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Prodi Magister Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat UNDIP, Jalan Professor Soedarto, Tembalang, Kota Semarang, Jawa Tengah 50275, Indonesia
Location
Kota semarang,
Jawa tengah
INDONESIA
Jurnal Manajemen Kesehatan Indonesia
Published by Universitas Diponegoro
ISSN : 23033622     EISSN : 25487213.     DOI : -
Core Subject : Health, Science,
Decision Sciences, Operations Research & Management Health Professions
Arjuna Subject : -
Articles 10 Documents
 1 
Search results for , issue "Vol 1, No 3 (2013): Desember 2013" : 10 Documents clear
Analysis on the Implementation of Iron Supplementation Program by Midwives at Primary Healthcare Center in South Minahasa District Sjenny Olga Tuju; Sri Achadi Nugraheni; Lucia Ratna Kartika
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.765 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Pelaksanaan program pemberian tablet Fe (besi) di Puskesmas Kabupaten Minahasa Selatan masih dibawah target nasional (78,8 %) target Nasional (90 %) walaupun sudah ada kebijakan tentang program pemberian tablet Fe (besi) pada bidan.  Survey pendahuluan yang dlakukan oleh 7 bidan di 7 Puskesmas diperoleh informasi bahwa masih ada bidan yang belum melaksanakan sesuai dengan standar operasional prosedur yang sudah ada. Penelitian ini bertujuan untuk menganalisis faktor yang mempengaruhi implementasi program pemberian tablet Fe (besi) oleh bidan di Puskesmas Wilayah Kabupaten Minahasa Selatan. Jenis penelitian merupakan deskriptif observasional analitik dengan pendekatan cross sectional.Pengumpulan  data  dilakukan  wawancara  kuesioner  dan  observasi  langsung  pada  saat  bidan memberikan  tablet  Fe  (besi)  di  polindes/Posyandu.  Jumlah  sampel  98  orang  bidan  desa  di  17 kecamatan  Kabupaten  Minahasa  Selatan.yang  diambil  secara Simple  Random  Sapling. Analisis univariat, bivariat dilakukan dengan chi-square test dan analisis multivariat dengan regresi logistik Bidan  sudah  melaksanakan  kegiatan-kegiatan  dengan  kategori  baik  dalam  komunikasi (46,9%),Sumberdaya  (52%),Disposisi  (57,1%)  dan  Struktur  Birokrasi  (53,1%).  variabel  yang berpengaruh terhadap implementasi program pemberian tablet Fe (besi) adalah birokrasi (nilai p=0,24 ) exp ß=2,584.Saran untuk Dinas Kesehatan Kabupaten Minahasa Selatan adalah : memberikan soaialisasi kepada bidan tentang manfaat dari pengunaan Standar Operasional Prosedur (SOP) pemberian tablet Fe(besi).  Memberikan  insentif  bagi  bidan  yang  telah  melaksanakan  sesuai  dengan  standar  yangmemenuhi cakupan, diberikan Hb Sahli set bagi semua bidan yang bertugas didesa yang belum mempunyai lat tersebutImplementation of iron tablets supplementation program in the primary healthcare centers of South Minahasa district was still below the national target (78.8%) although there was a policy regarding iron  supplementation  program  by  midwives.  The  national  target  was  90%.  Preliminary  survey conducted on 7 midwives showed that there were midwives who had not implemented the program according to the existed standard operating procedure. The objective of this study was to analyze factors affecting the implementation of iron tablets supplementation program by midwives in the primary healthcare centers in the area of South Minahasa district. This  was  an  observational  analytical  study  with  cross  sectional  approach.  Data collection  was done through interview guided by questionnaire and direct observation to midwives when giving iron tablets in a polindes/posyandu. The number of study samples was 98 village midwives in 17 sub districts of South Minahasa district. They were selected using simple random sampling method. Univariate analysis, bivariate analysis with chi square test, and multivariate analysis with logistic regression were applied in the data analysis. Results of the study showed that midwives had implemented the activities with good category incommunication (46.9%), resources (52%), disposition (57.1%), and structured bureaucracy (53.1%).Variable affecting the implementation of iron tablets supplementation program was bureaucracy (p= 0.24), exp â= 2.584.Suggestions for the South Minahasa district health office were to conduct socialization to midwives regarding the benefits of using standard operating procedures of the implementation of iron tables supplementation;  to  give  incentive  for  midwives  who  implement  the  program  according  to  the standard and reaching the target; to provide Hb Sahli set for all midwives who work in the village and they do not have the Hb Sahli set.
