Analisis Faktor-Faktor yang Mempengaruhi Bidan dalam Penerapan Asuhan Persalinan Normal di Kabupaten Kebumen Tahun 2011

Abstract

Univesitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Suhartini Analisis Faktor-Faktor yang Mempengaruhi Bidan dalam Penerapan Asuhan Persalinan Normal di Kabupaten Kebumen Tahun 2011 v + 96 halaman + 32 tabel + 5 gambar + 10 lampiran Di Kabupaten Kebumen AKI tahun 2009 terjadi15 kasus, kematian ibu atau 72/100.000 KH. Semua kasus kematian tersebut terjadi melalui pertolongan bidan walaupun 12 kasus kematian diantaranya di Rumah Sakit. Hal ini dapat disebabkan Penerapan Asuhan Persalinan Normal belum dilaksanakan dengan baik. Tujuan penelitian ini adalah menganalisis faktor- faktor yang mempengaruhi bidan dalam penerapan Asuhan Persalinan Normal di Kabupaten Kebumen. Jenis penelitian survai explanatory research, dengan rancangan kuantitatif dan pendekatan cross sectional. Populasi penelitian semua bidan yang menolong persalinan di Kabupaten Kebumen yaitu 530 bidan. Subjek sejumlah 85 bidan dipilih secara purposive sampling dari setiap wilayah kerja puskesmas. Analisis statistik yang digunakan pada uji bivariat adalah pearson product moment dan rank spearman. Pada analisis multivariat digunakan uji regresi linier berganda dengan metode enter. Hasil penelitian menunjukkan responden mempunyai pengetahuan dengan kategori sedang adalah yang terbanyak 45,9%, motivasi sedang 51,60%, sikap baik 58,83%, persepsi terhadap insentif sedang 60%, persepsi supervisi organisasi IBI baik 63,53%, sarana dan prasarana kategori baik 87,1%, penerapan Asuhan Persalinan Normal baik 96,5%. Terdapat hubungan positif antara pengetahuan (p = 0,000), motivasi (p = 0,000), sikap (p = 0,017), persepsi terhadap insentif (p = 0,040), supervisi (p = 0,002), sarana prasarana (p = 0,000) dengan penerapan Asuhan Persalinan Normal. Variabel yang berpengaruh secara bersama–sama dalam penerapan Asuhan Persalinan Normal adalah pengetahuan, motivasi, sikap, dan sarana prasarana. Disarankan bagi Dinas Kesehatan Kabupaten Kebumen untuk memberikan kesempatan lebih banyak kepada bidan untuk mengikuti pelatihan APN, mengadakan sarana dan prasarana bagi bidan untuk pertolongan persalinan agar dapat menerapan Asuhan Persalinan Normal sesuai standar. Bagi organisasi IBI untuk memfasilitasi anggotanya untuk mengikuti pelatihan APN, dan memberikan motivasi agar semua bidan mengikuti pelatihan APN. Kata Kunci : Penerapan Asuhan Persalinan Normal (APN), pengetahuan, motivasi, sikap, insentif, supervisi, sarana prasarana. Kepustakaan : 40 (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 2012 ABSTRACT Suhartini Analysis on Factors Affecting the Implementation of Normal Maternity Care by Midwives in Kebumen District, 2011 v + 96 pages + 32 tables + 5 figures + 10 enclosures Maternal mortality rate (AKI) 2009 in Kebumen district was 15 maternal mortality cases or 72/100.000 live birth. All those mortality cases occurred during midwives care, and 12 cases died in the hospital. It could be caused by inadequate application of normal delivery care (APN).The objective of this study was to analyse factors affecting midwives in implementing normal delivery care in Kebumen district. This was an explanatory research survey using quantitative design and cross sectional approach. Study population was all midwives who helped the delivery process in Kebumen district, which were 530 midwives. Study subjects were 85 midwives selected using purposive sampling method from every work area of the primary healthcare centre. Pearson product moment and rank spearman tests were applied for bivariate analysis of the data. Multiple linier regressions were applied for in the multivariate analysis. Results of the study showed that respondents with middle knowledge category were 45.9%; respondents with moderate motivation were 51.60%; respondents with good attitude were 58.83%; respondents with moderate perception on incentive were 60%; respondents with good perception on IBI organization supervision were 63.53%; good facilities were reported by 87.1% of respondents; respondents with good implementation of normal delivery care were 96.5%. Positive correlations were found between knowledge (p= 0.000), motivation (p= 0.000), attitude (p= 0.017), perception on incentive (p= 0.040), supervision (p= 0.002), facility (p= 0.000) and implementation of normal delivery care. Variables affecting simultaneously on the implementation of normal delivery care were knowledge, motivation, and facility. Suggestions for Kebumen district health office were to give more opportunity to midwives to obtain APN training; to supply delivery aids facilities for midwives to support implementation of normal delivery care according to the standard. IBI organization was suggested to facilitate the members to take APN training, to give motivation to all midwives to take APN training. Key words : Implementation of normal delivery care (APN), knowledge, motivation, attitude, incentive, supervision, facility Bibliography : 40 (1996-2010)