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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 928 Documents
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Analisis Data Riskesdas 2007/2008: Kontribusi Karakteristik Ibu terhadap Status Imunisasi Anak di Indonesia Hastono, Sutanto Priyo
Kesmas Vol. 4, No. 2
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Cakupan imunisasi terbukti dapat menurunkan secara signifikan kejadian kesakitan dan kematian yang diakibatkan penyakit tersebut, tetapi di Indonesia cakupan tersebut tergolong rendah. Tujuan penelitian adalah mengetahui hubungan karakteristik ibu dengan status imunisasi anak di Indonesia. Disain yang digunakan dalam penelitian adalah potong lintang dengan sampel anak yang berumur antara 1-2 tahun yang tinggal di wilayah Indonesia. Sumber data sekunder yang digunakan adalah Riskesdas Depkes tahun 2007/2008. Proporsi anak usia 12-24 bulan yang mendapat imunisasi lengkap adalah 56,2 % (95% CI :55,1-57,3). Pendidikan ibu dan pendidikan suami ditemukan berhubungan secara bermakna dengan status imunisasi dasar pada anak. Hasil analisis multilevel menemukan bahwa kontribusi variabel level kabupaten (92,5 %) jauh lebih besar daripada level individu (7,5 %). Disarankan pemerintah bersama masyarakat berupaya untuk meningkatkan pendidikan. Departemen Kesehatan dan sektor terkait disarankan menyusun pedoman upaya memobilisasi imunisasi dengan sasaran penyuluhan dan kampanye imunisasi secara tepat. The escalation on the immunization coverage has been proved to significantly reduce the morbidity and mortality of the immunized diseases. However, in Indonesia the coverage of immunization is still low. The research purpose is to understand the role of mother’s characteristics to child immunization status in Indonesia. This is an advance analysis of Riskesdas data 2007/2008. Sample of the research is children age 12-24 months. The results showed that only 56.2% children had had complete immunization. Multivariate analysis shows that characteristic factors, such as mother’s and husband’s education are significant to child immunization status. The result of Multilevel Analysis shows that the role of characteristic factors to child immunization status is 7.5% and the role of district level is 92.5%. Based on this result research, it is important for government to continuously improving education, immunization knowledge and encourage the utilization of health care especially immunization services. Ministry of Health and related sectors are supposed to arrange orientation program for immunization mobilization.
Menghadapi Ancaman Pandemi: Analisis Sumber Daya Rumah Sakit Rujukan Avian Influenza di Jakarta Adisasmito, Wiku; Sari, Mega Purba; Su’udi, Amir
Kesmas Vol. 4, No. 2
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Hingga kini, di Indonesia, pandemi Avian Influenza (AI) masih menjadi ancaman yang dapat menimbulkan banyak korban manusia dan kerugian ekonomi yang besar. Untuk mengantisipasi hal tersebut perlu persiapan dari rumah sakit rujukan AI secara matang khususnya di Jakarta yang merupakan provinsi dengan jumlah kasus AI terbesar. Tujuan dari penelitian ini adalah untuk mengetahui kemampuan sumber daya yang dimiliki rumah sakit rujukan AI RSPI Dr. Sulianti Saroso, RSUP Persahabatan dan RSPAD Gatot Soebroto dalam menghadapi ancaman pandemi AI. Penelitian ini menggunakan disain cross sectional, mengamati sumber daya rumah sakit meliputi fasilitas tempat tidur, peralatan, alat proteksi diri, dan obat-obatan. Metode perhitungan estimasi kebutuhan sumber daya menggunakan formula Radonovich LJ, et al. Hasil penelitian menunjukkan masih terbatasnya ketersediaan tempat tidur baik ICU maupun non ICU, APD, serta oseltamivir, amoxicillin dan cairan Intravena di rumah sakit rujukan khusus AI apabila terjadi pandemi AI di DKI Jakarta. Dalam rangka siap siaga menghadapi pandemik influenza, disarankan menambahkan rumah sakit rujukan AI di DKI Jakarta dengan mempertimbangkan hasil penelitian ini dan menggunakan pendekatan scenario planning. Avian Influenza (AI) pandemic has been threatening Indonesia people and may cause human fatality as well as huge economic lost. To anticipate any loss, a careful hospital preparation needs to be measured. The objective of this research was to explore the AI referral hospital resource capacity in Jakarta to cope with AI pandemic. The hospitals involved in this resource capacity study were Dr. Sulianti Saroso Infectious Hospital, Persahabatan Hospital, and Gatot Soebroto Hospital. This cross sectional research aimed at measuring the capacity of the hospital beds, ICU, equipments, personal protective equipments (PPE) and drugs. The Radonovich formula was used in the calculation. The results showed that the resource capacity of the AI referral hospitals in Jakarta was limited, especially in the number of ICU and non ICU beds, PPE, oseltamivir antiviral, amoxicillin and normal saline if AI pandemic occurred in Jakarta. In order to increase the capacity of Jakarta for pandemic influenza preparedness, it is suggested to assign more hospitals for AI in Jakarta to consider the data of this research and the scenario planning approach.
