Factors Affecting Village Midwives Work Performance in Conducting Early Detection of High Risk Pregnancy in the Antenatal Care in South Bengkulu District - Harlen Yunita; Tjahjono Kuntjoro; Cahya Tri Purnami (Jurnal Manajemen Kesehatan Indonesia, 2013)
Pelayanan antenatal adalah memberikan pelayanan kesehatan bagi ibu hamil dan janinnya sesuai standar minimal 7T serta minimal empat kali pemeriksaan selama kehamilan. Standar waktu tersebut untuk menjamin perlindungan kepada ibu hamil, berupa deteksi dini faktor risiko, pencegahan dan penanganan komplikasi. Berdasarkan cakupan Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS-KIA), angka kematian ibu dan bayi serta survei awal terhadap bidan desa disimpulkan bahwa masih rendahnya kineja bidan desa.Tujuan penelitian adalah mengetahui faktor apa saja yang mempengaruhi kinerja bidan desa dalam deteksi dini resiko tinggi ibu hamil pada pelayanan antenatal. Jenis penelitian bersifat explanatory research dengan pendekatan cross sectional. Pengumpulan data menggunakan kuesioner terstruktur danobservasi. Populasi penelitian adalah bidan desa, dengan sampel 93 responden diambil denganteknik simple random sampling. Hasil penelitian menunjukkan 73,1% bidan desa pada rentangumur 25-35 tahun dan 37,6% rentang masa kerja 36-60 bulan. Analisis bivariat dengan tabulasisilang dan uji Pearson Product Moment menunjukkan bahwa variabel yang berhubungan dengankinerja yaitu pengetahuan (ρ=0,000), motivasi (ρ=0,004), persepsi supervisi bidan koordinator(ρ=0,016), persepsi beban kerja (ρ=0,047). Analisis multivariat dengan uji regresi logistikberganda menunjukkan adanya pengaruh bersama-sama variabel pengetahuan dan saranaprasarana dengan nilai signifikansi 0,000 dan R2 0,394, berarti 39,4% variabel kinerja dapatdijelaskan oleh variasi dari kedua variabel tersebut. Dinas Kesehatan Kabupaten diharapkanmemberi pelatihan, melengkapi sarana prasarana bidan desa sebelum bekerja di desa,membentuk tim atau panitia sebagai wadah konsultasi. Puskesmas agar melengkapi saranapendokumentasian, kepala puskesmas dan bidan koordinator aktif mengadakan pembinaan. Antenatal care provided health service for pregnant women and their fetuses according to theminimum standard of 7T, and minimum of four examinations during pregnancy. These standards were intended to assure protection to pregnant women, such as risk factors early detection,complication prevention and management. Based on the coverage of maternal and children local area monitoring (PWS-KIA), maternal and infant mortality rates, and preliminary survey to village midwives, it was concluded that work performance of village midwives was still inadequate. Objective of this study was to identify factors affecting work performance of village midwives in conducting early detection of high risk pregnancy in the antenatal care. This was an explanatory research with cross sectional approach. Data were collected using structuredquestionnaire and observation. Study population was village midwives. Samples consisted of 93respondents who were selected using simple random sampling technique. Results of the studyshowed that 73.1% of village midwives’ age were in the range of 25-35 years old, and 37.6% of village midwifes duration of work were in the range of 36-60 months. Bivariate analysis withcross tabulation and Pearson Product Moment test indicated that variables related to workperformance were knowledge (p= 0.000), motivation (p= 0.004), perception on supervision ofcoordinator midwives (p= 0.016), and perception on workload (p= 0.047). Multivariate analysisusing multivariate logistic regression test indicated common effect of knowledge and facilitiesvariables with significance value of 0.000 and r 2 = 0.394; it meant that 39.4% of workperformance variable could be explained by variation of those two variables. District healthoffice is expected to provide training, to complete facilities for village midwives before startingto work in the village; to form team or committee as a consultation place. Puskesmas is expected to complete documentation facilities; head of puskesmas and coordinator midwives are advised to actively doing supervision.