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Journal : Jurnal Manajemen Kesehatan Indonesia

Pelaksanaan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) Ditinjau dari Aspek Bidan Desa sebagai Pelaksana di Kabupaten Jepara Sokhiyatun, Sokhiyatun; Widagdo, Laksmono; Sriatmi, Ayun
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 1 (2013): April 2013
Publisher : S2 IKM FKM UNDIP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (663.146 KB) | DOI: 10.14710/jmki1110316

Abstract

Kematian ibu di Kabupaten Jepara tahun 2011 sebesar 24 orang (AKI 113/100.00 KelahiranHidup), terutama pada periode kehamilan dan persalinan yang diakibatkan perdarahan.Program P4K sebagai terobosan untuk mengurangi kematian ibu telah dilaksanakan diKabupaten Jepara sejak tahun 2009. Survey pendahuluan menunjukkan meski cakupanindikator P4K sudah baik, namun tidak semua kolom stiker diisi, bidan hanya memberikanstiker pada ibu hamil dan seringkali tidak mendiskusikan rencana persalinan dengan ibu hamildan keluarga. Tujuan penelitian yaitu menjelaskan pelaksanaan P4K dari aspek bidan desasebagai pelaksana di wilayah puskesmas Kabupaten Jepara tahun 2012. Jenis penelitiandeskriptif observasional dengan metode kualitatif. Populasi seluruh bidan desa yang ada diKabupaten Jepara, Informan utama 8 bidan desa dari 4 puskesmas terpilih dengan kriteriapuskesmas di daerah perkotaan sebanyak 2 puskesmas dan 2 puskesmas daerah pedesaan.Informan triangulasi yaitu ibu hamil (8 orang), kader kesehatan (8 orang), Bidan Koordinator(4 orang ) dan Kasie Kesga Dinas Kesehatan. Pengumpulan data melalui wawancaramendalam.. Analisis data dilakukan dengan content-analysis. Berdasarkan hasil penelitiandiperoleh informasi umur bidan desa antara 25–36 tahun, berpendidikan D3 Kebidanan danmasa kerja 3-15 tahundengan rata-rata kerja 9 tahun. Pengetahuan dan sikap bidan tentangP4K sudah baik karena dari 8 bidan sudah memahami tujuan dari P4K dan mendukung P4Kdengan alasan program tersebut dapat membantu pencapaian program KIA, meski pelatihankhusus P4K tidak ada, hanya penunjang dari P4K yaitu APN dan BBLR, namun dana khususpenunjang kegiatan P4K, tidak tersedia. Buku KIA dan stiker P4K sebagai sarana danprasarana tersedia cukup, namun bidan kit belum lengkap. Tidak ada SOP khusus P4K,kecuali SOP penapisan awal dan deteksi bumil resti. Indikator keberhasilan yang dipahamibidan bahwa stiker harus terpasang di setiap rumah ibu hamil yang ada di wilayahnya. Bidandesa melakukan aspek perencanaan persalinan cukup baik, serta melakukan koordinasi dankomunikasi melalui sosialisasi dan pertemuan rutin.
Factors Related to the Midwaves’ Work Performance on Anemic Pregnant Women Manegement in Singkawang City, Kalimantan Barat Nasla, U. Evi; Widagdo, Laksmono; Purnami, Cahya Tri
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 2 (2013): Agustus 2013
Publisher : S2 IKM FKM UNDIP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1235.312 KB) | DOI: 10.14710/jmki1210319

Abstract

WHO estimates that approximately 40 % of maternal death in developing countries areassociated with anemia in pregnancy. Anemia in pregnancy is often called a "potential danger tomother and child", there for requires serious attention of all relevant parties, especially in healthcare. Detection of cases of anemia in pregnancy has not been conducted in accordance with thestandard management of anemia in pregnancy. There for it is necessary to analyze the factorsthat affect the performance of midwives in the management of anemia in pregnancy inSingkawang. The general objective of the study to determine the factors that affect theperformance of midwives in the management of anemia in pregnancy in Singkawang. Typeanalytic approach Retrospective survey research. The study population is the entire area of thehealth center midwife Singkawang totaling 110 people. The sample as many as 52 people from 5 regions Singkawang Health Center. The independent variables of knowledge, infrastructure,leadership , motivation and communication. The dependent variable performance of midwives inthe management of anemia in pregnancy. Data were collected by interviews using a structuredquestionnaire and observation. Data analyisis using the Spearman rank and logistic regression.The results of the study the majority of midwives aged between 20-35 years (63.5 %), educationDIII/DIV/S1 Midwifery (90.4 %), service life ≥ 10 years (55.8 %). Performance categorizedeither midwives (59.6 %), good knowledge (51.9 %), the complete infrastructure (53.8 %), goodleadership (63.5 %), good motivation (55.8 %), good communication (53.8 %). Allindependentvariables (knowledge, infrastructure, leadership, motivation and communication) has a value ofρ< 0,05, which means there is a connection with the performance of midwives in themanagement of anemia in pregnancy. Results of multivariate analysis , the variables that affectthe performance of midwives in the management of anemia in pregnancy is knowledge (ρ=0.002)and leadership (ρ=0.006).
Factors Associated to the Work Performance of Midwives in the Implementation of Village Allertness Program in the Boyolali District Astuti, Asih Dwi; Widagdo, Laksmono; Sriatmi, Ayun
Jurnal Manajemen Kesehatan Indonesia Vol 1, No 3 (2013): Desember 2013
Publisher : S2 IKM FKM UNDIP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (464.906 KB) | DOI: 10.14710/jmki1310331