Kepatuhan Membaca Label Informasi Zat Gizi di Kalangan Mahasiswa Zahara, Siti; Triyanti, Triyanti
Kesmas Vol. 4, No. 2
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Berdasarkan hasil kajian Badan Perlindungan Konsumen Nasional (BPKN), di Indonesia label pangan masih kurang mendapat perhatian dari konsumen. Hanya sekitar 6,7% konsumen yang memperhatikan kelengkapan label produk pangan yang mereka beli. Penelitian ini bertujuan untuk mengetahui tingkat kepatuhan mahasiswa Fakultas Kesehatan Masyarakat Universitas Indonesia membaca label informasi zat gizi dan komposisi makanan kemasan serta faktor-faktor yang mempengaruhinya. Penelitian dengan desain potong lintang (cross-sectional) ini dilakukan terhadap 215 responden. Dari hasil penelitian didapatkan bahwa variabel yang berhubungan bermakna dengan kepatuhan mambaca label informasi zat gizi adalah status pekerjaan ayah (OR = 2,44), sikap kesehatan dan label produk pangan (OR = 2,824), perencana makanan (OR= 2,27), pembelanja makanan (OR= 2,33), dan keterpaparan dengan informasi (OR= 2,171). Variabel yang berhubungan bermakna dengan kepatuhan mambaca label komposisi adalah status pekerjaan ayah (OR= 2,116), pembelanja makanan(OR= 1,906), dan penerimaan harga produk pangan (OR= 0,152). According to the results of the study by National Consumer Protection Institute, food label have been paid less attention from customers in Indonesia where only 6.7% consumers consider about the label. This study aims to know the level compliance to read the nutrition information and composition on food packages and its determinant factors among students in the Faculty of Public Health, University of Indonesia. This cross sectional study was conducted on 215 respondents. Results of the research shows that variables with significant relationship to food label compliance are father’s job status (OR = 2.443), attitudes toward health and food label (OR = 2.824), eating planner (OR= 2.274), food shopper (OR = 2.335), exposure to media (OR= 2.171). Variables that have significant relationship to composition compliance are father’s job status (OR = 2.116), food shopper (OR= 0.036), and acceptance to food price (OR= 0.152).
Gangguan Akibat Kekurangan Iodium di Indonesia: Tinjauan Epidemiologis dan Kebijakan Kesehatan Pramono, Laurentius Aswin
Kesmas Vol. 4, No. 2
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Abstract

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Pada masa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi terhadap permasalahan GAKI di Indonesia masih rendah. Demikian pula, publikasi ilmiah yang mengkaji GAKI dari sudut pandang epidemiologi dan aplikasinya bagi kebijakan kesehatan. Artikel ini diharapkan dapat memberi gambaran dan perspektif epidemiologi yang luas bagi para klinisi dan ahli kesehatan masyarakat. IDD (Iodine Deficiency Disorders) is the most common cause of preventable mental retardation in the world. Nowadays, IDD still one of the most important public health problems in Indonesia. Up to now, Indonesia has not yet reached the target of IDD elimination as expected. National IDD Survey at 2003 and National Health Survey at 2007 show the achievement of IDD control program in Indonesia is still below the target of Universal Salt Idozation and Indonesia Health 2010 (RAN KPP GAKI strategy). Cross-sectoral commitment is very important for the elimination of IDD in the future. Clinicians and epidemiologist concern for IDD elimination in Indonesia is still low, so does the publications in the field of IDD from epidemiology and health policy perspective. It is expected that this literature review can give broad description and epidemiological perspective for clinicians and public health experts.
