Faktor – Faktor yang Mempengaruhi Kinerja Bidan di Desa dalam Kunjungan Neonatus di Wilayah Puskesmas Kabupaten Jepara Tahun 2009

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2009 ABSTRAK Ita Rahmawati Faktor – Faktor yang Mempengaruhi Kinerja Bidan di Desa dalam Kunjungan Neonatus di Wilayah Puskesmas Kabupaten Jepara Tahun 2009 XII + 96 halaman + 14 lampiran Angka Kematian Bayi di Kabupaten Jepara meningkat dari tahun 2006 sebesar 2,3/1.000 kelahiran hidup menjadi sebesar 5,6/1.000 kelahiran hidup pada tahun 2007. Penyebab kematian terbanyak selain BBLR 22,03% disebabkan oleh hipotermi (22,03 %) yang sebenarnya dapat dicegah dengan perawatan bayi yang baik. Di Kabupaten Jepara tahun 2007, 28 % bayi belum mendapat kunjungan neonatus, padahal seharusnya bidan di desa proaktif melakukan kunjungan neonatus minimal dua kali pada semua bayi usia 0 - 28 hari di wilayah kerjanya. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi kinerja bidan di desa dalam kunjungan neonatus di wilayah Puskesmas Kabupaten Jepara tahun 2009. Penelitian observasional survey ini dilaksanakan dengan pendekatan cross sectional. Sampel dalam penelitian ini adalah 65 bidan desa di Kabupaten Jepara yang diambil secara Cluster Random Sampling. Instrumen penelitian menggunakan kuesioner dan lembar observasi. Data primer maupun sekunder diolah dan dianalisis secara univariat dengan distribusi frekuensi dan persentase, bivariat dengan Korelasi Product Moment dan multivariat dengan Regresi Linear. Hasil penelitian menunjukkan bahwa sebagian besar responden memiliki pengetahuan baik (66,2 %), motivasi tinggi (53,8 %), beban kerja berat (52,3 %), fasilitas dalam kunjungan neonatus yang lengkap (55,4 %), persepsi terhadap sistem kompensasi baik (50,8 %), persepsi terhadap sistem supervisi baik (55,4 %), dan kinerja baik (64,6 %). Faktor yang berhubungan dengan kinerja bidan desa dalam kunjungan neonatus di Kabupaten Jepara adalah pengetahuan (p : 0,001), motivasi (p : 0,024), beban kerja (p : 0,032) dan persepsi terhadap supervisi (p : 0,016). Faktor yang tidak berhubungan adalah fasilitas (p : 0,267) dan persepsi terhadap sistem kompensasi (p : 0,353). Faktor yang paling berpengaruh adalah beban kerja (p : 0,009). Disarankan bagi Kepala Puskesmas untuk meningkatkan pengetahuan Bidan Desa terutama tentang kunjungan neonatus melalui sosialisasi buku KIA, MTBM dan panduan resusitasi secara up to date bagi semua Bidan Desa dan supervisi dijadwal sesuai dengan program yang ada; untuk Dinas Kesehatan Kabupaten Jepara, perlu penilaian kinerja secara berkala dan obyektif, mempertegas tupoksi Bidan Desa melalui kebijakan tertulis dan sosialisasi ke perangkat desa; Pemerintah Kabupaten Jepara memberi penghargaan bagi Bidan Desa yang berprestasi. Kata Kunci : Bidan Desa, Kinerja, Kunjungan Neonatus Kepustakaan : 42 (1991 – 2008) Diponegoro University Postgraduate Program Master Program in Public Health Majoring in Health Policy Administration Sub majoring in Maternal and Child Health Management 2009 ABSTRACT Ita Rahmawati Influencing Factors to the Performance of Bidan di Desa in Doing Neonates Visit in the Coverage Area of Puskesmas in Jepara District, 2009 XII + 96 pages + 14 enclosures Infant mortality rate in the district of Jepara had increased from 2.3/1000 live-births in 2006 to 5.6/1000 live-births in 2007. Besides low birth weight, the cause of death was mostly hypothermia (22.03%) which could actually be prevented by good caring for the infants. In 2007 in the district of Jepara twenty eight percent of infants had not received neonates visit while, in fact, Bidan di Desa (midwife in the community) should had been proactively make neonates visit at least twice to all infants aged 0-28 days in her working area. The objective of this study was to know the influencing factors on bidan di desa performance in making neonates visit in the coverage area of puskesmas (primary health center) in Jepara district for the year of 2009. This study was an observational survey with cross sectional approach. Cluster random sampling was performed in this study to 65 bidan di desa in Jepara district. Questionnaire and observation list were used as study instruments. Primary and secondary data were collected, analyzed and presented in the form of frequency distribution and percentage. Statistical tests performed in this study were product moment correlation and linear multivariate regression. Results of this study indicated that most respondents had good knowledge (66.2%), high motivation (53.8%), heavy work load (52.3%), complete facility for neonates visit (55.4%), good perception of compensation system (50.8%), good perception on supervision system (55.4%), good performance (64.6%). Factors associated with the performance of bidan di desa in making neonates visit in Jepara district were knowledge (p: 0.001), motivation (p:0.024), work load (p:0.032) and perception on supervision (p:0.016). Facility (p: 0.267) and perception to the compensation system (p:0.353) were not associated with performance of bidan di desa in making neonates visit in Jepara district. The most influencing factor was work load (p:0.009). It was suggested to the head of Puskesmas to improve the knowledge of bidan di desa, specifically on neonates visit, by socialization of KIA book, MTBM, and by giving an up to date resuscitation guideline for bidan di desa. In addition, supervision should be scheduled according to the currently available programs. At the District Health Office level, routine and objective performance assessment should be conducted; bidan di desa job description (tupoksi) should be made clear through written policy and performing socialization to the village government officers. It is important for bidan di desa who had high achievement to be given reward by Jepara district government. Key words : Bidan di desa, performance, neonates visit Bibliography : 42 (1991-2008)