HUBUNGAN KARAKTERISTIK IBU HAMIL DAN DIMENSI KUALITAS PELAYANAN DENGAN KUNJUNGAN ULANG PELAYANAN ANTENATAL DI WILAYAH KERJA PUSKESMAS WELAHAN I KABUPATEN JEPARA (The Association among the Characteristics of Pregnant Women and the Dimension of Services Quality with the Re-Visit of Antenatal Care at Work Area of the Welahan I Primary Health Center at District of Jepara)

Abstract

Background, The high of maternal mortality rate is a problem of mother's health. One of the Ministry of Health policies to decrease a maternal mortality rate is increasing the antenatal services coverage. Re-visit can be occurred when the pregnant women satisfy with the quality of antenatal services that is received. The characteristics of pregnant women also determine to the re-visit of antenatal care.The coverage of completed re-visit antenatal care in Primary Health Center of the Welahan I is lowest among all of the primary health centers at district of Jepara. The aim of this research is to get the description of the pregnant women's characteristics, the quality of services, and re-visit of antenatal care, and to know the association of pregnant women characteristics, the dimension of services quality with the re-visit of antenatal care. Method, Research design uses Cross-Sectional approach. The subjects are the pregnant women of third trimester, who visit the Welahan I Primary Health Center, the Welahan I Sub Primary Health Center, and the Village Delivery Huts at work area of the Welahan I Primary Health Center. Variables of this research are age, education, job, parity, family's income, accessibility, technical competence, interpersonal relationship, amenity, and the cost. Data was collected by interview using close-ended questioner, in-depth interview to the pregnant women, and Focus Group Discussion to the midwives who do the antenatal services. Result, Based on bivariate analysis, it is known that the age (p value = 0,032) (r = -0,257), the parity (p value = 0,045) (r = -0,241), and the family's income (p value = 0,045) (r = -0,239) have significant association with the re-visit of antenatal services. Beside that, the accessibility (p value = 0,001) (r = 0,494), the technical competence (p value = 0,020) (r = 0,278), and the interpersonal relationship (p value = 0,047) (r = 0,239) have significant association with the re-visit of antenatal services. Multivariate analyzed, it is known that variables, which correlate with re-visit of antenatal services, are the accessibility (t = 5,003), the parity (t = -2,869), and the family's income (t = -2,674). That three variables contribution to the re-visit of antenatal services is 34,4%.Conclusions, Variables that significantly have association with the re-visit of antenatal services, are age, parity, family's income, accessibility, technical competence, and interpersonal relationship. Multivariate analyzed show the variables that association to the re-visit of antenatal services are the parity, the family's income, and the accessibility. The three variables' contribution is 34,4%. Suggestions, It needs to open the post of antenatal services at village far from the Primary Health Center, the Sub Primary Health Center, and the Village . It needs to add the schedule of antenatal services at the Primary Health Center, to increase Communication, Information, and Education, aud to increase the completness of equipments. Latar belakang : Masalah kesehatan ibu dihadapkan pada tingginya angka kematian ibu (AM), salah satu kebijakan Departemen Kesehatan untuk penurunan AKI adalah peningkatan cakupan pelayanan antenatal. Kunjungan Wang dapat terjadi bila ibu hamil merasa puas akan kualitas pelayanan antenatal yang diterima, dimana karakteristik ibu hamil juga menentukan. Puskesmas Welahan I mempunyai cakupan K4 terendah kedua dintara puskesmas di Kabupaten Jepara.Tujuan Penelitian adalah memperoleh gambaran karakteristik ibu hamil kualitas pelayanan serta kunjungan ulang pelayanan antenatal. Mengetahui hubungan antara variabel pada karakteristik ibu hamil dan kualitas pelayanan dengan kunjungan ulang pelayanan antenatal. Metode penelitian : Cross sectional , subyek penelitian bersumber pada ibu hamil yang berkunjung ke puskesmas, puskesmas pembantu, dan polindes di wilayah kerja Puskesmas Welahan I, dengan umur kehamilan pada tribulan III.Variabel penelitian meliputi umur, pendidikan, .pekerjaan, paritas, pendapatan keluarga, aksesibilitas, kmpetensi teknis, hubungan interpersonal. Kenyamanan dan biaya. Data penelitian dikumpulkan melalui wawancara dengan kuesioner tertutup yang sudah teruji, wawancara mendalam pada ibu hamil dan focus group discussion dengan bidan pelaksana pelayanan antenatal. Hasa penelitian : Hasil uji statistik bivariat ada hubungan antara umur (p= 0,032) ( r =-0,257) , parkas (p = 0,045 ) (r = -0,241), pendapatan (p= 0,045 )( r =-0,239 ) dengan kunjungan Wang pelayanan antenatal. Ada hubungan antara aksesibilitas (p = 0,001 ) (r = 0,494), kompetensi teknis (p=0,020) (r =0,278), hubungan interpersonal (p=0,047) (r =0,239) dengan kunjungan ulang pelayanan antenatal. Hasil uji multivariate variabel yang berhubungan dengan kunjungan ulang pelayanan antenatal adalah aksesibilitas (t=5,003), parkas (t= -2,869),dan pendapatan (-2,674), Besar sumbangan ketiga variabel tersebut terhadap kunjungan ulang pelayanan antenatal adalah 34,4 % Kesimpulan : Variabel yang berhubungan dengan kunjungan Wang pelayanan antenatal adalah umur, paritas, pendapatan, aksesibilitas, kompetensi teknis, hubungan interpersonal. Secara multivariate variabel yang berhubungan terhadap kunjungan ulang pelayanana antenatal adalah paritas, pendapatan dan aksesibilitas, dan besar sumbangan ketiga variabel tersebut adalah 34,4%. Saran •Masilt diperlukan membuka pos pelayanan antenatal pada dusun yang lokasinya jauh dari puskemas pembantu atau polindes, jadwal pelayanan antenatal di puskesmas perlu ditambah,KIE perlu ditingkatkan dan kelengkapan sarana masih perlu ditingkatkan.