Analisis Mutu Pelayanan Obstetri Neonatal Emergensi Dasar (PONED) oleh Petugas di Puskesmas Lau Kabupaten Maros Tahun 2012

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Nurdiana Analisis Mutu Pelayanan Obstetri Neonatal Emergensi Dasar (PONED) oleh Petugas di Puskesmas Lau Kabupaten Maros Tahun 2012 169 hal + 23 tabel + 9 gambar + 15 lampiran Salah satu kebijakan pemerintah dalam akselerasi penurunan AKI adalah melalui program PONED pada puskesmas rawat inap untuk menanggulangi kasus kegawatdaruratan obstetri dan neonatal. Di Puskesmas Lau masih ada kematian ibu pada persalinan yang diakibatkan oleh kegawatdaruratan obstetri. Tujuan penelitian adalah melakukan analisis mutu PONED oleh petugas di Puskesmas Lau Kabupaten Maros tahun 2012. Jenis penelitian ini menggunakan rancangan kualitatif, dalam bentuk studi kasus. Informan utama penelitian adalah semua petugas yang terlatih PONED di Puskesmas Lau. Informan Triangulasi terdiri d.ri Provider dan pasien. Data dikumpulkan dengan wawancara mendalam dan selanjutnya dilakukan pengolahan data menggunakan metode analisis isi (content analysis). Hasil penelitian menunjukkan bahwa mutu PONED oleh petugas dari segi aspek Tangible belum sesuai dengan standar, baik dari segi kualitas petugas, fasilitas bangunan, fasilitas peralatan dan dana. Aspek Reliability belum memenuhi standar, dalam hal alur pelayanan, pelaksanaan tugas belum sesuai kewenangan, pelaksanaan tindakan belum sesuai SOP serta petugas belum melaksanakan prosedur rujukan dengan baik. Aspek Responsiveness belum optimal karena respon terhadap keluhan pasien/anggota keluarga masih kurang, baik pada situasi dan kondisi yang dialami maupun yang berkaitan dengan pelayanan. Aspek Assurance belum optimal, dalam hal keterampilan petugas yang masih kurang, belum meyakinkan pasien/anggota keluarga, penggunaan pelindung diri. Aspek Empathy belum optimal dalam hal penjelasan kepada pasien/anggota keluarga, namun sudah berempati tanpa membedakan latar belakang sesuai Budaya Bugis “ sipakatau” Disimpulkan bahwa Mutu Pelayanan Obstetri Neonatal Emergensi Dasar oleh petugas masih belum sesuai standar dalam aspek Tangible, Reliability, Responsiveness, Assurance, dan Empathy, walaupun berbagai upaya sudah dilakukan melalui pelatihan dan supervisi oleh Dinas Kesehatan. Kata Kunci : Pelayanan Obstetri Neonatal Emergensi Dasar, petugas Kepustakaan : 40 ( 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 Nurdiana Analysis on the Service Quality of Basic Neonatal and Obstetric Emergency Care by Health Workers in Lau Primary Healthcare Center, Maros District, South Sulawesi, 2012 169 pages + 23 tables + 9 figures + 15 enclosures One of government policies to accelerate maternal mortality rate (AKI) reduction was a neonatal obstetrical basic emergency service (PONED) program. This program was implemented in the primary healthcare center (puskesmas) with inward room facility to solve neonatal and obstetrical emergency cases. Maternal death when giving birth due to obstetrical emergency case was found in Lau puskesmas. Objective of this study was to analyze the quality of PONED done by health workers in Lau puskesmas in Maros district in the year of 2012. This was a qualitative study with case study design. Main informants were all PONED trained workers in Lau puskesmas. Triangulation informants were provider and patients. Data were collected through in-depth interview, and then it was analyzed by applying content analysis method. Results of the study showed that based on tangible aspect: PONED quality by workers was not done according to the standard of workers quality, building facility, instrument and funding facilities. Reliability aspect did not suit with the standard. Service path and job implementation were not done according the authority; actions was not done according to standard operating procedure (SOP), and workers did not do proper referral procedure. Responsiveness aspect was not optimal due to insufficient response toward patients/ their family member complaints. The complaints included conditions or services experienced by patients/ their family member. Assurance aspect was not optimal. Workers ability was insufficient; they did not convince family member of patients; they did not use personal protective device. Empathy aspect was not optimal with regard to giving explanation to family member of patients. Conversely, respondents had already given empathy without discriminating patient’s background according to Bugis culture ‘sipakatau’. In conclusion, the quality of neonatal obstetrical basic emergency service by health workers did not suit with the standard of tangible, reliability, responsiveness, assurance, and empathy aspects even though many efforts had been done such as training and supervision by district health office. Key words : neonatal obstetrical basic emergency service, health worker Bibliography : 40 (1999-2011)