Analisis Pelayanan Antenatal pada Ibu Hamil Resiko Tinggi Anemia oleh Bidan Desa di Kabupaten Klaten Tahun 2010

Abstract

Univesitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2011 ABSTRAK SY. Trihana Wijayanti Analisis Pelayanan Antenatal pada Ibu Hamil Resiko Tinggi Anemia oleh Bidan Desa di Kabupaten Klaten Tahun 2010 xiii + 165 halaman + 44 tabel + 3 gambaran + 3 lampiran Angka Kematian Ibu Jawa Tengah Tahun 2009 117,2/ 100 KH, Kabupaten Klaten jumlah kematian ibu 19/ 19.968 KH. Pelayanan antenatal yang dilakukan oleh Bidan Desa di Poliklinik Kesehatan Desa (PKD) menunjukkan bahwa cakupan K1 dan K4 serta deteksi resiko tinggi anemia masih rendah. Kebijakan Dinas Kesehatan Kabupaten Klaten dalam upaya menurunkan kematian ibu karena perdarahan dilakukan pelatihan Persalinan Normal dan pengadaan sarana kebidanan untuk penanganan antenatal ibu hamil resiko tinggi anemia. Tujuan penelitian ini adalah menjelaskan pelaksanaan dari aspek deteksi dini, pengelolaan, konseling, pemantauan, pencatatan dan pelaporan pada penanganan antenatal ibu hamil resiko tinggi anemia di Kabupaten Klaten. Jenis penelitian ini adalah kualitatif dengan menggunakan wawancara mendalam dan observasi langsung dengan pendekatan cross sectional. Informan utama pada penelitian ini adalah bidan desa yang sedang menangani ibu hamil resiko tinggi anemia dan bekerja di Kabupaten Klaten. Informan triangulasi pasien bidan desa, Kepala Puskesmas dan Kepala seksi Dinas Kesehatan Kabupaten Klaten. Teknik analisis data dengan konten analisis meliputi wawancara mendalam dengan informan diolah kemudian dilakukan analisis data. Pelaksanaan penanganan antenatal ibu hamil resiko tinggi anemia dari deteksi dini sudah memenuhi standar namun masih ada yang belum dilaksanakan yaitu langkah pemeriksaan laboratorium kadar hemoglobin dan golongan darah. Dari pengelolaan sudah sesuai dengan standar kebidanan. Dari konseling belum memenuhi standar jenis edukasi yang diberikan masih belum lengkap, serta cara penyampaian materi belum sesuai standar. Dari pemantauan belum memenuhi standar pemeriksaan ulang kadar hemoglobin maupun kepatuhan ibu minum tablet Fe belum dilaksanakan sesuai standar. Dari pencatatan sudah memenuhi prosedur. Disarankan kepada Dinas Kesehatan kabupaten Klaten untuk membuat kebijakan untuk pemantauan ibu hamil resiko tinggi anemia dan membuat format kunjungan rumah, menyelenggarakan penyegaran penanganan antenatal ibu hamil anemia, memperbaiki format pencatatan dan pelaporan ibu hamil resiko tinggi anemia. Kata kunci : Pelayanan antenatal ibu hamil resiko tinggi anemia, bidan desa. Referensi : 43 (1980-2010) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2011 ABSTRACT SY. Trihana Wijayanti Analysis on Antenatal Service to Anemic Pregnant Women by Village Midwives in Klaten District, 2010 xiii + 165 pages + 44 tables + 3 figures + 3 enclosures Maternal mortality rate in Central Java in 2009 was 117.2/100.000 live births and in Klaten district was 19/19.968 live birth. Antenatal service done by village midwives at village health polyclinic (PKD) indicated that K1 and K4 and anemia high risk detection coverage were still low. Policy of Klaten district health office in the effort to decrease maternal mortality due to hemorrhage was implemented by performing training on normal delivery and by supplying obstetrical facilities for antenatal management on anemia high risk pregnancy. The objective of this study was to explain the implementation of early detection, management, counseling, monitoring, recording and reporting on antenatal management of anemia high risk pregnancy in Klaten district. This was a qualitative study with cross sectional approach using in-depth interview and direct observation to collect data. Main informants were village midwives working in Klaten district and who were taking care of patients with anemia high risk pregnancy. Triangulation informants were patients of the midwives, head of Puskesmas and head of units in Klaten district health office. Content analysis technique was used for analyzing the data. The implementation of antenatal management on anemia high risk pregnancy from early detection had fulfilled the standard. On the contrary, steps in examining hemoglobin concentration and blood group had not been followed according to the standard. Management of patients had been done according to the obstetrical standard. Counseling had not fulfilled the standard due to the type of education given was not complete and the way the materials were explained was not according to the standard. Based on the results of the monitoring, it was found that re-examination of hemoglobin concentration and the frequency of mothers to drink Fe were not done according to the standard. Recording was done according to procedure. It was suggested to Klaten district health office to make policies to monitor anemia high risk pregnancy and to produce house visit form, to conduct refreshing on anemia high risk pregnancy, to improve recording and reporting formats of anemia high risk pregnancy. Key words : Antenatal management, anemia high risk pregnancy, village midwives Bibliography : 43 (1980 – 2010)