Factors Associated to the Performance of Village Midwives in the Institutionalization of Local Area Monitoring in Maternal and Child Health (MCH- LAM) at Majalengka District West Java Province - Wawan Kurniawan; Cahya Tri Purnami; Lucia Ratna Kartika Wulan (Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro, 2014)
Upaya pemantauan cakupan pelayanan KIA yang dikenal dengan Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS-KIA) merupakan salah satu tugas bidan. Pelaksanaan PWS-KIA dengan baik dapat digunakan untuk melakukan tindak lanjut dan perbaikan pelayanan KIA. Namun berdasarkan data pelaksanaan PWS-KIA tahun 2011 hanya 40% bidan yang melakukan tahapan kegiatan PWS KIA secara lengkap. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kinerja Bidan Desa dalam Pelembagaan PWS-KIA di Wilayah KabupatenMajalengka Provinsi Jawa Barat Tahun 2011. Penelitian ini merupakan penelitian observasional dengan pengumpulan data secara cross sectional. Populasi penelitian ini adalah semua bidan desa yang ada di wilayah kerja Dinas Kesehatan Kabupaten Majalengka, yaitu 360 bidan tersebar di 31 Puskesmas dengan sampel sebanyak 190 secara simple random sampling. Pengumpulan data dilakukan dengan wawancara dan observasi menggunakan kuesioner dan lembar pengamatan serta analisis data dilakukan secara univariat, bivariat, dan multivariat. Dari hasil penelitian didapatkan bahwa kurang dari setengahnya (42,1%) Kinerja Bidan Desa dalam pelembagaan PWS-KIA kurang baik. Dari hasil analisis didapatkan variabel yang berhubungan dengan kinerja bidan dalam pelembagaan PWS-KIA di wilayah Kabupaten Majalengka Tahun 2011 adalah pengetahuan, ketersediaan sarana dan fasilitas PWS-KIA, pembinaan Kepala Puskesmas, dukungan Kepala Desa (nilai p < 0,05). Secara bersama-sama variabel yang berpengaruh paling besar adalah dukungan/ketersediaan sarana dan fasilitas PWS KIA dengan nilai exp (â)=9,784 (nilai p =0,000). Disarankan kepada Dinas Kesehatan Kab. Majalengka/Puskesmas, dalam rangka meningkatkan kinerja bidan desa dalam pelembagaan PWS-KIA adalah memberikan dukungan sarana dan fasilitas PWS-KIA berupa penyediaan buku pedoman PWS-KIA, alat tulis/perlengkapan kantor, peralatan komputer; pelatihan pengelolaan data PWS-KIA berbasis komputer; pembekalan bidan desa pada awal tugas; dan supervisi oleh Kepala Puskesmas kepada bidan desa; serta koordinasi kepada Kepala Desa maupun kepada Camat dalam rangka dalam pelembagaan PWS-KIA. Monitoring effort on maternal and child health (KIA) service coverage known as local area monitoring of maternal and child health (PWS-KIA) was one of midwives duties. Good implementation of PWS-KIA could be used to follow up and improve KIA service. However, based on PWS-KIA implementation data in 2011, only 40% midwives who performed complete steps of PWS-KIA activities. Objective of this study was to analyze factors related to work performance of midwives to institutionalize PWS-KIA in Majalengka district area of West Java province, 2011. This was an observational study, and data was collected cross sectionally. Study population was all village midwives who resided in the work area of Majalengka district health office. These 360 midwives were distributed in 31 primary healthcare centers. Samples were 190 midwives. They were selected using simple random sampling method. Data collection was done through interview and observation using questionnair and observation form. Univariate, bivariate, and multivariate analysis were applied in the data analysis. Results of the study showed that work performance of less than a half (42.1%) of village midwives who institutionalized PWS-KIA was inadequate. Variables related to work performance of midwives who institutionalized PWS-KIA in Majalengka district area in 2011 were knowledge, availability of PWS- KIA facility, supervision of the head of puskesmas, and village leader support (p< 0.05). The most influencing variables was support/ the availability of PWS-KIA facilities (exp (â)= 9.784, p= 0.000). Suggestions for Majalengka district health office or primary healthcare centers are to provide PWS-KIA facility support to improve work performance of village midwives who institutionalized PWS-KIA; the support is in the form of providing PWS-KIA guideline books, stationery, computer devices; to conduct training on computer based PWS-KIA management data; to provide training for village midwives in their first duty; to conduct supervision by the head of primary healthcare center to village midwives; .to conduct coordination with village leader and sub district leader for PWS-KIA institutionalization.