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Factors Related to the Use of Long Term Contraception Method (A Study on Contraceptive Users in Kabupaten Sidoarjo, East Java Province) Djauharoh A. Hadie; Martha Irene Kartasurya; Cahya Tri Purnami
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Laju pertumbuhan penduduk Indonesia cukup tinggi, sehingga penggunaan MKJP sangat diperlukan. Penggunaan MKJP di Kabupaten Sidoarjo cenderung menurun, dan lebih rendah dibanding penggunaan MKJP di tingkat Provinsi. Penelitian ini bertujuan untuk menganalisis hubungan pengetahuan, sikap akseptor terhadap MKJP, dan akses pelayanan KB, serta sikappetugas dalam pelayanan KB dengan penggunaan MKJP di Kabupaten Sidoarjo Provinsi Jawa Timur. Jenis penelitian adalah observasional analitik dengan disain Cross Sectional. Populasi penelitian adalah akseptor aktif di Kabupaten Sidoarjo. Subyek sejumlah 100 orang akseptor MKJP dan non MKJP, dipilih secara purposif. Pengumpulan data menggunakan data primer dan sekunder, dan dianalisis secara deskriptif menggunakan distribusi frekuensi, Analisis bivariat dilakukan dengan uji Chi-Square, dan analisis multivariat dengan Regresi Logistik ganda. Hasil penelitian menunjukkan 63% responden berumur lebih dari 30 tahun, 54% berpendidikan Dasar, 65% bekerja sebagai ibu rumah tangga, 52% berpenghasilan kurang dari UMR, 79% memiliki paritas rendah (<3), dan 81% umur anak terkecil ≥ 3 tahun. Analisis bivariat didapatkan ada hubungan pengetahuan (p=0,0001), sikap akseptor terhadap MKJP (p=0,001), sikap akseptor terhadap akses pelayanan KB dengan penggunaan MKJP (p=0,019). Sikap petugas dalam pelayanan KB (p=0,715) tidak berhubungan dengan penggunaan MKJP. Variabel yang bersamasama berhubungan dengan penggunaan MKJP adalah pengetahuan, sikap akseptor tehadap MKJP, dan akses pelayanan KB. Faktor yang berhubungan paling kuat dengan penggunaan MKJP adalah pengetahuan akseptor tentang MKJP. Growth rate of Indonesian population was high, and long term contraception method (MKJP) was needed. The use of MKJP in Sidoarjo district tended to decrease; it was lower than the use of MKJP in province level. Objective of this study was to analyze association between knowledge, attitude of acceptors towards MKJP, family planning access, workers attitude in the family panning (KB) service and the use of MKJP in Sidoarjo district, East Java province. This was an observational-analytical and quantitative study using cross sectional approach. Study population was active acceptors in Sidoarjo district.Study subjects were 100 MKJP and non MKJP acceptors who were purposively selected. Data collection was done by collecting primary and secondary data. Data was analyzed by applying descriptive analysis, Chi-Square test, and multiple logistic regressions. Results of the study showed that 63% of respondents were more than 30 years old, 54% of respondents’ level of education were elementary school, 65% of respondents worked as housewives, 52% of respondents had salary below the minimum regional pay (UMR), 79% of respondents had low parity (< 3), and 81% of respondents had the last child with age 3 years old or higher. Results of bivariate analysis showed association between the use of MKJP and knowledge (p= 0.0001), acceptor attitude towards MKJP (p= 0.019), acceptor attitude towards AKB service accessibility (p= 0.019). Workers attitude in the KB service (p= 0.715) did not associate with the use of MKJP. Variables that jointly rellated to the use of MKJP were knowledge, attitude of acceptor towards MKJP, and accessibility to KB service. The strongest factor that associated with the use of MKJP was knowledge of acceptor about MKJP.

