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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
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Search results for , issue "Vol 2, No 2 (2014): Agustus 2014" : 10 Documents clear
Implementation of Delivery Planning and Complication Prevention Program by Midwives at Primary Healthcare Center in Ambon Hasnawati Hasnawati; Atik Mawarni; Lucia Ratna Kartika
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (835.119 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakProgram Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dicanangkan untuk mempercepat penurunan Angka Kematian Ibu (AKI). Pelaksanaan program ini di Ambon belum optimal. Tujuan penelitian ini adalah menjelaskan implementasi dan faktor-faktor terkait P4K oleh bidan pada Puskesmas di Kota Ambon.Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan waktu cross sectional. Pengumpulan data dilakukan dengan tehnik wawancara mendalam (Indepth Interview) pada 3 bidan pelaksana P4K sebagai informan utama, 3 Kepala Puskesmas dan seorang Kabid Kesehatan Keluarga serta 3 orang ibu pasca salin 0-42 hari sebagai informan triangulasi. Analisa data menggunakan metode analisis isi (content analysis).Hasil dari penelitian menunjukkan bahwa implementasi P4K yaitu pemberian konseling secara komperhensif belum dilakukan oleh bidan. Kunjungan Antenatal (ANC) belum dilakukan sesuai standar. Masih ada persalinan yang ditolong dukun. Penggunaan KB pasca salin belum mencapai target. Tabulin dan penggalangan donor darah belum dilaksanakan. Sosialisasi program kepada masyarakat dan lintas sektor masih kurang. Jumlah bidan belum memadai. Sarana prasarana belum memadai serta tidak ada alokasi dana untuk kegiatan sosialisasi. Lemahnya manajemen kontrol dari Dinas Kesehatan Kota Ambon dan kepala Puskesmas. Bidan belum melaksanakan forum komunikasi khusus P4K. Sikap bidan pelaksana setuju dan berkomitmen baik dalam pelaksanaan P4K. SOP pelaksanaan P4K belum tersedia.Implementasi Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) oleh bidan di Kota ambon belum berjalan baik karena belum ada kebijakan daerah yang mengikat untuk mendukung P4K, komunikasi kepada masyarakat yang kurang, tenaga bidan, sarana dan dana yang belum memadai, lemahnya manajemen kontrol darin Dinas Kesehatan Kota Ambon serta belum adanya SOP untuk pelaksanaan P4K.AbstractThis was a descriptive-qualitative study with cross sectional time approach. Data collection was done using in-depth interview technique to 3 P4K executor midwives as main informants. Triangulation informants were three heads of primary healthcare centers, head of family health unit of Ambon district health office (DKK), and three mothers who gave birth in the last 0-42 days. Content analysis method was applied in the data analysis.Results of this study showed that P4K implementation in the form of giving comprehensive counseling was not done by midwives. Antenatal care (ANC) visit was not conducted according to the standard. Delivery assisted by ‘dukun’ was still found. Post delivery contraception use did not attain the target. ‘Tabulin’ (savings for giving birth time) and blood donor collection was not performed. Program socialization to the community and cross sectors was still insufficient. The number of midwives was still insufficient. Facilities were still insufficient, and no funding allocation for socialization activity was provided. Management control from Ambon city health office and head of puskesmas was inadequate. Communication forum for P4K was not performed by midwives. Commitment and attitude of P4K executor midwives were good. No standard operating procedure (SOP) for P4K implementation was provided.Implementation of P4K by midwives in Ambon city was insufficient. It was caused by no local policy that supported P4K; lack of communication to the community; insufficient number of midwives, facilities, and funding; inadequate management control by Ambon city health office; and no SOP for P4K implementation. 
