Analisis Faktor-Faktor yang Berpengaruh terhadap Pelaksanaan Standar Pelayanan bagi Ibu dan Bayi pada Masa Nifas oleh Bidan di Kota Bitung Propinsi Sulawesi Utara

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Freike Sofie Nonce Lumy Analisis Faktor-Faktor yang Berpengaruh terhadap Pelaksanaan Standar Pelayanan bagi Ibu dan Bayi pada Masa Nifas oleh Bidan di Kota Bitung Propinsi Sulawesi Utara xiv + 136 halaman + 34 tabel + 4 gambar + 11 lampiran Pelaksanaan standar pelayanan bagi ibu dan bayi pada masa nifas merupakan upaya untuk meningkatkan cakupan dan kualitas pelayanan nifas. Pelaksanaan standar pelayanan nifas di Kota Bitung belum optimal dilihat dari menurunnya cakupan kunjungan nifas (KF 3) 66% dibawah target nasional 90% dan terjadi kasus kematian ibu nifas. Tujuan penelitian adalah untuk mengetahui faktor – faktor yang berpengaruh terhadap pelaksanaan standar pelayanan bagi ibu dan bayi pada masa nifas oleh bidan di Kota Bitung Propinsi Sulawesi Utara. Jenis penelitian adalah studi kuantitatif dengan metode observasional analitik dengan pendekatan cross sectional. Populasi adalah semua bidan di Kota Bitung berjumlah 82 orang, jumlah sampel 46 orang dipilih dengan metode proporsional random sampling. Pengumpulan data melalui wawancara menggunakan kuesioner terstruktur dan pengamatan dengan lembar observasi. Analisis yang digunakan rank spearman dan regression logistic. Hasil penelitian menunjukkan mayoritas responden umur rerata 31,76 tahun; masa kerja rerata 9,35 tahun; pendidikan D3 Kebidanan (87%) dan belum pelatihan standar pelayanan nifas (71,7%). Pelaksanaan standar pelayanan bagi ibu dan bayi pada masa nifas masih kurang dalam hal memberikan pelayanan melalui kunjungan nifas (KF3) di puskesmas/ rumah, pemeriksaan hb pada hari ketiga bila ibu menderita anemia semasa hamil atau mengalami perdarahan berat selama proses persalinan, Ada pola hubungan yang positif pengetahuan, kemampuan, sikap, motivasi, peralatan berhubungan dengan pelaksanaan standar pelayanan nifas. Faktor yang berpengaruh terhadap pelaksanaan standar pelayanan nifas adalah pengetahuan (p value=0.019), kemampuan (p value=0.007) dan motivasi (p value=0.036). Kemampuan paling kuat berpengaruh (Exp.B=12.102). Disarankan perlu mengadakan pelatihan standar pelayanan nifas bagi bidan, mengalokasikan dana pelatihan serta pengadaan alat penunjang (hb sahli), perlu meningkatkan motivasi bidan dalam pelaksanaan standar pelayanan nifas di tempat tugas dan hendaknya memberikan informasi standar pelayanan nifas melalui pertemuan rutin IBI setiap bulan. Kata Kunci : Standar Pelayanan Nifas, Bidan Kepustakaan : 49 (2001-2012) 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 Freike Sofie Nonce Lumy Analysis on Factors Related to the Implementation of Service Standards for Mothers and Babies at Postpartum Period by Midwives in Bitung, North Sulawesi xiv + 136 pages + 34 tables + 4 figures + 11 enclosures The implementation of child and maternal service standard during the post delivery period was an effort to increase coverage and quality of post delivery services. The implementation of post delivery service standard in Bitung city was not optimal. It was shown by decreasing the number of post delivery visit coverage (KF 3) to 66%; it meant that it was below the national target (90%), and maternal dead during the post delivery period occurred. Objective of the study was to identify factors affecting the implementation of child and maternal service standard in the post delivery period by midwives in Bitung city, North Sulawesi province. This was a quantitative study with an observational-analytical method and cross sectional approach. Study population was all 82 midwives in Bitung city. Study samples were 46 midwives who were selected using proportional random sampling method. Data were collected through interview guided by structured questionnaire, and also through observation using observation form. Rank Spearman and logistic regression were applied in the data analysis. Results of the study showed that average age of respondents was 31.76 years old; average working duration was 9.36 years old. Majority of respondent’s level of education (87%) was at D3 midwifery level, and they had not received training on post delivery service standard (71.7%). Implementation of standard service for maternal and infant during the post delivery period was still insufficient. It included insufficient in providing service through post delivery visit (KF3) in puskesmas or home, hemoglobin examination in the third day for maternal with anemia history during pregnancy or maternal with severe hemorrhage during giving birth process. There was a positive association between implementation of post delivery service standard and knowledge, ability, attitude, motivation, instruments. Factors affecting the implementation of post delivery service standard was knowledge (p= 0.019), ability (p= 0.007), and motivation (p= 0.036). Ability was the strongest affecting factor (Exp B= 12.102). It was suggested to implement post delivery service standard training for midwives, to allocate training budget and to supply supporting instrument (hb Sahli), to improve midwives motivation in the implementation of post delivery service in the work place, to provide information on post delivery standard through routine IBI meeting every month. Key words : post delivery service standard, midwives Bibliography : 49 (2001-2012)