Evaluation on the Implementation of Maternal and Child Health Service Reporting by Coordinator Midwives at Primary Healthcare Centers in Nabire District, Papua Province Yokbeth Kareth; Cahya Tri Purnami; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Pencatatan data pelayanan KIA di Dinas Kesehatan Kabupaten nabire tidak lengkap karena data dari puskesmas tidak masuk tepat waktu. Disisi lain, hasil PWS digunakan untuk perencanaan program KIA dalam rangkan penurunan AKI. Tujuan penelitian adalah menjelaskan pelaksanaan pencatatan data pelayanan KIA dan pelaporannya oleh Bidan Koordinator di puskesmas Distrik Nabire. Penelitian menggunakan metode kualitatif. Informan utama bidan koordinator dan informan triangulasi bidan desa, kepala puskesmas dan Kasie KIA DKK. Pengumpulan data dengan wawancara mendalam dan dianalisis dengan content analysis. Hasil penelitian menunjukkan bahwa puskesmas yang pencatatan & pelaporan KIA baik, bidan koordinatornya melakukan pencatatan lengkap dan mengumpulkan tepat waktu setiap tanggal 10 ke DKK. Bidan telah mendapat pelatihan khusus tentang pencatatan & pelaporan KIA. Pada puskesmas yang pencatatan & pelaporan KIA kurang baik, bikor tidak mengisi kolom-kolom isian format secara lengkap dan tidak mengerti cara mengisi format isian yang sering berubah. Bidan belum mendapat pelatihan khusus. Keberhasilan dalam kelengkapan pencatatan & ketepatan pelaporan dipengaruhi oleh kelengkapan dan ketepatan pelaporan bidan pustu ke puskesmas. Keterlambatan disebabkan oleh jarak dan akses geografis yang sulit terjangkau serta beban kerja yang berat. Semua bikor mempunyai sikap dan motivasi baik. Supervisi Kepala Puskesmas yang pencatatan & pelaporan KIAnya baik dilakukan sebulan sekali dan yang kurang baik 3 bulan sekali. Supervisi DKK ke puskesmas yang baik 3 bulan sekali dan puskesmas yang kurang baik 6 bulan sekali. Disarankan agar DKK mengalokasikan anggaran untuk pelatihan khusus pencatatan & pelaporan KIA bagi bikor yang belum dilatih serta mengusahakan melengkapi sarana prasarana terutama di puskesmas dengan akses yang sulit. Recording of KIA (maternal and children health) data in Nabire district health office (DKK) was not complete because data from primary healthcare centers (puskesmas) did not arrive at DKK Nabire on time. On the other side, results of PWS (local monitoring area) were used for KIA program planning in order to reduce AKI (maternal mortality rate). Objective of this study was to explain the implementation of recording and reporting KIA service data by coordinator midwives in puskesmas of Nabire district. This was a qualitative study. Main informant was coordinator midwives, and triangulation informants were village midwives, heads of puskesmas, and heads of KIA section of DKK. Data were collected through in depth interview. Content analysis method was applied in the data analysis.Results of the study showed that in the puskesmas with good KIA recording and reporting, coordinator midwives did complete recording and reporting and submit them on time, every 10 th day of the month, to the district health office; midwives had received special training regarding KIA recording and reporting. In the puskesmas with inadequate KIA reporting and recording, coordinator midwives did not fill the provided coulombs in the forms completely, and they did not know how to fill the forms that were changed frequently; midwives had not received special training. Successfulness in completion of recording and reporting punctuality was influenced by completeness and punctuality of reporting by midwives in the subsidiary primary healthcare center to the main primary healthcare center. The delay was caused by distance and difficult geographical accessibility, and heavy workload. All coordinator midwives had good attitude and motivation. Supervision by head of puskesmas with good KIA recording and reporting was done every month, and for the puskesmas with inadequate KIA recording and reporting was done every 3 months. Supervision by DKK to puskesmas with good KIA recording and reporting was done every 3 months, and to puskesmas with inadequate KIA recording and reporting was done every 6 months.Suggestions for DKK are to allocate budget for special training in KIA recording and reporting for coordinator midwives who have not received training, and to complete facilities especially in puskesmas with difficult accessibility.

Implementation on the Referral System of High Risk Pregnant Women from Villages Midwives to Primary Healthcare Center with Basic Obstetric and Neonatal Emergency Care in Banjar District, South Kalimantan (a Case Study in Sungkai Primary Healthcare Center) Adriana Palimbo; Ayun Sriatmi; Tjahjono Kuntjoro
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Kualitas pelayanan rujukan kebidanan tidak bisa terlepas dari system rujukan yang dilaksanakan oleh bidan desa sebagai pos pelayanan terdepan di masyarakat. Selain karena faktor sistem penanganan kasusnya yang kurang sesuai dengan prinsip dasar merujuk, diduga juga karena keterlambatan menganal tanda bahaya dan mengambil keputusan dan terlambat mendapat pelayanan di fasilitas kesehatan. Tujuan penelitian adalah menjelaskan pelaksanaan sistem rujukan ibu hamil risiko tinggi oleh bidan desa ke Puskesmas PONED Kabupaten Banjar tahun 2011. Penelitian ini adalah penelitian observasional menggunakan rancangan deskriptif kualitatif, dalam bentuk studi kasus untuk menggambarkan dan memahami fenomena yang berkaitan dengan pendekatan crossectional. Instrumen penelitian adalah bidan desa Puskesmas Sungkai yang melakukan rujukan kasus ibu hamil risiko tinggi ke Puskesmas PONED. Data dikumpulkan dengan wawancara mendalam dan dianalisis dengan teknik kualitatif. Hasil penelitian menunjukkan bahwa masih ada bidan desa yang melakukan stabilisasi diluar kewenangan. Sebagian besar masyarakat menggunakan pembiayaan Jamkesmas, tetapi dari biaya dan ketersediaan transportasi/ambulan desa dan keperluan lain masih masih kurang memadai bagi pasien Jamkesmas. Selama proses pendampingan bidan sebagian besar hanya mendampingi jika pasien dirujuk ke RS swasta, tetapi hal sama tidak dilakukan pada pasein Jamkesmas. Dalam merujuk ibu hamil ke puskesmas PONED bidan desa tidak membawa surat pengantar rujukan, tetapi hal sama juga tidak dilakukan saat merujuk ke RS swasta. Bidan menyertakan surat dan lampiran buku KIA jika ke RS umum untuk tujuan klem Jamkesmas. Berdasarkan hasil penelitian tersebut disarankan kepada Dinas Kesehatan untuk melengkapi jumlah tenaga bidan desa dan kualifikasinya, serta kecukupan alat/obat/bahan di Polindes/Poskesdes. Bagi Puskesmas untuk melakukan pembinaan dan supervisi bidan di desa dan ada pembagian tugas yang jelas untuk bidan desa di wilayah kerjanya. Quality of obstetrical referral service could not be separated from referral system done by village midwives as a front health service post in the community. Obstetric case management that was not fully follow a basic principle of referral, delays to identify signs of dangerous pregnancy condition, delay to make decision, and delay to obtain services in the health facility were factors related to the quality of obstetrical referral service. The objective of this study was to explain the implementation of high risk pregnancy referral system by village midwives to PONED primary healthcare center Banjar district, 2011. This was an observational study using descriptive qualitative design. This study was in the form of a case study to describe and to comprehend related phenomena using cross sectional approach. Study instrument was village midwives from Sungkai primary healthcare center who referred high risk pregnant women to PONED primary healthcare center. Data were collected by conducting in-depth interview. Qualitative technique was applied to analyze the data. Results of the study showed that village midwives still performed stabilization beyond their authority. Majority of people in the community used Jamkesmas (community health insurance) funding; however, funding and transportation or village ambulance availability and other needs were insufficient for Jamkesmas patients. During midwives accompaniment, most of them only accompanied when the patient was referred to the private hospital, and they did not do that for Jamkesmas patients. Midwives did not bring reference letter to PONED primary healthcare centers when they were referring pregnant women; it was also done when they were referring pregnant women to private hospitals. Midwives included a letter and KIA book as an enclosure when they referred the patient to the general hospital for Jamkesmas claim purpose. Based on the study results, suggestions given to the head of district health office were to provide additional number of village midwives with its qualification; to assure the availability and sufficiency of instrument, medicine and materials in Polindes or Poskesdes; Suggestions for primary healthcare office were to conduct guidance and supervision for village midwives, to distribute clearly the job assignments to village midwives in their work areas.

