Analisis Faktor-Faktor yang Berpengaruh terhadap Kinerja Bidan Desa dalam Penerapan Manajemen Tatalaksana BBLR Saat Lahir di Kabupaten Tuban

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Kesehatan Ibu dan Anak 2012 ABSTRAK Dwi Rukma Santi Analisis Faktor-Faktor yang Berpengaruh terhadap Kinerja Bidan Desa dalam Penerapan Manajemen Tatalaksana BBLR Saat Lahir di Kabupaten Tuban 141 halaman + 33 tabel + 10 gambar + 10 lampiran Data tahun 2009 – 2010 menunjukkan bahwa kasus kematian akibat BBLR pada persalinan yang ditangani bidan di Kabupaten Tuban mengalami peningkatan 3 kali lipat dari 35 menjadi 106. Hasil studi pendahuluan menunjukkan bahwa masih banyak bidan desa yang tidak menyiapkan alat resusitasi pada pertolongan persalinan. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berpengaruh terhadap kinerja bidan desa dalam penerapan manajemen tatalaksana BBLR saat lahir di Kabupaten Tuban. Penelitian kuantitatif ini dilakukan dengan pendekatan survey cross sectional. Populasi adalah seluruh bidan desa berjumlah 270 orang. Pemilihan subjek sebanyak 99 orang dilakukan dengan Cluster Random Sampling. Variabel terikat adalah kinerja bidan desa dalam tatalaksana BBLR saat lahir, variabel bebas adalah pengetahuan, pelatihan, motivasi, beban kerja, fasilitas, persepsi supervisi dan variabel pengganggu adalah umur, masa kerja, pendidikan. Pengambilan data melalui wawancara dengan kuesioner terstruktur. Analisis bivariat dilakukan dengan Spearman Rank Test, dan analisis multivariat dengan Regresi Logistik Berganda. Hasil penelitian menunjukkan bahwa rerata umur responden adalah 36,5 tahun dengan SD=5,4 tahun. Sebagian besar (73,7%) sudah berpendidikan D3 Kebidanan ke atas. Rerata masa kerja 14 tahun dengan SD=6 tahun. Hanya 55,6% responden yang mempunyai kinerja baik dalam tatalaksana BBLR saat lahir. Hanya 54,5% responden yang berpengetahuan baik. Hanya 43,4% yang telah mengikuti > 1 pelatihan dan 53,5% bermotivasi tinggi. Sebagian besar (64,6%) merasa beban kerjanya berat. Hanya 49,5% yang mempunyai fasilitas memadai dan sebagian besar (61,6%) mempunyai persepsi tentang supervisi baik. Hasil analisis bivariat menunjukkan bahwa pengetahuan (p=0,0001), pelatihan (p=0,0001), motivasi (p=0,0001), fasilitas (p=0,0001), persepsi supervisi (p=0,0001), umur (p=0,004), masa kerja (p=0,002) berhubungan dengan kinerja bidan desa dalam tatalaksana BBLR saat lahir. Hasil analisis multivariat menunjukkan ada pengaruh secara bersama-sama antara fasilitas (p=0,0001;Exp B=11,246),pengetahuan (p=0,009;Exp B= 4,952),persepsi supervisi (p=0,026;Exp B=4,127) dan pelatihan (p=0,029;Exp B=3,795) terhadap kinerja bidan desa dalam penerapan manajemen tatalaksana BBLR saat lahir di Kabupaten Tuban. Kata Kunci : Kinerja, Bidan Desa, Manajemen BBLR Saat Lahir, BBLR Jumlah Pustaka : 44 (1990 – 2011) 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 Dwi Rukma Santi Analysis on Factors which Influence the Performance of Village Midwives in Low Birth Weight Management Care in Tuban Regency 141 pages + 33 tables + 10 figures + 10 enclosures Data in the period of 2009-2010 indicated that the number of dead cases caused by low birth weight neonates in midwives assisted delivery increased by three times, from 35 cases to 106 cases. Results of a preliminary study showed that many village midwives did not provide resuscitation instrument during delivery assistance. The objective of this study was to identify factors affecting work performance of village midwives in the application of low birth weight delivery neonates care management in Tuban district. This was a quantitative study with cross sectional survey approach. Study population was all 270 village midwives in Tuban district. Study samples were 99 village midwives selected using cluster random sampling method. The dependent variable was the work performance of village midwives in low birth weight neonates care management. The independent variables were knowledge, training, motivation, workload, facilities, and perception on supervision. Confounding variables were age, length period of working and education. Bivariate analysis was conducted by applying Spearman Rank Test, and multiple logistic regressions were applied in the multivariate analysis. Results of the study showed that respondent’s age average was 36.5 years with standard deviation (SD) = 5.4 years. The majority of respondents (73.7%) were in the D3 education level or higher. The average length period of working was 14 years with SD= 6 years. Only 55.6% of respondents had good knowledge. Only 43.4% of respondents had attended one or more training, and 53.5% of respondents had strong motivation. The majority of respondents (64.6%) felt that the workload was heavy. Only 49.5% of respondents had sufficient facilities. Good perception on supervision was reported by the majority of respondents (61.6%). Results of bivariate analysis showed that knowledge (p= 0.0001), training (p=0.0001), motivation (p= 0.0001), facility (p= 0.0001), perception on supervision (p= 0.0001), age (p= 0.004), working period (p= 0.002) were associated with village midwives work performance in low birth weight neonates care management. Results of multivariate analysis showed the joint influence of facility (p= 0.0001, Exp B= 11.246), knowledge (p= 0.009, Exp B= 4.952), perception on supervision (p= 0.026; Exp B= 4.127), and training (p= 0.029; Exp B= 3.795) towards the works performance of village midwives in the application of low birth weight neonates care management in Tuban district. Keywords : work performance, village midwives, low birth weight post delivery care management Bibliography : 44 (1990-2011)