Factors Associated to the Work Performance of Midwives in the Implementation of Village Allertness Program in the Boyolali District Asih Dwi Astuti; Laksmono Widagdo; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (464.906 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) di Kabupaten Boyolali masih tinggi, terlihat pada AKI tahun 2010 sebesar 114,80/10.000 KH dan pada tahun 2011 sebesar 116,23/100.000 KH sedangkan pada AKB tahun 2010 sebesar 9,18/1.000 KH dan pada tahun 2011 sebesar 12,27/1.000 KH. Dalam rangka mempercepat penurunan AKI dan AKB maka diperlukan intervensi pelayanan kesehatan yang berdasarkan pada kebutuhan dan kemampuan masyarakat, maka Dinas Kesehatan Kabupaten Boyolali melakukan pengembangan Desa Siaga. Akan tetapi keberlangsungan Desa Siaga masih belum maksimal, salah satu penyebabnya adalah rendahnya kinerja bidan dalam pengembangan Poliklinik Kesehatan Desa (PKD). Tujuan penelitian ini adalah menganalisis rendahnya kinerja bidan dalam pelaksanaan Desa Siaga yang meliputi ketrampilan dan kemampuan, motivasi, kepemimpinan dan imbalan.     Penelitian ini merupakan penelitian analitik dengan metode pendekatan waktu cross sectional. Populasinya adalah seluruh bidan desa yang berada di Boyolali sebanyak 267 bidan, sempel diambil dengan cara propotional random sampling dengan jumlah 75 responden, analisis univariat dengan frekuensi, bivariat dengan uji Chi Square dan analisis multivariate dengan regresi binary logistic.    Hasil analisis peneitian bivariat menunjukkan ada hubungan yang siknifikan antara kemampuan dan ketrampilan dengan kinerja (p=0,032), motivasi dengan kinerja (p=0,001), kepemimpinan dengan kinerja (p=0,002), dan imbalan dengan kinerja (p=0,001). Secara bersama-sama variabel kepemimpinan dan motivasi  berpengaruh terhadap kinerja.    Disarankan kepada Kepala Dinas Kabupaten Boyolali untuk memberikan pelatihan Asuhan Persalinan Normal (APN), kegawatdaruratan dalam rangka peningkatan kinerja bidan desa , perbaikan PKD, serta bantuan kegiatan Desa Siaga. Bagi Kepala bidan koordinator untuk melakukan pembinaan, pendampingan program.Maternal mortality rate (AKI) and infant mortality rate (AKB) in Boyolali district were still high. Facts showed that AKI in 2010 was 114.80/10000 live-births, and in 2011 was 116.23/100.000 live-births; AKB in 2010 was 9.18/1000 live-births, and in 2011 was 12.27/1000 live-births. To accelerate the decrease of AKI and AKB, health service intervention based on community need and capacity is required. Boyolali district health office had answered this challenged by developing alert village program. However, the continuity of this alert village program was not maximal. One of reasons of this condition was inadequacy of midwives work performance in the development of village health polyclinic (PKD). Objective of this study was to analyze the inadequacy of midwives work performance in the implementation of alert village such as skill, ability, motivation, leadership, and compensation. This was an analytical study with cross sectional approach. Study population was all 267 village midwives in the district of Boyolali. Samples were 75 village midwives selected using proportional random sampling method. Frequency distribution for univariate analysis, Chi square test for bivariate analysis, and binary logistic regression for multivariate analysis were applied in the data analysis. Results of the study showed that there were significant associations between ability, skill and midwives work performance (p= 0.032); motivation and midwives work performance (p= 0.001); leadership and midwives work performance (p= 0.002); compensation and midwives work performance (p= 0.001). Variables, in common, affecting work performance of midwives were leadership and motivation. Suggestions for the head of Boyolali district health office were to provide trainings on normal delivery care (APN) and emergency to improve village midwives work performance, to improve PKD, to provide assistance for alert village program activities. Suggestion for chief of coordinator midwives was to do program supervision and assistance. 
Analysis on the Implementation of Exclusive Breastfeeding in Working Area of Remu Primary Healthcare Center in Sorong, Papua Barat Daud Rumangun; Sri Achadi Nugraheni; Martha Irene Kartasursya
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (493.771 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

ASI eksklusif merupakan bagian penting dalam pemenuhan nutrisi bayi untuk mencapai pertumbuhan perkembangan optimal pada awal kehidupan dan masa pertumbuhan berikutnya. Kesepakatan Innocenti di Roma tahun 1990 mengamanatkan pencapaian ASI eksklusif 80%, sehingga target Standar Pelayanan Minimal (SPM) tahun  2003 di Indonesia ditetapkan 80%. Data SDKI tahun 1994 menunjukkan ibu-ibu  memberikan ASI eksklusif baru mencapai 47%. Metode penelitian adalah kualitatif. Subjek penelitian adalah tenaga Gizi dan Bidan KIA Puskesmas Remu. Sebagai Triangulasi adalah Pimpinan Puskesmas, Kepala Seksi Kesehatan Ibu dan Anak Dinas Kesehatan Kota Sorong serta  ibu  yang memiliki bayi usia kurang dari 6 bulan. Pengumpulan data dilakukan melalui wawancara mendalam dan studi dokumentasi  .    Hasil penelitian menunjukkan bahwa pelaksanaan program ASI ekslusif di Puskesmas Remu belum berjalan baik. Petunjuk teknis atau SOP tesedia di Puskesmas, namun dalam pelaksanaan program belum sesuai. Pelaksanaan program yang sering dilakukan berupa penyuluhan saat posyandu, ANC dan persalinan. Sosialisasi aktif dari puskesmas oleh bidan, dari bagian gizi di Puskesmas belum dilaksanakan. Dari DKK tidak mempunyai jadwal tetap. Sosialisasi dipaketkan saat ANC, posyandu, minilokakarya, saat evaluasi program dan menempelkan pamflet di Puskesmas. Sosialisasi hanya berupa penyuluhan tanpa dilengakapi alat peraga yang memadai. Ketersediaan dan kualitas tenaga di Puskesmas masih kurang,  belum mendapat pelatihan sehingga dibantu perawat yang belum dilatih. Dana yang tersedia langsung diserahkan ke ahli gizi Puskesmas untuk dikelola. Dana tersendiri untuk pelaksanaan program ASI ekslusif belum ada. Alat peraga kurang, hanya leaflet, namun sudah tidak layak pakai. Kendaraan yang tersedia hanya motor. Jumlah peralatan belum mencukupi. Klinik khusus laktasi belum tersedia. Watak atau sikap petugas yakni respon, komitmen dan pemahaman dalam program ASI ekslusif di Puskesmas Remu masih baik.          