A Study among Community Living Underneath SUTET about The General Health Condition and The Electromagnetic Fields Exposures Wawolumaya, Corrie; Darwanto, Djoko
Kesmas Vol. 4, No. 2
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Jaringan SUTET Perusahaan Listrik Negara banyak melalui daerah pemukiman. Tujuan penelitian mendapatkan gambaran kesehatan penduduk yang bermukim di bawah SUTET dan di daerah urban miskin Jakarta dan sekitarnya. Penelitian disain kroseksional ini dilakukan pada sample 1200 kepala keluarga yang ditarik secara stratifikasi proportional purposif berdasarkan zona kuat medan elektromagnet. Data dikumpulkan dengan metoda observasi, wawancara dan pemeriksaan kesehatan. Kuat medan listrik dan medan magnet diukur terpisah di luar rumah, dan di dalam rumah. Ditemukan kuat medan listrik tertinggi pada ketinggian 1 meter di atas tanah 3,1 kV/m. Kuat medan magnet 550 mA/m atau 687,5.10-3µT diidentifikasi dalam zona 1 0-20 m yang menurun berangsur pada zona 2 300mA/m dan mendekati 0 pada zona 3. Medan listrik dan medan magnet berada di bawah nilai ambang SNI 2003, 5 kV/m dan 0,1 mT atau 80.104 mA/m (note: 1 A/m = 1,25 µT). Medan listrik tertinggi ditemukan pada ketinggian 1 meter dari tanah 2,5 kV/m pada jam 02.00–03.00 pagi dan medan magnet ttinggi 2400 mA/m pada jam 12.00-16.00 .Jenis rumah terbanyak adalah rumah kumuh ( 30 %) telah dimukimi lebih 30 tahun. Penyakit utama di semua zona adalah gangguan gigi geligi, myopia dan hipertensi yang tidak berbeda antara zona. SUTET or the Extra High Voltage Transmission Line of 500 kV has passed through larger residential areas in the community. The aim of study is to provide the description of general health condition of community residing under SUTET in the urban poor of Jakarta and surrounding. The design of study was cross sectional, carried out among 1200 respondents which were taken stratified proportional purposively, based on zones of the electromagnetic field exposures. Data were collected through observation, interview and physical examination. The electric field and the magnetic field exposures were separately measured outside and inside the houses. The highest electromagnetic field exposures were measured at one meter height above the ground , for the electric field 3,1 kV/m. and the magnetic field 550 mA/m or 687,5.10-3µT, were identified in zone 1 0-20 ms. The magnetic field was decreasing gradually through zone 2 300mA/m and nearing zero in zone 3. Both the highest electric field and the magnetic field exposures were below the threshold values stated by SNI 2003, 5 kV/m dan 0,1 mT or 80.104 mA/m (note: 1 A/m = 1,25 µT). The highest electric field exposure was identified at one meter height from the ground 2,5 kV/m at 02.00–03.00 hours a.m and the highest magnetic field 2400 mA/m at 12.00-16.00 hours p.m. The biggest portion of houses was poor ( 30 %) were being housed for morethan 30 years. The major diseases were found similar in all zones i.e., dental diseases, myopia and hypertension.