Analysis on the Difference of Partograph Usage and the Associated Factors Between Private Practice and Village Midwives in Banjar District South Kalimantan Province Erni Yuliastuti; Martha Irene Kartasurya; Dharminto Dharminto
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1779.835 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakPartograf sebagai alat bantu dalam pemantauan kemajuan persalinan merupakan standar dalammemberikan asuhan persalinan dan berguna untuk mencegah terjadinya keterlambatan penanganan.Hasil studi pendahuluan pada lima wilayah kerja Puskesmas di Kabupaten Banjar menunjukkan50% bidan di desa dan 30% Bidan Praktik Swasta (BPS) belum memanfaatkan partograf secararutin. Penelitian ini bertujuan untuk menganalisis perbedaan pemanfaatan partograf dan faktor yangterkait oleh bidan di desa dan BPS. Jenis penelitian ini adalah observasional analitik denganpendekatan cross sectional. Variabel bebas adalah status kepegawaian yaitu BPS dan bidan di desa.Variabel terikat yaitu pemanfaatan partograf, pendidikan, masa kerja, pengetahuan, sikap, motivasi,dan persepsi supervisi. Pengumpulan data melalui wawancara dengan kuesioner terstruktur danlembar observasi. Populasi penelitian adalah seluruh bidan di desa dan BPS di Kabupaten Banjar.Responden sejumlah 86 orang dipilih secara purposif dan proporsional terhadap jumlah bidan ditiap Puskesmas. Analisis bivariat dilakukan dengan Mann Whitney Test dan analisis multivariatdengan regresi logistik. Hasil penelitian menunjukkan sebagian besar responden memiliki pendidikanDiploma III. Rerata umur BPS 39 tahun dan bidan di desa 36 tahun, rerata masa kerja BPS 18 tahundan bidan di desa 15 tahun. Pemanfaatan partograf oleh BPS lebih tinggi (83,7%) daripada bidan didesa (65,1%). Pengetahuan dan sikap BPS terhadap pemanfaatan partograf baik, sedangkan bidandi desa kurang. Motivasi dan persepsi supervisi BPS dan bidan di desa baik. Pemanfaatan partograf,pengetahuan dan sikap BPS terhadap pemanfaatan partograf lebih baik daripada bidan di desa.Faktor yang berpengaruh terhadap pemanfaatan partograf oleh BPS dan bidan di desa adalah sikap.Disimpulkan bahwa pemanfaatan partograf oleh BPS lebih baik daripada bidan desa. Faktordeterminan pemanfaatan partograf oleh bidan di desa dan BPS adalah sama, yaitu sikap terhadappemanfaatan partograf. AbstractPartograph, a supporting tool for monitoring the progress of delivery process, was a standard tool used in a delivery process, and it could be utilized to prevent delayed action. Results of a preliminary study on five work areas of primary healthcare centers (puskesmas) in Banjar district showed that 50% of village midwives and 30% of private practice midwives (BPS) did not use Partograph routinely. Objective of this study was to analyze the difference on the utilization of Partograph and related factors by village midwives and BPS. This was an observational-analytical study with cross sectional approach. Independent variable was worker status namely BPS and village midwives. Dependent variables were Partograph utilization, education, working period, knowledge, attitude, motivation, and perception on supervision. Data collection was done through interview guided by structured questionnaire and observation sheet. Study population was all village midwives and BPS in Banjar district. Study respondents were 86 midwives selected purposively and proportionally from each puskesmas. Mann Whitney test was applied in the bivariate analysis. Logistic regression was applied in the multivariate analysis. Results of the study showed that majority of respondents’ level of education were D3. The average age of BPS was 39 years old, and for village midwives was 36 years old. The average working period of BPS was 18 years old, and for village midwives was 15 years old. Utilization of Partograph by BPS was higher (83.7%) than that of by village midwives (65.1%). Knowledge and attitude of BPS toward Partograph utilization was good; however, it was still insufficient for village midwives. Motivation and perception on supervision by BPS and village midwives were good. A factor affecting the utilization of Partograph by BPS and village midwives was attitude towards Partograph utilization. In conclusion, utilization of Partograph by BPS was better than by village midwives, and the affecting factor was attitude. 
Analysis on the Implementation System of Early Breastfeeding Initation by Village Midwives in Pati District Mamik Aryani; Sri Achadi Nugraheni; Anneke Suparwati
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (748.291 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakPada tahun 2010 Kabupaten Pati berada pada urutan 16 tertinggi dari 35 kabupaten di Jawa Tengah yaitu masih >10 per 1.000 KH masih diatas target tahun 2013 Jawa Tengah sebesar 8,9 per 1.000 KH. Dengan IMD dapat menyelamatkan bayi karena Skin-to-skin akan memberikan kehangatan dan perlindungan pada bayi dan colustrum merupakan imunisasi pertama bagi bayi yang mengandung zat-zat kekebalan tubuh yang tidak tergantikan. Keberhasilan pelaksanaan inisiasi menyusui dini (IMD) sangat di pengaruhi oleh pengetahuan, sikap dan motivasi bidan atau penolong persalinan itu sendiri.Jenis penelitian adalah observasional kualitatif. Informan penelitian adalah 8 Bidan desa yang dipilih dari 2 Puskesmas, masing-masing 4 orang. Informan triangulasi adalah 8 pasien, 2 bidan koordinator dan 2 kepala Puskesmas. Data dikumpulkan dengan wawancara mendalam dan observasi terhadap pelaksanaan IMD. Pengolahan metode content analysis.Hasil penelitian menunjukkan 4 dari 8 bidan desa di polindes tidak sealu melaksanakan IMD karena pasien tidak menghendaki untuk dilakukan IMD, dan dalam pelaksanaan IMD dengan cara yang tidak tepat, kemampuan kognitif semua informan utama tentang IMD masih kurang. Dapat dilihat dari semua jawaban informan utama kurang tepat dalam menjawab tentang pengertian, manfaat dan langkah-langkah pelaksanaan IMD karena semua bidan hanya berbekal peltihan APN dan belum pernah mengikuti pelatihan manajemen laktasi karena terhambat pada