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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 3 (2014): Desember 2014" : 10 Documents clear
Evaluation on Rooming In Mardi Rahayu, Kudus Titik Ariyanti; Sudiro Sudiro; Lucia Ratna Kartika Wulan
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (534.395 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Tingginya Angka Kematian Bayi di Indonesia, adanya bukti ilmiah, bayi yang diberi susu formula kemungkinan meninggal lebih tinggi dibandingkan dengan yang diberi ASI eksklusif, Pelaksanaan Gerakan Rumah Sakit Sayang Ibu dan Bayi dengan melaksanakan program rawat gabung. Penelitian ini bertujuan untuk mengevaluasi pelaksanaan program rawat gabung di Rumah Sakit Mardi Rahayu Kudus. Desain penelitian deskriptif kualitatif, subyek penelitian 5 informan utama penentu kebijakan dan 5 informan trianggulasi sebagai pelaksana dan penerima program. Data dikumpulkan dengan wawancara mendalam (indepth interview), pengolahan data dengan metode analisis isi (content analysis). Hasil penelitian aspek output belum baik, ibu dan bayi dilakukan rawat gabung ± 2 jam/hari, masih diberi susu formula, Aspek input, SDM belum disesuaikan dengan standar tenaga rumah sakit tipe B, Pendanaan belum seimbang dari setiap program, sarana prasarana untuk ketersediaan, kecukupan dan kelayakan baik, sedangkan ruang nifas kelas tiga kurang lengkap dan kurang nyaman, SOP dilakukan sebagian, Pemasaran belum dilakukan. Aspek proses belum berjalan baik, kebijakan pimpinan sudah ada, sosialisasi, penggerakan dan koordinasi belum dilakukan, belum pernahdilakukan monitoring dan evaluasi, belum ada komitmen dalam pelaksanaan rawat gabung mulaidari pimpinan sampai dengan pelaksana. Simpulan Rumah Sakit Mardi Rahayu melaksanakan rawat gabung parsial, masih diberi susu formula. Dari aspek SDM belum sesui standar strata B, program dana belum seimbang, sarana prasarana kelas 3 belum swesui standar, SOP dilaksanakan sebagian, kurangnya pemasaran dan belum adanya komitmen bersama. Disarankan melaksanakan rawat gabung total dan susu formula diberikan sesuai indikasi, diadakan pelatihan manajemen laktasi, konselor ASI serta kelompok pendukung ASI, adanya monitoring dan evaluasi. Infant mortality rate in Indonesia was high. Scientific evidence showed that infants with formula milk had higher probability to die than infant with exclusive breastfeeding. Implementation of ‘Sayang Ibu dan Anak’ hospital movement was done by performing rooming in program. Objective of this study was to evaluate the implementation of rooming-in program in Mardi Rahayu hospital Kudus. This was a descriptive-qualitative study. Study subjects were five main informants as policy makers, and five triangulation informants as executors of the program. Data were collected through in- depth interview. Content analysis method was applied in the data analysis. Results of the study showed that output aspect was not good; rooming in for mother and child were conducted ± 2 hours/day; formula milk was still given. Input aspect: human resource was not standardized to the type B hospital worker standard. Budget for each program was not equal; availability, sufficiency, and feasibility of facility were good. Third class post delivery room was not complete and uncomfortable. Not all standard operating procedure was performed. Marketing was not done. Process aspect was inadequate. Leader’s policy was made; socialization, actuating, and coordination were not done; monitoring and evaluation were not done; no commitment from the leaders and executors in the implementation of rooming in. In conclusion, Mardi Rahayu hospital performed partial rooming in; formula milk was still given. Human resource aspects were not suitable with type B hospital standard; budgeting program was not equal; facilities for third class were not suitable with the standard. Not all SOP was performed; marketing was insufficient, and no collective commitment was done. It was suggested to do total rooming-in, and to give formula milk according to the indication; to do lactation management training, breast milk counselor and supporter training, to conduct monitoring and evaluation.
