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Kemitraan Bidan dan Dukun dalam Mendukung Penurunan Angka Kematian lbu di Puskesmas Mranggen I Kabupaten Demak

MEDIA KESEHATAN MASYARAKAT INDONESIA Vol 11, No 1 (2012): MKMI
Publisher : MEDIA KESEHATAN MASYARAKAT INDONESIA

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Abstract

Di wilayah kerja puskesmas Mranggen I, Kabupaten Demak masih banyak dukun (11 dukun) melakukan pertoloigan persalinan. Tujuan penilitian adalah menganalisis kebutuhan kernitraan dukun dan bidan diwilayah Keria Puskesmas Mranggen I, Kabupaten Demak. Jenis penelitian ini adalah observasional kualitatif dengan pendekatan cross sectional, dengan cara melakukan indepth interview terkait pendapat keberadaan dan peran dukun dan bidan, potensi dukungan responden terhadap kemitraan bidan dan dukun, termasuk dari para stakeholder. Hasil penelitian didapatkan semua dukun setuju dengan keberadaan bidan demikian halnya sebaliknya bidan, termasuk jika menjalin kerjasama. Bidan rela memberikan sebagian pendapatannya untuk dukun bayi dan bentuk dukungan yang bisa diberikan dukun adalah rnemberikan informasi tentang keberadaan bumil, termasuk kondisinya, selain juga keduanya rela mengeluarkan biaya untuk transportasi. Camat dan Kepala Puskesmas Mranggen I setuju adanya kerjasarna/kemitraan bidan dan dukun dengan memberikan peran lebih jelas antar keduanya selain juga memberikan perlindungan dalam bentuk regulasi. Dukungan Kepala Desa danTokoh masyarakat terhadap kemitraan ini adalah rela menjadi sosialisator dan mediaior pemerintah bersama petugas kesehatan dan didukung tokoh masyarakat memberikan secara intensif edukasi kepada masyaraknt tentang persalinan/keharnilan termasuk tidak meminta persalinan pada dukun. Kata kunci : kemitraan, dukun, bidan, AKB (Angka Kematian lbu)   Needs Analysis of Midwives and Medicaster Partnership on Supports Reduction in Maternal Mortality in Mranggen I Clinic, Demak Regency; In the area of Primary HealthCare Mranggen I, Demak there are still many medicaster (11 medicaster) conducts aid delivery. The purpose of the research was to analyze the needs of tie medicasters partnership in the area of  Employment and the midwife Mranggen I Clinic, Demak Regency. The type of the research is qualitative observational with cross sectional approach, by conducting indepth interview related to the opinion of existence and role from medicaster and midwife, potential respondents support to partnership between midwives and medicaster; including the stokeholders. The research result obtained by all medicaster agreed with the presence of a rnidwife so instead midwives, including if partnering. Midwife willingly give some revenues to the medicaster’s baby and forms of support that can be given of the shaman is provide information about the existence of pregnant woman, including the condition, as well as both are willing to spend for transportation. Head sub-district and head of primary health care Mranggen I agree there is coorperation /partnership with giving midwives and medicaster role more clearly between the two as well as provide some protection in thi form of regulation. Support from the head of the village and community leaders of this partnership is willing to be a mediator and sosialisator. Joint Goverment and health workers provide community leaders supported intensively about the childbirth education /pregnancy including childbirth was not asked on tke medicaster. Keywords : partnerships, medicaster, midwives, maternal mortality

Analisis Implementasi Kebijakan ASI Eksklusif Di Tingkat Kabupaten Kebumen Tahun 2013

Jurnal Kesehatan Masyarakat (e-Journal) Vol 2, No 1 (2014): Jurnal Kesehatan Masyarakat (e-Journal)
Publisher : Jurnal Kesehatan Masyarakat (e-Journal)