Makanan Etnik Minahasa dan Kejadian Penyakit Jantung Koroner Kandou, Grace Debbie
Kesmas Vol. 4, No. 1
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Penyakit jantung koroner yang menjadi kausa utama kematian di seluruh dunia merupakan masalah kesehatan masyarakat yang penting di seluruh dunia, termasuk Indonesia dan Sulawesi Utara. Kebiasaan makan yang dipengaruhi oleh faktor budaya, adat istiadat, agama dan kepercayaan berperan penting dalam proses kejadian penyakit. Penelitian ini bertujuan mengetahui pengaruh kebiasaan makan etnik Minahasa terhadap kejadian penyakit jantung koroner. Penelitian di RSU Prof. Dr. R.D. Kandou ini menggunakan disain studi kasus kontrol dengan ukuran sampel 128 kasus dan 128 kontrol. Data frekuensi makan dikumpulkan dengan Food Frequency Quationnaire (FFQ). Makanan etnik Minahasa ditentukan berdasarkan 41 jenis makanan yang dikompositkan. Asam lemak jenuh pada setiap jenis makanan etnik Minahasa umumnya mengandung ALJ dengan kisaran kadar 0,01-10,46% food per 100 gram. Pengkomsumsi makanan Mihahasa dengan frekuensi makan ≥ 2 kali/ bulan berisiko PJK 4,43 kali lebih besar daripada pengkonsumsi ≤ 1 kali/ bulan setelah dikontrol dengan variabel daging babi hutan(OR=4,3 95%CI:1,66-11,05), kotey(OR=7,15 95%CI: 1,70-30,08), merokok (OR=2,76 95% CI: 1,36-5,61), usia(OR=1,96 95%CI: 1,36-2,83), jenis kelamin(OR=2,86 95%CI: 1,41-5,78) dan hipertensi (OR=5,86 95%CI: 2,94-11,66). Kebiasaan makan dengan frekuensi sering berisiko 5,4 kali lebih besar untuk terkena PJK daripada yang mempunyai kebiasaan makan jarang setelah dikontrol variabel jenis kelamin, riwayat keluarga PJK dan diabetes. Coronary Heart Disease (CHD) is the leading cause of disability and mortality in the world, including Indonesia and North Sulawesi province. There are many factors that has contribution to the development of CHD. Food habit that influenced by culture and religion is known as a risk factor. The objective of this study is to know the effect of food habit and food variety of Minahasan to the risk of CHD. The methodology used in this research was case control, with respondents drawn from the Prof. Dr. R.D. Kandou General Hospital, Manado, North Sulawesi province. The samples were consisted of 128 cases of CHD and 128 controls of noncoronary heart diseases. Eating frequencies were collected through a Food Frequency Questionnaire (FFQ). Those who were eating “ babi putar ” (roasted pork) more than twice a month had potentially 4.43 times to develop CHD compare to those who were eating less than once a month controlled by consumption of “ babi hutan ” (wild boar) (OR=4,3 95% CI: 1,66-11,05), “ kotey/sa’ut ” (OR=7,15 95% CI: 1,70-30,08), smoking (OR=2,76 95% CI: 1,36-5,61), age (OR=1,96 95% CI: 1,36-2,83), gender (OR=2,86 95% CI: 1,41-5,78) and hypertension (OR=5,86 95% CI: 2,94-11,66). Those with food habit which include higher frequency of consumption of composite of “high risk” 41 Minahasan food items has 5.4 times higher risk to develop CHD compared to those who has lower frequency, after controlled by gender, family history of CHD and Diabetes Mellitus.
Pengaruh Kemiskinan Keluarga pada Kejadian Pneumonia Balita di Indonesia Machmud, Rizanda
Kesmas Vol. 4, No. 1
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Pneumonia merupakan penyakit infeksi saluran pernapasan akut yang menjadi kausa utama kematian balita. Di Indonesia, pada akhir tahun 2000, angka kematian balita akibat pneumonia diperkirakan 4,9/1000 balita. Faktor sosio-ekonomi berkontribusi besar terhadap penyakit saluran pernapasan. Tujuan penelitian ini adalah mengetahui faktor sosio-ekonomi yang paling berpengaruh terhadap pneumonia pada balita. Penelitian dengan dengan disain krosseksional ini menggunakan sumber data sekunder Benefit Evaluation Study (BES) II oleh Pusat Penelitian Kesehatan Universitas Indonesia bekerja sama dengan Proyek Intensifikasi Pemberantasan Penyakit Menular, Departemen Kesehatan. Sampel diambil berdasarkan multilevel statistical frameworkdari 7.170 ba-lita pada 10.900 rumah tangga di 27 kabupaten di tujuh provinsi. Metode analisis yang digunakan adalah multilevel logistic regression. Penelitian ini memperlihatkan bahwa sosio-ekonomi rumah tangga berperan secara bermakna terhadap kejadian pneumonia balita. Rumah tangga miskin berisiko lebih besar untuk terkena pneumonia. Pada keluarga miskin, risiko pneumonia yang lebih besar disebabkan oleh faktor kontekstual lingkungan yang buruk berupa pencemaran di dalam rumah yang dikontrol faktor komposisi status gizi (95% CI OR 4.05- 4.78). Kebijakan intervensi program P2ISPA disarankan lebih mengutamakan intervensi pada faktor kontekstual lingkungan buruk pencemaran dalam rumah tangga miskin. Pneumonia is an acute respiratory tract infection disease that becomes a major cause of death among under five years old children. In Indonesia, in 2000, pneumonia specific cause of death rate among under five children is predicted to be 4.9/ 1000. The socio-economic factor has significant contribution to respiratory tract infection. The objective of this study is to know the socioeconomic factor that affect pneumonia among under five children. The study uses cross sectional study design using secondary data of Benefit Evaluation Study (BES) II conducted by Centre for Health Research, University of Indonesia in collaboration with Intensification of Infectious Diseases Eradication Project, MOH-RI. The study sample is selected based on multilevel statistical framework from 7170 under five children in 10900 households within 27 districts in seven provinces. Analysis method used in this study is multilevel logistic regression. This study shows that the low level of socioeconomic status affect significantly the pneumonia occurrence among under five children. The risk of pneumonia among lower socioeconomic household is higher than that of the high socioeconomic household. It was found that the association was found for poor environmental factor including in-house hygienic condition after controlled by nutritional status. The pneumonia occurrence among under five children is more influenced by environmental factors than individual factors (compositional effect). It is suggested to prioritize intervention on environmental factors to eradicate respiratory tract infection.
