Faktor Determinan Kinerja Bidan Desa dalam Pelaksanaan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dengan Stiker di Dinas Kesehatan Kabupaten Batang

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Rinayati Faktor Determinan Kinerja Bidan Desa dalam Pelaksanaan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dengan Stiker di Dinas Kesehatan Kabupaten Batang xvii + 90 halaman + 24 tabel + 3 gambar + 14 lampiran Angka Kematian Ibu (AKI) di Kabupaten Batang tiga tahun terakhir (2009 – 2011) meningkat, ini belum sesuai dengan target MDG’s, dimana penyebab kasus kematian ibu sebenarnya dapat dicegah. Hal ini didukung dengan Program P4K, sebagai pelaksana utamanya adalah bidan desa, namun belum semua bidan desa melaksanakan program P4K sesuai standar. Tujuan penelitian ini adalah untuk mengetahui faktor determinan kinerja bidan desa dalam pelaksanaan program P4K dengan stiker di Kabupaten Batang. Jenis penelitian ini adalah observasional dengan metode survey analitik melalui pendekatan cross sectional. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner terstruktur dan lembar observasi. Populasi adalah seluruh bidan desa (191) pengambilan sampel dengan teknik consecutive sampling (130), serta dilakukan cross check pada 19 kader posyandu dan stiker yang terpasang. Analisis univariat menggunakan distribusi frekuensi, Analisis bivariat menggunakan rank spearman dan pearson product momen sedangkan analisis multivariat menggunakan multiple regresi linier. Hasil penelitian didapatkan Sebagian besar responden berpengetahuan (55,4%) dan bersikap (53,1%) baik. Namun dalam hal motivasi (56,2%), persepsi sumber daya (56,9%), desain pekerjaan (52,3%), dan kinerja (53,%) masih kurang. Motivasi terutama pada penghargaan. Persepsi sumber daya terutama dalam hal dana. Desain pekerjaan terutama dalam hal penjelasan tugas. Kinerja terutama pada operasionalisasi, dan peran bidan. Hasil analisis bivariat menunjukan adanya hubungan signifikan antara pengetahuan (p=0,0001), motivasi (p=0,0001), persepsi sumber daya (p=0,0001), desain pekerjaan (p=0,001) dengan kinerja bidan. Hasil multivariat menunjukan bahwa persepsi sumber daya yang memiliki pengaruh paling besar pada kinerja bidan. Direkomendasikan pada DKK Kabupaten Batang untuk meningkatkan dana khusus guna pengadaan sarana prasarana berupa ceklist rapat koordinasi tingkat desa, blangko surat pernyataan kesediaan sarana transportasi, kartu ibu, buku KIA,meningkatkan pengetahuan bidan desa tentang program P4K melalui pertemuan rutin guna membahas program P4K dengan program terkait,dan menyepakati mengisi stiker P4K sesuai dengan standar, mengikutsertakan bidan desa ke pelatihan program P4K, membuat SOP pelaksanaan program P4K di Kabupaten Batang. Kata Kunci : Kinerja Bidan Desa, Program KIA, Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) Kepustakaan : 39, 1996 – 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 Rinayati Determinants of Village Midwives Work Performance in the Implementation of Delivery Planning and Complication Prevention Program with Stickers in Batang District Health Office xvii + 90 pages + 24 tables + 3 figures + 14 enclosures Maternal mortality rate (AKI) in Batang district in the last three years (2009-2011) increased, and this did not meet with MDG’s target. Causes of maternal mortality could be prevented. This was supported by delivery planning and complication prevention (P4K) program. The executor of P4K program was village midwives. However, not all village midwives implemented P4K program according to the standard. The study objective was to identify determinant factors of village midwives work performance in the implementation of P4K program using stickers in Batang district. This was an observational study with survey method and using cross sectional approach. Data were collected through interview guided by structured questionnaire and observation sheet. Study population was all 191 village midwives. Samples were 130 midwives selected using consecutive sampling technique. Cross check was done to 19 posyandu cadres and the existence of attached stickers. Frequency distribution was presented in the univariate analysis. Rank Spearman and Pearson product moment tests were applied in the bivariate analysis. Multiple linear regressions were performed in the multivariate analysis. Results of the study showed that most of respondents (55.4%) had good knowledge and attitude. However, respondent’s motivation (56.2%), perception on resources (56.9%), work design (52.3%), and work performance (53%) were still insufficient. Respondent’s motivation was especially related to rewards. Respondent’s perception on resources was mainly in funding. Respondent’s work design was mainly in explanation of the job. Respondent’s work performance was mainly on operationalization and midwives roles. Results of bivariate analysis showed significant associations between midwives work performance and knowledge (p= 0.0001), motivation (p= 0.0001), perception on resources (p= 0.0001), work design (p= 0.001). Results of multivariate analysis showed that perception on resources was the biggest influence on midwives work performance. Recommendations for Batang district health office were to increase special funding to provide facilities such as coordination meeting checklist in the village level, consent form for providing transportation, maternal cards, KIA books; to improve knowledge of village midwives regarding P4K program through routine meeting to discuss P4K program with related programs; to make agreement to fill stickers according to the standard; to include village midwives in P4K program trainings; to formulate standard operating procedure (SOP) for P4K program implementation in Batang district. Key words : Village midwives work performance, KIA program, delivery planning and complication prevention (P4K) Bibliography : 39, 1996-2012