Analysis on Low Rate Utilization of Delivery Services by Health Workers at Wakaokili Community Health Center in Buton Regency Ira Yusnita; Chriswardani Suryawati; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Pemanfaatan layanan persalinan tenaga kesehatan di Indonesia masih rendah terutama di daerah pedesaan. Kondisi ini juga terjadi pada masyarakat di wilayah kerja Puskesmas Wakaokili Kabupaten Buton, dimana pada saat hamil sebagian besar ibu memeriksakan diri ke bidan tetapi saat bersalin lebih memilih dukun. Pemerintah telah melakukan berbagai upaya meningkatkan minat masyarakat untuk bersalin pada tenaga kesehatan namun sampai saat ini belum mencapai hasil yang diinginkan. Untuk itu penelitian ini dirancangan dengan pendekatan kualitatif, metode studi kasus guna memahami alasan yang melatar belakangi rendahnya pemanfaatkan layanan persalinan oleh masyarakat. Pengumpulan data dengan wawancara menggunakan pedoman wawancara dan observasi langsung pada layanan kesehatan. Jumlah informan utama 36 orang terbagi dalam 2 kelompok yaitu kelompok sasaran langsung program meliputi ibu bersalin oleh bidan, dukun dan oleh keluarga beserta para suami. Serta kelompok sasaran tidak langsung program yaitu Toma/Toga dan kader kesehatan. Adapun informan triangulasi bidan, dukun dan kepala Puskesmas Wakaokili serta Kabid Kesga DKK Buton. Hasil penelitian diketahui bahwa alasan yang melatarbelakangi rendahnya pemanfaatkan layanan persalinan tenaga kesehatan yaitu karena mereka tidak mengenal bidan di desa, karena tidak memahami manfaat persalinan oleh tenaga kesehatan, biaya di dukun lebih terjangkau dan karena bidan tidak selalu ada saat dibutuhkan. Selain itu adanya kepercayaan masyarakat bahwa lancar tidaknya persalinan bukan ditentukan oleh penolong persalinan tetapi oleh perbuatan ibu semasa hamil. Juga adanya keyakinan terhadap doa-doa yang dimiliki oleh dukun atau suami menyebabkan masyarakat selalu menyertakan dukun dalam kehamilan dan persalinan guna kelancaran proses persalinan. Untuk itu diharapkan bidan lebih aktif melakukan pendekatan pada warga binaanya. Juga puskesmas dan kepada Dinas Kesehatan untuk melakukan upaya peningkatan pengetahuan masyarakat, kapasitasi dan pembinaan dukun dan juga mengkaji ulang insentif bagi bidan dalam rangka peningkatan kunjungan pada bumil baik di rumah maupun yang di kebun. Utilization of delivery service by health workers in Indonesia was still low especially in rural areas. This condition occurred in communities in the work area of Wakaokili primary healthcare center (puskesmas) Buton district. Most of pregnant women in this community did antenatal care to midwives, however they chose traditional delivery assistant (dukun bayi) to assist their delivery process. Government had done many efforts to increase community interest to give birth with health workers assistance. However, this effort had not reached what was expected. This was a case study with qualitative approach. Objective of the study was to understand the background for low utilization of delivery services by the community. Data were collected through interview guided by interview guideline, and direct observation in the health services. The number of main informants was 36 people. They were divided into 2 groups. Those groups were direct target program group that included post-delivery women assisted by midwives, dukun bayi, and house member including husbands; indirect target program group consisted of community leaders and cadres. Triangulation informants were midwives, dukun bayi, the head of Wakaokili primary healthcare center, and the head of family health department of Buton district health office. Results of the study showed that background for the low utilization of delivery services by health workers was that community did not know village midwives; community did not understand benefits of giving birth assisted by health workers; the cost of giving birth assisted by dukun bayi was affordable; midwives were not always ready when needed. In addition, there was a stigma that smoothness of delivery process was not determined by who assisted the delivery but by what had been done by the mothers during pregnancy. Furthermore, there was a belief towards praying words spoken by dukun bayi or husbands; this was one of reasons why dukun bayi was included in the delivery process. They believed that dukun would make the delivery process success. Midwives are expected to be more active to approach their supervised community. Primary healthcare center and district health office are suggested to do efforts to improve community knowledge, to train and assist dukun, and to review the incentive for midwives in order to be able increase the number of visits to pregnant women in their house or in the field.