Pelaksanaan program ASI ekslusif dapat berjalan dengan baik dengan menjalankan SOP/petunjuk teknis oleh seluruh pelaksana program, menyiapkan tenaga gizi di tiap Puskesmas, meningkatkan sosialisasi, membuat job description dengan jelas, penyediaan reward dan insentif sesuai beban kerja dan kompetensi, keuangan tersendiri untuk program ASI ekslusif, monitoring dan koordinasi pelaksanaan program ASI ekslusif dan pendokumentasian kegiatan secara benar Exclusive breastfeeding was an important part in fulfilling infant nutrition to gain optimum growth and development in the early live and in the next growth period. Innocenti agreement in Rome in 1990 mandated that the exclusive breastfeeding coverage was 80%. Therefore, the minimum service standard (SPM) coverage for exclusive breastfeeding in 2003 for Indonesia was established to be 80%. Data of SDKI in 1994 indicated that exclusive breastfeeding coverage was still 47%. This was a qualitative study. Study subjects were nutrition field workers and maternal and child health (KIA) midwives of Remu primary healthcare centre. Triangulation respondents were the head of primary healthcare centre, head of maternal and child health section of Sorong city health office, and mothers of infants less than 6 months. Data were collected by conducting in-depth interview and documentation study. Results of the study showed that the implementation of exclusive breastfeeding program in Remu primary healthcare center was still inadequate. Standard operating procedure was provided in the primary healthcare center, but the program was not implemented according to the standard. Programs frequently implemented were giving education in the posyandu, ANC and delivery process. Active socialization by midwives and nutrition section workers from primary healthcare center had not done yet. District health office did not have routine schedule. Socialization was attached in the ANC, posyandu, mini workshops, and evaluation sessions. In addition, it was also done by putting pamphlets in the primary healthcare center. Socialization was only in the form of giving education without sufficient visual aids. The availability and quality of human resource in the primary healthcare was still insufficient; they had not been trained, and they were accompanied by untrained nurses. The available funding was given directly to the primary healthcare nutritionist to manage it. No special funding was available for exclusive breastfeeding program. Visual aids or models were insufficient; only leaflets with unfeasible condition were used. The available transportation vehicle was only motor cycle. The number of instruments was insufficient. No lactation clinic was available. Character and attitude of the workers such as giving response, commitment and understanding on the exclusive breastfeeding in Remu primary healthcare center were good. The implementation of exclusive breastfeeding program will be good by implementing the standard operating procedure or technical guidance, assigning nutritional field workers in every primary healthcare centre, improving socialization, formulating clear job description, providing rewards and incentive according to workload and competence, separating finance for exclusive breastfeeding program, monitoring and coordinating the implementation of exclusive breastfeeding program, and having an adequate documentation of the activities.
Correlation between Quality of Nutritional Workers Services and Patient’s Satisfaction in Nutritional Services for Inpatient at Kajen General Hospital of Pekalongan District Eko Wigiantoro; Martha Irene Kartasurya; Cahya Tri Purnami
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1079.875 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Pelayanan petugas gzi pada pasien rawat inap kelas III di RSUD Kajen Kabupaten belum sesuai harapan karena masih ada ketidakpuasan pasien/ keluarga pasien dalam hal pemberian makan yang tidak tepat waktu, tampilan makanan tidak menarik dan pelayanan petugas gizi yang kurang peduli, kurang tanggap dan kurang ramah. Penelitian ini bertujuan untuk mengetahui hubungan persepsi tentang mutu pelayanan petugas gizi dengan kepuasan pasien dalam pelayanan gizi di rawat inap kelas III. Jenis penelitian adalah survei analitik dengan pendekatan cross sectional. Pengumpulan data dilakukan dengan wawancara terstruktur. Variabel bebas adalah persepsi kehandalan, ketanggapan, jaminan, empati dan bukti langsung, variabel terikat adalah kepuasan pasien dalam pelayanan gizi. Jumlah sampel sebanyak 135 subjek diperoleh dengan teknik consecutive sampling. Analisis data menggunakan analisis korelasi Spearman Rank untuk analisis bivariat dan regresi linier ganda untuk analisis multivariat. Hasil penelitian menunjukan 59,3% persepsi kehandalan, baik, 61,5% ketanggapan, baik, 56,3% jaminan,, baik, 50,4% empati baik dan 65,2 % bukti langsung, baik serta 58,5% persepsi kepuasan, puas terhadap pelayanan gizi. Hasil analisis bivariat menunjukan bahwa ada hubungan yang signifikan antara kehandalan, ketanggapan, jaminan, empati dan bukti langsung terhadap kepuasan pasien dalam pelayanan gizi (p < 0,05 ). Hasil analisis mulitvariat menunjukan faktor yang berpengaruh paling kuat terhadap kepuasan pasien adalah persepsi bukti langsung (B=0,230). Disarankan kepada manajemen rumah sakit untuk meningkatkan pembinaan, pelatihan custumer service pada petugas gizi Nutritionist services to third-class inpatients in Kajen district general hospital (RSUD) of Pekalongan district were not according to what was expected. This was cause by unsatisfaction of patients or their family members regarding: meals that were not served in time; meal presentation that was not interesting; and nutritional staffs who did not care, were not responsive, and were unpolite. Objective of this study was to identify association between perception on service quality of nutritional staffs and patient satisfation toward nutritional service in the third-class inpatient rooms.  This was an analytical survey with cross sectional approach. Data were collected through interview guided by structured questionnaire. Independent variables were perception on validity, responsiveness, assurance, emphaty, and direct evidences. Dependent variable was patient satisfactory toward nutritional services. The number of study samples was 135 subjects selected using consecutive sampling. Data analysis was done by applying Spearman Rank correlation for bivariate analysis, and by applying multiple linier regression for multivariate analysis. Results of the study showed that 59.3% of respondent’s perception on validity were good; 61.5% of respondent’s perception on responsiveness were good; 56.3% respondent’s perception on assurance were good; 50.4% respondent’s perception on empathy were good, 65.2% of respondent’s perception on direct evidence were good; and 58.5% of respondent’s satisfaction were satisfactory toward nutritional service. Results of bivariate analysis showed significant associations between patient satisfaction toward nurtritional service and validity, responsiveness, assurance, empathy, and direct evidence (p< 0.05). Result of multivariate analysis showed that the most influencing factor toward patient satisfaction was perception on the direct evidence (B= 0.230). Hospital management is suggested to improve customer service assistance and training to nutritional staffs.