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Abstract

Kabupaten Kebumen adalah salah satu Kabupaten di Jawa Tengah yang cakupan ASI Eksklusifnya masih 54,6 %. Kabupaten Kebumen juga belum mempunyai suatu regulasi daerah tentang ASI Eksklusif.  Hal ini berakibat pelaksanaan ASI Eksklusif belum maksimal.  Permasalahan dalam implemetasi kebijakan ASI Eksklusif di Kabupaten Kebumen terdapat pada aspek komunikasi, sumber daya, disposisi dan struktur birokrasi. Tujuan penelitian adalah menganalisis implementasi kebijakan ASI Eksklusif di tingkat Kabupaten Kebumen.  Penelitian ini merupakan penelitian kualitatif dengan metode pendekatan observasional dan menggunakan wawancara mendalam dengan teknik pengumpulan data. Informan utama adalah Kepala DKK, Kabid Yankes, Kasie Gizi, Bagian Hukum Sekertariat Kabupaten Kebumen, Kepala Puskesmas Bonorowo dan Kuwarasan. Uji validitas dengan triangulasi sumber kepada Disnakertransos, Dikpora, TIM Penggerak PKK, BPPKB Kabupaten Kebumen dan PT. Sampoerna. Hasil penelitian menunjukkan bahwa pada aspek komunikasi sudah dilakukan dengan intensitas yang belum rutin. Pada aspek sumberdaya, ketersediaan dana Kabupaten masih kurang dan sarana prasarana berupa ruang menyusui harus difungsikan. Pada aspek disposisi masih kurangnya dukungan dari lintas sektor di Kabupaten Kebumen, masih adanya tenaga kesehatan yang bekerja sama dengan produsen susu formula dan penggunaan ruang menyusui yang belum maksimal. Pada aspek struktur birokrasi tidak terdapat petunjuk pelaksanaan yang khusus, yang dibuat oleh Dinas Kesehatan dan tidak ada Perda tentang ASI Eksklusis sedangkan Perda adalah peraturan tertinggi di tingkat daerah yang bisa mengikat semua kalangan masyarakat. Disarankan bagi Dinas Kesehatan segera membuat Perda dan menyelesaikan penyusunan Peraturan Bupati ASI eksklusif yang jelas dan rinci . Bagi Dinas Kesehatan dan kepala Puskesmas disarankan untuk melakukan supervisi dan monitoring ke tenaga kesehatan khususnya terkait dengan penggunaan ruang menyususi, dan sanksi terhadap bidan yang bekerja sama dengan produsen susu formula.

Analisis Alur Pelayanan Dan Antrian Di Loket Pendaftaran Pasien Rawat Jalan

Jurnal Kesehatan Masyarakat (e-Journal) Vol 2, No 1 (2014): Jurnal Kesehatan Masyarakat (e-Journal)
Publisher : Jurnal Kesehatan Masyarakat (e-Journal)

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Abstract

Instalasi Rawat Jalan merupakan unit fungsional yang menangani penerimaan pasien yang berobat rawat jalan di rumah sakit. RSUD Kota Semarang berpotensi menjadi rumah sakit rujukan utama bagi masyarakat Kota Semarang. Salah satu harapan pasien adalah tidak perlu menunggu lama untuk mendapatkan pelayanan, tetapi masih ada pernyataan pasien yang sedang menunggu pelayanan pendaftaran bahwa antriannya masih terlalu lama. Tujuan penelitian adalah menganalisis sistem antrian di loket pendaftaran pasien rawat jalan RSUD Kota Semarang. Jenis Penelitian yang dilakukan merupakan metode penelitian deskriptif dengan pendekatan studi pontong lintang. Data tingkat kedatangan dan waktu pelayanan setiap pasien diperoleh dari loket pendaftaran pasien rawat jalan selama satu minggu (Senin-Sabtu). Model antrian pendaftaran rawat jalan RSUD Kota semarang menggunakan sistem M/M/1, yaitu proses antrian dengan 1 petugas pelayanan di setiap jenis pembiayaan dan FIFO sebagai disiplin antrian. Angka kedatangan tertinggi di masing-masing jenis pembiayaan pada jam buka pengambilan nomor antrian yaitu jam 06.30-07.29. Rata-rata waktu pelayanan pendaftaran loket rawat jalan pada pasien askes 1,3 menit, pada pasien jamkesmas 0,98 menit dan pada pasien umum 1,6 menit. Rata-rata waktu tunggu pelayanan pendaftaran rawat jalan RSUD Kota Semarang pada pasien askes dan pasiem umum terlama terjadi pada jam pelayanan 07.30-08.29 dan tercepat pada jam pelayanan 11.30-12.00, sedangkan pada pasien jamkesmas waktu tunggu pelayanan terlama pada jam pelayanan 08.30-09.29 dan tercepat pada jam pelayanan 11.30-12.00. Untuk menghindari antrian panjang yang terjadi di semua jenis pembiayaan, perlu adanya penambahan loket sehingga dapat mengurangi panjang antrian, meskipun penambahan loket akan mempengaruhi penambahan tenaga dan peralatan yang ada, hal ini juga dapat dijadikan dasar untuk mengurangi lama waktu tunggu.