Masyarakat Depok Memilih Fogging yang Tidak Dimengerti Krianto, Tri
Kesmas Vol. 4, No. 1
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Sampai kini, demam berdarah dengue masih menjadi masalah kesehatan yang utama di Kota Depok. Hal tersebut terlihat pada jumlah kasus yang terus meningkat dan semua kelurahan sudah berkembang menjadi daerah endemis demam berdarah dengue yang dapat dicegah dengan mengendalikan vektor. Upaya pembersihan sarang nyamuk PSN 3M Plus adalah teknologi yang disarankan untuk mengendalikan kejadian demam berdarah dengue, tetapi belum mendapat dukungan pelaksanaan dari masyarakat. Studi ini bertujuan untuk menggali informasi tentang pengetahuan, sikap dan praktek masyarakat dalam pengendalian vektor demam berdarah dengue di Kota Depok. Hasil studi menunjukkan bahwa pengetahuan dan partisipasi masyarakat dalam pengendalian vektor DBD masih rendah, dan lingkungan sosial berpengaruh sangat dominan terhadap keputusan masyarakat. Until now, dengue hemorrhaegic fever (DHF) is the major health problem in Depok City, number of cases was increasing, and nowadays all sub-district have DHF endemic areas. DHF can be prevented by vector control. PSN 3M Plus is the recommended technology, but the community has not been implemented it yet. This study aims to explore information about knowledge, attitude and practice in dengue control among the communities. Results of this study indicated that knowledge and community participation dengue vector control were still low, and social environment factor was the dominant factor influencing community decision.
Penilaian Kualitas Pelayanan Puskesmas dengan Model Donabedian: Studi Kasus Puskesmas di Kota Depok Ayubi, Dian
Kesmas Vol. 4, No. 1
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Perkembangan struktur sosio-demografi penduduk dan infrastruktur Kota Depok yang pesat berpengaruh terhadap masalah kesehatan yang semakin kompleks. Pada era desentralisasi, Dinas Kesehatan Pemerintah Kota Depok dituntut memberikan pelayanan kesehatan masyarakat yang berkualitas antara lain melalui pelayanan kesehatan tingkat primer di puskesmas. Penelitian ini bertujuan menganalisis mutu pelayanan puskesmas dan hubungan struktur dan proses terhadap hasil pelayanan puskesmas, kepuasan pelanggan. Survey di rumah responden dilakukan pada bulan Maret 2004, dalam wilayah kerja enam puskesmas kecamatan di Kota Depok. Populasi adalah semua penduduk yang bermukim di wilayah kerja Puskesmas Kecamatan se-Kota Depok. Sampel adalah 300 rumah tangga yang tersebar di setiap kelurahan wilayah kerja masing-masing puskesmas kecamatan dengan responden ibu rumah tangga. Analisis dilakukan dengan pendekatan Structure, Process dan Outcome berdasarkan penilaian pasien. Penelitian ini menemukan nilai median atribut mutu struktur, proses dan kepuasan pelanggan adalah 75; 71,4 dan 75,0. Variasi pada dimensi struktur lebih lebar daripada dimensi proses. Secara bersama-sama, ada hubungan statistik yang bermakna antara struktur dan proses terhadap hasil di puskesmas kecamatan di Kota Depok. Aspek atribut struktur pelayanan puskesmas yang dinilai pelanggan perlu perbaikan adalah kelengkapan sarana, sedangkan untuk atribut proses adalah waktu tunggu pendaftaran. Rapid growth of sociodemographic and infrastructure in Depok City has influenced the complexity of health problems. In the decentralization era, one of community health center function is to provide quality primary health care. The aim of this study is to assess quality of health services that was provided by sub-district community health center based on Donabedian Model (Stucture Process Outcome). Survey was conducted in six sub-district community health centers. Data were collected using questionnaires. Respondents were interviewed in their home during March 2004. Samples covered 300 households in six areas. Median of stucture, process and outcome atributes of health services is 75, 71.4 and 75.0. Variation of stucture attribute is wider than process attribute. This study found there is a statistically significant correlation between structure and process attributes to outcome (patient satisfaction) of community health center services. In the structure attribute, equipment or facility aspect of community health center is needed to be improved while for process attribute, it is the aspect of waiting time in admission.