Factors Associated to the work Performance of Midwives in The Implementation on Stimulation, Early Detection and Intervention to Growth and Development of Infants and Pre-School Children (A Study on Midwives Working at Sidoarjo District Primary Healthcare Hanik Machfudloh; Martha Irene Kartasurya; Dharminto Dharminto
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (376.276 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Rata - rata cakupan SDIDTK balita dan anak prasekolah pada Dinas Kesehatan Kabupaten Sidoarjo tahun 2008, 2009 berturut-turut adalah 61,52% 46,93% dan masih dibawah SPM tahun 2009 yaitu 80%. Penelitian ini bertujuan mengetahui faktor-faktor yang mempengaruhi kinerja bidan dalam pelaksanaan SDIDTK balita dan anak prasekolah di Puskesmas Kabupaten Sidoarjo. Jenis penelitian observasional analitik dengan pendekatan cross sectional. Populasi penelitian adalah seluruh bidan di Puskesmas Kabupaten Sidoarjo berjumlah 375 bidan. Subjek penelitian sejumlah 77 bidan dipilih secara proportional random sampling berdasarkan Puskesmas. Pengumpulan data dengan angket dan observasi. Variabel bebas adalah pengetahuan, sikap, motivasi, beban kerja, peralatan dan persepsi supervisi sedangkan variabel terikat adalah kinerja bidan dalam pelaksanaan SDIDTK balita dan anak prasekolah. Uji statistik menggunakan Chi-Square test dan Regresi Logistik Ganda. Hasil penelitian menunjukkan rerata umur Bidan 35 tahun dengan simpang baku 7,2 tahun. Seluruh subjek berpendidikan D III Kebidanan, dan 90,9% mempunyai status kepegawaian PNS. Rerata masa kerja 11,7 tahun dengan simpang baku 7,6. Bidan telah mendapatkan pelatihan SDIDTK dengan rerata 5,3 ± 3,2 tahun yang lalu. Sebagian besar bidan(59,7%) memiliki pengetahuan kurang, 62,3% sikap negatif, 57,1% motivasi kurang, 58,4% berpersepsi beban kerja berat, 57,1% peralatan kurang, 54,5% berpersepsi supervisi kurang, dan 54,5% mempunyai kinerja kurang. Ada hubungan positif antara pengetahuan, sikap, motivasi, peralatan dan persepsi supervisi dengan kinerja bidan. Ada hubungan negatif antara beban kerja dengan kinerja bidan. Kelengkapan peralatan, pengetahuan dan sikap berhubungan secara bersama-sama dengan kinerja bidan. Faktor yang paling berkaitan dengan kinerja bidan dalam pelaksanaan SDIDTK balita dan anak prasekolah adalah kelengkapan peralatan. Disimpulkan bahwa kinerja bidan dalam pelaksanaan SDIDTK masih kurang. Hal ini berkaitan dengan kelengkapan peralatan, pengetahuan dan sikap bidan terhadap pelaksanaan SDIDTK.The average of SDIDTK coverage of under-five and pre-school children in the work area of Sidoarjo district health office in 2008 and 2009 respectively was 61.52% and 46.93%. It was still below 2009 SPM (80%). Objective of this study was to identify factors affecting the work performance of midwives in the implementation of SDIDTK of under-five and pre-school children in the primary healthcare centers of Sidoarjo district. This was an observational-analytical study with cross sectional approach. Study population was all 375 midwives in the primary healthcare centers (puskesmas) in Sidoarjo district. Study subjects were 77 midwives who were selected using proportional random sampling method. Data collection was done using questionnaire and by conducting observation. Independent variables were knowledge, attitude, motivation, workload, instruments, and perception on supervision. Dependent variable was work performance of midwives in the implementation of SDIDTK of under-five and pre-school children. Chi-square test and multiple logistic regressions were applied in the data analysis. Results of the study showed that the average age of midwives was 35 years old with standard deviation of 7.2 years old. All subjects’ education level was D3 in midwifery; 90.9% were government civil servants (PNS). The average working period was 11.7 years with standard deviation of 7.6 years. Midwives had received SDIDTK training with the average of 5.3 ± 3.2 years ago. The majority of midwives had insufficient knowledge (59.7%), negative attitude (62.3%), low motivation (57.1%), heavy workload perception (58.4%), inadequate instruments (57.1%), inadequate supervision (54.5%), and inadequate work performance (54.5%). There was a positive association between midwives work performance and knowledge, attitude, motivation, instrument, and perception on supervision. There was a negative association between workload and midwives work performance. Completeness of instruments, knowledge, and attitude were jointly associated with the work performance of midwives. The most related factor to the work performance of midwives in the implementation of SDIDTK of under-five and pre-school children was the completeness of instruments. In conclusion, the work performance of midwives in the implementation of SDIDTK was still inadequate. This was related to the completeness of instruments, knowledge, and midwives attitude toward the implementation of SDIDTK.