dana.Pelaksanaan IMD dipolindes oleh bidan desa tidak tepat. Terdapat 7 Langkah IMD yang di keluarkan oleh Kementrian Kesehatan Republik Indonesia yang seharusnya di dilaksanakan namun oleh bidan desa dalam pelaksanaan IMD tidak dilaksanakan. Diharapkan khususnya bidan desa selalu melaksanakan IMD pada setiap menolong persalinan. AbstractInfant mortality rate (IMR) in Pati district, in 2010, was > 10 per 1000 live births. It was the highest 16 th among 35 districts in Central Java province, and it was above the target of Central Java province, 8.9 per 1000 live births. Early breastfeeding initiation (IMD) could save infants due to skin-to-skin contact (contact between mother and child skins). Skin-to-skin contact gave warmness and protection to the infants. In addition, colostrum (the first breast milk being expressed) was a first immunization for infant. It contained irreplaceable body immune elements. Successfulness of IMD was influenced by knowledge, attitude, and motivation of midwives or delivery assistants. Results of a preliminary study showed that the IMD implementation was still inadequate. Village midwives did not implement IMD when they assisted deliveries because they were not patient to wait to implement IMD. The implementation of IMD was influenced by system that included input, process, and output. This system could determine the success of IMD. Objective of this study was to analyze early breastfeeding initiation system in the village maternity policlinics (polindes) by village midwives in Pati district. This was an observational qualitative study. Study informants were 8 village midwives selected from 2 primary healthcare centers (puskesmas); 4 informants were selected from each puskesmas. Triangulation informants were 8 patients, 2 midwives coordinators, and 2 heads of puskesmas. Data were collected by conducting in-depth interview and observation toward IMD implementation. Content analysis method was applied in the data management. Results of the study showed that four of eight village midwives in the polindes did not implement IMD continuously because patients did not want to do IMD; implementation of IMD was not done properly; cognitive ability of the main informants regarding IMD was insufficient. The main informants did not answer properly questions regarding definition, benefits, and steps to do IMD. All midwives were only equipped with knowledge from APN training, and they did not receive training regarding lactation management due to funding constraint. The implementation of IMD in the polindes by village midwives was not proper. Seven steps to implement IMD issued by Ministry of Health of the Indonesian Republic were not done by village midwives. Village midwives are suggested to always implement IMD when they assist a delivery.
Factors that Affect the Performance of the Village Midwife in the Standard Implementation of Midwifery Birthing Mothers and Orphans in Semarang Setiyana Sri Subekti; Laksmono Widagdo; Lucia Ratna Kartika Wulan
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (514.178 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakSalah satu indikator pelayanan kesehatan yang berkualitas dapat terlihat dari perbandingan AKI (Angka Kematian Ibu ) dan AKB ( Angka Kematian Bayi ). Di Kabupaten Semarang , AKI tahun 2010 mencapai 101, 92/ 100.000 kelahiran hidup,dan pada tahun 2011 naik menjadi 146,24/100.000 kelahiran hidup. Penyebab langsung kematian ibu 90 % disebabkan karena persalinan dan segera setelah persalinan. Penyebab kematian ibu diantara lain perdarahan (52%), ekalmasi (18 %), infeksi (15 %), persalinan lama (15 %). Untuk menurunkan angka kematian ibu, harus dilakukan pelayanan kesehatan maternal yang berkualitas sesuai dengan standar asuhan. Pelaksanaan standar asuhan di Kabupaten semarang belum dilaksanakan dengan baik. Tujuan penelitian adalah untuk menganalisis faktor-faktor yang mempengaruhi kinerja bidan desa dalam penerapan standar asuhan kebidanan ibu bersalin oleh bidan desa di Kabupaten Semarang. Jenis penelitian adalah observasional analitik dengan pendekatan crosssectional.Cara pengambilan data dilakukan dengan wawancara menggunakan kuesioner. Populasi adalah 311 bidan desa di Kabupaten Semarang. Pengambilan sampel dipilih dengan tehnik proportional random sampling dari bidan desa yang memenuhi kriteria inklusi dan eksklusi pada tiap puskesmas. Analisis data dilakukan dengan uji product moment dan regresi linier.Hasil penelitian menunjukkan bahwa bahwa rerata umur responden 33 tahun, dengan rerata masa kerja 11 tahun, pendidikan responden sebagian besar D III kebidanan (72,36 %). Hasil analisis univariat menunjukkan bahwa kinerja bidan desa dalam penerapan standar asuhan kebidanan ibu bersalin fisiologis adalah kurang (83 %), kinerja bidan dalam penerapan standar asuhan kebidanan ibu bersalin patologi kurang (87%), pengetahuan kurang (57 %), motivasi tinggi (51%), persepsi supervisi kurang (55 %), persepsi beban kerja rendah (57 %), persepsi imbalan kurang (57 %), persepsi sanksi kurang (55 %). Faktor yang berhubungan dengan kinerja adalah pengetahuan (nilai p = 0,000), motivasi (nilai p =0,007), persepsi supervisi ( nilai p = 0,008), persepsi beban kerja (nilai p =0,012), persepsi imbalan (nilai p = 0,000), persepsi sanksi (nilai p = 0,000). Faktor yang berpengaruh terhadap kinerja bidan desa dalam penerapan standar asuhan kebidanan ibu bersalin adalah pengetahuan (p = 0,000), persepsi beban kerja (p = 0,027), persepsi sanksi (p = 0,000).Saran bagi Dinas Kesehatan Semarang adalah sosialisasi tentang pelayanan ibu bersalin sesuai standar asuhan kebidanan kepada seluruh bidan desa, Memperbaiki teknik supervisi yang diterapkan antara lain dengan penyusunan jadwal supervisi dan kesepakatan waktu antara supervisor dan staf tentang pelaksanaan supervisi. AbstractIn Semarang district, maternal mortality rate (AKI) increased from 101.92/ 100000 live-births in 2010 to 146.24/100000 live-births in 2011. The majority of death patients were caused by referral delay and a delay in detection of in labour emergency signs. This