Analisis Kinerja Bidan Delima dalam Penerapan Standar Pelayanan Nifas (Studi Kasus di Kota Surabaya)

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Fauziyatun Nisa’ Analisis Kinerja Bidan Delima dalam Penerapan Standar Pelayanan Nifas (Studi Kasus di Kota Surabaya) 101 halaman + 6 tabel + 2 gambar + 22 lampiran Angka kematian ibu berdasarkan target MDG’s pada tahun 2015 yaitu 102/100.000 Kelahiran hidup. Tinginya AKI sebagian besar terjadi masa nifas. Dari data tahun 2008-2010 menunjukkan bahwa hasil cakupan pelayanan nifas yang dilakukan Bidan Delima belum sesuai target SPM yang ditetapkan. Berdasarkan survei pendahuluan didapatkan bahwa kinerja Bidan Delima dalam pelayanan nifas belum sesuai standar. Tujuan penelitian ini adalah menjelaskan bagaimana kinerja Bidan Delima dalam pelayanan nifas di Kota Surabaya. Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan cross sectional. Informan penelitian adalah Bidan Delima di Kota Surabaya. Sedangkan informan triangulasi adalah, ketua IBI, Kasie KIA dan ibu nifas. Data dikumpulkan dengan wawancara mendalam (indepth interview) dan selanjutnya dilakukan pengolahan data menggunakan metode analisis isi (content analysis ) Hasil penelitian menunjukkan bahwa kinerja Bidan Delima dari segi kualitas belum dilaksanakan sesuai standar pelayanan nifas baik dari pemberian pelayanan dan kesesuaian langkah-langkah pemeriksaan. Dari segi kuantitas didapatkan cakupan kunjungan yang menurun. Ketepatan waktu juga belum sesuai dengan penerapan jadual pelayanan nifas. Efektivitas sumber daya belum maksimal baik dari peralatan, asisten dan keikutsertaan program jampersal. Pengawasan dalam bentuk supervisi fasilitatif dilakukan bila ada laporan kasus. Serta jalinan kerja sama belum dilaksanakan secara maksimal dan menyeluruh. Sehingga tujuan program Bidan Delima sebagai pelayanan Kebidanan yang berkualitas dan sebagai Brand belum sepenuhnya terwujud. Berdasarkan hasil penelitian disarankan kepada profesi IBI dan Dinas Kesehatan untuk menyelenggarakan pelatihan, seminar dan konseling untuk meningkatkan kualitas pelayanan nifas, peningkatan kuantitas cakupan kunjungan, ketepatan waktu dalam pelayanan nifas serta pelaksanaan kerjasama yang intensif. Melakukan penilaian kinerja Bidan Delima setiap tahun dan memberikan reward terhadap bidan berprestasi dalam meningkatkan hasil pelayanan nifas serta menjalin kerja sama tertulis dengan lintas sektor dan program sampai lini terbawah agar tujuan program Bidan Delima dapat tercapai. Kata Kunci : Pelayanan Nifas, Bidan Delima, Kinerja Jumlah Pustaka : 47 (1994 – 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 Fauziyatun Nisa’ Analysis on Work Performance of Certified Midwives in the Implementation of Post Partum Service Standard (a Case Study in Surabaya) 101 pages + 6 table + 2 figures + 22 enclosures Maternal mortality rate (AKI) based on MDG’s target in 2015 will be 102/100.000 live births. The majority of maternal mortality occurred in the post delivery period. Data 2008-2010 indicated that coverage of post-delivery service by Delima midwives did not reach the SPM target. A preliminary study results showed that work performance of Delima midwives in the parturition period service was insufficient. The objective of this study was to explain the work performance of Delima midwives in the post delivery service in Surabaya municipality. This was a descriptive qualitative study with cross sectional approach. Study informants were Delima midwives in Surabaya municipality. Triangulation informants were a director of the local Indonesian Midwives Association (IBI), a head of maternal and child health (KIA) section and women in the post delivery period. Data were collected through in-depth interview. Data were managed and analyzed using content analysis method. Results of the study showed that, the work performance of Delima midwives was still below the post delivery service standard quality in providing services and in following the examination steps. From the quantity point of view, it was found that visit coverage decreased. Post delivery service schedule had not been followed properly. Resources were still insufficient. These included facilities, assistance and jampersal program participation. Supervision facilitative was done only when there was a case report. Collaboration network was not performed adequately and comprehensively. Not all purposes of Delima midwives program, as a qualified midwifery provider and as ‘Brand’, were attained. Based on the study results, it was suggested to IBI profession and Municipality Health Office to provide trainings, seminars, and counseling to improve post delivery service quality. In addition, visit coverage quantity, post delivery service time schedule accurateness, and intensive implementation of collaboration have to be improved. They have to conduct assessment on the work performance of Delima midwives annually; to provide rewards to midwives who have good achievement in improving results of post delivery service; to make written cross sector and program collaborations until the lowest level in order to attain the purpose of Delima midwives program. Key words : parturition service, Delima midwives, work performance Bibliography : 47 (1994-2010)