Analisis Faktor yang Mempengaruhi Keikutsertaan Bidan Praktek Swasta dalam Program Jaminan Persalinan di Surabaya

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Sefisa Andri Ratama Analisis Faktor yang Mempengaruhi Keikutsertaan Bidan Praktek Swasta dalam Program Jaminan Persalinan di Surabaya 128 halaman + 26 tabel + 6 gambar + 7 lampiran Hampir semua Bidan Praktek Swasta di Surabaya sudah memenuhi persyaratan untuk mengikuti program Jampersal namun kenyataannya keikutsertaan Bidan Praktek Swasta masih rendah. Hal ini dapat berdampak pada terlambatnya penurunan AKI dan AKB. Tujuan penelitian ini adalah menganalisis faktor yang mempengaruhi keikutsertaan Bidan Praktek Swasta dalam program Jampersal di Surabaya. Jenis penelitian observasional analitik dengan pendekatan cross sectional yang dilakukan secara kuantitatif dan kualitatif. Jumlah responden yang diteliti 74 Bidan Praktek Swasta yang dipilih secara clustered random sampling berdasarkan wilayah kerja Puskesma. Pengumpulan data dengan wawancara menggunakan kuesioner terstruktur untuk menganalisis faktor yang mempengaruhi keikutsertaan Bidan Praktek Swasta dan wawancara mendalam untuk mendapatkan informasi mendalam tentang kebijakan lokal, proses klaim Jampersal dan dukungan profesi terhadap program Jampersal. Data kuantitatif dianalisis menggunakan chi square dan regresi logistik, data kualitatif dianalisis dengan content analysis. Hasil penelitian menunjukkan bahwa 66,2% responden tidak mengikuti program Jampersal, 50% responden memiliki pengetahuan baik, 75,7% responden memiliki sikap baik, 68,9% responden memiliki motivasi tinggi, 77% responden menyatakan imbalan Jampersal kurang, 62,2% responden menyatakan persaingan antar BPS rendah, 71,6% responden memiliki persepsi klaim Jampersal sulit dan 67,6% responden menyatakan adanya dukungan profesi. Faktor yang berhubungan dengan keikutsertaan Bidan Praktek Swasta dalam program Jampersal adalah motivasi (p = 0,01), imbalan (p = 0,000), konflik/persaingan (p=0,000) dan persepsi terhadap klaim Jampersal (p = 0,007). Faktor yang bersama-sama berpengaruh terhadap keikutsertaan Bidan Praktek Swasta dalam program Jampersal adalah motivasi, imbalan, persaingan dan persepsi klaim Jampersal. DKK tidak mewajibkan Bidan Praktek Swasta mengikuti program Jampersal. Proses klaim Jampersal dipengaruhi oleh kelengkapan dan kesesuaian pengisian format serta banyaknya klaim yang diajukan. IBI sangat mendukung keikutsertaan Bidan Praktek Swasta dalam program Jampersal, tetapi teman seprofesi tidak mendukung Saran yang dapat diberikan untuk meningkatkan keikutsertaan Bidan Praktek Swasta dalam program Jampersal adalah meningkatkan sosialisasi Jampersal dan memberikan kemudahan dalam proses klaim. Kata Kunci : Bidan Praktek Swasta, Jaminan Persalinan, Keikutsertaan, motivasi Kepustakaan : 37 (1994-2012) 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 Sefisa Andri Ratama Analysis on Factors Related to Private Practice Midwives Participation in Delivery Assurance Program in Surabaya, 2012 128 pages + 26 tables + 6 features + 7 enclosures Almost all private practice midwives (BPS) in Surabaya were eligible to participate in the delivery assurance (Jampersal) program; however, in reality, participation of private practice midwives was low. This condition could delay the decrease of maternal mortality rate (AKI) and infant mortality rate (AKB). Objective of this study was to analyze factors affecting participation of private practice midwives in Jampersal program in Surabaya. This was an observational analytical study with cross sectional approach. In addition, the study was also applying qualitative and quantitative method. The number of respondents was 74 private practice midwives selected using clustered random sampling method based on primary healthcare center (puskesmas) work area. Data were collected through interview guided by structured questionnaire to obtain information on factors affecting participation of private practice midwives; in-depth interview was done to obtain information on the local policy, process of Jampersal claim, and support on Jampersal program from midwifery profession. Chi square test and logistic regression were applied to analyze quantitative data; content analysis was applied in the analysis of qualitative data. Results of study showed that 66.2% of respondents did not participate in the Jampersal program, 50% of respondents had good knowledge; 75.7% of respondents had good attitude; 68.9% of respondents had high motivation; 77% of respondents stated that Jampersal incentive was insufficient; 62.2% of respondents stated that competition among BPS was minimal; 71.6% of respondents’ perception on Jampersal claim were difficult; 67.6% of respondents stated that they obtain support from midwifery profession. Factors related to participation of BPS in the Jampersal program were motivation (p= 0.01), incentive (p= 0.000), conflict or competition (p= 0.000), and perception on the Jampersal claim (p= 0.007). Factors, in common, affecting participation of private practice midwives in the Jampersal program were motivation, incentive, competition, and perception on Jampersal claim. District health office stated that participatory in the Jampersal program was not compulsory. Jampersal claim process was influenced by completeness and appropriateness of fulfilling forms and the number of proposed claims. IBI supported participation of BPS in the Jampersal program; however, BPS colleagues did not support. Suggestions for improving participation of private practice midwives are to improve Jampersal socialization, and to give dispensation in the process of claiming. Key words : private practice midwives, delivery assurance, participation, motivation Bibliography : 37 (1994-2012)