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The Implementation Analysis of Community-Based Total Sanitation Program as Strategy for Improving Clean and Healthy Living Behavior by Primary Health Care Center Workers in Grobogan Regency Sutiyono Sutiyono; Zahroh Shaluhiyah; Cahya Tri Purnami
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakDi Kabupaten Grobogan, kejadian penyakit diare, campak, frambusia, dan difteri cukup tinggi. Kejadian penyakit – penyakit ini merupakan indikator PHBS masyarakat. STBM bertujuan untuk menurunkan penyakit – penyakit tersebut, namun pelaksanaan program STBM dengan indikator buang air besar sembarangan, cuci tangan pakai sabun, pengolahan air bersih, pengolahan sampah dan pengolahan limbah cair masih rendah. Penelitian ini bertujuan untuk menggambarkan pelaksanaan program STBM di Kabupaten Grobogan.Jenis penelitian adalah penelitian kualitatif dengan pendekatan fenomena. Pengumpulan data dilakukan dengan wawancara mendalam kepada 8 informan utama petugas promkes dan kesling, Focus Group Discussion dengan informan triangulasi yaitu kader, tokoh agama, tokoh masyarakat dan anggota masyarakat. Analisis data dengan content analysis.Hasil penelitian menunjukkan bahwa : sebagian besar petugas melaksanakan program STBM dengan baik. Hal yang masih kurang baik adalah kegiatan monitoring. Sebagian besar pengetahuan petugas tentang pelaksanaan program STBM sudah baik. Belum semua petugas bersikap baik dalam melaksanakan program STBM. Sebagian besar petugas belum mengetahui peraturan dalam melaksanakan program STBM tetapi kader sudah mengetahui. Semua petugas telah mendapatkan pelatihan program STBM. Semua kepala puskesmas telah melaksanakan pengawasan rutin. Sarana dan prasarana yang berupa alat pembuat jamban, sarana cuci tangan, alat pengolah sampah, lembar balik.Disarankan Dinas Kesehatan untuk meningkatkan kerjasama lintas program, lintas sektoral dalam pelaksanaan program STBM. Selain itu juga meningkatkan peran kader dalam pelaksanaan program STBM. AbstractIn Grobogan district, the occurrence of diarrhea, morbilli, framboesia, and diphtheria was relatively high. The presence of these diseases was an indicator of hygienic and healthy live behavior (PHBS) of a community. Objective of community based total sanitation (STBM) was to reduce those diseases. However, the implementation of STBM program was still inadequate. Indicators of STBM program were improper defecation, washing hand using soap, clean water management, waste management, and liquid waste management. Objective of this study was to describe the implementation of STBM program in Grobogan district.This was a qualitative study with phenomenon approach. Data collection was done by conducting in-depth interview to 8 main informants: health promotion and environmental health workers. Focus group discussion was conducted to triangulation informants; triangulation informants consisted of cadres, local religious leaders, local community leaders, and local people. Data were analyzed using content analysis method.Results of the study showed that the majority of workers implemented STBM program well. A thing that was still insufficient or inadequate was monitoring. The majority of worker’s knowledge regarding the implementation of STBM program was sufficient. Not all workers had good attitude in the implementation of STBM program. The majority of workers did not know regulations in implementing STBM program; however, cadres knew the regulation. All workers had received STBM program training. All heads of primary healthcare centers (puskesmas) had conducted routine supervision. Facilities were in the form of water closet maker instruments, hand washing facility, waste management instruments, and flip charts.Suggestions for District Health Office were to improve cross program and sector collaborations in the implementation of STBM program, to increase the role of cadres in the implementation of STBM program.