Analysis on Work Performance Difference between Trained and Untrained Midwives in Neonatal Case Integrated Management in Kudus District Muslimah Muslimah; Chriswardani Suryawati; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (516.445 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Latar Belakang : Tahun 2010 didapatkan AKB sebesar 24/1.000 kelahiran hidup dan AKN 15/1.000 kelahiran hidup. Upaya pelaksanaan penanganan bayi muda dimulai dengan memberikan pelatihan MTBM kepada para bidan desa. Karena sangat penting pelatihan MTBM bagi peningkatan kinerja bidan dalam melaksanakan kunjungan neonatal sesuai pedoman MTBM. Angka kematian bayi di Kabupaten Kudus pada tahun 2009 adalah 5,88/1000 kelahiran hidup, dari jumlah tersebut 80,2% kasus kematian terjadi pada periode neonatal. Tahun 2010 angka kematian bayi sebesar 6,39/1000 kelahiran hidup, dari jumlah tersebut 87,6% kasus kematian terjadi pada periode neonatal. Pada tahun 2011 angka kematian bayi sebesar 6,71/1000 kelahiran hidup, dari jumlah tersebut 78,43% terjadi pada periode neonatal. Tujuan penulisan adalah untuk menganalisis perbedaan kinerja bidan desa yang sudah dilatih dan belum dilatih tentang manajemen terpadu bayi muda dalam penatalaksanaan kunjungan neonatal di Kabupaten Kudus tahun 2011.Metode : Jenis penelitian survey dengan pendekatan cross sectional. Subyek penelitian adalah bidan desa yang sudah dilatih MTBM dan yang belum dilatih MTBM masing-masing sebanyak 35 orang. Data dikumpulkan dengan wawancara. Data yang telah terkumpul dianalisis dengan uji independent samples test.Hasil penelitian : Ada perbedaan kinerja bidan yang sudah dan belum dilatih manajemen terpadu bayi muda (MTBM) dalam penatalaksanaan kunjungan neonatal di Kabupaten Kudus tahun 2011 (p : 0,047) dengan selisih mean = 5,97. Dari aspek kualitas ada perbedaan kinerja bidan desa yang sudah dilatih dan belum dilatih (p:0,000) dengan selisin mean = 8,12. Dari aspek kuantitas (p : 892), ketepatan waktu/timeliness (p : 0,728), efektifitas sumberdaya/cost effectiveness (p:0,981), pengawasan/ kebutuhan akan supervisi (p:0,324), dan hubungan interpersonal (p:0,680).Simpulan : Ada perbedaan kinerja bidan desa yang sudah dan belum dilatih MTBM di Kabupaten Kudus tahun 2011. Bentuk pola pelatihan perlu diubah dari penyampaian materi, evaluasi dan praktik langsung dalam pelatihan sehingga pelatihan mampu meningkatkan semua kriteria evaluasi kinerja bidan desa dalam kunjungan neonatal.Background: Infant mortality rate (AKB) in 2010 was 24/1000 live-births, and neonates mortality rate was 15/1000 live-births. Implementation of neonatal management was started by giving training on neonatal integrated management (MTBM) to village midwives. This MTBM was important to improve work performance of midwives in the implementation of neonatal visit according to MTBM guideline. Infant mortality rates in Kudus district in 2009 was 5.88/1000 live-births, and 80.2% of infant deaths occurred in the neonatal period. Infant mortality rates in 2010 was 6.39/1000 live-births, and 87.6% of infant deaths occurred in the neonatal period. Infant mortality rates in 2011 was 6.71/1000 live-births, and 78.43% of infant deaths occurred in the neonatal period. Objective of this study was to analyze the difference between trained and untrained village midwives on neonatal integrated management in the management of neonatal visit in Kudus district, 2011.Method: This was a study using survey method and cross sectional approach. Study subjects were trained and untrained village midwives on MTBM. Each group of midwives consisted of 35 midwives. Data were collected through interview. Independent samples t-test was applied in the data analysis.Results: There was a work performance difference between trained and untrained midwives on MTBM in the management of neonatal   visit in Kudus district in 2011 (p: 0.047) with a mean difference of 5.97. Quality aspect: there was a work performance difference between trained and untrained village midwives on MTBM (p: 0.000) with a mean difference of 8.12. Quantity aspect (p: 0.892), timeliness (p: 0.728), cost effectiveness (p: 0.981), supervision (p: 0.324), and interpersonal relationship (p: 0.680).                  Conclusion: There was a work performance difference between trained and untrained village midwives on MTBM in Kudus district in 2011. Modification for training pattern such as teaching method, evaluation, and field practice is needed. Therefore, the training will increase the points of all evaluation criteria for work performance of village midwives in conducting neonatal visit.