Analisis Pengembangan Karir Jabatan Fungisional Peneliti Di Balai Litbang Gangguan Akibat Kekurangan Iodium (GAKI) Magelang Tahun 2013

Jurnal Kesehatan Masyarakat (e-Journal) Vol 2, No 3 (2014): Jurnal Kesehatan Masyarakat (e-Journal)
Publisher : Jurnal Kesehatan Masyarakat (e-Journal)

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Abstract

Pengembangan karir merupakan bentuk pengembangan SDM. Peneliti sebagai ujung tombak Balai Litbang GAKI mengalami beberapa hambatan dalam pengembangan karir yaitu kesempatan melaksanakan penelitian yang  masih kurang, penelitian dengan penunjukan, pelatihan belum sesuai kebutuhan, dan  sulitnya publikasi jurnal terakreditasi. Tujuan penelitian adalah mendeskripsikan jabatan fungsional peneliti dan aspek pengembangan karir meliputi keadilan karir, dukungan pimpinan, kesadaran tentang kesempatan, minat pegawai, dan kepuasan karir. Penelitian ini merupakan penelitian kualitatif dengan pendekatan deskriptif. Pengumpulan data dengan indepth interview. Informan utama adalah staf fungsional peneliti di Balai Litbang GAKI Magelang yang berstatus calon peneliti sebanyak 4 orang dan peneliti sebanyak 8 orang. Uji validitas dengan triangulasi sumber kepada Kepala Balai Litbang GAKI Magelang dan Ketua tim TP2U. Pelaksanaan tugas pokok sudah sesuai dengan pedoman LIPI, kompetensi minimal sudah tercapai, TP2U belum memantau angka kredit secara rutin, belum ada kebijakan dan prosedur yang mengatur kesempatan penelitian, penelitian dengan penunjukan belum memenuhi harapan peneliti, kendala bahasa dalam publikasi jurnal internasional, kurangnya sarana buku literatur dan dana. Disarankan TP2U memantau perolehan angka kredit peneliti secara berkala, perlu adanya prosedur dalam pengembangan kesempatan penelitian, perlu kompetisi untuk pengembangan diri, perlu pembinaan khusus publikasi ilmiah pada jurnal internasional, organisasi meningkatkan sarana dan dana untuk mendukung pengembangan karir peneliti

Hubungan Antara Persepsi Ibu Hamil Tentang Mutu Pelayanan Antenatal Dengan Kepuasan Ibu Hamil Di Puskesmas Krobokan Kota Semarang

Jurnal Kesehatan Masyarakat (e-Journal) Vol 2, No 2 (2014): Jurnal Kesehatan Masyarakat (e-Journal)
Publisher : Jurnal Kesehatan Masyarakat (e-Journal)

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Abstract

Maternal health issues and newly born babies in Indonesia is a public health problem that needs major attention, because it has a major impact on the quality of future generations. One of the maternal and child health services are Antenatal care is health care for all pregnant women with a relatively low cost. Antenatal care coverage is not optimal quantity is still below the target of Semarang City Health Office that is 95%, and Krobokan Health Center is one of the centers with the lowest ANC coverage. Based on the preliminary results of a survey conducted in pregnant women in health centers Krobokan through interviews that there is a link between the quality of health services in the form of reliability, responsiveness, tangibles, assurance, empathy with maternal satisfaction. This study aims to determine the relationship between maternal perception of the quality of antenatal care to the satisfaction of pregnant women in health centers Krobokan Semarang. Observational research using survey methods with cross sectional approach, a population of 413 pregnant women with a total sample of 85 respondents. Statistical analysis using chi square. The results showed that the quality of service that consists of responsiveness, tangibles, assurance, empathy, suggests that there is a connection with the satisfaction of pregnant women in health centers and reliability Krobokan has no association with maternal satisfaction. The proposed suggestions to improve the quality of PHC services Krobokan namely the improvement of existing SOPs, standards of antenatal care, and create a policy that officers can improve their skills in work, communication with patients, and also complete the facilities at PHC Krobokan

Factors Related to the Work Performance of Midwives in the IUD Contraception Service in Primary Healthcare Centers of Surabaya City

Jurnal Manajemen Kesehatan Indonesia Vol 1, No 2 (2013): Agustus 2013
Publisher : S2 IKM FKM UNDIP