Analysis on Policy Implementation of Exclusive Breastfeeding for Working Women in South Kalimantan Province Riny Henderawaty; Martha Irene Kartasurya; Anneke Suparwati
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakCakupan pemberian ASI eksklusif di Provinsi Kalimantan Selatan masih rendah (51,18%) lebih rendah dari target Nasional (80%). Di Provinsi ini jumlah pekerja wanita cukup tinggi (59,98%) dan semakin meningkat dalam beberapa tahun terakhir. Kebijakan berupa Undang-undang, Peraturan Pemerintah dan Peraturan Bersama 3 Menteri Tentang Peningkatan Pemberian ASI eksklusif Selama Waktu Kerja Di Tempat Kerja sudah ada, tetapi masih banyak instansi yang belum melaksanakan kebijakan tersebut. Tujuan penelitian adalah menjelaskan implementasi kebijakan pemberian ASI eksklusif bagi ibu bekerja di Provinsi Kalimantan Selatan.Penelitian ini mengunakan metode kualitatif. Pengumpulan data dilakukan melalui indepth interview dan observasi. Responden/subjek penelitian adalah Kasie Pemberdayaan Perempuan Badan Pemberdayaan Perempuan dan Perlindungan Anak (BPPPA), Kasie Ketenagakerjaan Dinas Tenaga Kerja dan Transmigrasi dan Kasie Gizi Dinas Kesehatan Provinsi Kalimantan Selatan sebagai informan utama serta Pimpinan Instansi Pemerintah dan Perusahaan sebagai informan triangulasi. Analisis dilakukan dengan content analysis.Hasil penelitian menunjukkan bahwa masih banyak instansi yang belum menyediakan ruang laktasi di tempat kerja. Belum ada komunikasi antara BPPPA, Disnakertrans dan Dinas Kesehatan Provinsi dan belum terbentuk kelompok kerja dari ketiga instansi tersebut. Hanya 1 dari 3 instansi swasta yang telah menerima informasi kebijakan. Belum ada alokasi dana, tenaga dan sarana khusus untuk pelaksanaan kebijakan. Semua pelaksana bersikap mendukung. Belum ada Perda khusus tentang ASI eksklusif. Disimpulkan bahwa implementasi kebijakan pemberian ASI eksklusif bagi ibu bekerja di Provinsi Kalimantan Selatan belum terlaksana dengan baik karena belum adanya Perda khusus tentang ASI eksklusif. AbstractCoverage of exclusive breastfeeding in the South Kalimantan province was still low (51.18%); it was lower than the national target (80%).The number of working mothers in this province was relatively high and it was increasing in the last several years. Policies concerning breastfeeding during working time in the work place, such as decrees, government regulations, and common regulation from three ministers had been established. However, a number of institutions had not obeyed the policies. Objective of the study was to explain the implementation of exclusive breastfeeding for working mothers in South Kalimantan Province.This was a qualitative study. Data collection was done through in-depth interview and observation. Study respondents/subjects were a head of women empowerment section of the women empowerment and child protection institution (BPPPA), a head of human resource section of the labor and transmigration department, and a head of nutrition section of South Kalimantan province health office. Those respondents were considered as main informants. Triangulation informants were leaders of government institutions and leaders of companies. Content analysis method was applied in the data analysis.Results of the study showed that a number of institutions had not provided lactation room in the work place. No communication was done among BPPPA, Disnakertrans, and province health office. Working group from those three institutions had not been established. Only one of three private institutions had received information regarding the policies. No funding was allocated, human resource and specific facilities to implement policies were not provided. All executors supported the policies. Specific district government regulations concerning exclusive breastfeeding had not been established. In conclusion, implementation of exclusive breastfeeding policy for working mothers in South Kalimantan province was not done properly. It was caused by no specific local government regulations concerning exclusive breastfeeding.