Correlation Between Village Midwife’s Characteristics And Behavior In Neonatal Care At Primary Health Care Center Area In Klaten District Endah Purwaningsih; Martha Irene Kartasurya; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Angka Kematian Bayi di Kabupaten Klaten pada tahun 2011 sebesar 13,346/ 1000 kelahiran hidup dan tahun 2012 AKB sebesar 10,36 per 1000 kelahiran hidup. Kematian bayi tersebut terjadi pada bayi umur 0 – 28 hari atau periode neonatal. Cakupan pelayanan kunjungan neonatus oleh bidan di Kabupaten Klaten dari tahun 2009 sampai dengan 2012 mengalami menurunan dari kunjungan murni dan kunjungan lengkap. Dalam pelayanan neonatus bidan desa hampir tidak semua melalukan sesuai dengan standar pelayanan minimal. Tujuan penelitian ini adalah untuk mengetahui hubungan karakteristik bidan desa dengan pelayanan neonatus di wilayah Puskesmas Kabupaten Klaten tahun 2013. Metodologi penelitian observasional survey ini dilaksanakan dengan pendekatan cross sectional. Sampel dalam penelitian ini adalah 82 bidan desa di Kabupaten Klaten yang diambil secara Cluster Random Sampling. Instrumen penelitian menggunakan kuesioner dan lembar observasi. Data primer maupun sekunder diolah dan dianalisis secara univariat dengan distribusi frekuensi dan persentase, bivariat dengan Korelasi Chi Square. Hasil penelitian menunjukkan bahwa hubungan karakteristik dengan perilaku bidan desa dalam pelayanan neonatus di Kabupaten Klaten adalah ada hubungan karakteristik dengan pengetahuan yaitu: umur (p = 0.002), pendidikan (p = 0.000), pelatihan (p = 0,011) dan lama kerja (p = 0,000). Ada hubungan karakteristik dengan sikap yaitu: umur (p = 0,005), pendidikan (p = 0,000), pelatihan (p = 0,003), lama kerja (p = 0,000) dan pengetahuan (p = 0,000). Tidak ada hubungan karakteristik dengan pelayanan neonatus yaitu: umur (p = 0.354), pendidikan (p = 0,751), pelatihan (p = 0.336) dan lama kerja (p = 0.950), pengetahuan (p = 0,739) dan sikap ( p = 0,896). Disarankan bagi Dinas Kesehatan Klaten untuk meningkatkan pengetahuan Bidan Desa terutama tentang pelayanan neonatus melalui pelatihan dan sosialisasi buku KIA serta MTBM bagi semua Bidan Desa. Melakukan supervisi ke bidan desa dalam pelayanan KIA. Infant Mortality Rate (IMR) in District of Klaten in 2011 and in 2012 respectively was 13.346/1,000 live births and 10.36/1,000 live births. The aged of infant mortalities ranged from 0 to 28 days or during a neonatal period. The coverage of neonatal services provided by village midwives in District of Klaten from year of 2009 to year of 2012 decreased in terms of pure and complete visits. Almost all village midwives did not provide the neonatal services which were in accordance with minimum services standards. This research aimed to find out about the relationship between characteristics of village midwives and neonatal services at health centers in District of Klaten in 2013. This was observational-survey research using cross-sectional approach. Number of samples was 82 village midwives in District of Klaten selected by a technique of Cluster Random Sampling. Research instruments used a questionnaire and an observation sheet. Primary and secondary data were analyzed using methods of univariate analysis (frequency distribution and percentage) and bivariate analysis (chi-square test). The result of this research revealed that variables of age (p=0.002), education (p=0.000), training (p=0.011), and work period (p=0.000) significantly related to a variable of knowledge. Furthermore, variables of age (p=0.005), education (p=0.000), training (p=0.003), work period (p=0.000), and knowledge (p=0.000) significantly related to a variable of attitude. On the other hand, variables of age (p=0.354), education (p=0.751), training (p=0.336), work period (p=0.950), knowledge (p=0.739), and attitude (p=0.896) did not relate to the neonatal services. As a suggestion, Klaten District Health Office needs to improve the knowledge of village midwives especially about neonatal services by conducting training and socialization of a Maternal and Child Health (MCH) book and Integrated Management of Young Infants for them. In addition, supervision needs to be done to village midwives in MCH services.