indicated that the implementation of obstetric standard care in Semarang district was not done properly. Objective of the study was to analyze factors affecting work performance of village midwives in the application of obstetric standard care for in labour mothers in Semarang district. This was an observational analytical study with cross sectional approach. Data were collected through interview guided by questionnaire. Study population was 311 village midwives in Semarang district. The number of respondents was 76 midwives selected purposively according to inclusion and exclusion criteria in each primary healthcare center. Product moment test and linear regression were applied in the data analysis.Results of the study showed that average age of respondents was 33 years old, average working period was 11 years old, majority of respondent’s education background was D III in midwifery (72.36%). Work performance of village midwives in the implementation of obstetric standard care for physiological mother in labour was insufficient (83%), work performance of village midwives in the implementation of obstetric standard care for pathological mother in labour was insufficient (87%), respondents with insufficient knowledge was 57%, respondents with high motivation was 51%, respondent’s perception on supervision was inadequate (55%), respondent’s perception on workload was low (57%), respondent’s perception on incentive was insufficient (57%), and respondent’s perception on sanction was inadequate (55%). Factors related to work performance of village midwives were knowledge (p= 0.000), motivation (p= 0.007), perception on supervision (p= 0.008), perception on workload (p= 0.012), perception on incentive (p= 0.000), perception on sanction (p= 0.000). Factors affecting work performance of village midwives in the implementation of obstetric standard care for in labour mothers were knowledge (p= 0.000), perception on workload (p= 0.027), perception on sanction (p= 0.000). Suggestions for Semarang district health office are to conduct refreshing on maternity services according to obstetric standard care to all village midwives, to improve supervision technique by implementing facilitative supervision. 
Analysis on Internal and External Factor Related to the Performance of Midwives in Neonatal Visits in Pati District Ferry Rachmawatie Suryaningtyas; Sri Achadi Nugraheni; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (693.925 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakDi Kabupaten Pati Kunjungan Neonatal selama 3 tahun terakhir cenderung mengalami fluktuasi, 93,75% pada tahun 2009, 90,79% pada tahun 2010, dan 97,02% pada tahun 2011. Keadaan ini menunjukkan belum semua bidan desa melaksanakan Kunjungan Neonatal. Tujuan penelitian menganalisis faktor internal dan faktor eksternal yang berhubungan dengan kinerja bidan desa dalam kunjungan neonatal di Kabupaten Pati.Jenis penelitian studi kuantitatif pendekatan cross-sectional. Subjek sejumlah 82 bidan desa yangdipilih secara Cluster Puskesmas. Pengumpulan data dengan wawancara menggunakan kuesioner terstruktur. Data dianalisis secara univariat, bivariat dengan  Chi Square, sedangkan multivariat dengan regresi logistik.Median dan simpang baku umur bidan desa 30 + 5,6 tahun, 91,5% berstatus kawin, median dan simpangan baku masa kerja 5,7 + 4,2 tahun, 70,7% memiliki pengetahuan baik dan sebagian besar 62,2% memiliki motivasi baik. Sebagian besar bidan desa 75,6% menyatakan supervisi baik, 51,2% memiliki persepsi kepemimpinan baik, 56,1% belum pernah mengikuti pelatihan kegawatdaruratan neonatal dan sebagian besar 65,9% menyatakan kompensasi yang diterima baik. Faktor yang berhubungan kinerja adalah umur, masa kerja, pengetahuan, motivasi, supervisi, kepemimpinan, pelatihan, dan kompensasi. Ada pengaruh bersama-sama pengetahuan, supervisi, kompensasi dan motivasi terhadap kinerja bidan desa dalam kunjungan neonatal. Pengetahuan memiliki pengaruh paling kuat terhadap kinerja bidan desa.Disarankan kepada Dinas Kesehatan Kabupaten Pati melaksanakan supervisi sesuai prosedur, menaikkan kompensasi untuk meningkatkan motivasi kerja bidan desa AbstractCoverage of neonatal visit in Pati district in the last 3 years showed fluctuation; 93.75% in 2009, 90.79% in 2010, and 97.02% in 2011. This condition indicated that not all village midwives conducted neonatal visit properly. Objective of this study was to analyze internal and external factors related to the work performance of village midwives in conducting neonatal visits in Pati district. This was an observational-analytical study with cross sectional approach. Study subjects were 82 village midwives selected using clustered random sampling method at primary healthcare center (puskesmas) level. Data were collected through questionnaire. Chi square test and logistic regression were applied in the data analysis. Results of the study showed that median and standard deviation of the age of village midwives were 30 ± 5.6 years old, 91.5% of respondents were married, median and standard deviation of the work period were 5.7 ± 4.2 years, 70.7% of respondents had adequate knowledge, and 62.2% of respondents had good motivation. Majority of village midwives (75.6%) stated that supervision was good, 51.2 % of respondents had good perception on leadership, 56.1% of respondents did not have training experience in the management of neonatal emergency, and 65.9% of respondents stated that they received insufficient compensation. Factors related to the work performance were age, period of work, knowledge, motivation, supervision, leadership, training, and compensation. Factors, in common, affecting the work performance of village midwives in conducting neonatal visit were knowledge, supervision, compensation, and motivation. Knowledge was the strongest factor affecting the work performance of village midwives. Suggestions for Pati district health office are to increase training opportunity for village midwives, to improve supervision, to improve rewards system in order to increase work motivation.