Evaluation on Drug Planning for Basic Health Services at Pharmaceutical Warehouses of Gunung Mas District, Central Kalimantan Margaretha Triana; Chriswardani Suryawati; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbsrakPerencanaan merupakan kegiatan menetapkan jenis dan jumlah obat sesuai kebutuhan. Perencanaan lemah ditandai terjadinya kekosongan atau penumpukan obat. Pada perencanaan obat di Gudang Farmasi Kabupaten Gunung Mas menggunakan data kurang akurat dan terjadi kesenjangan tingkat ketepatan perencanaan obat serta tingkat ketersediaan obat dari ketentuan. Tujuan penelitian adalah melakukan evaluasi terhadap perencanaan obat di GFK Gunung Mas dilihat dari kemampuan petugas dalam merencanakan obat dan kepatuhan petugas GFK menjalankan pedoman perencanaan obat.Jenis penelitian adalah deskriptive. Variabel penelitian yaitu 1) kemampuan petugas dilihat dari pendidikan, pengetahuan, beban kerja, pelatihan serta supervisi. 2) Kepatuhan petugas menjalankan pedoman perencanaan obat. Informan utama adalah Kepala GFK dan dua petugas GFK. Data diperoleh dengan wawancara mendalam dan observasi, Pengolahan data dengan metode analisis isi.Hasil penelitian bahwa perencanaan obat di GFK Gunung Mas belum berjalan baik, hal ini disebabkan karena belum didukung kemampuan petugas yang memadai serta kepatuhan petugas rendah dalam menjalankan pedoman perencanaan. Pendidikan petugas memenuhi ketentuan yaitu pendidikan kefarmasian, sebagian besar pengetahuan petugas sebatas definisi dan kriteria obat, beban kerja petugas GFK berlebihan. Semua petugas belum mendapatkan pelatihan perencanaan obat, supervisi belum dilakukan secara berkala oleh atasan, kepatuhan petugas terhadap pedoman perencanaan obat rendah.Saran kepada Dinas Kesehatan adalah pelatihan teknis perencanaan Obat Terpadu, meningkatkan supervisi secara berkala kepada petugas GFK. Saran kepada GFK Gunung Mas adalah membuat Standart Operating Procedure (SOP) perencanaan obat, melakukan perhitungan obat dengan benar,melakukan analisis ABC/VEN. AbstractPlanning was an activity to determine type and amount of drugs according to the need. Weak planning was indicated by no stored drugs or drugs accumulation in the storage. Drug planning in Gunung Mas district pharmacy storage (GFK) was based on inaccurate data; therefore, distortion in the drug planning precision and in the level of drug availability occurred. Objective of this study was to evaluate drug planning at GFK Gunung Mas based on the obedience of GFK workers in implementing drug planning guideline. This was a descriptive study. Study variables were 1) ability of workers that was based on their education, workload, training, and supervision; 2) obedience of workers in implementing drug planning guideline. Main informants were the head of GFK and two GFK workers. Data were collected by conducting in-depth interview and observation. Content analysis was applied in the data management.Results of the study showed that drug planning at GFK Gunung Mas was inadequate. This was caused by insufficient number of workers with adequate abilities, and the obedience of workers in implementing planning guideline was insufficient. Workers’ education level was suitable with the requirement namely pharmaceutical school. Majority of workers’ knowledge was limited to definition and drug criteria; majority of GFK workers’ workload was overload. All workers did not get training on drug planning. Supervision by their superior was not done periodically. Obedience of workers to drug planning guideline was insufficient.Suggestions for district health office are to conduct training on integrated drug planning technique, to improve periodic supervision to GFK workers. Suggestions to GFK Gunung Mas are to formulate standard operating procedure for drug planning, to do right drug calculation, to do ABC/ VEN analysis.