Analysis on Leadership, Budget Allocation and Disposition of Management Policy at Nursing Department of Kudus District General Hospital Abdul Aziz Achyar; Sudiro Sudiro; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (371.706 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Kegiatan perawatan yang dilakukan oleh perawat berada di tatanan pelayanan kesehatan terdepan dengan kontak pertama dan terlama dengan pasien. Terjadi penurunan jumlah kunjungan pasien pribadi/umum/bayar (28,33%) di RSUD Kabupaten Kudus dalam 5 tahun terakhir. Hasil Indeks Kepuasan Masyarakat untuk keperawatan kurang baik, sehingga pengelolaan keperawatan perlu perhatian dari manajer. Tujuan penelitian adalah menjelaskan kepemimpinan, alokasi dana dan disposisi pengambil kebijakan di bidang keperawatan RSUD Kabupaten Kudus. Penelitian ini adalah penelitian observasional kualitatif. Subjek penelitian adalah 3 orang pengambil kebijakan bidang keperawatan sebagai informan utama dan 3 orang perawat pelaksana kebijakan sebagai informan triangulasi. Analisis data dengan content analysis yaitu pengumpulan data, reduksi data, menyajikan data dan menarik kesimpulan. Hasil penelitian menunjukkan kepemimpinan telah dilakukan pengambil kebijakan dalam bimbingan dan hubungan antar perawat namun belum menjelaskan motivasi yang ada dalam sebuah reward & support system. Pengambil kebijakan telah mengalokasikan dana untuk pemenuhan SDM, infrastruktur dan peralatan penunjang keperawatan namun anggaran yang ada dan sedang berproses belum menyentuh peningkatan SDM keperawatan dari jalur pendidikan formal. Disposisi pengambil kebijakan telah memberdayakan perawat sebagai pelaksana kebijakan yang berkaitan dengan pembuatan keputusan dan pembuatan SOP, tetapi belum menyentuh pada instrumen evaluasi terstruktur pelayanan keperawatan. Disimpulkan bahwa bimbingan kepada pegawai hanya melibatkan pejabat struktural dan fungsional, peningkatan motivasi sudah dilakukan, anggaran belum menyentuh jalur pendidikan formal dan belum ada evaluasi yang terstruktur.Nursing activities conducted by nurses were at the first line in the health service; and it was the first and the longest duration of contact with patients. The number of private/ public/paying patients (28.33%) in Kudus district general hospital (RSUD) decreased in the last five years. Result from community satisfaction index was not good. Therefore, nursing management needed to get attention from the manager. Objective of this study was to explain leadership, budget allocation, and delegation of policy makers in the nursing section of Kudus district general hospital. This was an observational-qualitative study. Study subjects were three policy makers in the nursing section as main informants, and three policy-executor nurses as triangulation informants. Content analysis method was applied in the data analysis; this method consisted of data collection, data reduction, data presentation, and conclusion drawing. Results of the study showed that leadership had been done by policy makers in the supervision and in relationship among nurses; however, policy makers had not explained motivation that was in the reward and support system. Policy makers had allocated budget for human resource completion, infrastructure, and supporting instrument for nursing. However, the existing budget had not been used to increase nursing human resource that originated from a formal education path. Policy makers had delegated formulation of decisions and SOP to the nurses who implemented the policies; however this delegation did not include structured evaluation instruments on nursing service. In conclusion, supervision to workers involved only structural and functional authorities; motivation improvement had been done; budgeting had not included a formal education path; structured evaluation was not done.
Analysis on Private Practice Midwives Work Performance in the Implementation of Early Initation of Breastfeeding in Surabaya Yefi Marliandiani; Atik Mawarni; Ani Margawati
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (387.694 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Keberhasilan pemberian ASI eksklusif dipengaruhi oleh inisiasi menyusu dini (IMD). di Surabaya pelaksanaan IMD hanya dilakukan pada 33% dari seluruh persalinan oleh bidan praktik swasta pada tahun 2009 dan menurun menjadi 27% pada tahun 2010. Berdasarkan survey pendahuluan didapatkan bahwa kinerja bidan praktik swasta (BPS) dalam pelaksanaan IMD belum optimal. Penelitian ini bertujuan untuk menganalisis kinerja bidan praktik swasta dalam pelaksanaan inisiasimenyusu dini di Surabaya. Jenis penelitian adalah observasional dengan pendekatan kualitatif. Informan penelitian adalah 10 BPS yang dipilih dari wilayah dengan cakupan IMD tersedikit dan terbanyak, masing-masing 5 orang. Informan triangulasi adalah sekretaris IBI Cabang Surabaya, asisten bidan dan ibu nifas. Data dikumpulkan dengan wawancara mendalam dan observasi terhadap pelaksanaan IMD. Pengolahan metode content analysis. Hasil penelitian menunjukkan 6 dari 10 BPS sudah melaksanakan IMD tetapi dengan cara yang tidak tepat. Dilihat dari kemampuan kognitif semua responden tentang IMD masih kurang. Enam dari 10 BPS bersikap positif tentang IMD. Motivasi BPS untuk melaksanakan IMD dipengaruhi oleh manfaat IMD, himbauan dinas kesehatan dan IBI serta permintaan pasien. Semua responden mengatakan tidak pernah disupervisi oleh bidan koordinator (bikor) walaupun responden membutuhkan supervisi. Dapat disimpulkan bahwa kinerja BPS dalam pelaksanaan IMD belum optimal karena kemampuan kognitif masih kurang serta tidak adanya supervisi dari bikor Successfulness of an exclusive breastfeeding was influenced by early breastfeeding initiation (IMD). In Surabaya, implementation of IMD was only done by 33% of all deliveries assisted by private practice midwives in 2009, and it decreased to 27% in 2010. Based on a preliminary study, work performance of private practice midwives (BPS) in the implementation of IMD was not optimal. Objective of this study was to analyze work performance of private practice midwives in the implementation of early breastfeeding initiation in Surabaya. This was an observational-qualitative study. Study main informants were 10 BPS who were selected from area with the lowest and highest IMD coverage; each of area consisted of 5 BPS. Triangulation informants were a secretary of IBI Surabaya branch, midwives assistance, and post-delivery mothers. Data were collected through in-depth interview and observation on the implementation of IMD. Data were managed and analyzed by applying content analysis method. Results of the study showed that six out of 10 BPS had implemented IMD though with improper way. Cognitive ability of all respondents regarding IMD was still inadequate. Six out of 10 BPS had positive attitude toward IMD. Motivation of BPS to implement IMD was influenced by IMD benefits, suggestion from district health office and from IBI, and from patient’s request. All respondents told that no supervision by coordinator midwives was conducted although it was needed by respondents. In conclusion, work performance of BPS in the implementation of IMD was not optimal. It was caused by inadequate cognitive ability of BPS, and no supervision from a coordinator midwives.
