Evaluasi Pelayanan Persalinan oleh Bidan Desa selama Pelaksanaan Jampersal di Puskesmas Salomekko Tahun 2012 (Studi Kasus di Puskesmas Salomekko)

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Zulaeha A. Amdadi Evaluasi Pelayanan Persalinan oleh Bidan Desa selama Pelaksanaan Jampersal di Puskesmas Salomekko Tahun 2012 (Studi Kasus di Puskesmas Salomekko) 113 hal + 9 tabel + 2 bagan + 15 lampiran Jampersal merupakan program pemerintah mulai bulan April tahun 2011 dengan tujuan meningkatkan akses masyarakat terhadap pertolongan persalinan yang sehat oleh tenaga kesehatan di fasilitas kesehatan dengan cara memberikan kemudahan pembiayaan kepada seluruh ibu melahirkan, namun di wilayah Puskesmas Salomekko masih terdapat persalinan yang ditolong oleh tenaga non kesehatan dan berlangsung di non fasilitas kesehatan.Tujuan penelitian adalah melakukan evaluasi pelayanan persalinan oleh bidan desa selama pelaksanaan Jampersal di Puskesmas Salomekko Kabupaten Bone Sulawesi Selatan tahun 2012. Penelitian ini adalah penelitian observasional menggunakan rancangan deskriptif kualitatif yang bersifat evaluatif,dengan subyek penelitian adalah bidan desa Puskesmas Salomekko yang melakukan pelayanan persalinan selama pelaksanaan Jampersal. Data dikumpulkan dengan wawancara mendalam dan dianalisis dengan teknik kualitatif. Hasil penelitian menunjukkan bahwa semua bidan desa yang melaksanakan pelayanan persalinan belum berjalan dengan baik karena keterbatasan aspek input yaitu sebagian besar petugas belum mengikuti pelatihan APN, pembiayaan masih terbatas, belum adanya standar operasional prosedur dan sarana prasarana yang belum lengkap sehingga petugas memberikan pelayanan berdasarkan pengalaman dan kondisi, hal ini dari aspek proses yaitu perencanaan, pelaksanaan dan pengawasan tidak terlaksana dengan baik dengan melihat masih rendahnya cakupan pertolongan persalinan oleh tenaga kesehatan yang belum sesuai target Kabupaten yang mengacu pada target Depkes yaitu 90% untuk cakupan pertolongan persalinan oleh masing-masing bidan desa di wilayah Puskesmas Salomekko pada tahun 2011 di fasilitas kesehatan selama pelaksanaan Jampersal yaitu 25% sebagian besar berlangsung di non fasilitas kesehatan dan ditolong oleh non tenaga kesehatan atau dukun, namun semua diklaim menggunakan dana Jampersal tidak sesuai dengan petunjuk teknis Jampersal. Hal serupa juga terjadi pada periode bulan Januari sampai April 2012. Berdasarkan hasil penelitian tersebut disarankan kepada Dinas Kesehatan untuk member kemudahan pengklaiman dana Jampersal, melaksanakan pelatihan dan melengkapi kualifikasinya, alat/obat/bahan di Puskesmas/Poskesdes, dan melakukan pembinaan dan supervisi bidan di desa agar dalam memberikan pelayanan persalinan sesuai standar operasional prosedur dan Juknis Jampersal Kata Kunci : Pelayanan persalinan, Program Jampersal. 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 Zulaeha A. Amdadi Evaluation on Delivery Service by Midwives during the Implementation of Delivery Assurance Program in Bone District, South Sulawesi, 2012 (A Case Study in Salomekko Primary Healthcare Center) 113 pagesl + 9 tables + 2 figures + 15 enclosures Delivery assurance (Jampersal) was a government program since April 2011. The objective of jampersal program was to improve community access to healthy delivery assistance by health workers in the health facility. The approach used in jampersal was to give delivery cost reduction for all women who gave birth. However, in the work area of Salomekko primary healthcare center (puskesmas), there was a delivery process who was assisted by non-health workers in the non-health facility. The study objective was to evaluate delivery service by village midwives during jampersal implementation in Salomekko primary healthcare center in Bone district, South Sulawesi, 2012. This was an observational study using descriptive qualitative and evaluative design. Study subjects were village midwives of Salomekko primary healthcare center who conducted delivery service during Jampersal implementation. Data were collected through in-depth interview, and qualitative technique was applied in the data analysis. Results of the study showed that all village midwives who performed delivery service indicated that the service was still inadequate. This was caused by limitation on the input aspect such as most of health worker had not attended in APN training, limited funding, no standard operating procedure, and incomplete condition. Therefore, the workers did the service based on their experiences and conditions. Process aspect namely planning, implementing, and evaluating, was still inadequate; delivery assistance coverage by health workers was still low, and it was below the district target (90%). Delivery assistance coverage by village midwives in the work area of Salomekko primary healthcare center in 2011 and during Jampersal implementation was 25%. Majority of delivery was done in non-health facility and it was assisted by non-health workers or traditional healers. However, all activities were claimed using jampersal funding, and this was not suitable with jampersal technical guideline. A similar case was also occurred in the period of January-April 2012. Based on results of the study, it was suggested to district health office to facilitate jampersal funding claim, to implement training and to complete a qualification, to provide instrument/medicine/material in the primary health care center or village health policlinics, to perform assistance and supervision to village midwives in order to improve delivery service that is suitable with standard operating procedure and technical guideline of jampersal. Key words : delivery service, jampersal program