Correlation Service Quality of Normal Delivery by Village Midwives and the Satisfaction in Luwu District South Sulawesi Hikma Hikma; Martha Irene Kartasurya; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakPada tahun 2009 – 2011 cakupan persalinan oleh tenaga kesehatan di Kabupaten Luwu berkisar 76% - 77%, sedangkan target nasional 90%. Hal ini dapat diakibatkan karena kepuasan ibu terhadap mutu pelayanan persalinan oleh bidan masih rendah. Penelitian ini bertujuan untuk mengetahui hubungan mutu pelayanan persalinan normal oleh bidan desa dengan kepuasan ibu bersalin di Kabupaten Luwu Sulawesi Selatan.Jenis penelitian adalah kuantitatif, desain observasional analitik dengan pendekatan cross sectional. Subyek adalah 70 orang bidan desa dan 70 ibu bersalin di Kabupaten Luwu dipilih secara consecutive. Pengambilan data dilakukan secara angket dengan kuesioner terstruktur.Analisis data dilakukan secara bivariat dengan Chi-Square dan korelasi Pearson.Hasil penelitian menunjukkan rerata umur bidan 29 ± 4,4 tahun. Rerata masa kerjanya 6,5 ± 4,07 tahun. Pendidikan bidan sebagian besar (92,9%) D3 Kebidanan. Rerata umur ibu 27± 4,3 tahun. 84,3% tidak bekerja, 57,1% berpendidikan menengah keatas. 77,1% bidan memberikan pelayanan persalinan yang bermutu. Tidak ada hubungan antara umur (p = 0,147), masa kerja (p=0,214), pendidikan (p = 0,343) bidan dengan mutu pelayanan persalinan. Tidak ada hubungan antara umur (p = 0,622), pekerjaan (p=0,072) pasien dengan kepuasan terhadap pelayanan persalinan oleh bidan desa. Ada hubungan antara pendidikan ibu bersalin dengan kepuasan terhadap pelayanan persalinan oleh bidan desa (p = 0,005). Pasien yang merasa puas sebanyak 60,0%. Ada hubungan antara mutu pelayanan persalinan oleh bidan desa dengan kepuasan ibu bersalin (r = 0,164, p=0,043).Disimpulkan bahwa mutu pelayanan persalinan bidan berhubungan positif dengan kepuasan ibu bersalin. Pendidikan ibu bersalin berhubungan negatif dengan kepuasan terhadap mutu pelayanan bidan desa. AbstractIn 2009-2011, coverage of delivery by health workers in Luwu district was about 76-77%, and the national target was 90%. This could be caused by post-delivery maternal who were not satisfy towards delivery service quality by midwives. Objective of this study was to identify association between normal delivery service quality by village midwives and post-delivery maternal satisfactory in Luwu district, South Sulawesi.This was a quantitative study using observational-analytical design with cross sectional approach. Study subjects were 70 village midwives and 70 post-delivery maternal in Luwu district that were selected consecutively. Data were collected using structured questionnaire. Chi-square and Pearson correlation were applied in the bivariate data analysis.Results of the study showed that midwives average age was 29 ± 4.4 years, and average work period was 6.5 ± 4.07 years. The majority of midwives level of education was D3 in midwifery (92.9%). Maternal average age was 27 ± 4.3 years. Majority of mothers were unemployed (84.3%) and in the intermediate school or higher level of education (57.1%). The majority of midwives provided good quality of delivery service. No significant associations were found between quality of delivery service and age (p= 0.147), work period (p= 0.214), education (p= 0.343). No significant associations were found between satisfaction towards village midwives delivery service and age (p= 0.622), occupation (p= 0.072) of patients. Significant association was found between maternal education and satisfaction towards village midwives delivery service (p= 0.005). Sixty percent of patients were satisfied. Significant association between village midwives delivery service quality and maternal satisfaction (r= 0.164, p= 0.043) was found.In conclusion, quality of midwives delivery service had positive association with maternal satisfaction. Maternal level of education had negative association with satisfaction towards village midwives service quality.