The Effect of Training by Simulation Method on Cadres to the Successfulness of Diversity Food Application (a Study in Kecamatan Trawas Kabupaten Mojokerto) Shinta Ayu Retnawati; Laksmi Widajanti; Sri Achadi Nugrahaeni
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (460.499 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Keluarga Sadar Gizi tercermin dari pola konsumsi pangan yang beraneka ragam dan bermutu gizi seimbang. Perlunya makan beraneka ragam agar tercukupi semua kebutuhan zat gizi yang diperlukan oleh tubuh. Hasil dari pemetaan Kadarzi terhadap 288 keluarga di Kecamatan Trawas terutama makan beraneka ragam masih rendah sekali yaitu 30,9%, dengan diberikan pelatihan agar tercapai kompetensi kader pendamping. Tujuan penelitian ini untuk mengetahui pengaruh pelatihan metode simulasi terhadap keberhasilan penerapan makan beraneka ragam oleh kader pendamping. Jenis penelitian ini adalah quasi experimental dengan rancangan penelitian Non Randomized with pretest and postest group. Jumlah Populasi 146 kader pendamping dan sampel 60 kader pendamping. Variabel bebas penelitian adalah pelatihan dengan metode simulasi dan metode konvensional serta variabel terikatnya adalah pengetahuan, sikap dan keterampilan kader pendamping. Data dianalisis dengan menggunakan analisis univariat dan bivariat. Hasil penelitian menunjukkan bahwa dengan pelatihan simulasi kepada kader pendamping dapat meningkatkan skor pengetahuan 16 poin dan metode konvensional 5 poin tetapi tidak bermakna dengan nilai p=0,127. Peningkatan skor sikap sebesar 11 poin untuk metode simulasi dan 19 poin untuk metode konvensional, terjadi perbedaan secara bermakna dengan nilai p=0,000 sedangkan peningkatan skor keterampilan 12 poin untuk metode simulasi dan 10 poin untuk metode konvensional tetapi tidak bermakna dengan nilai p=0,102. Disimpulkan untuk meningkatkan pengetahuan, sikap dan keterampilan kader pendamping dapat diberikan pelatihan dengan mengkombinasikan antara metode simulasi dan metode konvensional. Diharapkan bagi dinas Kesehatan Kabupaten Mojokerto dalam peningkatan kompetensi kader pendamping bisa diberikan pelatihan dengan menggunakan metode simulasi dan metode konvensional dengan memperpanjang waktu pelatihan minimal 3 hari. Nutrition-aware family was reflected from their variety of food consumption pattern and equal nutritional quality. Eating variety of food was needed to fulfill all nutrition needed by human body. Results of Kadarzi mapping on 288 families in Trawas district showed that eating variety of food was still low namely 30.9%. Training to cadres to improve their competence was needed. Objective of this study was to know the influence of training using simulation method on the success of eating variety of food application by cadres. This was a quasy experimental study using non-randomized with pretest and posttest group design. Study population was 146 cadres. Samples were 60 cadres. Independent variables consisted of training with simulation method and with conventional method. Dependent variable was knowledge, attitude, and skills of cadres. Univariate and bivariate analysis were applied in the data analysis. Results of the study showed that no difference in score change on knowledge and skills between simulation method and conventional method groups (p> 0.05). The increase of mean value for knowledge was 15 points for simulation method group and 9 points for conventional method group. The increase of score (median value) for skill was 12 points for simulation method group and 10 points for conventional method group. Score change difference on attitude between simulation method group and conventional group was identified (p< 0.05). The increase of score for simulation method group was 9 points and for conventional method group was 19 points. In conclusion, a training that combines simulation method and conventional method is able to improve knowledge, attitude and skill of cadres. Mojokerto district health office is expected to improve cadres’ competence by giving trainings using simulation and conventional methods, and to provide longer time for training.