Implementation System Analysis of Integrated Health Service Post of Model at Work Area of Private Companies in Cilacap Ernawati Ernawati; Laksmono Widagdo; Atik Mawarni
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Peran serta masyarakat untuk ikut berpartisipasi dalam menurunkan AKI dan AKB dapat dilakukan dengan cara yang sederhana yaitu dengan mengikuti kegiatan posyandu. Posyandu merupakan salah satu kegiatan yang didalamnya terdapat pelaksanaan program-programpemerintah terkait pelayanan kehamilan, balita, PUS dan lansia. Dari berbagai jenis atau strata posyandu terdapat “Posyandu Model “ yang kegiatannya sudah dikembangkan dan terintegrasi. Posyandu model diharapkan mampu menjadi wadah yang dapat meningkatkan peran serta masyarakat untuk mendukung program-program MDG’s. Kabupaten Cilacap merupakan wilayah industri karena terdapat perusahaan-perusahaan besar, mulai tahun 2009 DKK Cilacap bekerjasama dengan perusahaan swasta mengenai program CSR. Hal ini diharapkan mampu mendukung program penurunan AKI dan AKB. Terdapat 10 Posyandu model yang menjadi binaan perusahaan swasta tersebut, yang berada pada 6 kelurahan disekitar wilayah perusahaan (Zona I, II dan III). Tujuan penelitian ini untuk menganalisis sistem pelaksanaan posyandu model (Di Wilayah Binaan Perusahaan Swasta). Desain penelitian ini adalah cross sectional dengan pendekatan kualitatif. Pemilihan informan dengan cara purposive, pengambilan data melalui wawancara (indepth interview) pada informan utama 6 ketua pokja IV, 6 Lurah/Kepala Desa, 10 kader dan 1 humas perusahaan swasta. Analisis data menggunakan metode analisis isi (content analysis). Hasil penelitian dari variabel input yaitu mengenai SDM, jumlah kader pada posyandu model lebih banyak mencapai 10 orang. Sumber dana utama dari iuran warga, pihak perusahaan lebih banyak memberikan bantuan dalam bentuk modal usaha dan perlengkapan. Tempat posyandu mempengaruhi kenyamanan kader maupun masyarakat dalam melaksanakan kegiatan. Pada proses ditemukan belum semua posyandu membuat rencana tahunan, pendirian posyandu model diperkuat dengan SK lurah. Belum dilakukan evaluasi rutin dari instansi terkait. Kegiatan integrasi yang aktif dan sudah berjalan dengan baik Pos PAUD. Disarankan untukdinas kesehatan maupun instansi terkait (Bapermas dan Dinas Pendidikan) melaksanakansupervisi terhadap kegiatan pengembangan dan integrasi tersebut, serta pendampingan danevaluasi secara rutin Community participation in decreasing Maternal and Infant Mortality Rate can be simply done by following activities of Integrated Health Service Post (IHSP). In addition, Integrated Health Service Post of Model is one of the IHSP types that has developed and integrated activities. The IHSP of model is hoped to be a place that can increase community participation in Millennium Development Goals (MDGs) program. District of Cilacap is an industry area. Since 2009, Cilacap District Health Office has collaborated with private companies in terms of the Corporate Social Responsibility (CSR) program. The collaboration aimed to support the program of diminishing Maternal and Infant Mortality Rate. There are any 10 IHSP of model located in 6 villages surrounding companies (Zone I, II, and III). This research aimed to analyze the implementation system of IHSP of model (in work area of private companies). This was cross-sectional research with qualitative approach. Informants were selected purposively. Data were collected by doing indepth interview on 6 persons who were head of work group IV, 6 persons who were head of village, and 1 company public relation. Additionally, data were analyzed using a method of content analysis. The results of this research revealed that regarding an input variable, a maximum number of cadres at IHSP of model was 10 persons. Furthermore, a main source of funding was from resident tuition. Otherwise, companies contributed business capital and equipment. As a suggestion, District Health Office and related institutions (Community Empowerment Body and Education Office) need to supervise activities of development and integration, mentor, and evaluate routinely.

Determinant Factors of Formula Milk Feeding to Infant of 0-6 months (A Study to the Mothers of the Infants of 7-12 months in the Area of Public Health Centers in Demak Regency) Ida Nurmawati; 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