Factors Related to the Midwives Work Performance on the Implementation of Obstetric Care Standard in Antenatal Care (Study in Primary Healthcare Centers with in Patient Unit in Gresik District) Siti Hamidah; Laksmono Widagdo; Lucia Ratna Kartika
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakAKI di Kabupaten Gresik tahun 2011 sedikit menurun dibanding tahun 2010, dari 20 kematian ibu (105,91/100.000 KH) menjadi 19 kematian ibu (98,82/100.000 KH). AKB tahun 2010, 47 bayi (2,48/1000 KH)) menjadi 140 bayi (7,49/1000KH) tahun 2011. Hasil AMP; selain penyebab langsung, kematian juga karena penyebab tidak langsung yaitu keterlambatan deteksi dini komplikasi kehamilan. SAK ANC merupakan tugas yang harus dilaksanakan semua Bidan. Hasil monitoring IBI Kabupaten Gresik, 50% Bidan belum memberikan asuhan ANC sesuai standar. Tujuan penelitian untuk mengetahui faktor faktor yang berpengaruh terhadap Kinerja Bidan dalam Pelaksanaan SAK ANC di Puskesmas Rawat Inap Kabupaten Gresik.Metode penelitian; jenis penelitian kuantitatif dengan desain crossectional. Pengambilan data secara angket terstrukur dan observasi dokumentasi hasil kinerja ANC. Populasi semua Bidan Puskesmas Rawat Inap Kabupaten Gresik berjumlah 119 Bidan. Jumlah sampel 87 Bidan dipilih secara simple random sampling. Analisis bivariat dengan uji Chi square, multivariat dengan uji regresi logistik ganda. Hasil penelitian; Kinerja Bidan dalam Pelaksanaan SAKANC kurang (44,8%). Sistem Manajemen SAK kurang (55,2%). Kepemimpinan SAK kurang (55,2%). Kreativitas SAK kurang (57,5%). Pengetahuan SAK kurang (56,3%). Tidak ada hubungan antara Kepemimpinan, kreativitas dan pengetahuan dengan Kinerja Bidan dalam SAK ANC. Ada hubungan antara Sistem Manajemen SAK ANC dengan Kinerja Bidan dalam Pelaksanaan SAK ANC (p-Value 0,031<0,05). Ada pengaruh antara Sistem Manajemen SAKANC terhadap Kinerja Bidan dalam pelaksanaan SAK ANC, (p-Value 0,045<0,05).Disarankan pada Dinas Kesehatan, meninjau kembali PerMenKes N0 938/SK/MenKes/VIII/2007, menghimbau pelaksanaan SAK ANC pada Kepala Puskesmas, memfasilitasi pelatihan manajemen organisasi dan SAK ANC untuk Bidan, melakukan supervisi SAK ANC secara berkala. Kepala Puskesmas membuat SK pelaksanaan SAK ANC, membuat program pelatihan manajemen organisasi dan pelatihan SAK ANC, lebih intensif memonitoring kinerja Bidan. IBI melakukan monitoring, evaluasi, menindaklanjuti secara berkesinambungan. AbstractMaternal mortality rate (AKI) in Gresik district in 2011 slightly decreased compared to 2010, from 20 maternal deaths (105.91/100.000 live births) to 19 maternal deaths (98.82/100.000 live birth). The number of death infants in 2010 was 47 infants (2.48%), and it became 140 infants (7.49/1000 live birth) in 2011. Result of MP showed that besides direct cause of death, it was also resulted from indirect cause such as delay in conducting early detection of pregnancy complication. Obstetric standard of care (SAK) for ante natal care (ANC) was a task that should be implemented by all midwives. A monitoring done by IBI of Gresik district showed that 50% of midwives had not conducted ANC according to the standard. Objective of the study was to identify factors affecting work performance of midwives in the implementation of SAK ANC in the inpatient primary healthcare centers of Gresik district.This was a quantitative study with cross sectional approach. Data were collected using structured questionnaire and by conducting documentation observation toward results of ANC performance. Study population was all 119 midwives in the inpatient primary healthcare centers in Gresik district. Study samples were 87 midwives who were selected using simple random sampling method. Chi square test was applied in the bivariate analysis, and multiple logistic regressions were applied in the multivariate analysis.Results of the study showed that work performance of midwives in the implementation of SAK ANC was inadequate (44.8%), SAK management system was inadequate (55.2%), and knowledge on SAK was insufficient (56.3%). No association was found between work performance of midwives in the implementation of SAK ANC and leadership, creativity, knowledge. Significant association was found between SAK ANC management system and work performance of midwives in the implementation of SAK ANC (p: 0.031). There was an influence of SAK management system toward work performance of midwives in the implementation of SAK ANC (p: 0.045).District health office is suggested to review PerMenKes no. 938/SK/MenKes/VIII/2007, to advice heads of primary healthcare centers to implement the SAK ANC, to facilitate organization management training and SAK ANC training, to do more intensive monitoring of the work performance of midwives. Suggestions for IBI were to monitor, to evaluate, and to follow up the implementation of SAK ANC continuously.