Factors Related to the Implementation of Infection Prevention Procedures on Normal Delivery Cares in Pati District (Study on Normal Delivery Care Trained Midwives) Ulin Nafiah; Cahya Tri Purnami; Lucia Ratna Kartika Wulan
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (683.53 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakAKI di Kabupaten Pati tahun 2011 meningkat lagi menjadi 24 kasus (116.17/100.000 KH) dengan penyebab langsung kematian ibu masih saja didominasi oleh perdarahan 3 kasus (12.5%), infeksi 2 kasus (8.33%), hipertensi 8 kasus (33.33%), eklamsi 1 kasus. Tujuan penelitian adalah untuk menganalisis beberapa faktor yang mempengaruhi pelaksanaan tindakan pencegahan infeksi pada pertolongan persalinan oleh bidan desa pasca pelatihan asuhan persalinan normal di Kabupaten Pati.Jenis penelitian observasional dengan pendekatan  cross sectional  Populasi adalah seluruh bidandesa pasca pelatihan APN. Jumlah sempel 69 bidan desa pasca pelatihan APN dipilih secara  purposive dengan kriteria inklusi. Pengumpulan data dengan kuesioner terstruktur dan observasi langsung. Data dianalisis secara kuantitatif dengan uji korelasi Chi-square dengan metode Yate Correction dan regresi logistik linear.Responden mempunyai pengetahuan baik (76,2%), responden mempunyai sikap baik (75,0%), responden mempunyai motivasi baik (71,4%), responden mempunyai persepsi terhadap supervisi baik (69,8%), responden mempunyai peralatan lengkap (70,8%), responden melaksanakan prosedur pencegahan infeksi dalam kategori baik (59,4%). Faktor yang mempengaruhi pelaksanaan prosedur pencegahan infeksi adalah pengetahuan (ρ = 0,001), sikap (ρ = 0,0001), motivasi (ρ = 0.004), supervisi (ρ = 0,046), peralatan (ρ = 0,008).Semua variabel (pengetahuan, sikap, motivasi, supervisi, dan peralatan) berpengaruh terhadap pelaksanaan prosedur pencegahan infeksi karena nilai signifikan dibawah 0.05 (p-value < 0.05) namun variabel yang paling berpengaruh adalah sikap (p-value = 0.000, Exp(B) =9.6000)  dan pengetahuan (p-value = 0.001, Exp(B) = 6.400).Kepada Dinas Kesehatan dan organisasi IBI Kabupaten Pati untuk memberikan pembinaan agar lebih meningkatkan ketrampilan dan pengetahuan bidan desa yang terkait dengan tugas dan fungsi bidan lewat pelatihan-pelatihan, supervisi yang positif terutama tentang prosedur pencegahan infeksi pada pertolongan persalinan. AbstractMaternal mortality rate (AKI) in Pati district in 2011 increased to 24 cases (116.17/100000 live- births). Direct causes of maternal death were dominated by hemorrhage (3 cases or 12.5%), infection (2 cases or 8.33%), hypertension (8 cases or 33.33%), and eclamsia (1 case). Therefore, analysis of factors affecting the implementation of infection prevention actions in the delivery assisted by village midwives with post normal-delivery care (APN) training in Pati district was done. This was an observational study with cross sectional approach. The number of samples was 69 village midwives with post APN training. They were selected purposively according to the inclusion criteria. Data were collected through interview guided by structured questionnaire and through direct observation. Data were analyzed quantitatively by applying Chi Square test, Yate Correction, and linear logistic regression. Results of the study showed that respondents had good knowledge (76.2%), good attitude (75.0%), good motivation (71.4%), good perception on supervision (69.8%), complete instruments (70.8%), and good category for the implementation of infection prevention procedure (59.4%). Factors affecting the implementation of infection prevention procedure were knowledge (p= 0.001), attitude (p= 0.0001), motivation (p= 0.004), supervision (p= 0.046), instruments (p= 0.008). All variables (knowledge, attitude, motivation, supervision, and instruments) influenced the implementation of infection prevention procedure (p-value d” 0.05). However, the most influencing variables were attitude (p= 0.000, Exp(B) = 9.60) and knowledge (p= 0.001, Exp(B) = 6.40). Suggestions for district health office and IBI organization of Pati district are to give guidance to improve skills and knowledge of village midwives related to the job and function of midwives; it can be done through trainings, positive supervision mainly on infection prevention procedure in delivery assistance.
