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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 373 Documents
 3   4   5   6   7 
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.
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.

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