Implementasi Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) oleh Bidan pada Puskesmas di Kota Ambon (Studi pada Puskesmas Binaan)

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Hasnawati Nukuhaly Implementasi Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) oleh Bidan pada Puskesmas di Kota Ambon (Studi pada Puskesmas Binaan) xii + 93 halaman + 10 tabel + 3 gambar + 6 lampiran Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dicanangkan untuk mempercepat penurunan Angka Kematian Ibu (AKI). Pelaksanaan program ini di Ambon belum optimal. Tujuan penelitian ini adalah menjelaskan implementasi dan faktor-faktor terkait P4K oleh bidan pada Puskesmas di Kota Ambon. Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan waktu cross sectional. Pengumpulan data dilakukan dengan tehnik wawancara mendalam (Indepth Interview) pada 3 bidan pelaksana P4K sebagai informan utama,dan informan triangulasi yaitu 3 Kepala Puskesma Kabid Kesehatan Keluarga DKK Ambon serta 3 orang ibu pasca salin 0-42 hari. Analisa data menggunakan metode analisis isi (content analysis). Hasil dari penelitian menunjukkan bahwa implementasi P4K yaitu pemberian konseling secara komperhensif belum dilakukan oleh bidan. Kunjungan Antenatal (ANC) belum dilakukan sesuai standar. Masih ada persalinan yang ditolong dukun. Penggunaan KB pasca salin belum mencapai target. Tabulin dan penggalangan donor darah belum dilaksanakan. Sosialisasi program kepada masyarakat dan lintas sektor masih kurang. Jumlah bidan belum memadai. Sarana prasarana belum memadai serta tidak ada alokasi dana untuk kegiatan sosialisasi. Lemahnya manajemen kontrol dari Dinas Kesehatan Kota Ambon dan kepala Puskesmas . Bidan belum melaksanakan forum komunikasi khusus P4K. Sikap bidan pelaksana setuju dan berkomitmen baik dalam pelaksanaan P4K. SOP pelaksanaan P4K belum tersedia. Implementasi Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) oleh bidan di Kota Ambon belum berjalan baik karena belum ada kebijakan daerah yang mengikat untuk mendukung P4K, komunikasi kepada masyarakat yang kurang, tenaga bidan, sarana dan dana yang belum memadai, lemahnya manajemen kontrol dari Dinas Kesehatan Kota Ambon serta belum adanya SOP untuk pelaksanaan P4K. Kata Kunci : Implementasi Program Perencanaan Pesalinan dan Pencegahan Komplikasi (P4K), Bidan, Komunikasi, Sarana Prasarana Kepustakaan : 35 (1999-2011) 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 Hasnawati Nukuhaly Implementation of Delivery Planning and Complication Prevention Program by Midwives at the Primary Healthcare Centers in Ambon xii + 93 pages + 10 tables + 3 figures + 6 enclosures Delivery planning and complication prevention program (P4K) was established to accelerate the decrease of maternal mortality rate (AKI), Implementation of this program in Ambon was not optimal. Objective of this study was to explain the implementation and related factors of P4K by midwives in the primary health care centers of Ambon city. This was a descriptive-qualitative study with cross sectional time approach. Data collection was done using in-depth interview technique to 3 P4K executor midwives as main informants. Triangulation informants were three heads of primary healthcare centers, head of family health unit of Ambon district health office (DKK), and three mothers who gave birth in the last 0-42 days. Content analysis method was applied in the data analysis. Results of this study showed that P4K implementation in the form of giving comprehensive counseling was not done by midwives. Antenatal care (ANC) visit was not conducted according to the standard. Delivery assisted by ‘dukun’ was still found. Post delivery contraception use did not attain the target. ‘Tabulin’ (savings for giving birth time) and blood donor collection was not performed. Program socialization to the community and cross sectors was still insufficient. The number of midwives was still insufficient. Facilities were still insufficient, and no funding allocation for socialization activity was provided. Management control from Ambon city health office and head of puskesmas was inadequate. Communication forum for P4K was not performed by midwives. Commitment and attitude of P4K executor midwives were good. No standard operating procedure (SOP) for P4K implementation was provided. Implementation of P4K by midwives in Ambon city was insufficient. It was caused by no local policy that supported P4K; lack of communication to the community; insufficient number of midwives, facilities, and funding; inadequate management control by Ambon city health office; and no SOP for P4K implementation. Key words : Implementation of delivery planning and complication prevention program (P4K), midwives, facilities Bibliography : 35 (1999-2011)