Negeri Alang, Kabupaten Maluku Tengah dan merupakan jejaring pelayanan kesehatan dari Puskesmas induk yaitu Puskesmas Alang. Permasalahan yang terjadi di Posyandu tersebut adalah dari sisi pelaksana posyandu yaitu kader, dimana pergantian kader Posyandu berdampak pada perbedaan tingkat pengetahuan antar kader dan belum optimalnya pelaksanaan Posyandu dengan lima program terpadu melalui implementasi sistem pelayanan lima meja. Tujuan dari pengabdian ini adalah untuk meningkatkan pengetahuan dan keterampilan kader Posyandu. Untuk itu, dalam kegiatan pengabdian ini metode pelaksanaan yang digunakan adalah refreshing kader dan role play lima program terpadu melalui implementasi sistem lima meja. Berdasarkan hasil evaluasi diketahui bahwa terjadi peningkatan pengetahuan dan keterampilan kader setelah dilakukan kegiatan pengabdian. Hal ini dapat dilihat dari nilai post-test yang menunjukkan bahwa pengetahuan mitra terkait dengan sistem pelayanan lima meja meningkat 95% dari nilai pre-test dan didukung dengan hasil dari lembar observasi kesesuaian pelaksanaan kegiatan lima meja yang sudah dilaksanakan dengan baik oleh kader pada saat role play. Dari hasil tersebut, diharapkan agar terjadi peningkatan peran kader dalam pelaksanaan lima program terpadu melalui implementasi sistem pelayanan lima meja di Posyandu. Kata Kunci: Kader, Posyandu. Lima Program Terpadu, Sistem Lima Meja ABSTRACT Integrated service post (Posyandu) is an extension of the Puskesmas that provides health services and monitoring that is carried out in an integrated manner. Posyandu is a form of community-based health effort (UKBM) targeting the entire community/family, especially newborns, infants, toddlers, pregnant women, breastfeeding mothers, postpartum mothers, and couples of childbearing age (PUS). The Posyandu Toddler Namakoli is located in Negeri Alang, Central Maluku Regency, and is a network of health services from the main health center, namely Alang Health Center. The problems that occur in the Posyandu are from the posyandu implementing side, namely cadres, where the replacement of Posyandu cadres has an impact on differences in the level of knowledge between cadres and the implementation of Posyandu with five integrated programs is not optimal through the implementation of a five-table service system. The purpose of this service is to increase the knowledge and skills of Posyandu cadres. For this reason, in this service activity, the implementation method used is refreshing cadres and role-play of five integrated programs through the implementation of the five-table system. Based on the results of the evaluation, it was found that there was an increase in the knowledge and skills of cadres after service activities were carried out. This can be seen from the post-test score which shows that the knowledge of partners related to the five-table service system increased by 95% from the pre-test value and was supported by the results of the observation sheet on the suitability of the five-table activity implementation that had been carried out well by the cadres at the time of the role. play. From these results, it is hoped that there will be an increase in the role of cadres in the implementation of five integrated programs through the implementation of a five-desk service system in Posyandu. Keywords: Cadre, Posyandu. Five Integrated Programs, Five Desk System

PENGARUH IBU HAMIL PEROKOK PASIF TERHADAP KEJADIAN LAHIR MATI DI KOTA AMBON Magdalena Paunno; Ova Emilia; Abdul Wahab
JURNAL KESEHATAN REPRODUKSI Vol 2, No 3 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