Factors Related to the Work Performance of Private Midwives in Using the “Poedji Rochjati” Scores for Early Detection of High Risk Pregnancy in Gresik Regency Sri Rulihari; Martha Irene Kartasurya; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakSkor “Poedji Rochjati” merupakan salah satu metode yang digunakan di provinsi Jawa Timur dalam mendeteksi resiko tinggi kehamilan. Bidan Praktek Swasta (BPS) ternyata tidak melakukan upaya deteksi resiko tinggi dengan skor “Poedji Rochjati” secara optimal dan hanya melakukannya bila ada indikasi tertentu saja. Tujuan penelitian mengetahui faktor yang mempengaruhi kinerja BPS dalam penggunaan skor “Poedji Rochjati” dalam deteksi resiko tinggi ibu hamil. Jenis penelitian observasional analitik dengan pendekatan belah lintang. Pengumpulan data dengan metode angket. Populasi adalah BPS di Kabupaten Gresik dengan subyek sejumlah 90 orang. Data dianalisis bivariat dengan chi-square dan multivariat dengan regresi logistik berganda.Hasil penelitian menunjukkan sebesar 56,67% BPS mempunyai kinerja baik dalam penggunaan skor “Poedji Rochjati”. Variabel yang berhubungan dengan kinerja adalah pengetahuan (p=0,04), sikap (p= 0,001), motivasi (p=0,000), persepsi supervisi Dinas Kesehatan (p=0,000) dan persepsi supervisi IBI (0,003). Variabel beban kerja terbukti tidak berhubungan dengan kinerja (p=0,443). Sikap dan motivasi secara bersama-sama berhubungan dengan kinerja.Dinas Kesehatan dan IBI perlu meningkatkan kualitas supervisi dan pembinaan bagi BPS dalam penggunaan skor “Poedji Rochjati” serta memberikan refreshing rutin sehingga meningkatkan pengetahuan, sikap dan motivasi BPS dalam deteksi resiko tinggi sebaik-baiknya. AbstractPoedji Rochjati score was a method used in East Java province to detect high risk pregnancy. Private practice midwives (BPS), surprisingly, did not optimally detect high risk pregnancy using ‘Poedji Rochjati’ score; they only used the score when there was a certain indication. Objective of this study was to identify factors affecting work performance of BPS in utilizing ‘Poedji Rochjati’ score to detect pregnancy risk. This was an observational analytical study with cross sectional approach. Data were collected using questionnaire. Study population was BPS in Gresik district, and 90 of them were selected as study subjects. Chi square was applied in the bivariate analysis, and multiple logistic regressions were applied in the multivariate analysis. Results of the study showed that 56.67% of BPS had good work performance in utilizing ‘Poedji Rochjati’ score. Variables related to work performance were knowledge (p= 0.04), attitude (p= 0.001), motivation (p < 0.001), perception on IBI supervision (p= 0.003). Workload was not significantly associated with work performance (p= 0.443). Attitude and motivation together were associated with work performance. District health office and IBI are suggested to improve the quality of supervision and guidance to BPS in utilizing ‘Poedji Rochjati’ score; to give routine refreshing to improve knowledge, attitude, and motivation of BPS in conducting proper detection of high risk pregnancy.