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Abstract

The decrease of IUD active family planning participants’ coverage in Surabaya in the last three years, from 12.27% to 6.1%, became a special attention for Surabaya district health office. The decrease was caused by inadequate work performance of midwives in implementing IUD contraception service in the primary healthcare centers in Surabaya area. Objective of the study was to analyze factors related to the work performance of midwives in the IUD contraception service in the primary healthcare centers of Surabaya city area. This was an analytical- observational study using cross sectional approach. Study population was all midwives in the primary healthcare centers in Surabaya city who provide family planning service, and who had attended in CTU training (362 midwives). Study subjects were 78 respondents, and they were selected using proportional stratified random sampling method. Data collection was conducted through structured interview and observation. Multiple linear regression tests were applied in the data analysis. Results of the study showed that work performance of midwives in the IUD contraception service in Surabaya city area was in a good category (55.1%). Midwives’ knowledge on IUD contraception service specifically on screening and counseling before insertion was insufficient (82.1%). Motivation of midwives was good (55.1%). Midwives attitude regarding IUD contraception service was not supportive (51.3%). Perception of midwives towards head of primary healthcare center leadership was good (52.6%). Midwives perception on remuneration they received was good (53.8%). Facilities to support IUD contraception service were available (53.8%).Motivation, attitude, and perception on the leadership were associated with midwives’ work performance. However, knowledge, perception of remuneration, and facilities were not associated with midwives’ work performance in the IUD contraception service. Motivation and perception on the leadership, in common, were associated with midwives’ work performance in the IUD contraception service.Suggestions for district health office was to perform supervision directly and periodically, to evaluate and monitor the implementation of program in every primary healthcare center, and to provide permission for midwives who want to take further study.

Analysis on Policy Implementation of Exclusive Breastfeeding for Working Women in South Kalimantan Province

Jurnal Manajemen Kesehatan Indonesia Vol 2, No 1 (2014): April 2014
Publisher : S2 IKM FKM UNDIP

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Abstract

Coverage of exclusive breastfeeding in the South Kalimantan province was still low (51.18%); itwas lower than the national target (80%).The number of working mothers in this province wasrelatively high and it was increasing in the last several years. Policies concerning breastfeedingduring working time in the work place, such as decrees, government regulations, and commonregulation from three ministers had been established. However, a number of institutions had notobeyed the policies. Objective of the study was to explain the implementation of exclusive breastfeeding for working mothers in South Kalimantan Province.This was a qualitative study. Data collection was done through in-depth interview and observation.Study respondents/subjects were a head of women empowerment section of the women empowermentand child protection institution (BPPPA), a head of human resource section of the labor andtransmigration department, and a head of nutrition section of South Kalimantan province healthoffice. Those respondents were considered as main informants. Triangulation informants were leadersof government institutions and leaders of companies. Content analysis method was applied in thedata analysis.Results of the study showed that a number of institutions had not provided lactation room in the workplace. No communication was done among BPPPA, Disnakertrans, and province health office. Workinggroup from those three institutions had not been established. Only one of three private institutions hadreceived information regarding the policies. No funding was allocated, human resource and specificfacilities to implement policies were not provided. All executors supported the policies. Specific districtgovernment regulations concerning exclusive breastfeeding had not been established.In conclusion, implementation of exclusive breastfeeding policy for working mothers in SouthKalimantan province was not done properly. It was caused by no specific local governmentregulations concerning exclusive breastfeeding.

Analysis on the Implementation System of Early Breastfeeding Initation by Village Midwives in Pati District

Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : S2 IKM FKM UNDIP

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Abstract

Infant mortality rate (IMR) in Pati district, in 2010, was > 10 per 1000 live births. It was the highest 16 th among 35 districts in Central Java province, and it was above the target of Central Java province, 8.9 per 1000 live births. Early breastfeeding initiation (IMD) could save infants due to skin-to-skin contact (contact between mother and child skins). Skin-to-skin contact gave warmness and protection to the infants. In addition, colostrum (the first breast milk being expressed) was a first immunization for infant. It contained irreplaceable body immune elements. Successfulness of IMD was influenced by knowledge, attitude, and motivation of midwives or delivery assistants. Results of a preliminary study showed that the IMD implementation was still inadequate. Village midwives did not implement IMD when they assisted deliveries because they were not patient to wait to implement IMD. The implementation of IMD was influenced by system that included input, process, and output. This system could determine the success of IMD. Objective of this study was to analyze early breastfeeding initiation system in the village maternity policlinics (polindes) by village midwives in Pati district. This was an observational qualitative study. Study informants were 8 village midwives selected from 2 primary healthcare centers (puskesmas); 4 informants were selected from each puskesmas. Triangulation informants were 8 patients, 2 midwives coordinators, and 2 heads of puskesmas. Data were collected by conducting in-depth interview and observation toward IMD implementation. Content analysis method was applied in the data management. Results of the study showed that four of eight village midwives in the polindes did not implement IMD continuously because patients did not want to do IMD; implementation of IMD was not done properly; cognitive ability of the main informants regarding IMD was insufficient. The main informants did not answer properly questions regarding definition, benefits, and steps to do IMD. All midwives were only equipped with knowledge from APN training, and they did not receive training regarding lactation management due to funding constraint. The implementation of IMD in the polindes by village midwives was not proper. Seven steps to implement IMD issued by Ministry of Health of the Indonesian Republic were not done by village midwives. Village midwives are suggested to always implement IMD when they assist a delivery.

