Faktor Psikologi dan Organisasi yang Mempengaruhi Kepatuhan Bidan Desa terhadap Standar Operasional 7T pada Pelayanan Antenatal di Kabupaten Semarang Tahun 2011

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak Semarang 2011 ABSTRAK Sri Rahayu Faktor Psikologi dan Organisasi yang Mempengaruhi Kepatuhan Bidan Desa terhadap Standar Operasional 7T pada Pelayanan Antenatal di Kabupaten Semarang Tahun 2011 114 halaman + 21 tabel + 6 gambar + 13 lampiran Cakupan K4 di Kabupaten Semarang tahun 2009 belum sesuai target (90,1%). Studi pendahuluan menunjukkan bahwa rerata kepatuhan bidan desa terhadap pelaksanaan pelayanan antenatal berdasar standar 7T hanya 70%. Peneltian ini bertujuan untuk mengetahui faktor psikologi dan organisasi yang mempengaruhi kepatuhan bidan desa terhadap standar operasional 7T pada pelayanan antenatal di Kabupaten Semarang. Jenis penelitian adalah observasional bersifat analitik dengan pendekatan cross sectional. Metode pengumpulan data dilakukan dengan dengan observasi dan wawancara terstruktur dengan kuesioner dan observasi. Variabel dependen adalah kepatuhan dan variabel independen sikap, motivasi, supervisi, kepemimpinan, komunikasi, sarana. Subjek penelitian adalah 71 bidan desa dipilih secara acak dan proporsional. Analisa bivariat dengan uji Rank Spearman, multivariat dengan regresi logistik. Hasil penelitian menunjukkan sebagian besar responden berumur antara 25-46 tahun dengan rerata masa kerja 13,3 tahun. Rata-rata kepatuhan bidan desa 76% , faktor psikologi: sikap dan motivasi sebagian besar baik, faktor organisasi: persepsi terhadap supervisi bidan koordinator, persepsi tentang kepemimpinan kepala puskesmas, persepsi komunikasi bidan koordinator dan sarana semuanya baik. Hasil uji korelasi menunjukkan variabel sikap, motivasi, kepemimpinan, komunikasi dan sarana berhubungan dengan kepatuhan terhadap standar operasional 7T, sedangkan variabel persepsi supervisi tidak berhubungan. Hasil uji regresi logistik menunjukkan variabel motivasi, sarana dan persepsi komunikasi secara bersama-sama berpengaruh terhadap kepatuhan bidan desa. Untuk meningkatkan kepatuhan bidan desa terhadap standar operasional 7T khususnya pemeriksaan hemoglobin dan proteinuri perlu ditingkatkan motivasi dengan melakukan penyegaran yang berkaitan dengan pelayanan antenatal baik dibiayai maupun swadana,adanya sangsi bagi bidan yang tidak melakukan standar 7T serta secara bertahap menambah jumlah sarana khususnya alat pemeriksaan hemoglobin, proteinuri dan media konseling. Kata Kunci : Standar Operasional 7T, Pelayanan Antenatal, Bidan desa, Kepatuhan. Pustaka : 52 (1996-2010) 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 Sri Rahayu Psychological and Organizational Factors Affecting Village Midwives Compliance to the Operational Standard of Antenatal Services in Semarang District, 2011 114 pages + 21 tables + 6 figures + 13 enclosures Coverage of K4 in Semarang district in 2009 had not reached the target (90.1%). Preliminary study indicated that the average village midwives compliance to the implementation of antenatal service based on the standard of 7T was only 70%. The objective of this study was to know psychological and organizational factors that influenced midwives compliance to the operational standard of 7T in antenatal services in Semarang district. This was an observational study with analytical characteristic and using cross sectional approach. Data were collected by doing observation and interview using structured questionnaire. Dependent variable in this study was midwives compliance and independent variables were attitude, motivation, supervision, leadership, communication and facilities. The study subjects were 71 village midwives that were selected randomly and proportionally. Bivariate analysis was done using Rank Spearman test and multivariate analysis was done by applying logistic regression. Results of the study showed that most of respondents were between 25 and 46 years old with average of working period of 13.3 years. The average of village midwives compliance was 76%. Psychological factors, attitude and motivation of respondents, were mostly good. Organizational factors: perception towards supervision of coordinator midwives, perception on the head of puskesmas leaderships, perception on the midwives coordinator communication and facilities, were all good. Results of correlation test showed that attitudes, motivation, leaderships, communication and facilities variables were associated with compliance to the operational standard of 7T. On the other hand, perception on supervision was not related to the operational standard of 7T. Result of logistic regression test indicated that motivation, facilities and communication perception variables jointly influenced village midwives compliance. Village midwives compliance to the operational standard of 7T, especially hemoglobin and protein in the urine examinations, needed to be improved. Motivation of village midwives needed to be increased by conducting refreshing related to antenatal services. Sanction for midwives who did not comply the standard of 7T had to be applied. The number of facilities especially hemoglobin, protein in the urine examination tools and counseling media, had to be added gradually. Key words : Operational standard of 7T, antenatal services, village midwives, compliance Bibliography : 52 (1996 – 2010)