Analysis on Patien’s Linen in Management of Permata Bunda Hospital Purwodadi Muhamad Nur Aini; Martha Irene Kartasurya; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (443.477 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Berdasarkan BOR pada tahun 2010 dapat diketahui bahwa jumlah kunjungan pasien rawat inap di Rumah Sakit Permata Bunda  relatif tinggi, sehingga jumlah kebutuhan linen yang disediakan akan semakin meningkat. Berdasarkan studi pendahuluan dapat diketahui belum baiknya perencanaan, pelaksanaan,  dan  pengendalian  linen.  Tujuan penelitian  ini  adalah  Mengetahui  Bagaimana pengelolaan linen di Rumah Sakit Permata Bunda Purwodadi  saat ini dilakukan. Jenis penelitian adalah deskriptif eksploratif dengan pendekatan cross sectional. Populasi dalam penelitian  ini  adalah  karyawan  RS Permata  Bunda  Purwodadi  yang  terlibat  dalam  pengelolaan linen. Informan Utama dalam penelitian ini adalah kepala perawat yang ada di ruang perawatan umum, kepala dan wakil kepala logistik linen, dan kepala dan wakil kepala di unit laundry.Informan triangulasi dalam penelitian ini adalah manajer umum, kepala logistik dan pasien. Hasil penelitian menunjukkan bahwa perencanaan peramalan kebutuhan linen belum baik karena dilakukan berdasarkan asumsi linen yang hilang dan rusak, proses pemesanan linen belum berjalan dengan  baik  karena  belum  ada  petugas  khusus  yang  melakukan  pemesanan  linen,  pengadaan kebutuhan linen belum berjalan baik karena belum ada standar baku pengadaan linen, pemeliharaan linen sudah berjalan dengan baik karena sudah dilakukan sesuai dengan fase dan prosedur yang benar, pendistribusian linen tidak berjalan dengan baik karena ruangan dipisahkan oleh badan jalan, pelayanan linen pasien tidak berjalan dengan baik karena tidak semua pasien mendapatkan pelayanandengan mengganti linen setiap 1 hari sekali, organisasi pengelola linen yang belum baik karena masih dilakukan secara bersama-sama, pengendalian persediaan linen belum berjalan dengan baik karena penghitungan kebutuhan linen yang masih kurang dan belum menggunakan standar 3 kali jumlah  tempat  tidur,  pelaksanaan  inventarisasi linen  belum  berjalan  baik  karena  belum  dicatat secara  spesifik  sesuai  tingkat  kekotoran  linen  itu  sendiri,  identifikasi/  pengkodean  linen  belum berjalan baik karena pengkodean linen yang dilakukan belum dilakukan secara detail. Berdasarkan hasil penelitian disarankan penghitungan kebutuhan linen supaya dilakukan berdasarkan jumlah  tempat  tidur  dengan  ketersediaan  3  par  stok  linen  pada  setiap  tempat  tidur,  perlu  dibuat prosedur  kerja  tetap  yang  baku  dan  tertulis  dalam  pengelolaan  linen,  sehingga  dapat  dijadikan pegangan atau standar oleh pelaksana/petugas pengelola linen, dibuat identifikasi/pengkodean linen yang lebih baik, yang meliputi nama rumah sakit, nama ruang, jenis linen, jenis bahan.Based on bed occupancy ratio (BOR) in 2010, it was known that the number of inpatient visit at Permata Bunda hospital was relatively high. As a consequence, the need of linen increased. Based on preliminary study, it was known that planning, implementation, and controlling of linen were not  adequate.  The  objective  of  this  study  was  to  know  how  linen  in  Permata  Bunda  hospital  Purwodadi was managed. This was a descriptive explorative study with cross sectional approach. Study population was workers of Permata Bunda hospital Purwodadi who were involved in linen management. Main informants were chief of nurse in the general ward, chief and assistance chief of linen logistic unit, chief and assistant chief of laundry unit. Triangulation informants were general manager, logistic unit chief and patients. Results of the study showed that planning for linen requirement estimation was not good because it was done  based  on  lost  or  damaged  linen  assumptions.  Ordering  process  was  still  insufficient  due  to  no special staff who ordered the linen. Supply linen was inadequate due to no standard for linen supply. Maintenance  of  linen  was  good;  it  was  performed  according  to  the  right  phases  and  procedures. Distribution of linen was not good due to separation of the rooms by the street. Linen service to patient was inadequate; not all patients’ linen was changed once a day. Linen management organization was not good; it was still done together. Linen stock control was not good; calculation for linen requirement was still lacking, and it had not used the standard of 3 times of the number of bed. Implementation of linen inventory was still inadequate; no specific recording was done according to the dirtiness level of the linen. Linen coding or identification was still inadequate; coding was not in detail. Based on the results of the study, it is suggested that calculation of linen requirement should be done based on the number of bed with availability of 3 par stock linen in each bed. Written standard operating  procedure  in  linen  management  should  be  produced;  it  will  be  used  as  guideline  or standard by linen staffs or management. Identification or coding of linen should be improved; it includes hospital name, room name, type of linen and type of material.