Analysis of the Difference between Iron Supplementation Program and Primary Healthcare Center in Kendal Vepti Triana Mutmainah; Sri Achadi Nugraheni; Anneke Suparwati
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (660.77 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakBerdasarkan SDKI survei terakhir tahun 2007 AKI Indonesia sebesar 228 per 100.000 Kelahiran Hidup. Salah satu penyebabnya adalah anemia. Untuk mengatasi masalah anemia kekurangan zat besi pada ibu hamil pemerintah Depkes RI sejak tahun 1970 telah melaksanakan suatu program pemberian tablet zat besi pada ibu hamil di seluruh Puskesmas dan Posyandu. Kenyataannya program tersebut sulit dilaksanakan, ditunjukan dengan hasil cakupan di Kendal 53,2 %. Berdasarkan hasil prasurvey disampaikan bahwa satu tahun terakhir belum ada monitoring program, Standar operasional prosedur belum ada, dana yang disediakan untuk program belum mencukupi, baru 40% dana yang tersedia. Tujuan penelitian ini adalah untuk menganalisis implementasi program suplementasi tablet besi ibu hamil di puskesmas wilayah Dinas Kesehatan Kendal.Penelitian ini termasuk penelitian deskriptif eksploratif yang dilakukan dengan metode kualitatif dan menggunakan analisis konten. Informan utama yaitu 4 orang petugas gizi di Puskesmas dan informan triangulasi yaitu 4 orang Pimpinan Puskesmas, 2 orang pembuat kebijakan dari DKK Semarang dan 4 orang ibu hamil.Hasil penelitian menunjukkan bahwa implementasi program suplementasi tablet besi ibu hamil di puskesmas dengan cakupan tinggi dan rendah tidak ada perbedaan yang signifikan. Demi kesinambungan program dan mencapai tujuan perlu adanya pembahasan permasalahan dan selanjutnya keputusan di SK kan dan disosialisasikan. AbstractBased on the last SDKI survey in 2007, Indonesian maternal mortality rate (AKI) was 228/100000 live-births. One of causes of maternal death was anemia. To solve iron deficiency anemia problems on pregnant women, Indonesian Ministry of Health had implemented iron tablet distribution program to pregnant women in all puskesmas (primary healthcare center) and posyandu (integrated health services post) since 1970. In reality, that program was difficult to implement; it was shown by the fact that coverage of iron tablet distribution in Kendal was only 53.2%. Results of preliminary survey showed that no monitoring program was performed during the last year, no standard operating procedure was formulated, and funding provided for the program was insufficient; the available funding was only 40%. Objective of this study was to analyze the implementation of iron tablet supplementation program for pregnant women in the work area of Kendal district health office. This was a descriptive-explorative study with qualitative method, and using content analysis method. Main informants were 4 nutritional staffs in puskesmas. Triangulation informants were 4 heads of puskesmas, 2 policy makers from Semarang city health office, and 4 pregnant women. Results of the study showed that implementation of iron tablet supplementation for pregnant women in the puskesmas with high and low iron tablet coverage indicated no significant difference. For the continuity of the program and to attain the objective, discussions on the problems are needed; then decisions are legitimated by issuing decrees and conducting socialization.
Analysis of Determinant Factors of Midwives Behaviour on the Implementation of Infection Prevention Standard at Family Planning Services in Malang District Sulastri Sulastri; Zahroh Shaluhiyah; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (907.722 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakAplikasi pelayanan KB oleh bidan membutuhkan kepatuhan melaksanakan kewaspadaan standar (standar precaution) untuk memenuhi prasyarat pelayanan KB yang bermutu karena risiko infeksi dapat terjadi pada KB IUD dan Implant. Berdasarkan wawancara masih ada sebagian bidan belum melaksanakan pencegahan infeksi sesuai standar. Penelitian ini bertujuan menganalisis pengaruh pengetahuan, sikap, motivasi, persepsi bidan tentang supervisi dan kelengkapan sarana prasarana terhadap perilaku standar pencegahan infeksi pelayanan KB di Kabupaten Malang.Desain penelitian cross sectional dengan pendekatan kuantitatif, pengambilan sampel metode Simple Random Sampling, dengan kriteria inklusi: bidan yang bekerja di wilayah Kabupaten Malang, bidan yang memberikan praktik mandiri, dan mempunyai latar belakang pendidikan minimal D3 kebidanan sejumlah 131 responden.Hasil Penelitian menunjukkan pengetahuan bidan rendah 45,8%, sikap bidan kurang baik 43,5%, motivasi bidan rendah 49,6%, persepsi mengenai supervisi kurang baik 46,6%, sarana prasarana tidak lengkap 45,0%, perilaku pencegahan infeksi tidak sesuai standar 49,6%. Ada hubungan pengetahuan bidan, sikap bidan, motivasi bidan, persepsi bidan mengenai supervisi, dan sarana prasarana dengan perilaku standar pencegahan infeksi. Ada pengaruh secara bersama-sama antara pengetahuan (Exp (B) = 19,293), sikap (Exp (B) = 6,691), motivasi (Exp (B) = 12,112), dan sarana prasarana (Exp (B) = 34,458) terhadap perilaku standar pencegahan infeksi.Saran: untuk meningkatkan perilaku bidan dalam pelaksanaan standar pencegahan infeksi perlu dilakukan pembinaan dan memotivasi secara