Factors Associated to the Performance of Village Midwives in the Institutionalization of Local Area Monitoring in Maternal and Child Health (MCH- LAM) at Majalengka District West Java Province Wawan Kurniawan; Cahya Tri Purnami; Lucia Ratna Kartika Wulan
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (602.876 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Upaya pemantauan cakupan pelayanan KIA yang dikenal dengan Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS-KIA) merupakan salah satu tugas bidan. Pelaksanaan PWS-KIA dengan baik dapat digunakan untuk melakukan tindak lanjut dan perbaikan pelayanan KIA. Namun berdasarkan data pelaksanaan PWS-KIA tahun 2011 hanya 40% bidan yang melakukan tahapan kegiatan PWS KIA secara lengkap. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kinerja Bidan Desa dalam Pelembagaan PWS-KIA di Wilayah KabupatenMajalengka Provinsi Jawa Barat Tahun 2011. Penelitian ini merupakan penelitian observasional dengan pengumpulan data secara cross sectional. Populasi penelitian ini adalah semua bidan desa yang ada di wilayah kerja Dinas Kesehatan Kabupaten Majalengka, yaitu 360 bidan tersebar di 31 Puskesmas dengan sampel sebanyak 190 secara simple random sampling. Pengumpulan data dilakukan dengan wawancara dan observasi menggunakan kuesioner dan lembar pengamatan serta analisis data dilakukan secara univariat, bivariat, dan multivariat. Dari hasil penelitian didapatkan bahwa kurang dari setengahnya (42,1%) Kinerja Bidan Desa dalam pelembagaan PWS-KIA kurang baik. Dari hasil analisis didapatkan variabel yang berhubungan dengan kinerja bidan dalam pelembagaan PWS-KIA di wilayah Kabupaten Majalengka Tahun 2011 adalah pengetahuan, ketersediaan sarana dan fasilitas PWS-KIA, pembinaan Kepala Puskesmas, dukungan Kepala Desa (nilai p < 0,05). Secara bersama-sama variabel yang berpengaruh paling besar adalah dukungan/ketersediaan sarana dan fasilitas PWS KIA dengan nilai exp (â)=9,784 (nilai p =0,000). Disarankan kepada Dinas Kesehatan Kab. Majalengka/Puskesmas, dalam rangka meningkatkan kinerja bidan desa dalam pelembagaan PWS-KIA adalah memberikan dukungan sarana dan fasilitas PWS-KIA berupa penyediaan buku pedoman PWS-KIA, alat tulis/perlengkapan kantor, peralatan komputer; pelatihan pengelolaan data PWS-KIA berbasis komputer; pembekalan bidan desa pada awal tugas; dan supervisi oleh Kepala Puskesmas kepada bidan desa; serta koordinasi kepada Kepala Desa maupun kepada Camat dalam rangka dalam pelembagaan PWS-KIA. Monitoring effort on maternal and child health (KIA) service coverage known as local area monitoring of maternal and child health (PWS-KIA) was one of midwives duties. Good implementation of PWS-KIA could be used to follow up and improve KIA service. However, based on PWS-KIA implementation data in 2011, only 40% midwives who performed complete steps of PWS-KIA activities. Objective of this study was to analyze factors related to work performance of midwives to institutionalize PWS-KIA in Majalengka district area of West Java province, 2011. This was an observational study, and data was collected cross sectionally. Study population was all village midwives who resided in the work area of Majalengka district health office. These 360 midwives were distributed in 31 primary healthcare centers. Samples were 190 midwives. They were selected using simple random sampling method. Data collection was done through interview and observation using questionnair and observation form. Univariate, bivariate, and multivariate analysis were applied in the data analysis. Results of the study showed that work performance of less than a half (42.1%) of village midwives who institutionalized PWS-KIA was inadequate. Variables related to work performance of midwives who institutionalized PWS-KIA in Majalengka district area in 2011 were knowledge, availability of PWS- KIA facility, supervision of the head of puskesmas, and village leader support (p< 0.05). The most influencing variables was support/ the availability of PWS-KIA facilities (exp (â)= 9.784, p= 0.000). Suggestions for Majalengka district health office or primary healthcare centers are to provide PWS-KIA facility support to improve work performance of village midwives who institutionalized PWS-KIA; the support is in the form of providing PWS-KIA guideline books, stationery, computer devices; to conduct training on computer based PWS-KIA management data; to provide training for village midwives in their first duty; to conduct supervision by the head of primary healthcare center to village midwives; .to conduct coordination with village leader and sub district leader for PWS-KIA institutionalization.
