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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
 4   5   6   7   8 
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.
Analysis on Determinants of Pulmonary Tuberculosis Officer Motivations In Tuberculosis Case Invention in Semarang Regency (A Case Study in Several Primary Health Care Centers) Joyo Minardo; Ayun Sriatmi; Septo Pawelas Arso
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (274.01 KB) | DOI: 10.14710/jmki.3.1.2015.%p

Abstract

Penderita Tuberkulosis dengan status Basil Tahan Asam (BTA) positif dapat menularkan ke 1015 orang lain setiap tahunnya, sehingga penemuan kasus penting dilaksanakan. Cakupan penemuan kasus tuberkulosis dengan BTA positif di Kabupaten Semarang tahun 2009 jauh di bawah cakupan nasional. Rendahnya disebabkan karena motivasi petugas yang kurang. Tujuan penelitian ini untuk menganalisis faktor yang dapat menurunkan motivasi petugas TB dalam  penemuan kasus di Kabupaten Semarang. Penelitian dilakukan dengan metode kualitatif.  Pengumpulan data primer dilakukan dengan wawancara mendalam, dan data sekunder dengantelaah dokumentasi. Subjek penelitian adalah petugas Tuberkulosis Paru di Puskesmas.  Pemilihan subjek dilakukan secara purposive. Informan utama berjumlah 18 orang, terdiri dari 6 orang perawat, 6 orang Analis dan 6 orang dokter kepala Puskesmas. Informan triangulasi adalah 6 orang petugas BP, dan satu orang Kasie P2M Dinkes Kabupaten Semarang. Analisis data dilakukan dengan content analysis. Hasil penelitian menunjukkan bahwa motivasi  petugas rendah karena pekerjaannya merupakan penunjukkan pimpinan Puskesmas dan membutuhkan waktu yang lama serta berisiko tertular oleh penderita. Tanggung jawab dalam menyelesaikan pekerjaan kurang karena beban pekerjaan yang banyak, bekerja tanpa target dan motivasi. Petugas tidak mendapatkan kompensasi, membutuhkan dukungan dari pimpinan untuk mengeluarkan ide dan gagasan dalam penemuan kasus. Sarana transportasi untuk penemuan kasus tidak ada. Puskemas tidak memiliki rencana implementasi kebijakan program penemuan kasus, dan sistem supervisi terhadap cakupan penemuan kasus belum optimal. Disimpulkan bahwa motivasi petugas Tuberculosis Paru dalam penemuan kasus masih rendah, karena belum ada dukungan dan tanggung jawab masih kurang serta sistem kompensasi dan supervisi yang belum ada. Tuberculosis patients with positive acid fast bacilli (BTA) were able to infect 10-15 other people every year; therefore case detection was important to be implemented. Detection coverage of tuberculosis cases with positive BTA in Semarang district was far below national coverage. This low coverage could be caused by low motivation of tuberculosis (TB) health workers. Objective of this study was to analyze factors that decreased motivation of TB workers in conducting case detection in Semarang district. This was a qualitative study. Primary data collection was done by conducting in-depth interview; secondary data collection was done by conducting documentation review. Study subjects were lung tuberculosis workers in the primary healthcare centers. Subjects were purposively selected. The number of main informants was 18 people. The main informants were six nurses, 6 analysts, and six heads of primary health care centers. Triangulation informants were six polyclinic health workers, and one head of communicable disease control unit of Semarang district health office. Content analysis method was applied in the data analysis. Results of the study showed that motivation of TB workers was low due to the works were assigned by the primary healthcare centers leader, the work took longer time, and workers were at risk to get infection from patients. Responsibility to finish the works was low due to high amount of workload, work without target and motivation. TB workers did not get compensation; they needed support from the leader to express their ideas in the case detection. Transportation facility for case detection was not provided. The primary healthcare centers did not have planning to implement case detection program policy. Supervision system on case detection coverage was not optimal. In conclusion, motivation of lung tuberculosis workers in case detection was low. It was caused by no supports, insufficient responsibility, and no compensation and supervision.
Quality Management of Emergency Room (ER) Services in the District General Hospital of Kudus Elok Mariyatul Qibtiyah; Sudiro Sudiro; Lucia Ratna Kartika Wulan
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.143 KB) | DOI: 10.14710/jmki.3.1.2015.%p

