Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Penanganan Kasus Resiko Tinggi dalam Persalinan pada Peserta Jampersal di Kabupaten Pati

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Anggia Widiari Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Penanganan Kasus Resiko Tinggi dalam Persalinan pada Peserta Jampersal di Kabupaten Pati v + 150 halaman + 30 tabel + 4 gambar + 6 lampiran Jaminan Persalinan (Jampersal) bertujuan untuk menurunkan AKI (Angka Kematian Ibu) melalui peningkatan akses pertolongan persalinan oleh tenaga kesehatan. AKI di Kabupaten Pati meningkat setelah ada program Jampersal. Hasil studi pendahuluan menunjukkan kinerja bidan dalam penanganan kasus resiko tinggi dalam persalinan masih kurang. Tujuan penelitian ini adalah menganalisis faktor-faktor yang berhubungan dengan kinerja bidan desa dalam penanganan kasus resiko tinggi persalinan peserta Jampersal di Kabupaten Pati. Jenis penelitian observasional dengan pendekatan cross sectional. Jumlah populasi adalah seluruh bidan desa di Kabupaten Pati. Responden yang diteliti 81 orang bidan desa yang dipilih secara purposif dengan kriteria inklusi. Pengumpulan data dengan wawancara menggunakan kuesioner terstruktur dan observasi langsung. Data dianalisis secara kuantitatif menggunakan uji rank spearman dan regresi logistik berganda. Hasil penelitian : 53,1% responden mempunyai kinerja kurang, 79 % responden mempunyai pengetahuan baik, 60,5% responden mempunyai masa kerja > 5 tahun, 55,6% responden mempunyai persepsi tentang penghargaan rendah, 51,9% responden mempunyai ketersediaan fasilitas sumberdaya kurang, 54,3% responden mempunyai sikap baik, 67,9% responden mempunyai beban kerja beban berat, 69,1% responden mempunyai persepsi terhadap supervisi baik. Faktor yang berhubungan dengan kinerja bidan desa adalah pengetahuan (p = 0,0001), persepsi terhadap penghargaan (p = 0,0001), ketersediaan fasilitas (p = 0,0001), beban kerja (p = 0,0001), persepsi terhadap supervisi (p = 0,0001). Faktor yang secara bersama-sama berhubungan dengan kinerja bidan desa dalam penanganan kasus resiko tinggi adalah persepsi terhadap penghargaan, ketersediaan fasilitas, beban kerja dan persepsi terhadap supervisi. Kinerja bidan desa dalam penanganan kasus resiko tinggi dalam persalinan masih kurang. Hal ini dipengaruhi oleh persepsi tentang supervisi, ketersediaan fasilitas sumberdaya/peralatan, beban kerja dan persepsi tentang penghargaan yang masih kurang. Kata kunci : Kinerja, Bidan Desa, Jaminan Persalinan, Resiko Tinggi Kepustakaan : 37 (1990-2012) 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 Anggia Widiari Factors Related to the Village Midwives' Work Performance on High Risk Delivery Cares of Delivery Assurance Program Participants in Pati District v + 150 pages + 30 tables + 4 figures + 6 enclosures The purpose of delivery assurance (Jampersal) was to reduce maternal mortality rate (AKI) through improvement of delivery assistance access by healthcare workers. AKI in Pati district increased after Jampersal program. Results of a preliminary study indicated that work performance of midwives in the management of high risk delivery cases was inadequate. Objective of this study was to analyze factors related to work performance of village midwives in the management of high risk delivery cases among Jampersal participants in Pati district. This was an observational study with cross sectional approach. Study population was all village midwives in Pati district. Study respondents were 81 village midwives who were purposively selected based on inclusion criteria. Data collection was conducted through interview guided by structured questionnaire and through direct observation. Data were analyzed quantitatively using rank Spearman test and multiple logistic regressions. Results of the study showed that work performance of 53.1% of respondents was inadequate; 79.0% of respondents had good knowledge; 60.5% of respondents had work period of 5 years or more; 55.6% of respondents had insufficient perception on rewards; 51.9% of respondents had insufficient human resource facilities; 54.3% of respondents had good attitude; 67.9% of respondents had heavy workload; 69.1% of respondents had good perception on supervision. Factors related to work performance of village midwives were knowledge (p = 0.0001), perception on rewards (p= 0.0001), perception on supervision (p= 0.0001), workload (p= 0.0001). Factors that in common were associated with work performance of village midwives in the management of high risk cases were perception on rewards, availability of facilities, workload, and perception on supervision. Work performance of village midwives in the management of high risk delivery cases was still inadequate. This was influenced by inadequate perception on supervision; insufficient availability of facilities, insufficient human resource and instruments; heavy workload, and inadequate perception on rewards. Key words : work performance, village midwives, delivery assurance, high risk Bibliography : 37 (1990-2012)