Kinerja Bidan di Desa dalam Program Jaminan Pemeliharaan Kesehatan Masyarakat Miskin Husna, Arfah; Besral, Besral
Kesmas Vol. 4, No. 1
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Cakupan pelayanan kebidanan program Jaminan Pelayanan Kesehatan Masyarakat Miskin (JPKMM) di Kabupaten Aceh Selatan tahun 2006 yang belum mencapai target mengindikasikan kinerja bidan di desa dalam pelayanan kebidanan program JPKMM masih rendah. Penelitian ini bertujuan mengetahui kinerja bidan desa dan faktor-faktor yang berhubungan. Kinerja bidan desa diukur dengan melihat cakupan pelayanan kebidanan program JPKMM meliputi cakupan pemeriksaan kehamilan minimal 4 kali dan cakupan pertolongan persalinan. Disain penelitian yang digunakan adalah cross sectional dengan populasi seluruh bidan desa yang bertugas di Kabupaten Aceh Selatan tahun 2007. Sampel adalah bidan desa yang sudah bertugas minimal setahun yang berjumlah 104 orang. Disimpulkan bahwa sebagian besar kinerja bidan desa masih rendah (56%). Faktor-faktor yang berhubungan dengan kinerja bidan desa adalah: tidak adanya pesaing, adanya pembinaan, pengetahuan dan motivasi. Faktor-faktor yang tidak berhubungan dengan kinerja bidan desa adalah umur, status pernikahan, status kepegawaian (PNS/PTT), domisili, jumlah desa, sikap, imbalan, kemampuan dan pendidikan. Disarankan kepada Dinas Kesehatan untuk memberikan pembinaan yang lebih intensif kepada bidan desa dan memberikan penghargaan untuk meningkatkan motivasinya. Disarankan kepada bidan di desa untuk terus-menerus melakukan peningkatan pelayanan kepada pasien dan selalu menerapkan prinsip 3S (salam, senyum dan sopan) serta proaktif mendatangi pasien ke rumahnya untuk memberikan pelayanan kebidanan ataupun memelihara hubungan sosial yang baik. This research aimed to find out the performance of village midwife and its determinant factors. The performance of midwifery service within the Jaminan Pemeliharaan Kesehatan Masyarakat Miskin (JPKMM) program was measured by the coverage of antenatal care and coverage of trained birth attendance. The design of this study is cross sectional and data was analyzed using univariate, bivarite, and multivariate logistic regression. The population was all village midwives (137 persons) in Aceh Selatan District in the year 2007. The sample was village midwife who has at least one year work experience in a certain village and it consists of 104 persons. The result shows that the performance of village midwife is still low (56%). Multivariate logistic regression analysis confirmed that the dominant factor related to good performance were no competitor, good supervision, knowledge and motivation. Factors which not associated with performance were age, marital status, employee status, domicile, number of village to be covered, attitude, reward, and education. We recommend that the District Health Office must supervise intensively and giving more reward to improve work motivation. The village midwife should improve their quality of services and implement the 3S principle ( salam, senyum and sopan) and conducting home visit to provide maternal health services and to maintain good social relationship with the community.

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