Abstract

Mutu pelayanan Instalasi Gawat Darurat (IGD) RSUD Kudus yang meliputi sumber daya manusia, kebijakan dan prosedur serta sarana prasarana IGD belum sesuai standar IGD RS level III. Penelitian ini bertujuan untuk mengetahui manajemen mutu pelayanan IGD yang meliputi proses manajemen mutu, kepemimpinan mutu dan organisasi mutu. Jenis penelitian ini dilakukan secara kualitatif menggunakan metode observasi, Focus Group Discussion (FGD) dan wawancara mendalam. Subyek sebanyak 13 orang terdiri atas: 4 orang sebagai informan utama, 9 orang sebagai informan triangulasi terdiri atas 3 orang petugas IGD RSUD Kudus dan 6 orang keluarga pasien. Variabel yang diukur adalah proses manajemen mutu, kepemimpinan mutu, organisasi mutu dan mutu pelayanan IGD RSUD Kudus. Hasil penelitian ini meliputi perencanaan mutu: jumlah dan kompetensi petugas kurang, belum ada pedoman orientasi, belum ada pedoman mutasi, pengadaan, pemeliharaan dan kalibrasi alat kurang. Pengendalian mutu : evaluasi kinerja belum ada. Peningkatan mutu : peningkatan sumber daya manusia kurang, belum ada pedoman pelatihan, belum ada pengaturan anggaran terintegrasi dengan pengadaan sarana prasarana dan sarana prasarana kurang. Kepemimpinan mutu : gaya demokratis dengan kebijakan yang jelas. Organisasi mutu: pengalaman manajemen dan kompetensi Kepala IGD baik, perubahan yang mundukung mutu pelayanan IGD bisa diterima baik. Mutu pelayanan IGD meliputi SDM yaitu kepala IGD yang mempunyai kriteria khusus baik, petugas IGD yang mempunyai kriteria khusus kurang, sarana prasarana kurang, kebijakan dan prosedur kurang. Kesimpulan penelitian ini adalah proses manajemen mutu IGD RSUD Kudus belum berjalan baik, gaya kepemimpinan demokratis dengan kebijakan jelas, organisasi mutu berjalan baik, petugas IGD belum memenuhi kriteria khusus. Saran penelitian ini adalah mengadakan rapat kerja guna menyusun rencana strategis dan kebijakan pimpinan yang jelas sebagai arah dan pedoman yang dituangkan dalam program kerja tahunan di RSUD Kudus. Service quality of an emergency room unit (IGD) of Kudus District General Hospital (RSUD) included human resource, policy, procedure and facility of IGD. This was not fit properly with level III IGD standard. Objective of this study was to identify service quality management of IGD including quality management process, quality of leadership, and quality of organization. This was a qualitative study using observation, focus group discussion, and in-depth interview methods. Study subjects were 13 people: four main informants, nine triangulation informants. Triangulation informants included 3 workers at IGD of RSUD Kudus, and six patient’s family members. Measured variables were quality management, quality of leadership, organizational quality, and service quality of IGD of RSUD Kudus. Results of this study included quality planning: the number of workers and worker’s competence were insufficient; no orientation guideline and transfer or workers guideline were provided; maintenance and instrument calibration were insufficient. Quality control: no evaluation of work performance was provided. Quality improvement: human resource improvement was not adequate; no training guideline was provided; no integrated budget regulation was performed; supply of facilities was not adequate. Quality of leadership: Democratic style with understandable policy was applied. Organizational quality: management experience and the competence of head of IGD were good; changes that supported IGD service quality were well accepted; Service quality of IGD, that included human resource such as chief of IGD with special criteria, was good. IGD workers with special criteria were insufficient. Facilities were insufficient. Policy and procedure were insufficient. In conclusion, the quality management process of IGD RSUD Kudus was insufficient; democratic leadership with understandable policy was applied; organizational quality was good; IGD workers were not matched with specific qualification. Suggestions: to conduct meeting to formulate clear strategic plan and clear leader policy as guidelines. It should be included in the annual working program in RSUD Kudus.
Supplementary Feeding Program Evaluation Restoration Malnourished In Children Under Five In The District Wonogiri Seen From Input and Process Aspects Ratna Indriati; Sri Achadi Nugraheni; Apoina Kartini
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (217.747 KB) | DOI: 10.14710/jmki.3.1.2015.%p

