Analisis Faktor-Faktor yang Berhubungan dengan Implementasi Manajemen BBLR Sehat oleh Bidan Desa di Kabupaten Purbalingga Tahun 2013

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2014 ABSTRAK Ema Wahyu Ningrum Analisis Faktor-Faktor yang Berhubungan dengan Implementasi Manajemen BBLR Sehat oleh Bidan Desa di Kabupaten Purbalingga Tahun 2013 xvi + 133 halaman + 27 tabel + 3 gambar + 11 lampiran Angka kejadian BBLR dan kematian akibat BBLR di Kabupaten Purbalingga tahun 2010-2012 cenderung meningkat walaupun sebagian besar BBLR lahir terklasifikasi BBLR sehat. Manajemen BBLR sehat merupakan salah satu upaya untuk menurunkan angka kematian bayi akibat BBLR. Tujuan penelitian menganalisis faktor-faktor yang berhubungan dengan implementasi manajemen BBLR sehat oleh bidan desa di Kabupaten Purbalingga. Jenis penelitian adalah observasional analitik dengan pendekatan cross sectional. Populasi penelitian seluruh bidan desa yang telah mengikuti pelatihan manajemen BBLR. Responden yaitu 36 bidan desa yang dipilih secara acak dari semua puskesmas di Kabupaten Purbalingga. Pengumpulan data dengan wawancara menggunakan kuesioner terstruktur dan observasi. Variabel terikat: implementasi manajemen BBLR sehat; variabel bebas: komunikasi, sumberdaya (tenaga dan dana), disposisi dan struktur birokrasi. Analisis bivariat dengan uji chi square dan Fisher’s Exact, analisis multivariat dengan regresi logistik berganda. Hasil penelitian menunjukkan rerata umur responden 33,1±5,5 tahun dan masa kerja 11,2±5,5 tahun, semua responden berpendidikan DIII Kebidanan. Implementasi sebagian besar baik (72,2%), komunikasi sebagian besar baik (55,6%), sumberdaya tenaga sebagian besar baik (52,8%), sumberdaya dana sebagian besar kurang (69,4%), disposisi sebagian baik (50%), struktur birokrasi sebagian besar baik (61,1%). Komunikasi (p=0,002), sumberdaya tenaga (p=0,025), sumberdaya dana (p=0,016), disposisi (p=0,026) dan struktur birokrasi (p=0,026) berhubungan dengan implementasi manajemen BBLR Sehat. Komunikasi (Exp(B)=31.627,p=0,006) dan sumberdaya tenaga (Exp(B)=10.550,p=0,032) bersama-sama berpengaruh terhadap implementasi manajemen BBLR sehat. Disarankan kepada dinas kesehatan kabupaten, bidan koordinator untuk meningkatkan komunikasi yang efektif kepada bidan desa. Selain itu juga agar bidan desa meningkatkan pengetahuan dan ketrampilan Perawatan Metode Kanguru (PMK) dan Pencegahan Infeksi (PI). Kata Kunci : Implementasi, Manajemen BBLR sehat, Bidan Desa. Pustaka : 35 (2002-2012) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2014 ABSTRACT Ema Wahyu Ningrum Analysis of Factors Relating to the Management Implementation of Healthy Low Birth Weight Babies by Village Midwives in District of Purbalingga in 2013 xvi + 133 pages + 27 tables + 3 figures + 11 enclosures The incidence of low birth weight (LBW) babies and infant mortality rate (IMR) due to LBW in District of Purbalingga in 2010-2012 tended to increase even though most of them were classified as healthy LBW babies. Management of healthy LBW babies is one of the efforts to decrease IMR due to LBW. This research aimed to analyze factors relating to the management implementation of healthy LBW babies by village midwives in District of Purbalingga. This was analytical observational study research with cross-sectional approach. Research population was all midwives who had followed the training of the LBW management. Number of respondents were 36 village midwives selected randomly from all health centers in District of Purbalingga. Data collection used a structured questionnaire and an observing method. Implementation management of health LBW babies was as a dependent variable. On the other hand, independent variables consisted of communication, resources (human and fund), disposition, and bureaucratic structure. Furthermore, data were analysed using bivariate analyses consisted of Chi Square test and Fisher’s Exact test and multivariate analyses (Multiple Logistic Regression test). The result of this research showed that respondents had mean age 33.1±5.5 years old and mean working period 11.2±5.5 years. All respondents graduated from DIII Midwifery. Most of the respondents had good implementation (72.2%), good communication (55.6%), good human resource (52.8%), and good bureaucratic structure (61.1%). In contrast, most of them did not have sufficient funds (69.4%) and part of them had good disposition (50.0%). Factors of communication (p=0.002), human resource (p=0.025), fund resource (p=0.016), disposition (p=0.026), and bureaucratic structure (p=0.026) had significant relationship with the management implementation of healthy LBW babies. Furthermore, the factors of communication (Exp(B)=31.627; p=0.006) and human resource (Exp(B)=10.550; p=0.032) jointly influenced the management implementation of healthy LBW babies. As suggestions, District Health Office and Coordinator Midwife need to improve communication effectively to village midwives. In addition, village midwives need to improve their knowledge and skills of Kangaroo Mother Care (KMC) and Infection Prevention. Key Words : Implementation, Management of Health LBW Babies, Village Midwife Bibliography : 35 (2002 – 2012)