Analisis Implementasi Program Pelayanan Antenatal Terpadu pada Ibu Hamil dengan Malaria di Puskesmas Tobelo Kabupaten Halmahera Utara Provinsi Maluku Utara

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Anna Mieke Analisis Implementasi Program Pelayanan Antenatal Terpadu pada Ibu Hamil dengan Malaria di Puskesmas Tobelo Kabupaten Halmahera Utara Provinsi Maluku Utara xi + 94 halaman + 6 tabel + 5 gambar + 19 lampiran Pelayanan antenatal pada ibu hamil dengan malaria merupakan bagian dari pelayanan antenatal terpadu yang difokuskan pada penanganan malaria ibu hamil melalui deteksi dini, pengobatan dan pencegahan malaria serta komplikasinya. Tujuan Penelitian ini adalah untuk menganalisis implementasi pelayanan antenatal terpadu malaria pada ibu hamil dari aspek komunikasi, disposisi, ketersediaan sumberdaya dan struktur birokrasi di Puskesmas Tobelo Kecamatan Tobelo Kabupaten Halmahera Utara Provinsi Maluku Utara. Jenis penelitian adalah observasional dengan pendekatan kualitatif. Pemilihan informan dengan cara purposive, data dikumpulkan melalui wawancara mendalam (indepth interview) pada informan utama 2 bidan desa, 8 informan triangulasi terdiri dari 1 bidan koordinator, 1 kepala puskesmas,1 petugas pemberantasan penyakit menular, 1 kepala seksi kesehatan keluarga, 1 kepala seksi pemberantasan penyakit menular dan 3 orang ibu hamil dengan malaria. Analisis data menggunakan metode analisis isi (content analysis). Hasil penelitian menunjukkan bahwa belum semua bidan yang bertugas memberikan terapi obat anti malaria (OAM) pada ibu hamil dengan malaria sesuai tatalaksana. Komunikasi pemberi informasi tentang pelayanan antenatal terpadu pada ibu hamil dengan malaria melalui pimpinan, tenaga bidan untuk melaksanakan pelayanan antenatal terpadu malaria masih kurang. Disposisi/ sikap bidan ditunjukkan dengan keinginan dan kemauan dalam mensosialisasikan pelayanan antenatal terpadu malaria. Namun dalam pemberian OAM, bidan masih ragu karena pernah mengalami kematian ibu hamil dengan malaria yang diberi OAM. Belum adanya SOP dan pelatihan sudah diberikan tetapi belum semua bidan mengikutinya. Disimpulkan bahwa pelayanan antenatal terpadu malaria pada ibu hamil belum dilaksanakan oleh bidan sesuai pedoman penanganan dan pencegahan malaria pada ibu hamil. Hal ini dipengaruhi kurangnya tenaga bidan dan belum adanya SOP yang jelas dan banyak bidan yang belum mengikuti pelatihan tentang pencegahan dan penanganan malaria pada ibu hamil. Kata Kunci : Pelayanan Antenatal Terpadu, Ibu Hamil Malaria 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 2013 ABSTRACT Anna Mieke Analysis on the Implementation of Integrated Antenatal Care and Malaria Program at Tobelo Primary Healthcare Center North Halmahera District, North Maluku Province xi + 94 pages + 6 tables + 5 figures + 19 enclosures Antenatal service for pregnant women with malaria was a part of integrated antenatal service. This service was focused on the management of pregnant women with malaria through early detection, treatment and prevention of malaria and the complication of malaria. Objective of the study was to analysis the implementation of malaria integrated antenatal service for pregnant women viewed from communication, disposition, availability of resources and bureaucracy structure aspects in Tobelo primary healthcare center (puskesmas), Tobelo sub district, North Halmahera district, province of North Maluku. This was an observational study with qualitative approach. Informants were selected using purposive method. Data were collected through in depth interview to main and triangulation informants. The main informants were 2 village midwives. The triangulation informants were 8 people: 1 coordinator midwives, 1 head of puskesmas, 1 staff of communicable disease control unit, 1 head of family health section, 1 head of communicable disease control unit, and 3 pregnant women with malaria. Content analysis method was applied in the data analysis. Results of the study showed that not all on duty midwives gave anti malaria drugs (OAM) to pregnant women with malaria according to the procedure. Communication among health workers who gave information about integrated antenatal service to pregnant women was through the leader. The number of midwives who conducted malaria integrated antenatal service was still insufficient. Disposition or midwives attitude was shown by willingness of midwives in conducting socialization of malaria integrated antenatal service. However, in distributing OAM, midwives were still reluctant to distribute OAM because the experience of maternal with malaria who died after being given OAM. No SOP was provided. Training had been conducted, but not all midwives attended in the training. In conclusion, malaria integrated antenatal service to pregnant women had not been implemented by midwives according to the guideline on the management and prevention of malaria for pregnant women. This was influenced by insufficient number of midwives, no clear SOP was provided, and many midwives had not attended in the training regarding prevention and management of malaria for pregnant women. Key words : integrated antenatal service, pregnant women with malaria Bibliography : 39 (1996-2012)