PENGARUH IBU HAMIL PEROKOK PASIF TERHADAPKEJADIAN LAHIR MATI DI KOTA AMBONMagdalena Paunno1, Ova Emillia2, Abdul Wahab3ABSTRACTBackground: Intervention in the care for pregnant women can reduce antenatal mortality until 75%.Antenatal Care (ANC) in Ambon municipality is categorized good if compared from the mean rate ofnational level, that is, Visit 1 (89%) and Visit 4 (87.76%); however, the incidence of stillbirths in Ambonis still considered high. Data about the incidence of stillbirths in three hospitals of Ambon showed thatthere were 44.2 stillbirths per 1000 live births while national data in 2003 showed that there were only9.6 stillbirths per 1000 live births. The direct cause of stillbirth is hypoxia, that is, the lack of oxygenin a pregnant woman’s body due to the exposure of cigarette smoke. In Ambon municipality, 65% ofhouseholds have 1 active smoker and almost all of the smokers (90%) smoke inside the house. This rateof course exceeds the national rate. In addition, other factors causing stillbirth are the quality of antenatalcare, age, parity, anemia and women’s educational level.Objective: To study whether passive smoking during pregnancy is a risk factor of the incidence of stillbirths.Method: This was an observational study with case-control study design. Study sites were in three hospitalsof Ambon municipality, namely Dr. M. Haulussy District Hospital, Al-Fatah Hospital, and Sumber HidupHospital. Subjects were divided into two groups which were case and control with comparison of 1:1 (69stillbirths as case and 69 live births as control) from January to December 2007. Samples were taken usingnon probability sampling which was determined with quota sample. The analysis of quantitative dataused univariable analysis, bivariable analysis with chi-square test (χ²) and stratification, and multivariableanalysis with logistic regression.Result and Discussion: There was a significant relationship between passive smoking during pregnancyand the incidence of stillbirth based on bivariable analysis with OR=3.36 (95% CI=1.20-5.41) while basedon multivariable analysis with OR=2.8 (1.01-7.94). Other risk factors that affected the incidence of stillbirthwere the quality of antenatal care with OR=3.2 (95% CI=1.39-7.52) and anemia during pregnancy withOR=2.3 (95% CI=1.20-5.41). Meanwhile, stratification analysis showed that non anemic women duringpregnancy was significantly related to stillbirths with OR=5.7 (95% CI 1.10-55.22). However, age, parity andeducation were not the risk factors of the incidence of stillbirth in Ambon.Conclusion: Passive smoking during pregnancy was a risk factor of the incidence of stillbirth in Ambonmunicipality. Other factors that caused the incidence of stillbirths were the quality of antenatal care andanemia. However, age, and parity were not the risk factors of the incidence of stillbirths in Ambon.Keywords: pregnant woman, passive smoking, stillbirthINTISARILatar belakang: Intervensi pada perawatan ibu hamil dapat menurunkan kematian perinatal hingga 75%.ANC di Kota Ambon dikategorikan baik, bila dilihat angka rata-rata secara nasional yaitu K1 89%, K4 87,76%namun, kejadian lahir mati sangat tinggi dibanding angka nasional. Salah satu penyebab langsung lahirmati adalah hypokxia yaitu kekurangan oksigen dalam tubuh ibu, akibat dari ibu hamil terpapar asaprokok. Di Kota Ambon, 65% rumah tangga mempunyai 1 orang perokok, dan hampir semua perokok (90%)merokok di rumah. Angka ini lebih tinggi dari angka nasional. Faktor lain menyebabkan lahir mati adalahkualitas antenatal care, umur, paritas anemia ibu selama hamil, pendidikan ibu yang rendah.Tujuan: Penelitian ini untuk mengetahui apakah ibu hamil perokok pasif merupakan faktor risiko kejadianlahir mati.Metode: Penelitian observasional dengan rancangan kasus-kontrol. Lokasi penelitian pada 3 RS di KotaAmbon yaitu: RSUD dr. M. Haulussy, RS. Al-Fatah, RS. Sumber Hidup. Subjek penelitian 1:1 69 lahir mati(kasus) dan 69 lahir hidup (kontrol) pada bulan Januari sampai dengan bulan Desember 2007. Pengambilansampel dengan cara non probability sampling, ditentukan secara quota sample . Analisis data terdiridari analisis univariabel, analisis bivariabel menggunakan uji chi-square (χ²), stratifikasi serta analisismultivariabel menggunakan regresi logistik.Hasil dan Pembahasan: Ada hubungan yang bermakna antara ibu hamil perokok pasif dengan kejadianlahir mati. Analisis bivariabel OR=3,36 (95% CI=1,20-5,41) analisis multivariabel OR=2,8 (1,01-7,94). Faktorrisiko lain yang mempengaruhi kejadian lahir mati adalah: Kualitas antenatal care mempunyai nilai OR=3,2(95% CI=1,39-7,52), ibu hamil anemia OR=2,3 (95% CI=1,20-5,41) dan pendidikan OR=2,42 ( 1,15-5,10).Saat analisis strativikasi, ibu tidak anemia mempunyai hubungan bermakna dengan lahir mati OR=5,7 (95%CI 1,10-55,22). Umur, paritas dan pendidikan bukan merupakan faktor risiko lahir mati di Kota Ambon.Kesimpulan : Ibu hamil perokok pasif merupakan faktor risiko terhadap kejadian lahir mati di Kota Ambon.Faktor lain yang menyebabkan lahir mati adalah kualitas antenatal care dan anemia ibu hamil.Kata kunci: ibu hamil, perokok pasif, lahir mati.1 Air Selobar Community Health Center, Ambon Health Office, Maluku Province2 Obstetric and Gynecology Division, Faculty of Medicine,Gadjah Mada University, Yogyakarta3 Maternal and Child Health-Reproductive Health, Graduate Program,Faculty of Medicine, Gadjah Mada University, Yogyakarta

