Evaluasi Pelaksanaan Program Pelayanan Obstetri Neonatal Emergency Dasar (PONED) di Puskesmas Rawat Inap Kabupaten Tegal

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2014 ABSTRAK Seventina Nurul Hidayah Evaluasi Pelaksanaan Program Pelayanan Obstetri Neonatal Emergency Dasar (PONED) di Puskesmas Rawat Inap Kabupaten Tegal xiv + 82 halaman + 7 tabel + 6 gambar + 6 lampiran Kasus kematian ibu di Kabupaten Tegal meningkat dari 38 kasus pada tahun 2011 menjadi 51 kasus pada tahun 2012, walaupun sudah ada lima Puskesmas PONED. Dari lima Puskesmas PONED tersebut ada yang sudah berjalan baik dan ada yang belum. Penelitian ini bertujuan mengevaluasi perbedaan faktor-faktor yang mempengaruhi pelaksanaan PONED di Puskesmas yang berjalan baik dan yang belum berjalan baik. Jenis penelitian adalah observasional kualitatif dengan pendekatan cross sectional. Subjek penelitian terdiri dari informan utama sebanyak enam orang yaitu tim PONED (dokter, bidan dan perawat) dari dua puskesmas dan informan triangulasi lima orang terdiri dari dua ibu hamil risti atau ibu bersalin, dua orang Kepala Puskesmas, dan satu orang Seksi Kesehatan Keluarga DKK. Hasil penelitian menunjukkan bahwa di Puskesmas PONED yang belum berjalan baik jumlah tenaga pelaksana cukup tetapi komitmen kurang khususnya pada kehadiran petugas jaga, kurang aktif dalam pengajuan dana, sarana yang belum memadai, form pencatatan dan pelaporan kurang tertata. Selain itu protap PONED belum tertempel di dinding, jumlah kunjungan sedikit, dan respon time yang terlalu panjang. Puskesmas PONED yang berjalan baik telah melaksanakan jaga shift sesuai jadwal yang telah ditentukan, sumber daya dan sarana prasarana yang memadai dan komitmen tenaga pelaksana cukup baik dalam mendukung program PONED. Direkomendasikan kepada Puskesmas untuk mengefektifkan peran tugas pelaksana, pelatihan PPGD, pengalokasian dana khusus untuk pemenuhan sarana prasarana Puskesmas PONED, penertiban pelaporan dari Puskesmas ke DKK. Direkomenasikan kepada DKK untuk memberikan pembinaan yang intensif dengan pemberian umpan balik kepada Puskesmas PONED di Kabupaten Tegal. Kata kunci : Evaluasi Pelaksanaan PONED Kepustakaan : 35, 2006-2013 Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2014 ABSTRACT Seventina Nurul Hidayah Evaluation of the Program Implementation of Basic Emergency Obstetric and Newborn Care (BEmONC) at Inpatient Health Center in Tegal District xiv + 82 pages + 7 tables + 6 figures + 6 enclosures Maternal Mortality Rate in Tegal District increased from 38 cases in 2011 to 51 cases in 2012 even though there was any five health centers providing Basic Emergency Obstetric and Newborn Care (BEmONC). Some of these health centers had provided good services. This research aimed to evaluate the differences of factors influencing the implementation of BEmONC at health centers with good and bad implementation. This was observational-qualitative research with cross-sectional approach. Subjects comprised six main informants, namely BEmONC team (physician, midwife, and nurse) selected from two health centers. In additions, two high-risk pregnant women or maternal, two heads of health centers, and head of family health section at District Health Office (DHO) were selected as informants for triangulation purpose. The results of this research showed that at a health center which had not well implemented BEmONC yet, number of human resources were sufficient but they did not have a good commitment particularly in terms of the attendance of duty officers, inactive in obtaining funding, insufficient means, and less organized recording and reporting form. In addition, Standard Operating Procedure had been attached on wall, there was a few visit, and response time was too long. In contrast, at a health center which had well implemented BEmONC, duty officers worked in accordance with a schedule, resources and means were sufficient, and commitment of the officers was good to support the program of BEmONC. As a suggestion, heads of health centers need to maximize the role of officers, to conduct training of PPGD, to allocate specific budget to purchasing means of BEmONC at health centers, and to improve reporting from health centers to DHO. Furthermore, DHO needs to supervise intensively by providing feedback to health centers of BEmONC in Tegal District. Key Words : Evaluation of BEmONC Implementation Bibliography : 35 (2006-2013)