Analysis on the Implementation of Community Empowerment by Midwives to Support Delivery Planning and Complication Prevention Program (P4K) at Primary Healthcare Centers in Kediri Dessy Lutfiasari; Cahya Tri Purnami; Lucia Ratna Kartika
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

AbstrakImplementasi P4K bisa berjalan apabila bidan pelaksana dapat memberdayakan masyarakat untuk melaksanakan P4K. Namun Implementasi P4K di Kota Kediri khususnya dalam pemberdayaan masyarakat masih dibawah target yang ditetapkan oleh Dinas Kesehatan Kota Kediri. Tujuan dari penelitian ini adalah menjelaskan implementasi kegiatan pemberdayaan masyarakat oleh bidan untuk mendukung P4K di Puskesmas Kota Kediri tahun 2011.Penelitian ini dilakukan pada bulan Mei sampai Juli 2011, dilakukan di seluruh Puskesmas Kota Kediri. Jenis penelitian ini adalah deskriptif yang bersifat kualitatif dengan pendekatan cross sectional. Data yang digunakan adalah data primer dengan menggunakan teknik indepth interview serta menggunakan data sekunder. Analisis data dalam penelitian ini menggunakan content analysis (analisis isi).Hasil penelitian menujukkan bahwa kegiatan pemberdayaan masyarakat yang tidak berjalan adalah tabulin dikarenakan banyaknya jaminan kesehatan untuk masyarakat, ukuran dasar dan tujuan kebijakan yang tidak jelas. Meskipun sumber daya manusia sudah sesuai namun tidak ada dana dan fasilitas khusus walaupun sudah ada bantuan dari gerdu sehati. Selaian itu manajeman kontrol yang tidak dijalankan oleh puskesmas dan pembinaan oleh bidan tanpa memiliki forum khusus menjadikan proses komunikasi antara kader dan masyarakat menjadi kabur. Walaupun sikap bidan positif dalam menjalankan tanggung jawabnya jika tidak ditunjang dengan dukungan dari masyarakat maka tidak akan berjalan.Saran yang dapat diberikan kepada Dinas Kesehatan adalah perlu dibuatnya ukuran dasar dan tujuan kebijakan yang jelas tentang pelaksanaan P4K serta pelatihan bidan dan kader secara berkala tentang pemberdayaan masyarakat. Fungsi kontrol yang baik harus dijalankan oleh Puskesmas serta peningkatan komunikasi yang dilakukan oleh bidan untuk menjalankan kegiatan pemberdayaan masyarakat. AbstractImplementation of delivery planning and complication prevention program (P4K) could run if midwives could empower people to do P4K. However, implementation of P4K in Kediri city particularly in community empowerment was still below the target set by Kediri city health office. The objective of this study was to explain implementation of community empowerment by midwives to support P4K at primary healthcare centers in Kediri city, in 2011. This study was conducted in May – July 2011 in all primary healthcare centers in Kediri city. This was a qualitative study with cross sectional approach. Primary data were collected through in- depth interview technique, and secondary data were also used. Content analysis method was applied in the data analysis. Results of the study showed that tubulin was the community empowerment activity that was not implemented due to many options for health insurance in the community; basic indicator, purpose of the policy were not clear. Although human resources was appropriate, and there was a support from gerdu sehati; however, there was no funding and special facilities. Additionally, control management was not performed by primary healthcare center; supervision by midwife did not provide special forum for communication between cadres and people in the community. Although attitude of midwives was positive in doing their responsibilities but there was no support from the community, as a result the program would not run. Suggestions for district health office are to make clearly basic indicator and policy objective regarding P4K implementation; to conduct routine training for midwives and cadres regarding community empowerment. Primary healthcare center has to implement good control function; to improve communication done by midwives to implement community empowerment activities.

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

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

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

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.

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Prodi Magister Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat UNDIP, Jalan Professor Soedarto, Tembalang, Kota Semarang, Jawa Tengah 50275, Indonesia

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Jawa tengah

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Editorial Address 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

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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