terus menerus kepada bidan agar melengkapi sarana prasarana sesuai SOP, dan meningkatkan pengetahuan melalui pelatihan atau seminar, serta melakukan supervisi bekerjasama antara Dinas Kesehatan dengan IBI. AbstractApplication of family planning (KB) service by midwives required an obedience to implement standard precaution in order to fulfill requirement of a qualified KB service. Risk of infection could occur in KB IUD and Implant. Based on the interview, not all midwives implemented infection prevention according to the standard. Objective of this study was to analyze the influence of knowledge, attitude, motivation, and perception of midwives regarding supervision and completeness of facility toward midwives behaviors on the infection prevention standard in the KB service in Malang district. This was a quantitative study with cross sectional approach. Samples were selected using simple random sampling method. Inclusion criteria applied in this study were midwives who worked in the Malang district area, conducted self employed (mandiri) practice, and had D3 in midwifery as a minimum level of education. The number of respondent was 131 respondents. Results of the study showed that knowledge of midwives was insufficient (45.8%); attitude of midwives was not good (43.5%); motivation of midwives was inadequate (49.6%); facilities were not complete (45.0%); infection prevention behavior was not according to the standard (49.6%). Associations were shown between midwives behavior on the infection prevention standard and midwives’ knowledge, attitude, motivation, perception on supervision, facilities. Joint effect was shown among knowledge (Exp (B)= 19.293), attitude (Exp (B)= 6.691), motivation (Exp (B)= 12.112), and facilities (Exp (B)= 34.458) toward midwives behavior on the infection prevention standard. To improve behavior of midwives in the implementation of infection prevention standard, it is needed to guide and to motivate midwives to complete facilities according to SOP; Improvement of midwives’ knowledge through training or seminars is required. Supervision was needed in collaboration with district health office and IBI.
Performance Analysis in the Village Midwife Neonatal Care in Infants with Low Birth Weight in PHC Pati Puji Hastuti; Atik Mawarni; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (583.579 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakDari data tahun 2009-2010 menunjukkan bahwa Kasus BBLR serta AKB yang cukup tinggi dan berdasarkan survei pendahuluan didapatkan bahwa kinerja bidan desa dalam pelayanan neonatal pada BBLR belum optimal, pencatatan hasil pelayanan neonatal belum dilaksanakan dengan baik, fasilitas/alat belum dimanfaatkan secara maksimal dan supervisi dilakukan berdasarkan laporan hasil kegiatan. Tujuan penelitian ini adalah menjelaskan bagaimana kinerja bidan desa dalam pelayanan neonatal di Kabupaten Pati. Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan analitik kualitatif. Informan penelitian adalah bidan desa di wilayah Puskesmas Kabupaten Pati. Data dikumpulkan dengan wawancara mendalam (indepth interview) dan selanjutnya dilakukan pengolahan data menggunakan metode analisis isi (content analysis). Hasil penelitian menunjukkan bahwa kinerja bidan desa dalam pelayanan neonatus belum dilaksanakan sesuai standar pelayanan neonatal pada BBLR baik dari pemberian pelayanan dan penerapan jadual pelayanan neonatal, sumber daya belum dimanfaatkan secara optimal dan ketersediaan fasilitas belum merata, serta kelengkapan alat pemeriksaan bayi dilakukan secara mandiri. Pengawasan dalam bentuk supervisi suportif dan belum sesuai dengan kebutuhan bidan desa yaitu terjadual, rutin, materi dan waktu berkaitan dengan kegiatan pelayanan neonatal pada BBLR, Jalinan kerja sama sudah dilaksanakan secara maksimal dan menyeluruh. AbstractNumber of Low Birth Weight Babies (LBWB) cases and Maternal Mortality Rate from 2009 to 2010 was high. The result of preliminary study revealed that the performance of village midwives in providing neonatal services for LBWB had not been optimal, recording results of neonatal services had not been done well, available facilities had not been used optimally, and supervision was just conducted based on the reports of activities. This research aimed to explain village midwives’ performance in providing neonatal services in District of Pati. This was descriptive-qualitative research with analytic-qualitative approach. Informants were village midwives at work area of Health Centers in District of Pati. Data were collected using indepth interview and analyzed using content analysis. The result of this research showed that village midwives in providing neonatal services had not conducted in accordance with the service standards for LBWB especially in terms of the methods and the schedule of services. In addition, resources had not been used optimally, availability of facilities had not been distributed equally, and baby proofing tools were prepared independently. Form of monitoring was supportive supervision and had not been in accordance with midwives’ necessity namely scheduled, routine, materials and time integrated with the activities of providing neonatal for LBWB. Additionally, cooperation had been done comprehensively.