Abstract

Maternal mortality rate (AKI) and infant mortality rate (AKB) in Boyolali district were still high.Facts showed that AKI in 2010 was 114.80/10000 live-births, and in 2011 was 116.23/100.000 live-births; AKB in 2010 was 9.18/1000 live-births, and in 2011 was 12.27/1000 live-births. To acceleratethe decrease of AKI and AKB, health service intervention based on community need and capacity isrequired. Boyolali district health office had answered this challenged by developing alert villageprogram. However, the continuity of this alert village program was not maximal. One of reasons ofthis condition was inadequacy of midwives work performance in the development of village health polyclinic (PKD). Objective of this study was to analyze the inadequacy of midwives workperformance in the implementation of alert village such as skill, ability, motivation, leadership,and compensation.This was an analytical study with cross sectional approach. Study population was all 267 villagemidwives in the district of Boyolali. Samples were 75 village midwives selected using proportionalrandom sampling method. Frequency distribution for univariate analysis, Chi square test forbivariate analysis, and binary logistic regression for multivariate analysis were applied in the dataanalysis.Results of the study showed that there were significant associations between ability, skill and midwiveswork performance (p= 0.032); motivation and midwives work performance (p= 0.001); leadershipand midwives work performance (p= 0.002); compensation and midwives work performance (p=0.001). Variables, in common, affecting work performance of midwives were leadership andmotivation.Suggestions for the head of Boyolali district health office were to provide trainings on normaldelivery care (APN) and emergency to improve village midwives work performance, to improvePKD, to provide assistance for alert village program activities. Suggestion for chief of coordinatormidwives was to do program supervision and assistance.
Evaluation on Integerated Health Post Monitoring Process by Health Workers in Singkawang City Primary Healthcare Centers,West Kalimantan Sulistyawati, Dwi; Widagdo, Laksmono; Purnami, Cahya Tri
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : S2 IKM FKM UNDIP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (346.139 KB) | DOI: 10.14710/jmki2110344

Abstract

Infant mortality rate (IMR) in Singkawang in 2011 was high, 9/1000 live births (absolute number ofdeath was 44). In the integrated health service post (Posyandu), basic services that would reduceIMR were nutritional program and diarrhea control. The development of posyandu in Singkawangin 2011 was not optimal, and the total number of active posyandu was 9.7% of 134 units. Cases ofunder-five children with ‘below the red line (BGM)’ and with severe malnutrition found in theposyandu in 2011 were still low; it was 5.1% and 1.09% respectively from all cases in the field.Policy regarding posyandu in Singkawang was to delegate supervision activity to local midwives.Problems faced by midwives in the posyandu supervision were the implementation of supervisionfor 5 tables was not optimal, home visits were rarely conducted, cadres had difficulty in conductingeducation activities, and funding for posyandu supervision was insufficient.This was a qualitative study. Main informants were midwives supervisors, and triangulationinformants were cadres, mothers who participated in the posyandu, and coordinator of posyandu.Data collection was done by conducted in-depth interview using interview guidelines. Method ofanalysis used was content analysis.Results of the study showed that there was inappropriate implementation of coordination meeting;supervision of posyandu information system (SIP) and supervision of reporting and recording werenot properly done; this supervision was only between posyandu coordinator and cadres; it did notinclude midwives who were the supervisors of the posyandu. Young health workers who served inthe posyandu made posyandu participants uncomfortable. The participants of posyandu felt thathealth workers had insufficient experiences. There was a tribe that was reluctant to have theirchildren immunized in the posyandu. Health workers from the main puskesmas came late; no properplace for posyandu was provided; health workers who had not received training, and there was nojob description and work procedure in the supervision of posyandu.Coordination among health workers are needed specifically for posyandu coordinator and midwivesin the field during supervision, and it includes relative young health workers; an approach to keypersons are needed; time management for puskesmas workers is required to avoid they come late inthe posyandu; appropriate place for posyandu should be provided together with the community;training and formulation of policies related to posyandu supervision are required.
Factors Related to the Midwives Work Performance on the Implementation of Obstetric Care Standard in Antenatal Care (Study in Primary Healthcare Centers with in Patient Unit in Gresik District) Hamidah, Siti; Widagdo, Laksmono; Kartika, Lucia Ratna
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : S2 IKM FKM UNDIP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (673.988 KB) | DOI: 10.14710/jmki2110353

