Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Deteksi Dini Resiko Tinggi Ibu Hamil pada Pelayanan Antenatal di Kabupaten Bengkulu Selatan Tahun 2013

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Harlen Yunita Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Deteksi Dini Resiko Tinggi Ibu Hamil pada Pelayanan Antenatal di Kabupaten Bengkulu Selatan Tahun 2013 xvii + 161 halaman + 43 tabel + 3 gambar + 15 lampiran Pelayanan Antenatal adalah memberikan pelayanan kesehatan bagi ibu hamil dan janinnya sesuai standar minimal 7T serta minimal empat kali pemeriksaan selama kehamilan. Standar waktu tersebut untuk menjamin perlindungan kepada ibu hamil, berupa deteksi dini faktor risiko, pencegahan dan penanganan komplikasi. Berdasarkan cakupan Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS-KIA), angka kematian ibu dan bayi serta survey awal terhadap bidan desa disimpulkan bahwa masih rendahnya kineja bidan desa. Tujuan penelitian adalah mengetahui faktor apa saja yang mempengaruhi kinerja bidan desa dalam deteksi dini resiko tinggi ibu hamil pada pelayanan antenatal. Jenis penelitian bersifat explanatory research dengan pendekatan cross sectional. Pengumpulan data menggunakan kuesioner terstruktur dan observasi. Populasi penelitian adalah bidan desa, dengan sampel 93 responden diambil dengan teknik simple random sampling. Hasil penelitian menunjukkan 73,1% bidan desa pada rentang umur 25-35 tahun dan 37,6% rentang masa kerja 36-60 bulan. Kinerja bidan desa kurang baik (92,5%), pengetahuan kurang baik (83,9%), motivasi kurang baik (73,1%), sarana prasarana baik (61,3%), komunikasi baik (54,8%), persepsi sebagai bidan desa baik (62,4%), persepsi kepemimpinan baik (59,1%), persepsi supervisi bidan koordinator kurang baik (67,7%), persepsi beban kerja yang berat (66,7%). Analisis bivariat dengan tabulasi silang dan uji Pearson Product Moment menunjukkan bahwa variabel yang berhubungan dengan kinerja yaitu pengetahuan (p=0,000), motivasi (p=0,004), perepsi supervisi bidan koordinator (p=0,016), persepsi beban kerja (p=0,047). Analisis multivariat dengan uji regresi logistik berganda menunjukkan adanya pengaruh bersama-sama variabel pengetahuan dan sarana prasarana dengan nilai signifikansi 0,000 dan r² 0,394, berarti 39,4% variabel kinerja dapat dijelaskan oleh variasi dari kedua variabel tersebut. Dinas Kesehatan Kabupaten diharapkan memberi pelatihan, melengkapi sarana prasarana bidan desa sebelum bekerja di desa, membentuk tim atau panitia sebagai wadah konsultasi. Puskesmas agar melengkapi sarana pendokumentasian, kepala puskesmas dan bidan koordinator aktif mengadakan pembinaan. Kata kunci : Kinerja, Deteksi Dini Resiko Tinggi, Pelayanan Antenatal Kepustakaan : 78 (1989-2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2013 ABSTRACT Harlen Yunita Factors influencing Village Midwives’ Performance in doing Early Detection of High Risk Pregnant Women in Antenatal Care Services in District of South Bengkulu in 2013 xvii + 161 pages + 43 tables + 3 figures + 15 enclosures Antenatal care (ANC) is to provide health services for pregnant women and their infants in accordance with a minimum standard of 7T and a minimum of four times examining during pregnancy. The standard is to protect them which consists of early detection of risk factors, prevention, and management of complications. According to coverage of Local Monitoring for Maternal and Child Health, Maternal and Infant Mortality Rate, and preliminary survey towards village midwives, it concluded that their performance was still low. The aim of this research was to identify factors influencing village midwives’ performance in doing early detection of high risk pregnant women in ANC. This was explanatory research with cross-sectional approach. Data collection used a structured questionnaire and observation. Population was village midwives. Number of samples was 93 respondents taken by a technique of simple random sampling. The results of this research showed that 73.1% of respondents were from those in the 25 to 35 age group and 37.6% of them had been working for 36 to 60 months. Mostly respondents had bad performance (92.5%), bad knowledge (83.9%), bad motivation (73.1%), bad perception of coordinator midwife supervision (67.7%), and perception of heavy workload (66.7%). Otherwise, mostly respondents had good means (61.3%), good communication (54.8%), good perception as a village midwife (62.4%), and good leadership perception (59.1%). Cross tabulation and pearson product moment test revealed that variables of knowledge (p=0.000), motivation (p=0.004), perception of coordinator midwife supervision (p=0.016), and perception of workload (p=0.047) had a significant relationship with performance. Moreover, multivariate logistic regression test showed that variables of knowledge and means jointly influenced performance with p-value=0.000 and r2=0.394. It means that 39.4% of the performance could be explained by variation from both variables. As a suggestion, District Health Office needs to provide training, complete tools for midwives before working at a village, and build a team or a committee for consultation. In addition, health centers need to complete means for documentation. Head of health centers and coordinator midwives needs to actively develop village midwives’ skills. Key Words : Perfomance, High Risk Early Detection, Antenatal Care Services Bibliography : 78 (1989-2013)