Faktor-faktor yang Mempengaruhi Kelengkapan Pengisian Buku KIA oleh Bidan dalam Deteksi Dini Risiko Tinggi Ibu Hamil di Puskesmas Kabupaten Banyumas Tahun 2012

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Tri Anasari Faktor-faktor yang Mempengaruhi Kelengkapan Pengisian Buku KIA oleh Bidan dalam Deteksi Dini Risiko Tinggi Ibu Hamil di Puskesmas Kabupaten Banyumas Tahun 2012 Buku KIA merupakan salah satu alat untuk mendeteksi dini risiko tinggi ibu hamil. Penggunaan buku KIA oleh bidan di Kabupaten Banyumas masih belum maksimal, ditunjukkan dengan cakupan deteksi dini risiko tinggi yang masih di bawah target (20%) dan kasus kematian ibu yang meningkat dari tahun 2010 sebesar 123,9/100.000 kelahiran hidup ke tahun 2011 menjadi 129,35/100.000 kelahiran hidup. Tujuan penelitian adalah mengetahui pengaruh pengetahuan, persepsi supervisi, motivasi, dukungan sarana dan beban kerja terhadap kelengkapan pengisian buku KIA oleh bidan dalam deteksi dini risiko tinggi ibu hamil di Puskesmas Kabupaten Banyumas. Desain Penelitian adalah observasional analitik dengan pendekatan cross sectional. Instrumen penelitian menggunakan kuesioner terstruktur. Pengumpulan data dilakukan dengan wawancara dan observasi. Populasi adalah bidan sebanyak 495 responden, teknik pengambilan sampel menggunakan proportional random sampling dengan jumlah sampel 84 responden. Analisis bivariat dilakukan dengan uji chi square dan multivariat dengan regresi logistik. Hasil penelitian menunjukkan bahwa kelengkapan pengisian buku KIA sebagian besar lengkap sebanyak 60,7%, pengetahuan baik sebanyak 82,1% dan persepsi supervisi baik sebanyak 54,8%. Responden yang mempunyai motivasi rendah sebanyak 51,2%, dukungan sarana lengkap sebanyak 53,6% dan beban kerja berat sebanyak 50%. Hasil analisis bivariat menunjukkan bahwa pengetahuan (p=0,001), motivasi (p=0,001), beban kerja (p=0,023) berhubungan secara positif dengan kelengkapan pengisian buku KIA. Analisis multivariat menunjukkan adanya pengaruh pengetahuan (p=0,002; Exp B= 10,981), motivasi (p=0,001; Exp B=7.713) dan beban kerja (p= 0,021; Exp B= 0.260) terhadap kelengkapan pengisian buku KIA. Disarankan kepada pihak puskesmas agar membentuk tim kerja tingkat puskesmas sesuai program yang dijalankan untuk meringankan beban kerja bidan. Kepada Dinas Kesehatan Kabupaten Banyumas agar memberikan penghargaan bagi bidan yang berprestasi. Kata Kunci : Kelengkapan Pengisian Buku KIA, Deteksi Dini Risiko Tinggi, Ibu Hamil. Pustaka : 44 (1987-2012) 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 Tri Anasari Factors Related to the Completeness of Maternal and Child Health Book Filling by Midwives in Early Detection of High Risk Pregnancy in Primary Healthcare Centers in Banyumas District, 2012 KIA book is one of early detection tools for high risk pregnancy. Utilization of KIA book by midwives in Banyumas district was not maximal. This was indicated by the high risk pregnancy early detection coverage that was still below the target (20%). In addition, the number of maternal death cases increased from 123.9/100,000 live birth in 2010 to 129.35/100,000 live births in 2011. The objective of this study was to know the influence of knowledge, supervision perception, motivation, facility support and workload towards the completeness of KIA book filling by midwives in the early detection of high risk pregnancy in the primary healthcare centers (puskesmas) of Banyumas district. This was an observational analytical study with cross sectional approach. Structured questionnaire was used as a research instrument. Data were collected through interview and observation. Study population was 495 midwives. Proportional random sampling was applied to obtain 84 samples. Bivariate analysis using chi-square test and multivariate analysis using logistic regression were applied in the data analysis. Results of the study showed that most of the KIA books (60.7%) were completely filled; 82.1% of respondents had good knowledge; and 51.2% of respondents had good perception on supervision. Proportion of respondents with low motivation was 51.2%, proportion of respondents with complete facility support was 53.6%; and proportion of respondents with heavy workload was 50%. Result of Bivariate analysis showed that knowledge (p= 0.001), motivation (p= 0.001), workload (p= 0.023) had positive associations with the completeness of KIA book filling. Multivariate analysis indicated the influence of knowledge (p=0.002; Exp B= 10.981), motivation (p= 0.001; Exp B= 7.713) and workload (p= 0.021; Exp B= 0.260) towards the completeness of KIA book filling. Recommendation addressed to Puskesmas is to form puskesmas task force team for the implemented programs; and it is intended to reduce midwives workload. Suggestion for the head of Banyumas district health office is to provide rewards for midwives who have good achievement. Keywords : Completeness of KIA book filling, early detection of a high risk pregnancy Bibliography : 44 (1987-2012)