Cakupan ASI Eksklusif di Kabupaten Demak sebesar 41,3% masih di bawah Standar Pelayanan Minimal Provinsi Jawa Tengah. Rendahnya cakupan ASI Eksklusif dikarenakan masih banyak ibu yang memberikan susu formula pada bayi usia 0-6 bulan. Tujuan penelitian adalah menganalisis faktor determinan pemberian susu formula pada bayi usia 0-6 bulan. Jenis penelitian ini merupakan Explanatory Survey dengan pendekatan cross sectional. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner terstruktur yang telah diuji validitas dan reliabilitasnya. Subyek 77 ibu bayi usia 7-12 bulan yang dipilih dengan Clustered Random Sampling. Analisis bivariat menggunakan uji chi square dan analisis multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa pemberian susu formula pada bayi usia 0-6 bulan sebesar 72,7%. Karakteristik ibu : 55,8% berpendidikan dasar, 64,9% tidak bekerja, 50,6% berpendapatan keluarga tinggi. Sebagian besar ibu berpengetahuan kurang (92,2%), bersikap negatif (50,6%), melaksanakan IMD (80,5%), tidak memiliki fasilitas untuk pemberian ASI (51,9%), akses yang jauh (64,9%), petugas kesehatan tidak mendukung (50,6%), keluarga mendukung (50,6%), dan teman tidak mendukung (57,1%). Ada hubungan pengetahuan (p=0,005), status bekerja (p=0,038), pendapatan keluarga (p=0,034), sikap (p=0,002), dukungan petugas kesehatan (p=0,013), dan dukungan keluarga (p=0,0001) dengan pemberian susu formula pada bayi usia 0-6 bulan. Tidak ada hubungan pendidikan (p=0,690), pelaksanaan IMD (p=0,215), ketersediaan fasilitas (p=0,185), akses susu formula (p=0,942), dan dukungan teman (p=0,438) dengan pemberian susu formula pada bayi usia 0-6 bulan. Variabel yang berpengaruh secara bersama-sama terhadap pemberian susu formula adalah dukungan keluarga (ExpB=41,863) dan sikap ibu (ExpB=6,996) terhadap pemberian susu formula. Dinas Kesehatan Kabupaten Demak perlu meningkatkan pengetahuan ibu dan keluarga ibu dengan memberikan informasi tentang ASI Eksklusif dan dampak negatif susu formula. Coverage of Exclusive Breastfeeding in District of Demak was 41.3% below the Minimum Service Standards in Province of Central Java. It was due to most of the mothers preferred to provide formula milk for their babies aged 0-6 months. This research aimed to analyze determinant factors of providing formula milk for babies aged 0-6 months. This was Explanatory Survey with cross-sectional approach. Data were collected by interview using a structured questionnaire which had been tested validity and reliability. Number of respondents were 77 mothers of babies aged 7-12 months selected using Clustered Random Sampling. Furthermore, data were analysed using bivariate analyses consisted of Chi Square test and multivariate analyses (Logistic Regression test). The result of this research showed that most of the respondents had provided formula milk to their babies aged 0-6 months (72.7%). Most of them had basic education (55.8%), did not work (64.9%), had high family income (50.6%), had low knowledge (92.2%), had negative attitude (50.6%), did early initiation of breastfeeding (EIB) (80.5%), and did not have facilities for providing breastfeeding (51.9%). In addition, most of them had far access (64.9%), did not have health worker support (50.6%), had family support (50.6%), and did not have friend support (57.1%). Factors of knowledge (p=0.005), work status (p=0.038), family income (p=0.034), attitude (p=0.002), health worker support (p=0.013), and family support (p=0.0001) had significant relationship with providing formula milk aged 0-6 months. Otherwise, factors of education (p=0.690), implementing EIB (p=0.215), availability of facilities (p=0.185), access to formula milk (p=0.942), and friend support (p=0.438) were not significant. Furthermore, factors of family support (ExpB=41.863) and attitude (ExpB=6.996) jointly influenced providing formula milk. As suggestions, Demak District Health Office needs to improve knowledge of mothers and their families regarding information of exclusive breastfeeding and adverse effects of formula milk.

Analysis on the Implementation of Nutrition Services in Tugurejo General Hospital Semarang Emy Shinta Dewi; Martha Irene Kartasurya; Ayun Sriatmi
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKGizi merupakan faktor penting dalam upaya perawatan dan penyembuhan pasien. Hasil evaluasi Unit Litbang Gizi RSUD Tugurejo pada tahun 2011 menunjukkan bahwa sisa makan pasien masih di bawah Standar Pelayanan Minimal. Tujuan penelitian ini adalah melakukan analisis terhadap implementasi pelayanan gizi di RSUD Tugurejo Semarang. Penelitian dilakukan secara kualitatif dengan informan utama 4 ahli gizi, 8 pramumasak dan 8 pramusaji. Informan triangulasi adalah Kabid Penunjang, Ka. Instalasi Gizi, Ka. Ruang Perawatan dan 6 orang pasien dari kelas 1, 2 dan 3 dengan diit biasa dan diit khusus. Pengumpulan data melalui indepth interview, focus group discussion dan observasi. Pengolahan data dengan metode content analysis. Hasil penelitian menunjukkan bahwa implementasi pelayanan gizi belum optimal. Komunikasi kebijakan pelayanan gizi belum jelas dan konsisten. Sumberdaya belum mencukupi dengan latar belakang pengetahuan dan ketrampilan kurang mendukung. Usulan sarana terpenuhi namun tidak tersedia tepat waktu. Petugas menunjukkan sikap kurang mendukung kegiatan pengolahan dan distribusi diit. Tugas dan wewenang kurang dipahami oleh pramusaji, SOP kurang jelas dan kurang dipahami oleh petugas serta mekanisme pertanggungjawaban tugas distribusi diit belum berjalan. Pasien menyatakan bahwa makanan sudah baik, alat makan lengkap dan bersih namun belum mendapatkan penjelasan tentang diit yang diberikan. Hasil observasi menunjukkan bahwa sisa nasi, lauk nabati dan sayur pasien masih cukup banyak. Disimpulkan bahwa implementasi pelayanan gizi belum optimal berkaitan dengan komunikasi kebijakan tidak jelas/tidak konsisten, tugas, wewenang, SOP dan mekanisme pertanggungjawaban tugas tidak jelas/tidak dipahami oleh petugas. Disarankan kepada rumah sakit untuk mengevaluasi kebijakan, memperbaiki hubungan antar petugas dengan family gathering/outbond dan koordinasi serta menata ulang tupoksi SDM.Kata kunci : Implementasi, Pelayanan Gizi, Rumah SakitABSTRACTNutrition was an important factor for patient care and cure. Results of an evaluation by nutritional research and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated that food remains of patient were still below the minimal standard of service. Objective of this study was to analyze the implementation of nutritional service in the RSUD Tugurejo Semarang. This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as main informants. Triangulation informants were a head of supporting unit, a head of nutritional installation, a chief of nursing room, and 6 patients from 1,2,3 classes with ordinary and special diet. Data were collected through in-depth interview, focus group discussion, and observation. Content analysis was applied in the data management. Results of the study showed that nutritional service implementation was not optimal. Nutritional service policy communication was not clear and consistent. Human resources were insufficient, and they had inadequate educational and skill backgrounds. Facilities were sufficient, but it was not provided on time. Workers did not fully support processing and diet activities. Tasks and responsibilities were not understood by waitresses. Standard operating procedure (SOP) was not clear, and it was not understood by the workers. Job responsibility mechanism of diet distribution was inadequate. Patients stated that the food was good, utensils were complete and clean. They did not get explanation regarding diet that they had received. Results of the observation showed that rice remains and vegetable site dish of the patients were sufficient. In conclusion, the implementation of nutritional service was not optimal. It was related to unclear or inconsistence of policy communication, task, authority, and SOP. The workers did not understand the job responsibility mechanism. Hospital workers are suggested to evaluate the policies, to improve relationship among workers by conducting family gathering or outbound, to coordinate and re-arrange functional main tasks (tupoksi) of human resource.Keywords : Implementation, nutritional service, hospital

