Faktor-Faktor yang Menpengaruhi Kinerja Bidan Puskesmas dalam Penanganan Ibu Hamil Risiko Tinggi di Kabupaten Pontianak Tahun 2012

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Emy Yulianti Faktor-Faktor yang Menpengaruhi Kinerja Bidan Puskesmas dalam Penanganan Ibu Hamil Risiko Tinggi di Kabupaten Pontianak Tahun 2012 112 halaman + 17 tabel + 3 gambar + 13 lampiran Risiko tinggi kehamilan merupakan keadaan kehamilan yang terjadi penyimpangan dari normal, secara langsung menyebabkan kesakitan dan kematian ibu maupun bayi. Diperlukan deteksi dini oleh tenaga kesehatan dan masyarakat tentang adanya faktor risiko dan komplikasi, serta penanganan yang adekuat sedini mungkin. Berdasarkan data ibu hamil risiko tinggi / komplikasi yang ditangani dari tahun 2008 sampai dengan 2010 kurang dari 50% dibawah target Nasional (80%).Tujuan umum penelitian untuk mengetahui faktor-faktor yang mempengaruhi kinerja bidan puskesmas dalam penanganan ibu hamil risiko tinggi di kabupaten Pontianak Jenis penelitian survey analitik pendekatan cross sectional. Populasi penelitian adalah seluruh bidan Puskesmas 47 orang dari 14 Puskesmas di wilayah kabupaten Pontianak. Variabel bebas pengetahuan, keterampilan, kepemimpinan dan motivasi. Variabel terikat kinerja bidan puskesmas dalam penanganan ibu hamil risiko tinggi. Pengumpulan data dengan wawancara mengunakan kuesioner terstruktur dan pengamatan. Analisis data menggunakan Rank Spearman dan regresi logistik Hasil penelitian mayoritas Bidan Puskemas berusia antara 31 - 40 tahun (68,1%), pendidikan DIII Kebidanan (48,9%), masa kerja antara 11- 20 tahun (63,8%). Kinerja Bidan Puskesmas kategori baik (74,5%), berpengetahuan kurang (89,4%), keterampilan baik (61,7%), kepemimpinan baik (53,2%), motivasi baik (51,1%). Variabel berhubungan dengan kinerja bidan puskesmas dalam penanganan ibu hamil risiko tinggi yaitu pengetahuan (p = 0,018 dan ρ= 0,345) keterampilan (p = 0,014 dan ρ= 0,357), kepemimpinan (p = 0,020 dan ρ= 0,338), motivasi (p = 0,026 dan ρ= 0,325). Hasil analisis multivariat variabel berpengaruh terhadap kinerja bidan puskesmas dalam penanganan ibu hamil risiko tinggi adalah keterampilan (p=0,041). Saran untuk Dinas Kesehatan dan Puskesmas adalah meningkatkan pengetahuan dan ketrampilan bidan puskesmas dalam penangan ibu hamil risiko tinggi dengan pelatihan GDON. Supervisi dan rapat koordinasi minimal 3 bulan. Memberi penghargaan kepada yang berhasil menangani kasus risiko tinggi. Kata Kunci : kinerja bidan, risiko tinggi kehamilan, deteksi resiko tinggi. Kepustakaan : 45, 1985-2011 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 Emy Yulianti Factors Related to the Work Performance of Primary Healthcare Center Midwives in High Risk Pregnancy Care in Pontianak District, 2012 112 pages + 17 tables + 3 figures + 13 enclosures High risk pregnancy was a pregnancy that is not normal; it directly caused pain and death for the mother or the baby. Early detection by health workers and community regarding the existence of risk factors and complication, and also adequate management as earliest as possible is required. Based on data, high risk pregnancy/ complications that had been handled in 2008-2010 were 50%; it was below national target (80%). Objective of the study was to identify factors affecting the work performance of primary healthcare center (puskesmas) midwives in the management of high risk pregnancy in Pontianak district. This was an analytical survey with cross sectional approach. Study population was all 47 staffs of 14 puskesmas in Pontianak district. Independent variables were knowledge, skill, leadership, and motivation. Dependent variable was work performance of puskesmas midwives in the management of high risk pregnancy. Data were collected through interview guided by structured questionnaire and through observation. Rank Spearman and logistic regression were applied in the data analysis. Results of the study showed that puskesmas midwives were in the age group of 31-40 years old (68.1%), D III level of education in midwifery (48.9%), 22-20 years period of work (63.8%), good work performance of puskesmas midwives (74.5%), insufficient knowledge (89.4%), good skills (61.7%), good leadership (53.3%), and good motivation (51.1%). Variables related to work performance of puskesmas midwives in the management of high risk pregnancy were knowledge (p= 0.018 and ß= 0.345), skills (p= 0.014 and β=0.357), leadership (p= 0.020 and ß= 0.338), motivation (p= 0.026 and ß= 0.325). Result of multivariate analysis showed that variable affecting work performance of puskesmas midwives in the management of high risk pregnancy was skills (p= 0.041). Suggestions for district health office and puskesmas are to improve knowledge and skills of puskesmas midwives in the management of high risk pregnancy by conducting GDON training, to do supervision and coordination meeting at least 3 times a month, to provide rewards to midwives who succeed in managing high risk case. Key words : work performance of midwives, high risk pregnancy, high risk detection Bibliography : 45, 1985-2011