Implementation Screening Program of the “Prevention of Mother to Child Transmission of HIV” (PMTCT) by Midwives in Health Center at Sorong West Papua. Elisabeth Samaran; Zahroh Shaluhiyah; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (491.655 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Berdasar data DKK Sorong 2010, dari total wanita penderita HIV/AIDS, 83,5% wanita usia reproduktif, yang sebagian besar tertular dari suami. Ketika hamil, terjadi resiko penularan HIV pada bayi. DKK Sorong telah melaksanakan program PMTCT dan memberikan pelatihan VCT-PMTCT pada tenaga kesehatan di puskesmas. Jumlah ibu hamil yang berkunjung ke klinik ANC-PMTCT sebanyak 2325 ibu hamil. Dari jumlah tersebut yang mendapat konseling pra-tes 1.171 ibu (50,36%). Dari yang mendapat konseling pra-tes dan melakukan tes HIV1.005 ibu (85,82%) dan ditemukan serologis positif HIV sebanyak 20 ibu (1,99%). Tujuan penelitian menjelaskan implementasi programPMTCT) di puskesmas.Jenis penelitian deskriptif dengan metode kualitatif. Pengumpulan data menggunakan wawancara mendalam pada informan utama bidan koordinator puskesmas dan informan triangulasi adalah Kepala Puskesmas, Kasie KIA dan Kasie Yankes DKK, sedangkan pada ibu hamil, data dikumpulkan melalui FGD.Hasil penelitian menunjukkan bahwa sosialisasi PMTCT telah dilakukan DKK melalui pelatihan dan kunjungan lapangan. Bidan juga melakukan sosialisasi pada ibu hamil yang pertama kali berkunjung untuk periksa hamil. Sosialisasi secara verbal dengan penyuluhan dan berkelompok. Bidan dari puskesmas yang program PMTCT baik telah melakukan langkah konseling pre-tes, testing HIV dan konseling post-test. Pada puskesmas yang program PMTCT tidak berjalan, bidan hanya menjelaskan manfaat PMTCT tetapi tidak pernah menyarankan untuk melakukan test darah. Pengetahuan dan sikap bidan sudah baik terutama dalam memberikan penyuluhan, sosialisasi dan informasi tentang HIV/AIDS dan PMTCT. Jumlah tenaga terlatih PMTCT dan sarana prasarana terbatas, terutama ruang khusus konseling serta laboratorium. Tidak ada regulasi khusus terkait PMTCT kecuali Pedoman Nasional PMTCT yang dikeluarkan oleh Kemenkes. Ada SK tentang puskesmas PMTCT dan pelaksanaannya menggunakan pedoman alur yang dibuat puskesmas berdasarkan kesepakatan dengan DKK. Dukungan pimpinan dan rekan sejawat dalam PMTCT di puskesmas baik.DKK perlu mengalokasikan anggaran secara bertahap untuk pelatihan PMTCT bagi bidan yang belum dilatih dan melengkapi sarana prasarana yang dibutuhkan terutama ruang khusus konseling dan laboratorium. Perlu reward yang dapat memotivasi bidan dan pembinaan yang terjadwal rutin. Based on Sorong city health office (DKK) data in 2010, 83.5% women with HIV/AIDS were in the productive age group, and the majority of them were transmitted from their husbands. Risk of HIV transmission to a baby occurred during pregnancy. DKK Sorong had implemented PMTCT program and given VCT-PMTCT training to health workers of primary healthcare centers. The number of pregnant women visited ANC-PMTCT clinic was 2325 women. Among them, 1.171 (50.36%) received pre testing counseling. Among women who received pre-testing counseling, 1.005 women conducted HIV1 test, and positive HIV was found in 20 women (1.99%). Objective of this study was to explain the implementation of PMTCT in the primary healthcare center (puskesmas). This was a descriptive study using qualitative method. Data were collected through in-depth interview to main informants and triangulation informants. Main informant was coordinator midwives in the puskesmas. Triangulation informants were heads of puskesmas, a head of KIA section of DKK, a head of Health Service section of DKK, and pregnant women. Data from pregnant women were collected through focus group discussion.  Results of the study showed that PMTCT socialization had been done by DKK through trainings and field visits. Midwives had done socialization to pregnant women who conducted antenatal visit for the first time. Verbal socialization was conducted by giving education, and it was done in groups. Midwives from puskesmas with good PMTCT had conducted pre-test counseling, HIV testing, and post-test counseling. In the puskesmas with improper PMTCT program, midwives only explained the benefit of conducting PMTCT; they did not suggest pregnant women to do blood test. Knowledge and attitude of midwives were sufficient specifically when they gave education, socialization, and information about HIV/AIDS and PMTCT. The number of skilled workers on PMTCT and facilities were limited; specific limitation on facilities was on the availability of specific rooms for counseling and laboratory. No specific regulations related to PMTCT except National guideline on PMTCT issued by Ministry of Health was provided. There was a decree regarding PMTCT puskesmas; the implementation of this decree was done by using flowchart guideline made by puskesmas with the agreement from DKK. Support for PMTCT from the leader and colleague in the puskesmas was good. Suggestions for DKK are to allocate the budged, in stages, for PMTCT trainings for midwives who have not received training, to complete facilities especially specific rooms for counseling and laboratory. Rewards that motivate midwives and routine scheduled supervision are required.