Abstract

Salah satu upaya untuk mengatasi masalah kurang gizi di Kabupaten Wonogiri adalah dengan program PMT-P. Program ini sudah dilakukan sejak tahun 2007 namun belum menunjukkan hasil yang bermakna. Hasil studi pendahuluan menunjukkan masih ada kendala dalam aspek input dan proses dalam pelaksanaan program ini. Tujuan penelitian untuk mengevaluasi pelaksanaan program PMT-P balita kurang gizi. Jenis penelitian observasional analitik dengan metode kualitatif untuk mengevaluasi pelaksanaan program PMT-P oleh TPG dan kuantitatif untuk membandingkan pelaksanaan program PMT-P oleh bidan desa antara puskesmas yang mengalami peningkatan dan penurunan kasus balita kurang gizi. Informan utama 4 TPG dari 4 puskesmas yang mengalami peningkatan dan penurunan kasus balita kurang gizi. Informan triangulasi yaitu 4 kepala puskesmas, Kasi Kesga dan Gizi DKK, 4 bidan desa, 4 kader posyandu, dan ibu balita penerima PMT-P. Subjek penelitian kuantitatif adalah 60 bidan desa yang dipilih secara purposif dari puskesmas tersebut. Pengumpulan data kualitatif melalui wawancara mendalam dan kuantitatif dengan angket. Analisis data kualitatif dengan contentanalysis dan kuantitatif dengan uji statistik Mann Whitney. Pelaksanaan PMT-P di puskesmas yang mengalami penurunan kasus kurang gizi lebih banyak yang optimal (83,3%) dibandingkan puskesmas yang mengalami peningkatan kasus (56,7%). Perbedaan mencolok pada pelaksanaan meliputi sosialisasi ke masyarakat, registrasi sasaran, pemantauan daya terima makanan tambahan, penggunaan kartu pemantauan serta pendampingan bidan terhadap kader lebih banyak dilakukan oleh puskesmas yang mengalami penurunan kasus balita kurang gizi. Pemberian paket PMT-P di puskesmas yang mengalami peningkatan kasus dilakukan pada semua balita dengan rata-rata pemberian selama satu bulan. Selain itu puskesmas kurang melibatkan perangkat desa dan kecamatan dalam PMT-P. Penentuan sasaran dengan tepat dan peningkatan peran serta masyarakat dapat menurunkan kasus kurang gizi. One of efforts to solve undernourishment problems in Wonogiri district was a recovery food supplement distribution (PMT-P) program. This program has been implemented since 2007. However, it had not shown significant results. Preliminary studies showed that there were problems in input and process aspects in the implementation of this program. Objective of the study was to evaluate the implementation of PMT-P program for undernourished under-five children (balita). This was an observational-analytical study. A qualitative method was applied to evaluate the implementation of PMT-P program by TPG. A quantitative method was used to compare the implementation of PMT-P program by midwives in the primary healthcare centers (puskesmas) with increasing and decreasing numbers of undernourished under-five children cases. The main informants were four TPG from four puskesmas that experienced the increase and decrease numbers of undernourished under-five children cases. Triangulation informants were four heads of puskesmas, a head of Kesga and nutrition section of the district health office, four village midwives, four posyandu cadres, and mothers of under-five children who received PMT-P. Subject of the quantitative study were 60 midwives selected purposively from each puskesmas. Qualitative data were collected through in-depth interview; quantitative data were collected using questionnaire. Content analysis was applied for qualitative data analysis, and Mann-Whitney statistic test was applied for quantitative data analysis. Implementation of PMT- P in puskesmas that experienced the decrease of the number of undernourished cases was more optimal (83.3%) than in puskesmas that experienced the increase of the cases (56.7%). Distinct difference that was shown in the implementation included socialization to the community, target registration, monitoring of PMT absorption ability, monitoring card usage. Midwives accompaniment to cadres was conducted more frequent by puskesmas that experienced the decrease of the number of undernourished under-five children cases. PMT-P packages were distributed continually to all under-five children in the puskesmas that experienced the increase of the cases for a month in average. Additionally, puskesmas did not optimally involve village staffs and sub district office staffs in the PMT-P program activities. The implementation of PMT- P in puskesmas that experienced the decrease of undernourished cases is better. Accurate determination of the target and improvement of community involvement should be able to decrease undernourished cases.

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