Evaluation on the Implementation of Integrated Health Service Post in Decreasing Underfive Protein Energy Malnutrition Cases in Baubau, Southeast Sulawesi Province Wa Ode Asma Isra; Chriswardani Suryawati; Apoina Kartini
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (570.637 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

 Tahun 2010 di Kota Baubau kasus gizi  buruk mengalami peningkatan dibanding tahun sebelumnya.Posyandu merupakan salah satu upaya untuk mendeteksi awal gizi buruk. Sejak tahun 2001 kegiatan posyandu direvitalisasi agar terjadi peningkatan  fungsi dan kinerja posyandu, sehinggas status gizi anak dapat dipertahankan atau ditingkatkan. Tujuan penelitian ini adalah untuk mengevaluasi pelaksanaan revitalisasi posyandu dalam penurunan prevalensi balita gizi buruk sebagai upaya peningkatan kinerja posyandu.Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan studi kasus. Pemilihan subyek dengan metode purposive sampling. Data dikumpulkan dengan wawancara mendalam pada informanutama: ketua kader dan informan triangulasi: petugas puskesmas dan Kabid Pelayanan Medik,Kesehatan Keluarga dan Gizi Masyarakat serta Focus Group Discussion (FGD) kepada informant triangulasiibu balita. Analisa data menggunakan metode content analysis. Hasilpenelitian menunjukkan bahwa kegiatan pemenuhan jumlah kader sudah cukup yaitu 4-5 orang tetapi yang hadir hanya 3-4 orang/posyandu. Kader lama yang sudah dilatih banyak yang drop out dan kader baru belum dilatih.Pemberian insentif diberikan kepada semua kader tanpam memperhitungkankehadiran sehingga tidak efektif mengaktifkan kader. Pemenuhan sarana danp prasaranabelum lengkap, tidak tersedia KMS dan buku KIA, sehingga hanya digunakan fotocopy KMS buku atau kertas untuk mencatat berat badan balita. Meja I dan Meja IV belum dilaksanakan dengan baik karena kader tidak mampu melaksanakan penyuluhan. Kegiatan pembinaan danp pengawasandari petugas puskesmas bersifat insidentil, tidak ada pembinaan dan pengawasan darip pengurusPKK Kelurahan.Disimpulkan bahwa pelaksanaan revitalisasi posyandu belum berjalan dengan baik karena pelatihan kader terhenti, keterbatasan sarana dan prasarana, pembagian insentif yang tidak tepat, sertak kurangnyapembinaan dan pengawasan. Severe malnutrition cases in Baubau city in 2011 increased compared to the related number in the previous year. Posyandu was one of efforts to detect early severe malnutrition. Posyandu activity had been revitalized since 2001 with the intention of improving function and performance of posyandu, and nutritional status of children could be maintained and improved. Objective of this study was to evaluate the implementation of posyandu revitalization to decrease severe malnutrition prevalence, and this was an effort of improving posyandu performance. This was a descriptive-qualitative study with case study approach. Data were collected through in- depth interview to the main informant namely head of cadres. Triangulation informants were puskesmas workers, head of medical service unit, head of family health and community nutrition unit. Focus group discussion was conducted to the mothers of under-five children. Content analysis was applied in the data analysis. Results of the study showed that the number of cadres listed for each posyandu was enough, 4-5 cadres. However, the number of cadres who attended in each posyandu was only 3-4 cadres. Many of old cadres who had been trained did not participate again in posyandu activities (drop out); new cadres had not received training. Incentives were given to all cadres without considering the number of attendance in the posyandu activities; this was not an effective way to activate cadres. Facilities were still inadequate; KMS and KIA book were not provided. Therefore only copy of KMS was used, and a book was used to record the body weight of under-five children. Activities in table 1 and IV were not properly performed due to lack of skilled cadres in giving health education. Supervision activities by puskesmas workers were not done periodically (incidental), and no supervision and assistance from village PKK were done. In conclusion, the implementation of posyandu revitalization was inadequate due to no training for cadres, facility limitation, unfair incentive distribution, and inadequate assistance and supervision.
Analysis on the Influence of Nurses Perception in Nursing Management and Working Environment on Nurses Job Satisfaction at Inpatient Unit of Tugurejo General Hospital, Semarang Komariyatun Komariyatun; Cahya Tri Purnami; Bambang Edi Warsito
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (583.07 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Manajemen keperawatan merupakan proses perencanaan, pengorganisasian, pengarahan dan pengawasan untuk mencapai tujuan keperawatan. Kepuasan kerja adalah berbagai persepsi perawat terhadap lingkungan pekerjaannya. Kenyataan pelaksanaannya belum sesuai dengan perencanaan, pengorganisasian, pengarahan dan pengawasan, serta perlu lingkungan kerja yang baik. Tujuan penelitian adalah mengetahui hubungan dan pengaruh persepsi perawat pelaksana dalam perencanaan, pengorganisasian, pengarahan dan pengawasan manajemen keperawatan serta lingkungan kerja terhadap kepuasan kerja perawat di ruang rawat inap RSUD Tugurejo Semarang. Penelitian ini merupakan penelitian observasional deskriptif analitik dengan pendekatan cross sectional. Responden penelitian adalah 114 orang perawat pelaksana. Analisis data dengan analisis univariat, analisis bivariat dan analisis multivariat dengan regresi logistik. Hasil penelitian menunjukkan persepsi manajemen keperawatan berhubungan dengan kepuasan kerja perawat pelaksana adalah perencanaan (p value = 0,0001), pengorganisasian (p value= 0,0001), pengarahan (p value = 0,0001) dan pengawasan (p value= 0,0001), serta didapatkan lingkungan kerja baik (p value = 0,0001). Persepsi manajemen keperawatan yang berpengaruh bersama-sama terhadap kepuasan kinerja perawat pelaksana adalah perencanaan (exp B=27,631), pengorganisasian (exp B=7,549) dan pengawasan (exp B=17,166). Rekomendasi penelitian untuk manajer keperawatan perlu menyusun kembali perencanaan strategis, uraian tugas, tanggung jawab dan wewenang perawat pelaksana, mengoptimalkan pendelegasian wewenang kepada kepala ruang, memberi