Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Melakukan Proses Rujukan Komplikasi Obstetri di Kabupaten Jember

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2011 ABSTRAK Indah Muflihatin Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Melakukan Proses Rujukan Komplikasi Obstetri di Kabupaten Jember xi + 108 halaman + 33 tabel + 3 gambar + 8 lampiran Dalam melakukan pelayanan proses rujukan bidan harus memiliki kesiapan untuk merujuk ibu ke fasilitas rujukan secara optimal dan tepat waktu jika terjadi penyulit. Standar pelayanan rujukan yang harus dilakukan dan dipersiapkan oleh bidan adalah standar BAKSOKU. Pelayanan rujukan yang dilakukan oleh bidan desa di Kabupaten Jember masih belum optimal. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi kinerja bidan desa dalam melakukan proses rujukan komplikasi obstetri di Kabupaten Jember. Jenis penelitian ini adalah penelitian explanatory research studi kuantitatif dengan pendekatan cross sectional, dengan populasi penelitian adalah seluruh bidan desa yang ada di Kabupaten Jember yaitu sejumlah 127 bidan desa, dan didapatkan jumlah sampel sebesar 119 bidan desa. Data dianalisis dengan pendekatan kuantitatif antara variabel pengetahuan, motivasi, kompensasi, persepsi supervisi, beban kerja, dan fasilitas dengan kinerja bidan desa. Pengumpulan data melalui wawancara dengan menggunakan kuesioner dan pengamatan dengan menggunakan chek list. Analisis bivariat menggunakan rank spearmen, sedangkan untuk analisis multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa 67,2% pengetahuan bidan desa kurang baik, 53,8% mempunyai motivasi yang tinggi, 52,9% kompensasi bidan desa baik, 52,1% persepsi supervisi bidan desa baik, 53,8% beban kerja bidan desa tinggi, 84,9% bidan desa tidak memiliki fasilitas yang kurang lengkap, 55,5% kinerja bidan desa dalam melakukan proses rujukan komplikasi obstetri adalah baik. Hasil analisis bivariat menunjukkan bahwa variabel yang berhubungan dengan kinerja bidan desa adalah pengetahuan, motivasi, kompensasi, supervisi, beban kerja, dan fasilitas. Hasil analisis multivariat menunjukkan bahwa variabel yang mempengaruhi kinerja bidan desa secara bersama-sama adalah pengetahuan (p 0,035, Exp B 2,477), motivasi (p 0,004, Exp B 7,202), kompensasi (p 0,000, Exp B 20,353), supervisi (p 0,000, Exp B 12,121), beban kerja (p 0,001, Exp B 9,638). Dalam rangka meningkatkan kinerja bidan desa dalam melakukan proses rujukan komplikasi, maka disarankan kepada kepala Dinas Kesehatan Kabupaten jember untuk melakukan supervisi secara langsung dan berkala, mengadakan penyuluhan dan pelatihan, memberikan kompensasi yang sesuai dengn beban ker bidan desa, memberikan bantuan fasilitas berupa alat-alat yang berhubungan pelayanan rujukan komplikasi obstetri, bidan desa diberi tugas dan tanggung jawab yang sesuai dengan tugas pokok bidan. Kata Kunci : Kinerja, Proses Rujukan Komplikasi Obstetri, Bidan Desa Kepustakaan : 35, 1992 – 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 Indah Muflihatin Factors Affecting Work Performance of Village Midwives in Referral Process for Obstetric Complications in Jember District xi + 108 pages + 33 tables + 3 figures + 8 enclosures In implementing referral process service, midwives should be ready to refer the mother to referral facilities in the right time when problems occurred. Referral service standard that had to be prepared and implemented by midwives was BAKSOKU standard. Referral service carried by village midwives in Jember district was not done optimally. The objective of this study was to identify factors affecting village midwives work performance in implementing obstetric complication referral process in the district of Jember. This was an explanatory research with cross sectional approach. Study population was 127 village midwives in Jember district. Samples were 119 village midwives. Quantitative approach was applied for data analysis. Association between knowledge, motivation, compensation, supervision perception, workload, facilities and village midwives work performance was studied. Data were collected through interview using questionnaire and observation guided by checklist. Rank Spearman test was applied for bivariate analysis and logistic regression was applied for multivariate analysis. Results of the study showed that 67.2% of village midwives had poor knowledge, 53.8% of village midwives had strong motivation, 52.9% of respondents received good compensation, 52.1% of village midwives had good perception on supervision, 53.8% of village midwives had high workload, 84.9% of village midwives had incomplete facilities, 55.5% of village midwives had good performance in implementing obstetric complication referral process. Results of bivariate analysis indicated that knowledge, motivation, compensation, supervision, workload and facilities were associated with village midwives work performance. Multivariate analysis results indicated that variables that jointly influenced village midwives work performance were knowledge (p: 0.035, Exp B: 2.477), motivation (p: 0.004, Exp B: 7.202), compensation (p: 0.000, Exp B: 20.353), supervision (p: 0.000, Exp B: 12.121), workload (p: 0.001, Exp B: 9.638). In order to improve work performance of village midwives in implementing complication referral process, several suggestion are given. The head of Jember district health office was suggested to conduct supervision directly and routinely, to perform exposition and training, to give compensation according to the workload of village midwives, to support the availability of facilities in the form of instruments related to obstetric complication referral service, to assign task and responsibility for village midwives according to the main duties of midwives. Key words : Work performance, obstetric complication referral process, village midwives Bibliography : 35, 1992 - 2010