KEPATUHAN BIDAN PRAKTEK SWASTA DALAM PELAPORAN PENCATATAN PELAYANAN KIA DI KABUPATEN BLITAR PROPINSI JAWA TIMUR TAHUN 2009

Abstract

The Health Office of East Java Province obliges private midwives to fill a provided form and report it to a health center every month. The report consists of the following indicators: number of first and fourth visit on pregnant women group, number of delivery, number of postpartum, number of lifebirth and deadbirth, number of new and old visit on children under five years group, number of immunization, number of mother and child who are referred, and number of family planning services. The result of recording and reporting could be used to value a health status and health degree at an area. By completing and submitting the report timely, data of maternal and child health status could be assessed and observed in accordance with a condition at that time and could be determined a priority for further action. Finally, each problem could be early detected and handled well. The objective of this research was to find out more about the obedience, knowledge, motivation, procedure, and facility for supporting this program. This was an observational research with survey method and cross-sectional approach. The research instrument used a structured questionnaire. Number of sample was seventy-five private midwives. Data were analyzed quantitatively using the methods of univariate, bivariate, and multivariate analysis (Logistic Regression Test using software of SPSS version 11.5. The result of this research showed that most of the respondents were a young adult (64%), had a work period more than 5 years (90.7%), were obedient (56.6%), had a good knowledge about the reporting program (50.7%), had a good motivation (52%), had a good perception about the reporting procedure (52%), had a good perception about supervision (54.7%), and had a poor perception about the provided facilities (66.7%). Based on bivariate analysis, variables of procedure (p = 0.030), motivation (p = 0.0001), and work period (p = 0.039) had a significant association with the obedience of the private midwives (p < 0.05). The result of multivariate analysis using Logistic Regression Test showed that variables of motivation (p = 0.0001) and procedure (p = 0.004) together influenced the obedience of the private midwives (p < 0.05). As a suggestion, Head of the Health Centers should complete facilities for improving the midwives’ motivation and for supporting the success of recording and reporting program regarding on maternal and child health. Dinas Kesehatan Propinsi Jawa Timur mewajibkan Bidan Praktek Swasta (BPS) mengisi lengkap form yang telah disediakan dan melaporkan catatan pelayanan KIA ke Puskesmas setiap bulan. Laporan pencatatan ini meliputi jumlah K1 dan K4 ibu hamil, jumlah persalinan, jumlah kunjungan ibu nifas, jumlah bayi lahir hidup dan mati, jumlah kunjungan baru dan lama balita, jumlah imunisasi, jumlah ibu dan bayi yang dirujuk dan jumlah pelayanan KB. Dari hasil pelaporan dan pencatatan pelayanan KIA dapat digunakan untuk menilai status kesehatan dan derajat kesehatan suatu daerah.Dari pelaporan pencatatan yang lengkap dan penyerahan laporan yang tepat waktu, maka data status kesehatan ibu dan anak dapat dinilai dan diintervensi sesuai dengan keadaan saat itu, sehingga setiap terjadi masalah dapat dideteksi sedini mungkin dan mendapatkan penanganan yang baik. Penelitian ini bertujuan untuk mengetahui kepatuhan, pengetahuan, motivasi dan prosedur serta fasilitas yang mendukung berjalannya program ini. Jenis penelitian observasional dengan metode survey dan pendekatan crossectional. Instrumen penelitian menggunakan kuesioner pada 75 BPS. Data penelitian diolah secara kuantitatif dengan metode univariat, bivariat dan multivariat dengan uji analisa regresi logistik program SPSS 11.5. Hasil penelitian menunjukkan sebagian besar responden berusia dewasa muda (64%), masa kerja > 5 tahun (90,7%), lebih besar presentase bidan yang patuh (56%), pengetahuan bidan tentang program pelaporan baik (50,7%), motivasi bidan baik (52%), persepsi prosedur pelaporan baik (52%), persepsi supervisi baik (54,7%), dan fasilitas yang disediakan puskesmas kurang memadai (66,7%). Hasil analisis hubungan p value < 0,05 menunjukkan ada hubungan antara prosedur dengan kepatuhan (p-value = 0,030), motivasi dengan kepatuhan (p-value = 0,0001), masa kerja dengan kepatuhan (p-value = 0,039). Dari hasil analisis regresi logistik multivariate (p value < 0,05) didapatkan bahwa motivasi (p-value = 0,0001) dan prosedur (p-value = 0,004) memiliki pengaruh secara bersama-sama terhadap kepatuhan BPS. Disarankan kepada Puskesmas agar lebih melengkapi fasilitas guna meningkatkan motivasi bidan dan mendukung keberhasilan program pelaporan pencatatan KIA