Implementation of the Standards of Pharmaceutical Services by the Pharmacists in Semarang District Lilik Tri Cahyono; Sudiro Sudiro; Anneke Suparwati
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKPada tahun 2004, terbit Kepmenkes RI No. 1027/Menkes/SK/IX/2004 tentang Standar Pelayanan Kefarmasian di Apotik dan diikuti Buku Juknis Pelaksanaan Standar Pelayanan Kefarmasian di Apotik tahun 2008. Namun demikian, praktik pelayanan kefarmasian pada apotik di Kabupaten Semarang belum sesuai standar tersebut. Nilai skor pelayanan kefarmasian di apotik, dari hasil penelitian pendahuluan yaitu 6 apotik nilainya kurang, 4 apotik nilainya cukup dan tidak ada apotik yang nilainya baik. Tujuan penelitian ini adalah menganalisis pelaksanaan standar pelayanan kefarmasian pada apotik di Kabupaten Semarang. Jenis penelitian adalah deskriptif kualitatif. Pengumpulan data dilakukan dengan observasi dan wawancara mendalam (indepth interview) pada 6 Apoteker Pengelola Apotik (APA) sebagai informan utama, satu orang Kepala Seksi Farmasi, Pengawasan Obat, Makanan dan Minuman (POM) dan satu orang Ketua Ikatan Apoteker Indonesia (IAI) Cabang Kabupaten Semarang sebagai informan triangulasi. Analisa data menggunakan metode analisis isi (content analysis). Hasil penelitian menunjukkan, pelaksanaan Standar Pelayanan Kefarmasian di Apotik masih menitikberatkan pada administrasi dan pengelolaan obat, belum pada pelayanan kefarmasian secara menyeluruh. Sebagian besar informan utama belum memiliki pengetahuan yang memadai tentang Juknis Pelaksanaan Standar Pelayanan Kefarmasian di Apotik, belum menyediakan SOP/Protap, belum pernah mendapatkan sosialisasi tentang Juknis Pelaksanaan Standar Pelayanan Kefarmasian di Apotik. Seluruh informan utama belum pernah mendapatkan pembinaan dari Dinas Kesehatan Kabupaten Semarang maupun IAI Cabang Kabupaten Semarang tentang Standar Pelayanan Kefarmasian di Apotik secara menyeluruh. Dapat disimpulkan bahwa pelaksanaan Standar Pelayanan Kefarmasian di Apotik belum optimal karena pengetahuan tentang Juknis belum memadai, SOP/Protap belum ada, belum ada sosialisasi dan pembinaan sesuai Juknis dari Dinas Kesehatan Kabupaten Semarang maupun IAI Cabang Kabupaten Semarang.Kata kunci : Standar Pelayanan Kefarmasian di Apotik, Dinas Kesehatan Kabupaten Semarang, Apoteker Pengelola Apotik (APA)ABSTRACTHealth Minister Decree of Indonesian Republic number 1027/Menkes/SK/IX/ 2004 regardingpharmaceutical service standard in pharmacies had been enacted in 2004. In 2008, technicalguidance (juknis) to implement pharmaceutical service standard in pharmacies in Semarang district was published. However, pharmaceutical service practice in pharmacies in Semarang district was not done according to the standard. Results of a previous study indicated that score value of pharmaceutical service in six pharmacies was low; four pharmacies received moderate scores, and no pharmacies obtained good scores. Objective of this study was to analyze the implementation of pharmaceutical service standard in pharmacies in Semarang district. This was a descriptive-qualitative study. Data collection was done by conducting observation and in-depth interview to six pharmacists who managed the pharmacies (APA) as main informants. Triangulation informants were a head of pharmacy section and one head of IAI Semarang district branch. Data analysis was performed by applying content analysis method. Results of the study showed that the implementation of pharmaceutical service standard in the pharmacies was still focused on administrative activities and drug management, and holistic pharmaceutical service had not become the main focus. Majority of main informants had insufficient knowledge regarding technical guidance of pharmaceutical service standard in the pharmacy; they did not have standard operating procedure (protap); they did not get information about technical guidance of pharmaceutical service standard in the pharmacy. All main informants did not receive supervision from Semarang district health office or from IAI Semarang district branch regarding holistic pharmaceutical service standard in the pharmacy. In conclusion, pharmaceutical service standard in the pharmacy was not optimal. It was related to insufficient knowledge regarding technical guideline, no standard operating procedure, no socialization and supervision that was done according to technical guideline from Semarang district health office or IAI Semarang district branch.Keywords : Pharmaceutical service standard in the pharmacy, Semarang district health office, pharmacy manager pharmacist (APA)