Analysis on Factors Associated with the Implementation of the Pulmonary Tuberculosis Care Finding in Tuberculosis Control Program at Primary Healthcare Center in Semarang Rosmila Tuharea; Anneke Suparwati; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (780.034 KB) | DOI: 10.14710/jmki.2.2.2014.%p

Abstract

AbstrakKeberhasilan penanggulangan tuberkulosis di kota Semarang sangat bervariatif berdasarkan angka penemuan pasien TB Paru dari 37 Puskesmas yang ada di Kota Semarang hanya terdapat dua Puskesmas yang mencapai target >55% yaitu Puskesmas Karangdoro (76,67%) dan puskesmas Ngesrep (63,89%), sedangkan 35 puskesmas diantaranya belum mencapai target. Penelitian ini bertujuan untuk Mengetahui faktor-faktor yang berhubungan dengan implementasi penemuan pasien TB Paru dalam program penanggulangan TB di puskesmas Kota Semarang.Jenis penelitian adalah Explanatory Research dengan pendekatan Cross Sectional. Populasi dalam penelitian ini adalah seluruh koordinator TB Paru di Puskesmas kota Semarang sebanyak 37 orang. Analasis data dilakukan secara univariat dan bivariat.Hasil penelitian dengan uji statistik menunjukkan bahwa ada hubungan yang bermakna antara faktor komunikasi dengan penemuan pasien TB Paru (p= 0,009 <0,05), ada hubungan yang bermakna antara faktor sumberdaya dengan penemuan pasien TB Paru (p = 0,010<0,05), ada hubungan yang bermakna antara faktor disposisi dengan penemuan pasien TB Paru (p = 0,016 <0,05), dan ada hubungan yang bermakna antara faktor SOP dengan penemuan pasien TB Paru (p= 0,012<0,05).Untuk meningkatkan komunikasi yang baik dinas kesehatan perlu mengikutkan sertakan petugas yang belum mendapat pelatihan, memudahkan prosedur pelaporan pertanggung jawaban dana, pengadaan alat-alat laboratorium yaitu mikroskop terhadap puskesmas satelit, melakukan verifikasi laporan secara rutin 3 bulan sekali supaya tidak terjadi over reporting dan under reporting data TB Paru agar cakupan yang didapatkan akurat, pelaksanaan supervisi oleh dinas kesehatan dengan menggunakan daftar tilik, dan membuat dokumen perencanaan penemuan pasien TB Paru secara tertulis dengan melibatkan kepala puskesmas dan atau koordinator TB Paru di puskesmas.Kepala puskesmas melakukan pemantauan kepada koordinator TB Paru untuk selalu ikut sertadalam pertemuan koordinator TB Paru yang dilaksanakan setiap bulan, melakukan perencanaan puskesmas dalam penemuan pasien TB Paru serta perencanaan pengadaan alat laboratorium yaitu mikroskopis untuk mempermudah petugas dalam pemeriksaan dahak suspek TB Paru dan mengikutsertakan petugas TB Paru dalam pelatihan yang dilakukan baik oleh dinas kesehatan kota maupun dinas kesehatan propinsi. AbstractSuccess of tuberculosis (TB) control in Semarang city varied. Based on the case detection of pulmonary TB among 37 primary health centers (puskesmas) in Semarang city, only 2 puskesmas reached the target of 55% or more. Those Puskesmas were Karangdoro (76.67%) and Ngesrep (63.89%). The other 35 puskesmas had not reached the target. The objective of this study was to identify factors related to the implementation of pulmonary TB case detection in TB control program at Puskesmas in Semarang city. This was an explanatory research with cross sectional approach. Study population was all pulmonary TB coordinators at puskesmas in Semarang city with the total number of 37 persons. Bivariate and multivariate methods were implemented for analyzing the data. Results of the study using statistical test indicated significant association between communication factor and pulmonary TB case detection (p: 0.009), resource factor and pulmonary TB case detection (p: 0.010), disposition factor and pulmonary TB case detection (p: 0.016) and SOP factor and pulmonary TB case detection (p: 0.012) To improve a good communication, Health Office needs to include untrained workers to make the procedure of budgeting report easier, to provide laboratory facilities such as microscope to satellite puskesmas, to do routine report verification every 3 months to avoid over reporting and under reporting pulmonary TB data in order to obtain valid coverage, to do supervision by health office staffs using check list, to write pulmonary TB case detection planning documents by involving head of puskesmas and/or puskesmas pulmonary TB coordinators. Heads of puskesmas have to monitor their pulmonary TB coordinators to be involved in the pulmonary TB coordinator meeting every month, to make puskesmas planning on the pulmonary TB case detection and planning on providing the laboratory instrument that is microscopic to make it easier for laboratory workers to examine sputum of pulmonary TB suspects and to involve pulmonary TB workers in the training conducted by either district or provincial health office.

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