Analysis of the Difference between Iron Supplementation Program and Primary Healthcare Center in Kendal

Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : S2 IKM FKM UNDIP

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Abstract

Based on the last SDKI survey in 2007, Indonesian maternal mortality rate (AKI) was 228/100000 live-births. One of causes of maternal death was anemia. To solve iron deficiency anemia problems on pregnant women, Indonesian Ministry of Health had implemented iron tablet distribution program to pregnant women in all puskesmas (primary healthcare center) and posyandu (integrated health services post) since 1970. In reality, that program was difficult to implement; it was shown by the fact that coverage of iron tablet distribution in Kendal was only 53.2%. Results of preliminary survey showed that no monitoring program was performed during the last year, no standard operating procedure was formulated, and funding provided for the program was insufficient; the available funding was only 40%. Objective of this study was to analyze the implementation of iron tablet supplementation program for pregnant women in the work area of Kendal district health office. This was a descriptive-explorative study with qualitative method, and using content analysis method. Main informants were 4 nutritional staffs in puskesmas. Triangulation informants were 4 heads of puskesmas, 2 policy makers from Semarang city health office, and 4 pregnant women. Results of the study showed that implementation of iron tablet supplementation for pregnant women in the puskesmas with high and low iron tablet coverage indicated no significant difference. For the continuity of the program and to attain the objective, discussions on the problems are needed; then decisions are legitimated by issuing decrees and conducting socialization. Keywords : iron tablet supplementation, bureaucracy structure, disposition, commu

Analysis on Factors Associated with the Implementation of the Pulmonary Tuberculosis Care Finding in Tuberculosis Control Program at Primary Healthcare Center in Semarang

Jurnal Manajemen Kesehatan Indonesia Vol 2, No 2 (2014): Agustus 2014
Publisher : S2 IKM FKM UNDIP

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Abstract

Success of tuberculosis (TB) control in Semarang city varied. Based on the case detection of pulmonary TB among 37 primary health centers (puskesmas) in Semarang city, only 2 puskesmas reached the target of 55% or more. Those Puskesmas were Karangdoro (76.67%) and Ngesrep (63.89%). The other 35 puskesmas had not reached the target. The objective of this study was to identify factors related to the implementation of pulmonary TB case detection in TB control program at Puskesmas in Semarang city. This was an explanatory research with cross sectional approach. Study population was all pulmonary TB coordinators at puskesmas in Semarang city with the total number of 37 persons. Bivariate and multivariate methods were implemented for analyzing the data. Results of the study using statistical test indicated significant association between communication factor and pulmonary TB case detection (p: 0.009), resource factor and pulmonary TB case detection (p: 0.010), disposition factor and pulmonary TB case detection (p: 0.016) and SOP factor and pulmonary TB case detection (p: 0.012) To improve a good communication, Health Office needs to include untrained workers to make the procedure of budgeting report easier, to provide laboratory facilities such as microscope to satellite puskesmas, to do routine report verification every 3 months to avoid over reporting and under reporting pulmonary TB data in order to obtain valid coverage, to do supervision by health office staffs using check list, to write pulmonary TB case detection planning documents by involving head of puskesmas and/or puskesmas pulmonary TB coordinators. Heads of puskesmas have to monitor their pulmonary TB coordinators to be involved in the pulmonary TB coordinator meeting every month, to make puskesmas planning on the pulmonary TB case detection and planning on providing the laboratory instrument that is microscopic to make it easier for laboratory workers to examine sputum of pulmonary TB suspects and to involve pulmonary TB workers in the training conducted by either district or provincial health office.