Development of Blood Stock Decision Supporting System in The Blood Transfusion Unit of PMI Banjar District Branch, South Kalimantan, to Support Blood Stock Planning Khairir Rizani; Cahya Tri Purnami; Dharminto Dharminto
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 2 (2015): Agustus 2015
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

ABSTRAKABSTRAK Unit transfusi darah cabang PMI Kabupaten Banjar memberikan pelayanan bagi rumah sakit milik pemerintah dan swasta serta klinik-klinik kesehatan yang ada di daerah Kabupaten Banjar sendiri dan beberapa kabupaten/kota disekitar. Unit transfusi darah cabang PMI Kabupaten Banjar belum menggunakan sistem informasi yang berbasis komputer meliputi input data masih dilakukan dengan mengisi formulir, data yang ada ditulis dibuku register, proses pengolahan data masih dengan cara menghitung secara manual menggunakan kalkulator, penyimpanan data masih bercampur dengan data-data lain, pencarian data memerlukan waktu yang relatif lama ( > 5 menit), serta belum melakukan peramalan/prediksi dalam perencanaan kebutuhan darah. Penelitian ini bertujuan untuk mengembangkan sistem pendukung keputusan persediaan darah di unit transfusi darah cabang PMI Kabupaten Banjar untuk mendukung perencanaan persediaan darah. Pengembangan sistem berdasarkan langkah-langkah FAST (Framework for the Application of Systems Thinking). Jenis penelitian yang akan digunakan adalah penelitian kualitatif. Variabel penelitian adalah kemudahan akses, keakuratan, kelengkapan, dan kesesuaian. Objek penelitian adalah sistem pendukung keputusan persediaan darah di unit transfusi darah cabang PMI Kabupaten Banjar untuk mendukung perencanaan persediaan darah dan pengguna, . subjek penelitian adalah peneliti sendiri. Instrumen penelitian yang digunakan adalah pedoman wawancara dan lembar observasi. Analisis data pada penelitian ini dilakukan dengan cara analisis isi. Hasil penelitian yaitu ditemukannya permasalahan sistem dalam hal performance, information, economic, control, efficiency, dan service, diketahui kebutuhan pengguna akan input data, proses pengolahan data dan output, diperoleh rancangan basis data sistem, tersedia model prediksi kebutuhan darah, tersedia model SMS gateway untuk output informasi stok darah bagi pengguna eksternal, Terjadi peningkatan kualitas informasi yaitu peningkatan kemudahan dalam mendapatkan informasi, informasi yang dihasilkan lebih lengkap, lebih sesuai, dan lebih akurat. Saran untuk unit transfusi darah cabang PMI Kabupaten Banjar adalah sistem sebaiknya diaplikasikan dan melakukan sosialisasi kepada masyarakat untuk menggunakan SMS dalam mendapatkan informasi stok darah baik melalui leaflet maupun lewat media cetak dan elektronik,, serta perlu pengembangan aplikasi untuk mengelola pedonor dengan SMS Alert untuk mengingatkan jadual donor berikutnya, ucapan terimakasih dan penghargaan bagi pedonorKata kunci : Sistem Pendukung Keputusan, Persediaan Darah, Unit Transfusi Darah Cabang, Perencanaan Persediaan Darah.ABSTRACTBlood transfusion unit of Indonesian Red Cross (PMI) Banjar district branch provided service to government and private hospitals and also health clinics in the district of Banjar and several surrounding districts/cities. Transfusion unit of PMI Banjar district branch had not utilized computer base information system. Data input was still done by filling the forms, data was written in the registration books, data management process was done by counting manually using calculator, Data storage was still mixed with other data, data searching required longer time (> 5 minutes), prediction/estimation had not been done in the blood requirement planning. The objective of this study was to develop blood stock decision supporting system in the blood transfusion unit of PMI Banjar district branch, South Kalimantan, to support blood stock planning. Development of the system was based on FAST (Framework for the Application of System Thinking) steps. This study was a qualitative research. Study variables were the ease of access, validity, completeness and appropriateness. The study object was a blood stock decision supporting system in the transfusion unit of PMI Banjar district branch to support blood stock planning and users. The study subject was the researcher herself/himself. Study instrument used in this study was interview guideline and observation forms. Content analysis was used to analyze the data.The result of the study found a system problem on the performance, economic, control efficiency and service. The user needs for data input, data management process and output was known. Basic data system design was obtained, blood requirement prediction model was available, and text messaging (SMS) gateway model for output of blood stock information for external user was available. The quality of information was improving such as improvement in the ease of obtaining information; the produced information was more complete, more appropriate and more accurate. Suggestions for blood transfusion unit of PMI Banjar district branch are it is better to apply the system and conducting socialization to the community to use SMS in order to obtain information on the blood stock through both leaflet and printing or electronic media. It is important to develop an application to manage the donors via SMS alert to remind their next giving blood donation schedule, to give thank you and awards to the donors.Keywords : Decision supporting system, blood stock, blood transfusion unit, blood stock planning

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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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INDONESIA

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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

Abstract

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Contact Name
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Contact Email
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Journal Mail Official
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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