FAKTOR-FAKTOR YANG MEMPENGARUHI RENDAHNYA IBU BERSALIN MENGGUNAKAN JAMINAN PERSALINAN DI WILAYAH KERJA PUSKESMAS RIJALI KOTA AMBON TAHUN 2020 Magdalena Paunno
MOLUCCAS HEALTH JOURNAL Vol 3, No 1 (2021)
Publisher : Lembaga Penerbitan Fakultas Kesehatan Universitas Kristen Indonesia Maluku

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54639/mhj.v3i1.608

ABSTRACTMaternity insurance (Jampersal) is a program used to increase access to antenatal care, deliveries carried out by health workers to mothers by removing financial barriers for all deliveries from residents who do not have health insurance in order to reduce maternal mortality and infant mortality. The research design used was a cross sectional approach. This research was conducted from January to February 2020 in the working area of the Rijali Health Center with a sample of 86 respondents. The results showed that there was no relationship between knowledge and the use of jampersal with p value = 0.266. There is no relationship between access to information and the use of jampersal with p value = 0.021. There is a relationship between experience and use of jampersal with p value = 0.001. Suggestions are given to puskesmas officers to communicate educational information (KIE), counseling, counseling and motivation that creates mutual trust in order to create a sense of comfort, so that every pregnant woman during childbirth wants to follow, using the Jampersal program so that every delivery occurs in health facilities assisted by health workers. Keywords : Knowledge, Access to Information, Experience, Use of Jampersal ABSTARKJaminan persalinan (Jampersal) merupakan program yang digunakan untuk meningkatkan akses pemeriksaan kehamilan, persalinan yang dilakukan oleh tenaga kesehatan kepada ibu dengan menghilangkan hambatan finansial diperuntukkan bagi seluruh persalinan dari penduduk yang belum memiliki Jaminan Kesehatan dalam rangka menurunkan angka kematian ibu dan angka kematian bayi. Rancangan penelitian yang digunakan adalah pendekatan Cross sectional. Penelitian ini dilakukan dari bulan januari sampai bulan februari tahun 2020 di wilayah kerja Puskesmas Rijali dengan jumlah sampel 86 responden. Hasil penelitian menunjukkan bahwa tidak ada hubungan antara pengetahuan dengan penggunaan jampersal dengan nilai p value = 0,266. Tidak ada hubungan antara akses informasi dengan penggunaan jampersal dengan nilai p value = 0, 021. Ada hubungan antara pengalaman dengan penggunaan jampersal dengan nilai p value = 0,001. Saran disampaikan bagi petugas puskesmas untuk melakukan komunikasi informasi edukasi (KIE), penyuluhan, konseling serta motivasi yang menimbulkan saling percaya agar dapat menimbulkan rasa nyaman, sehingga setiap ibu hamil saat bersalin mau mengikuti, menggunakan program jampersal agar tiap persalinan terjadi di fasilitas kesehatan ditolong oleh tenaga kesehatan. Kata Kunci : Pengetahuan, Akses Informasi, Pengalaman, Penggunaan Jampersal