arahan dan penjelasan kembali kepada perawat pelaksana tentang prosedur pelayanan keperawatan serta memberikan perhatian serta motivasi dalam pengembangan profesional perawat, menjadi mediator yang baik dalam penyelesaian masalah dan melakukan monitoring dan evaluasi berkala program keperawatan di RSUD Tugurejo Semarang. Influence Analysis of Nurses Perception in Nursing Management and Work Environment with Job Satisfaction of Nurses in Ward of Tugurejo General Hospital of Semarang Nursing Management is process of planing, organizing, directing and controlling to achieve the aim of nursing services. Job satisfaction is many perception of nurse with work environment. The nursing management is not matched with planing, organizing, directing and controlling and need good environment of work. The purpose of this study was to describe the correlation and influence of nurses perception in nursing management such as planing, organizing, directing and controlling and work environment with job satisfaction of nurses in ward of Tugurejo General Hospital of Semarang. This study was a analytic describtive observational, cross sectional approach. Respondens were 114 nurses. Analysis of data using bivariat analysis, univariat analysis and multivariat analysis with logistic regression. The results showed nursing management perception related to job satisfaction of nurses was planing (p value=0,0001), organizing (p value=0,0001), directing (p value=0,0001) and controlling (p value=0,0001), and good environment of work (p value=0,0001). Nursing management perception influenced together with job satisfaction of nurses was planing (exp B=27,631), organizing (exp B=7,549) and controlling (exp B=17,166). Recommendations from this research is aimed to nursing management in Tugurejo General Hospital of Semarang to restructure a strategic planing and nurses job description, empower head of ward to delegate responsibility, redirect to nurses about nursing services standard, make attention and motivation to nurses professional development, made as mediator in problem solving and make schedule monitoring and controlling nursing programme.
Analysis on the Reasons for Selecting Birth Attendants by Delivery Mothers at Semarang Regency Ana Puji Astuti; Martha Irene Kartasurya; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (386.85 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

AKI dan AKB di Kabupaten Semarang masih tinggi yaitu 146,24/100.000 KH dan 13,40/1000 KH pada tahun 2011. Pertolongan persalinan oleh tenaga kesehatan menurun dan masih terdapat 410 persalinan oleh dukun dengan 0,24 % kematian ibu pada tahun 2011. Hal ini terjadi meskipun sudah dilakukan kemitraan bidan dukun dan jampersal. Tujuan penelitian ini untuk menganalisis alasan pemilihan penolong persalinan oleh ibu di Kabupaten Semarang. Penelitian dilakukan dengan metode kualitatif. Pengumpulan data dengan wawancara mendalam dan observasi. Subyek penelitian terdiri dari informan utama sejumlah 8 ibu bersalin (4 ibu bersalin oleh dukun dan 4 ibu bersalin oleh bidan) dan 17 informan triangulasi (4 suami/keluarga dari ibu bersalin dengan dukun, 4 suami/keluarga dari ibu bersalin dengan bidan, 4 tokoh masyarakat/ tokoh agama, 4 bidan koordinator dan Kepala Seksi Kesehatan Keluarga Dinas Kesehatan. Metode analisis data dengan content analysis. Hasil penelitian menunjukkan tingkat pengetahuan ibu tentang persalinan sehat dan aman masih kurang. Ibu yang memilih dukun sebagai penolong persalinan bersikap negatif terhadap bidan karena bidan merobek jalan lahir. Ibu yang memilih bidan berpersepsi baik karena bidan ramah, trampil dan cekatan, ibu yang memilih dukun berpersepsi baik dalam hal perawatan post partum. Tidak adabudaya khusus dalam pertolongan persalinan baik oleh bidan maupun dukun. Kemudahan akses pada saat melahirkan merupakan faktor penentu pada pemilihan penolong persalinan. Biaya persalinan dukun terjangkau karena bersifat suka rela dan dapat berbentuk barang. Dukungan suami dan keluarga cukup kuat dalam pemilihan penolong persalinan. Disimpulkan bahwa pemilihan dukun sebagai penolong persalinan berkaitan dengan pengetahuan, sikap, persepsi mutu pelayanan, biaya dan kemudahan akses bagi ibu bersalin.AKI and AKB in Semarang district were still high, 146.24/100 000 live-birth and 13.40/ 1000 live-birth in 2011. Delivery assistance by health workers deceased, and 140 deliveries were assisted by dukun (traditional delivery assistance) with 0.24% maternal mortality in 2011. Although collaboration between dukun and jampersal (maternity insurance), yet this situation still happened. Objective of this study was to analyze reasons for selection of delivery assistance by maternities in Semarang district. Qualitative method was applied in this study. Data were collected through in-depth interview and observation. Study subjects were main informants and triangulation informants. The main informants were eight maternities (four maternities were assisted by dukun, and 4 maternities were assisted by midwives); 17 triangulation informants (four husbands/ family of maternity assisted by dukun, four husbands/ family of maternity assisted by midwives, four coordinator midwives, and a head of family health section of Semarang district health office. Content analysis was applied in the data analysis. Results of the study showed that knowledge level of mothers about healthy and safe labour was deficient. Mothers who chose dukun as their delivery assistance had negative attitude towards midwives because midwives torn the birth canal. Mothers who chose midwives had good perception towards midwives; they said that midwives were kind and skillful. Mothers who chose dukun had good perception on the post-partum management. No special culture in the delivery assistance by midwives or dukun. Accessibility to the delivery assistance when mothers were in labour was a determinant factor in the selection of the delivery assistance. Fee of delivery by dukun was reachable because it was voluntary and could be substituted by goods. Support from husband and family in the selection of delivery assistance was strong enough. In conclusion, selection of dukun as delivery assistance was related to knowledge, attitude, perception on the quality of service, fee, and accessibility for in labour mother.