Abstract

Maternal mortality rate (AKI) in Gresik district in 2011 slightly decreased compared to 2010, from 20 maternal deaths (105.91/100.000 live births) to 19 maternal deaths (98.82/100.000 live birth). Thenumber of death infants in 2010 was 47 infants (2.48%), and it became 140 infants (7.49/1000 live birth)in 2011. Result of MP showed that besides direct cause of death, it was also resulted from indirect causesuch as delay in conducting early detection of pregnancy complication. Obstetric standard of care (SAK)for ante natal care (ANC) was a task that should be implemented by all midwives. A monitoring done byIBI of Gresik district showed that 50% of midwives had not conducted ANC according to the standard.Objective of the study was to identify factors affecting work performance of midwives in the implementationof SAK ANC in the inpatient primary healthcare centers of Gresik district.This was a quantitative study with cross sectional approach. Data were collected using structuredquestionnaire and by conducting documentation observation toward results of ANC performance.Study population was all 119 midwives in the inpatient primary healthcare centers in Gresik district.Study samples were 87 midwives who were selected using simple random sampling method. Chisquare test was applied in the bivariate analysis, and multiple logistic regressions were applied in themultivariate analysis.Results of the study showed that work performance of midwives in the implementation of SAK ANCwas inadequate (44.8%), SAK management system was inadequate (55.2%), and knowledge onSAK was insufficient (56.3%). No association was found between work performance of midwives inthe implementation of SAK ANC and leadership, creativity, knowledge. Significant association wasfound between SAK ANC management system and work performance of midwives in theimplementation of SAK ANC (p: 0.031). There was an influence of SAK management system towardwork performance of midwives in the implementation of SAK ANC (p: 0.045).District health office is suggested to review PerMenKes no. 938/SK/MenKes/VIII/2007, to adviceheads of primary healthcare centers to implement the SAK ANC, to facilitate organizationmanagement training and SAK ANC training, to do more intensive monitoring of the workperformance of midwives. Suggestions for IBI were to monitor, to evaluate, and to follow up theimplementation of SAK ANC continuously.
Factors that Affect the Performance of the Village Midwife in the Standard Implementation of Midwifery Birthing Mothers and Orphans in Semarang Subekti, Setiyana Sri; Widagdo, Laksmono; Kartika Wulan, Lucia Ratna
Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : S2 IKM FKM UNDIP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (514.178 KB) | DOI: 10.14710/jmki2210374

Abstract

In 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.
Implementation System Analysis of Integrated Health Service Post of Model at Work Area of Private Companies in Cilacap Ernawati, Ernawati; Widagdo, Laksmono; Mawarni, Atik
Jurnal Manajemen Kesehatan Indonesia Vol 3, No 1 (2015): April 2015
Publisher : S2 IKM FKM UNDIP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (312.799 KB) | DOI: 10.14710/jmki3110438

Abstract

Community participation in decreasing Maternal and Infant Mortality Rate can be simply doneby following activities of Integrated Health Service Post (IHSP). In addition, Integrated HealthService Post of Model is one of the IHSP types that has developed and integrated activities. TheIHSP of model is hoped to be a place that can increase community participation in MillenniumDevelopment Goals (MDGs) program. District of Cilacap is an industry area. Since 2009, Cilacap District Health Office has collaborated with private companies in terms of theCorporate Social Responsibility (CSR) program. The collaboration aimed to support theprogram of diminishing Maternal and Infant Mortality Rate. There are any 10 IHSP of modellocated in 6 villages surrounding companies (Zone I, II, and III). This research aimed to analyzethe implementation system of IHSP of model (in work area of private companies).This was cross-sectional research with qualitative approach. Informants were selectedpurposively. Data were collected by doing indepth interview on 6 persons who were head ofwork 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 thatregarding 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, companiescontributed business capital and equipment. As a suggestion, District Health Office and relatedinstitutions (Community Empowerment Body and Education Office) need to supervise activitiesof development and integration, mentor, and evaluate routinely.