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PEMBERIAN IMUNISASI DASAR LENGKAP BAYI 0-11 BULAN DI WILAYAH PUSKESMAS TEPA KECAMATAN PULAU-PULAU BABAR KABUPATEN MALUKU BARAT DAYA TAHUN 2019 Magdalena Paunno
MOLUCCAS HEALTH JOURNAL Vol 3, No 2 (2021)
Publisher : Lembaga Penerbitan Fakultas Kesehatan Universitas Kristen Indonesia Maluku

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54639/mhj.v3i2.655

ABSTRACTImmunization is an attempt to provide immunity to an infant or child by inserting a vaccine into the body so that the body makes antibodies to prevent certain diseases. The immunization program is a success in preventing infectious diseases such as diphtheria, pertussis, and tetanus. This study aims to determine the factors associated with the Completeness of Basic Immunization in Infants in the Work Area of Tepa Health Center, Babar Pulau Subdistrict, MBD Regency. The research method used is the Analytic method with cross sectional approach. Sampling using total sampling with a sample size of 71 samples. Data were collected by interview using a questionnaire. Data collection using a questionnaire. Data analysis includes univariate and bivariate analysis. The results of bivariate analysis found a relationship between knowledge and completeness of basic immunization (p = 0.007), distance (p = 0.004), birth attendants (p = 0.001), vaccine availability was found to be associated with immunization completeness (p = 0,000). The conclusion of this study is that there is a significant relationship between knowledge, distance, delivery assistance and availability of vaccines with basic immunization completeness in the Tepa Health Center Work Area. Suggestions for respondents to be able to use health service facilities and facilities to obtain health services. Keywords: Completeness of Basic Immunization, Knowledge, Distance, Birth Assistance, Vaccine Availability ABSTARKImunisasi adalah usaha memberikan kekebalan pada bayi atau anak dengan memasukan vaksin kedalam tubuh agar tubuh membuat zat anti bodi untuk mencegah penyakit tertentu.Program imunisasi merupakan sebuah keberhasilan dalam mencegah penyakit infeksi yaitu difteri, pertussis, dan tetanus. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan pemberian imunisasi dasar lengkap bayi 0-11 bulan Di Wilayah Puskesmas Tepa Kecamatan Pulau-Pulau Babar Kabupaten Maluku Barat Daya. Metode penelitian yang di gunakan adalah metode Analitik dengan pendekatan cross sectional. Pengambilan sampel menggunakan Total sampling dengan jumlah sampel yaitu 71 sampel. Data dikumpulkan dengan cara wawancara menggunakan kuesioner. Pengumpulan data menggunakan kuesioner.Analisis data mencakup analisis univariat dan bivariat.Hasil analisis bivariat didapatkan adanya hubungan antara pegetahuan dengan kelengkapan imunisasi dasar (p = 0,007), jarak (p = 0,004), penolong persalinan (p = 0,001), ketersediaan vaksin ditemukan hubungan dengan kelengkapan imunisasi (p = 0,000). Kesimpulan penelitian ini adalah adanya hubungan yang signifikan antara pengetahuan, jarak, penolong persalinan dan ketersediaan vaksin dengan kelengkapan imunisasi dasar di Wilayah Kerja Puskesmas Tepa.Saran bagi responden agar dapat memanfaatkan fasilitas dan sarana pelayanan kesehatan untuk mendapatkan pelayanan kesehatan.Kata Kunci : Imunisasi dasar lengkap, Pengetahuan, Jarak, Penolong Persalinan, Ketersediaan Vaksin.

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