Analisis Kinerja Bidan Puskesmas dalam Pelayanan MTBS di Wilayah Puskesmas Kota Malang

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Yuniar Angelia Puspadewi Analisis Kinerja Bidan Puskesmas dalam Pelayanan MTBS di Wilayah Puskesmas Kota Malang 105 halaman + 26 tabel + 3 gambar + 17 lampiran Untuk meningkatkan kualitas dan akses pelayanan kesehatan bagi bayi baru lahir dan bayi dan anak balita kegiatan yang dilakukan adalah melalui penerapan Manajemen Terpadu Balita Sakit (MTBS). Hasil pelaksanaan kegiatan MTBS di Kota Malang yang berupa cakupan hasil kegiatan pelayanan MTBS balita pada tahun 2010 yaitu 58,07 % dan pada tahun 2011 mengalami penurunan yaitu 49, 38%. Hal ini memperlihatkan bahwa cakupan pelayanan MTBS di Kota Malang masih dibawah target yaitu 80 %. Berdasarkan survei pendahuluan didapatkan kinerja bidan puskesmas dalam pelayanan MTBS masih belum optimal. Penelitian ini bertujuan untuk menganalisis kinerja bidan puskesmas dalam pelayanan MTBS di wilayah puskesmas Kota Malang. Jenis penelitian adalah observasional kualitatif. Informan utama adalah bidan puskesmas yang diambil dari 4 Puskesmas dengan cakupan pelayanan MTBS tertinggi dan terendah, masing-masing 2 orang. Informan triangulasi adalah Kepala Puskesmas, Kasie. KIA Dinas Kesehatan dan ibu balita. Data dikumpulkan dengan wawancara mendalam dan observasi terhadap pelayanan MTBS. Pengolahan metode content analysis. Hasil penelitian menunjukkan bahwa belum semua bidan dilatih MTBS, kinerja Bidan Puskesmas dalam pelayanan MTBS belum dilaksanakan sesuai standar pelayanan MTBS baik dari persiapan alat, pemberian pelayanan dan penerapan jadual pelayanan MTBS, ketersediaan tenaga dan fasilitas belum memenuhi, serta pemanfaatan alat belum semuanya dimanfaatkan. Kebutuhan supervisi belum sesuai dengan kebutuhan Bidan Puskesmas yaitu terjadual dan rutin berkaitan dengan kegiatan pelayanan MTBS. Disarankan kepada Kepala Puskesmas dan Dinas Kesehatan untuk memberikan pelatihan MTBS bukan hanya kepada bidan dan dokter melainkan perawat yang juga sebagai petugas, melakukan supervisi secara berkala untuk meningkatkan kualitas, kuantitas dan ketepatan waktu dalam pelayanan MTBS. Meningkatkan pengetahuan dan kemampuan seperti seminar, diklat, pelatihan teknis dan sosialisasi standar secara berkala. Kata Kunci : Pelayanan MTBS, Bidan Puskesmas, Kinerja Jumlah Pustaka : 57 (1991 – 2011) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2013 ABSTRACT Yuniar Angelia Puspadewi Analysis on Midwives Performance in Integrated Management of Childhood Illness (IMCI) Services at Primary Healthcare Centers 105 pages + 26 tables + 3 figures + 17 enclosures Activities that had to be done to improve quality and accessibility of health service for the newborns, infants and under-five children were the implementation of integrated management of healthy under-five children (MTBS). Results of the implementation of MTBS activities in Malang city were MTBS coverage for 2010 (58.07%), and it decreased in 2011 (49.38%). This showed that the coverage of MTBS service in Malang city was still below the target (80%). Based on a preliminary survey, work performance of primary healthcare center (puskesmas) midwives in MTBS service was not optimal. Objective of this study was to analyze the work performance of puskesmas midwives in MTBS service in the puskesmas area of Malang city. This was an observational qualitative study. Main informants were puskesmas midwives from 4 puskesmas with the highest and the lowest MTBS service coverage. Two people were selected from each puskesmas. Triangulation informants were heads of puskesmas, a head of maternal and children health unit of local district health office, and mothers of under-five children. Data were collected through in-depth interview and observation on MTBS service. Content analysis was applied in the data analysis. Results of the study showed that not all midwives had been trained regarding MTBS; puskesmas midwives had not conducted MTBS service properly according to MTBS service and equipment preparation standards; MTBS services were not done according to the schedule; availability of human resource and facilities was inadequate; not all instruments were utilized. Supervision was not conducted according to the need of puskesmas midwives; MTBS service activities should be scheduled and routinely conducted. Head of puskesmas and district health office are suggested to conduct MTBS training not only to midwives and physicians but also for nurses; to conduct routine supervision to improve the quality, quantity, and time precision in conducting MTBS services; to improve knowledge and skills including seminars, education and trainings, technical training, and routine socialization of the standard. Key words : MTBS service, puskesmas midwives, work performance Bibliography : 57 (1991-2011)