Analisis Faktor-Faktor yang Berpengaruh terhadap Kinerja Bidan dalam Deteksi Dini Faktor Risiko HIV/AIDS di Puskesmas Kota Malang

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2011 ABSTRAK Agus Setyo Utomo Analisis Faktor-Faktor yang Berpengaruh terhadap Kinerja Bidan dalam Deteksi Dini Faktor Risiko HIV/AIDS di Puskesmas Kota Malang xv + 126 halaman + 24 tabel + 6 gambar + 12 lampiran Secara kumulatif jumlah kasus HIV/AIDS Kota Malang menempati urutan ketiga di Jawa Timur, hingga September 2010 tercatat 1.545 kasus dengan usia reproduksi aktif 88,9%. Pencegahan penularan HIV dari ibu ke bayi (PMTCT) telah dijalankan di Kota Malang sejak tahun 2008 dengan hasil cakupan tahun 2009 sebesar 2,19% bumil mendapat konseling HIV, 5,41% melakukan test HIV. Salah satu peran bidan dalam program PMTCT yaitu deteksi dini faktor risiko HIV/AIDS pada ibu yang menerima pelayanan KIA, namun peran ini belum dilaksanakan oleh semua bidan. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berpengaruh terhadap kinerja bidan dalam deteksi dini faktor risiko HIV/AIDS di Puskesmas Kota Malang. Penelitian observasional survey ini dilaksanakan dengan pendekatan cross sectional. Semua bidan yang memenuhi kriteria sebanyak 79 responden dijadikan sampel. Pengambilan data dilakukan dengan wawancara dan pengamatan langsung. Variabel bebas terdiri dari umur, masa kerja, beban kerja, pengetahuan, motivasi, sikap dan persepsi bidan terhadap supervisi dinas kesehatan, sedangkan variabel terikat adalah kinerja bidan dalam dalam deteksi dini faktor risiko HIV/AIDS. Data primer dan sekunder diolah dan dianalisis secara univariat, analisis bivariat dengan korelasi Pearson Product Moment dan Rank Spearman dan analisis multivariat dengan regresi linier ganda. Hasil penelitian menunjukkan bahwa median umur responden 29 tahun, median masa kerja 6 tahun. Sebagian besar kinerja dan pengetahuan cukup, beban kerja berat, persepsi bidan terhadap supervisi dinas kesehatan, motivasi dan sikap baik. Faktor yang berhubungan dengan kinerja bidan adalah beban kerja (p=0,000), pengetahuan (p=0,000), persepsi terhadap supervisi Dinas Kesehatan (p=0,000), motivasi (p=0,000) dan sikap (p=0,000). Variabel yang berpengaruh secara bersama-sama terhadap kinerja adalah beban kerja, persepsi bidan terhadap supervisi dinas kesehatan, motivasi dan sikap. Variabel yang berpengaruh paling besar adalah motivasi. Disarankan bagi Dinas Kesehatan Kota Malang agar pelaksanaan supervisi dilakukan menyeluruh termasuk deteksi dini faktor risiko HIV/AIDS, perhitungan kembali rasio beban kerja dengan jumlah bidan, mengoptimalkan tenaga administrasi, mewujudkan pelaksanaan pelatihan yang menunjang kinerja dan motivasi, menciptakan lingkungan kerja pelayanan yang lebih nyaman serta peninjauan sistem pemberian penghargaan dan sanksi. Kata Kunci : Bidan, Kinerja, Deteksi Dini Faktor Risiko HIV/AIDS Kepustakaan : 49 (1997 – 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 Agus Setyo Utomo Analysis on the Factors Related to the Performance of Midwives in Early Detection of HIV/AIDS Risk Factors at the Primary Healthcare Centers of Malang City, 2011 xv + 126 pages + 24 tables + 6 figures + 12 enclosures The number of HIV/AIDS cases in Malang city, cumulatively, was in the third rank in East Java. Up until September 2010, it was recorded 1.545 cases and 88.9% of it was in the active reproduction age. Prevention of HIV transmission from mother to the baby (PMTCT) had been done in Malang city since 2008 with the results showed 2.19% pregnant women received HIV counseling in 2009, 5.14% of them did HIV test. One of midwife’s roles in PMTCT program was early detection of HIV/AIDS risk factors among mothers who received KIA service. Unfortunately this role had not been done by all midwifes. The objective of this study was to know factors affecting to midwives work performance in early detection of HIV/AIDS risk factors in Malang city puskesmas. This observational survey was conducted using cross sectional approach. All 79 eligible midwives were included as samples. Data was collected through interview and direct observation. Independent variables were age, work period, work load, knowledge, motivation, attitude and perception of midwives towards district health office supervision. The dependent variable was midwives work performance in the early detection of HIV/AIDS risk factors. Primary and secondary data were managed and analyzed using univariate analysis. Bivariate analysis was performed by applying Pearson Product Moment and Rank Spearman correlations. Multiple linier regression method was applied for multivariate analysis. Results of the study showed that respondent’s age median was 29 years and work period median was 6 years. Most of respondent’s work performance and knowledge were in moderate level; respondent’s work load was heavy; perception toward district health office supervision was good, respondent’s motivation and attitude were good. Factors related to midwives work performance were work load (p <0.001), knowledge (p < 0.001), perception toward district health office supervision (P < 0.001), motivation (p < 0.001) and attitude (p < 0.001). Variables that had joint influence toward work performance of midwives were work load, midwives perception toward district health office supervision, motivation and attitude. The most influencing variable was motivation. It was suggested for Malang district health office to do comprehensive supervision including early detection of HIV/AIDS risk factors, to recalculate of work load ratio based on the number of midwives, to optimize administration staff’s work performance, to actualize more comfortable working environment and to review rewards and sanctions system. Key words : midwives, performance, early detection HIV/AIDS risk factors Bibliography : 49 (1997 – 2010)