Evaluation on the Implementation of Ten Steps to Successful Breast Feeding by Midwives at Doctor Ramelan Naval Hospital Surabaya Krisnamurti Krisnamurti; Cahya Tri Purnami; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (539.756 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Penerapan 10  langkah menuju keberhasilan menyusui (LMKM) merupakan upaya pemerintah untuk meningkatkan program  ASI eksklusif. Di lingkungan   RSAL dr. Ramelan Surabaya sudah tertempel  tentang 10 LMKM namun belum ada kebijakan khusus tentang ASI eksklusif sehingga  bidan masih memberikan  susu formula (PASI) pada bayi baru lahir rawat gabung . Secara umum penelitian ini bertujuan untuk mengevaluasi pelaksanaan 10 langkah menuju keberhasilan menyusi (LMKM) oleh bidan di RSAL dr. Ramelan Surabaya    Metode penelitian yang digunakan adalah kualitatif yang disajikan secara  deskriptif eksploratif. Informan utama adalah 7 bidan pelaksana di poli hamil, kamar bersalin dan ruang rawat gabung, sedangkan  3 bidan kepala ruangan dan 1 bidan supervisor, serta 3 pasien sebagai informan triangulasi. Pengumpulan data dilakukan melalui wawancara mendalam dan studi dokumentasi Analisis data hasil wawancara dengan menggunakan metode interactive model melalui beberapa tahapan seperti: data collection,  dan data reduction,  data display Conclusion drawingHasil penelitian menunjukkan bahwa pelaksanaan 10 LMKM belum terlaksana dengan baik antara lain : belum semua bidan memberikan penjelasan tentang manfaat dan tehnik menyusui yang benar, bidan masih memberikan susu formula pada bayi rawat gabung, belum terbentuk kelompok pendukung ASI (KP-ASI). Hal tersebut disebabkan masih sebagian kecil bidan yang sudah mengikuti pelatihan manajemen laktasi, sehingga motivasi diri kurangPerlu adanya kebijakan tertulis tentang pemberian ASI Eksklusif, serta diharapkan semua bidan dapat mengikuti pelatihan manajemen laktasi sehingga pelaksanaan 10 langkah menuju keberhaslan menyusui (LMKM) lebih optimal, dan perlu juga adanya kebijakan yang tegas tentang keberadaan susu formula Establishment of the 10 steps to be success in breastfeeding (LMKM) was a government effort to improve exclusive breastfeeding program. Ten LMKM information had been displayed in dr. Ramelan navy hospital (RSAL) Surabaya; however, there was no special policy regarding exclusive breastfeeding. Therefore, midwives were still giving formula milk (PASI) to infants in the integrated care room. In general, the objective of this study was to evaluate the implementation of 10 steps to be success in breastfeeding (LMKM) by midwives in RSAL dr. Ramelan Surabaya.  This was a qualitative study with descriptive explorative approach. Main informants were 7 midwives in the pregnancy policlinic, delivery room, and integrated care room. Triangulation informants were 3 midwives as chief of the room, one supervisor midwives, and 3 patients. Data were collected through in-depth interview and documentation study. Interactive model was applied in the data analysis. Steps on the interactive model included data collection, data reduction, data display, and conclusion drawing.Results of the study showed that ten LMKM had not been implemented properly. Not all midwives explained correctly breastfeeding benefits and breastfeeding technique; midwives still gave formula milk to infants in the integrated care room; breastfeeding support group (KP-ASI) had not been formed yet. Only a small portion of midwives who had attended lactation management training; and it caused an insufficient self-motivation among midwives.  Written policy regarding exclusive breastfeeding is needed. All midwives are expected to attend in lactation management training; it will optimize the implementation of 10 LMKM. Strong policy regarding the existence of formula milk is needed.
Determinant Factors on the Implementation of Stimulation Detection and Early Intervention on Growth and Development (SDIDTK) by Health Cadres in Malang City Patemah Patemah; Martha Irene Kartasurya; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (454.144 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Stimulasi Deteksi dan Intervensi Dini Tumbuh Kembang (SDIDTK), adalah kegiatan merangsang kemampuan dasar anak umur 0-6 tahun agar anak tumbuh dan berkembang secara optimal. Kurangnya stimulasi dapat menyebabkan penyimpangan tumbuh kembang anak bahkan gangguan yang menetap. Cakupan SDIDTK di Kota Malang pada tahun 2010 mencapai 56,13%, tahun 2011 mencapai 69,41% dibawah target 90%. Tujuan penelitian ini adalah menganalisis faktor determinan pelaksanaan SDIDTK oleh kader di Puskesmas Wilayah Kota Malang.Jenis penelitian ini adalah observasional analitik dengan pendekatan cross sectional. Variabel bebas adalah karakteristik kader (umur, pendidikan, pekerjaan, lama menjadi kader), pengetahuan, sikap, fasilitas dan sarana prasarana, dukungan masyarakat,dukungan bidan,dan pelatihan. Variabel terikat adalah pelaksanaan SDIDTK. Subjek penelitian adalah 81 kader yang telah melakukan SDIDTK yang dipilih secara purposive. Data dikumpulkan dengan wawancara menggunakan kuesioner terstruktur dan lembar observasi. Analisis bivariat dilakukan dengan uji korelasi Chi-square dan Fisher Exact  dan multivariat dengan regresi logistik. Hasil penelitian menunjukkan rerata usia responden 45,4 tahun, rerata lama jadi kader 10,6 tahun, pendidikan SMA 49,4%, pekerjaan sebagai ibu rumah tangga 88,9%, pelaksanaan SDIDTK baik 50,6%, pengetahuan baik 95,1%, sikap kader baik 61,7%, fasilitas dan sarana prasarana memadai 23,5%, dukungan masyarakat baik 74,1%, dukungan bidan baik 88,9%.  Tidak ada hubungan umur kader (p=0,311), pendidikan  (p=0,146), pekerjaan (p=0,647), pengetahuan (p=0,551), sikap (p=0,218), fasilitas (p=0,233), dukungan masyarakat (p=0,749), dukungan bidan (p=0,516) dengan pelaksanaan SDIDTK. Ada hubungan pelatihan (p=0,001), lama menjadi kader (p=0,035) dengan pelaksanaan SDIDTK Ada hubungan bersama-sama lama menjadi kader dan pelatihan dengan  pelaksanaan SDIDTK oleh kader. Faktor determinan pelaksanaan SDIDTK oleh kader adalah pelatihan dan lama menjadi kader. Untuk  perbaikan pelaksanaan program SDIDTK perlu diadakan pelatihan SDIDTK pada semua kader  Posyandu.
