Pengaruh Pengawas Minum Obat dan Pemberian Multiple Micronutrient terhadap Kadar Hemoglobin Ibu Hamil (Studi pada Ibu Hamil di Kabupaten Klaten dan Kabupaten Boyolali)

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2014 ABSTRAK Nur Aini Rahmawati Pengaruh Pengawas Minum Obat dan Pemberian Multiple Micronutrient terhadap Kadar Hemoglobin Ibu Hamil (Studi pada Ibu Hamil di Kabupaten Klaten dan Kabupaten Boyolali) xvi + 72 halaman + 14 tabel + 15 lampiran Prevalensi anemia pada ibu hamil di Kabupaten Klaten lebih rendah (31,8%) daripada prevalensi di Kabupaten Boyolali (55,8%). Di Kabupaten Klaten sudah dilakukan program pemberian MMN (Multiple Micronutrient) pada ibu hamil sejak tahun 2011, sedangkan di Kabupaten Boyolali belum. Keberhasilan program untuk menurunkan anemia ibu hamil tersebut dipengaruhi kepatuhan. PMO (Pengawas Minum Obat) dapat meningkatkan kepatuhan dalam mengkonsumsi suplemen. Tujuan penelitian ini adalah untuk menganalisis pengaruh pemberian MMN dan PMO terhadap kadar Hemoglobin pada ibu hamil di Kabupaten Klaten dan Kabupaten Boyolali. Jenis penelitian ini adalah quasi experiment dengan pre and post test design with control group. Ada 3 kelompok yaitu : 1) MMN dengan PMO; 2) Fe dengan PMO; 3) Fe tanpa PMO. Kelompok 1 dilakukan di Kabupaten Klaten dan kelompok 2 dan 3 dilakukan di Kabupaten Boyolali. Pengambilan sampel pada penelitian ini menggunakan purposive sampling dengan kriteria inklusi. Analisis bivariat menggunakan uji Wilcoxon, untuk analisis multivariat menggunakan regresi linier berganda. Hasil penelitian menunjukkan bahwa pemberian MMN meningkatkan kadar hemoglobin lebih tinggi daripada pemberian Tablet Fe (p=0,0001). PMO meningkatkan kepatuhan minum tablet Fe pada ibu hamil (p=0,001). Pemberian MMN dan PMO meningkatkan kadar hemoglobin ibu hamil lebih tinggi daripada pemberian tablet Fe saja (p=0,002) setelah dikontrol dengan asupan dan kepatuhan. Ada peningkatan kadar hemoglobin pada kelompok MMN dengan PMO dari 11,92 gr/dl ± 1,18 SD menjadi 13,25 gr/dl; kelompok Fe dengan PMO dari 11,71 gr/dl ± 0,88 SD menjadi 12,88 gr/dl, kelompok Fe tanpa PMO dari 11,21 gr/dl ± 1,03 SD menjadi 12,58 gr/dl. Disimpulkan bahwa PMO meningkatkan kepatuhan konsumsi MMN dan tablet Fe. MMN meningkatkan kadar hemoglobin lebih tinggi daripada tablet Fe saja. Kata Kunci : Pengawas Minum Obat (PMO), Multiple Micronutrient (MMN), Kadar Hemoglobin (Hb), Ibu Hamil Kepustakaan : 61 (1990 – 2012). 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 2014 ABSTRACT Nur Aini Rahmawati The Influence of Treatment Supervisors and Providing Multiple Micronutrients to Haemoglobin Levels of Pregnant Women (Study on Pregnant Women in District of Klaten and District of Boyolali) xvi + 72 pages + 14 tables + 15 enclosures The prevalence of anaemia in pregnant women in District of Klaten was equal to 31.8% and was lower than the prevalence of anaemia in pregnant women in District of Boyolali (55.8%). In District of Klaten, a program of Multiple Micronutrients (MMN) has been done on pregnant women since 2011, whereas District of Boyolali has not implemented yet. The success of the program was influenced by a factor of adherence. Treatment supervisors (TS) could improve adherence in consuming supplements. This research aimed to analyze the influence of providing MMN and TS to haemoglobin (Hb) levels on pregnant women in District of Klaten and District of Boyolali. This was quasi-experiment research using a pretest-posttest design with control group. There were three groups consisted of as follows: 1) MMN with TS, 2) Fe with TS, and 3) Fe without TS. The first group was investigated in District of Klaten, whereas the two other groups were studied in District of Boyolali. Samples were carried out by using a technique of purposive sampling with inclusion criteria. Furthermore, bivariate analysis used Wilcoxon test and multivariate analysis used multiple linear regression test. The result of this research showed that providing MMN enhanced the Hb levels higher than providing Fe tablets (p=0.0001). TS improve adherence in consuming Fe tablets on pregnant women (p=0.001). Providing MMN and TS increased Hb levels on pregnant women higher than that of providing Fe tablets (p=0.002) after controlling intake and adherence. The increases of Hb levels on a group of MMN with treatment supervisors was from 11.92 gr/dl ± 1.18 SD to 13.25 gr/dl, whereas Hb levels on a group of Fe with TS was from 11.71 gr/dl ± 0.88 SD to 12.88 gr/dl, Hb levels on a group of Fe without TS was from 11.21 gr/dl ± 1.03 SD menjadi 12.58 gr/dl. As a conclusion, TS needs to improve adherence in consuming MMN and Fe tablets. MMN increases Hb levels higher than Fe tablets. Key Words : Treatment Supervisors (TS), Multiple Micronutrients (MMN), Hb levels, Pregnant Women Bibliography : 61 (1990-2012)