Management of High Risk Pregnancy Early Detection on Antenatal Care at Primary Health Care in Jepara District Triana Widiastuti; Martha Irene Kartasurya; Dharminto Dharminto
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 3 (2014): Desember 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (339.692 KB) | DOI: 10.14710/jmki.2.3.2014.%p

Abstract

Angka Kematian Ibu di Jepara tahun 2012 menduduki peringkat ke 10 di Jawa Tengah sebesar 21 per 100.000 kelahiran hidup. Penyebab terbanyak preeklamsi berat 8 orang (30%). Data PWS KIA menunjukkan cakupan deteksi dini risiko tinggi oleh tenaga kesehatan tahun 2012 sebesar 19,01%, belum mencapai target nasional. Tujuan penelitian ini untuk mengetahui manajemen deteksi dini ibu hamil risiko tinggi pada pelayanan antenatal di tingkat puskesmas Kabupaten Jepara. Jenis penelitian ini adalah kualitatif. Variabel pada penelitian ini adalah input (SDM, dana, sarana, SOP), Proses (perencanaan, pembinaan, supervisi dan monitoring) dan Output. Informan utama adalah kepala Puskesmas dan Bidan koordinator. Informan triangulasi adalah Kasi Kesga (kepala seksi kesehatan keluarga) dari DKK (Dinas Kesehatan Kabupaten) dan 16 bidan desa. Pengumpulan data dilakukan melalui wawancara mendalam dan Focus Group Discussion. Pengolahan data dilakukan dengan metode analsis isi (content analysis). Hasil penelitian menunjukkan bahwa Puskesmas dengan cakupan rendah mempunyai rasio bidan per penduduk yang rendah, SOP belum ditempel, perencanaa dilaksanakan per tahun, pembinaan dilakukan setiap 6 bulan dan umpan balik hasil supervisi disampaikan secara lisan. Puskesmas dengan cakupan tinggi juga mempunyai rasio bidan per penduduk masih rendah, perencanaan dilaksanakan per bulan melalui lokakarya mini, pembinaan dilakukan per bulan, umpan balik supervisi disampaikan secara tertulis serta ada sangsi apabila laporan terlambat. Disimpulkan bahwa manajemen deteksi dini ibu hamil risiko tinggi dipengaruhi oleh perencanaan, pembinaan, dan supervisi/ monitoring. Disarankan kepada puskesmas untuk melakukan perencanaan dan pembinaan per bulan serta supervisi dan monitoring secara lebih intensif. Maternal Mortality Rate in Jepara District in 2012 placed the 10 th rank in Central Java, namely 21 per 100.000 live births. Severe preeclampsia was the most common cause, namely 8 persons (30%). Data of Local Area Monitoring in 2012 showed that coverage of high risk early detection by health workers was only 19.01% and had not achieved the national target yet. This research aimed to identify early detection management of a high risk pregnant woman on Antenatal Care services at health center in District of Jepara. This was qualitative research. Research variables were Input (human resources, funds, means, and Standard Operating Procedure), Process (planning, actuating, supervising, and monitoring), and Output. Main informants were head of health center and midwife coordinator. In addition, informants for triangulation purpose were head of family health section at District Health Office and 16 village midwives. Data were collected by conducting indepth interview and Focus Group Discussion. Furthermore, data were analyzed using a method of content analysis. The result of this research revealed that at health centers with low coverage, ratio between midwife and population was low, Standard Operating Procedure had not been displayed, planning was arranged annually, actuating was done every six month, and feedback of supervision results was informed verbally. In contrast, health centers with high coverage indicated that ratio between midwife and population was low, planning was arranged monthly through mini workshop, actuating was done every month, feedback of supervision results was informed in writing, and there also was any punishment if a report was late to submit. As a conclusion, early detection management of a high risk pregnant woman was influenced by planning, actuating, and supervising/monitoring. As a suggestion, head of health center needs to make a plan and actuate every month, and also supervise and monitoring intensively.

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