Evaluation of the Implementation of Posyandu (Integrated Service Center) Development Policy by Operasional Working Group (Pokjanal) City of Banjarmasin South Kalimantan Province (Case Study in The District of East Banjarmasin) Anggrita Sari; Lucia Ratna Kartika; Tjahjono Kuntjoro
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (344.068 KB) | DOI: 10.14710/jmki.1.3.2013.%p

Abstract

Sejak tahun 2010 di Kecamatan Banjarmasin Timur telah ditetapkan pengurus Pokjanal kecamatan berdasarkan SK No 10/2010 tentang pengurus Pokjanal kecamatan, tetapi masih ditemukan bahwa peran dan fungsinya  belum berjalan secara maksimal.. Tujuan penelitian ini  menjelaskan evaluasi pelaksanaan kebijakan pembinaan Posyandu oleh Pokjanal yang dilihat dari aspek output, Input dan proses pembinaan.    Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan waktu cross sectional. Pengumpulan data dilakukan dengan teknik wawancara mendalam  pada 4 orang pengurus Pokjanal kecamatan sebagai Informan utama, dan 10 orang sebagai informan triangulasi. Analisa data menggunakan metode content analysisHasil penelitian menunjukkan  Pokjanal kecamatan secara organisatoris sudah dibentuk,  tetapi berdasarkan evaluasi yang dilakukan dari aspek output ditemukan tidak ada kelengkapan data dan Informasi, tidak pernah dilakukan analisis masalah dan intervensi, tidak pernah menyusun rencana tahunan dan penjadwalan kegiatan pembinaan, kegiatan koordinasi dan laporan hasil kegiatan tidak pernah dilakukan. Aspek Input  dilihat dari SDM, Sarana/prasarana serta Pendanaan  tidak berjalan sesuai dengan peran dan fungsinya dalam pembinaan Posyandu dan aspek proses berupa pengumpulan data, informasi dan analisis masalah tidak pernah dilakukan. Penyusunan rencana tahunan,  pemantauan serta evaluasi kegiatan juga tidak berjalan sesuai dengan fungsinya karena tidak ada sosialisasi dan  petunjuk teknis yang dijadikan pedoman kerja sehingga tidak ditemukan dokumen laporan  kegiatan Pokjanal. Kesimpulan yang diperoleh dari penelitian ini adalah tidak berfungsinya organisasi Pokjanal  dilihat dari aspek  output  bahwa kegiatan pembinaan Posyandu belum berjalan, aspek input  tidak berfungsi sesuai perannya dan aspek proses tidak dilakukan sesuai dengan pedoman Pokjanal. Saran yang dapat diberikan adalah perlu komitmen dan ketegasan dari stakeholder serta perlu optimalisasi koordinasi dan komunikasi lintas sektor dan program.Since 2010, in East Banjarmasin sub-district, members of sub-district operational team work (pokjanal) had been established based on the decree no. 10/2010 regarding sub-district Pokjanal board member. The role and function of this pokjanal was not maximal. Objective of this study was to evaluate the implementation of posyandu supervision by pokjanal based on supervision output, input, and process aspects.This was a descriptive-qualitative study with cross sectional approach. Data collection was done using in-depth interview technique on four sub-district pokjanal board members as main informants. Triangulation informants consisted of ten people. Content analysis was applied in the data analysis. Results of the study showed that sub-district pokjanal was established. However, based on evaluation on output aspect, it was found that completeness of data and information were insufficient; problem analysis and intervention were not done; annual planning and supervision activity schedule formulation were not performed; coordination activity and report of activities results were not done. Input aspect: human resource, facilities, and funding were not provided according to the role and function of pokjanal in implementing the supervision. Process aspect: data collection, information, and problem analysis were not done. Annual plan formulation, monitoring and activity evaluation were not implemented according to pokjanal function. This was caused by no socialization and technical guidance that could assist the work of pokjanal; therefore, no pokjanal activity report documents were found.Conclusion of this study was that Pokjanal organization did not function properly. Reasons for this condition could be viewed from output aspect: posyandu supervision activity was not done; input aspect: Pokjanal did not function according to their role; process aspect was not implemented according to the pokjanal guideline. It is suggested that stakeholder commitment and clarity are needed; cross sectors and cross programs coordination and communication should be optimized.

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