Evaluasi Pelaksanaan Program Inisiasi Menyusu Dini di RSUD Dr. R. Soetijono Blora

Abstract

UniversitasDiponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Siti Kistimbar Evaluasi Pelaksanaan Program Inisiasi Menyusu Dini di RSUD Dr. R. Soetijono Blora xx + 163 halaman + 3 tabel + 2 gambar + 51 kotak + 12 lampiran Dari tahun 2011 sampai dengan 2013. Angka Kematian Bayi (AKB) di kabupaten Blora semakin meningkat sekitar 3 persen. Sedangkan di RSUD Blora kematian bayi tahun 2011-2013 rata-rata 60 bayi dari 1300 kelahiran, dan sekitar 50% meninggal pada minggu pertama kehidupannya. Salah satu tindakan yang dapat menekan AKB adalah IMD. Berdasarkan survey pendahuluan di RSUD Blora dalam 6 tahun terakhir pelayanan IMD kurang berjalan dengan baik. Tujuan penelitian adalah mengevaluasi pelaksanaan program IMD di RSUD Dr. R. Soetijono Blora ditinjau dari input dan proses. Jenis penelitian adalah observasional kualitatif. Dengan informan utama pelaksana IMD di RSUD Dr. R. Soetijono Blora dan team bidang pelayanan perawatan sebanyak 5 orang. Sedangkan informan triangulasi adalah ibu bersalin normal dan patologis sebanyak 4 orang. Data dikumpulkan dengan wawancara mendalam. Pengolahan data dengan metode content analysis. Hasil penelitian menunjukkan pelaksanaan program IMD di RSUD Dr. R. Soetijono Blora dilaksanakan bila pasien menghendaki dan belum sesuai prosedur. Setiap bayi baru lahir diletakkan di dada ibu dengan posisi mulut bayi diarahkan ke puting susu ibu. Hal tersebut terjadi karena unsur input SDM kompetensi petugas kurang, sebagian besar pelaksana IMD belum pernah pelatihan manajemen laktasi, maupun konselor ASI dan tidak mematuhi SOP, terbatasnya sarana prasarana, kurangnya pemasaran, kurangnya koordinasi antara bidan penolong persalinan dan perawat perinatal, kurangnya penggerakan, dan tidak adanya monitoring dan evaluasi. Di RSUD Blora jugabelum ada kelompok pendukung ASI sebagai syarat RS sayang bayi. Selain itu unsur proses yang mempengaruhi adalah belum ada kebijakan tertulis direktur RS, ketidaktahuan kabid pelayanan tentang program IMD di RSUD Blora karena sejak dinas di RSUD Blora program sudah tidak berjalan, yang berpengaruh pada proses perencanaan dan pelaksanaan. Penelitian ini merekomendasikan beberapa saran untuk rumah sakit yaitu menggalakkan kembali program IMD bekerja sama dengan Dinkes dalam upaya pelatihan dan monitoring evaluasi, meningkatkan koordinasi antar bidang di rumah sakit misal dalam upaya pemasaran program oleh pengembangan informasi, melengkapi sarana prasarana dan memotivasi karyawan mematuhi SOP. Kata Kunci : Pelaksanaan, Inisiasi Menyusu Dini, Evaluasi. Jumlah Pustaka : 53 (2001 – 2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Siti Kistimbar Evaluation of Program Implementation of Early Initiation of Breastfeeding at Dr. R. Soetijono Public Hospital in Blora xx + 163 pages + 3 tables + 2 figures + 51 boxes + 12 enclosures Infant Mortality Rate (IMR) in Blora District increased approximately 3% during the period of 2011 – 2013. At Blora Public Hospital, average infant mortality during the same period was 60 infants per 1,300 childbirths and about 50% died in the first week of their lives. One of the methods to prevent IMR was early initiation of breastfeeding (EIB). A preliminary study at Blora Public Hospital in the past 6 years showed that EIB service was not well implemented. The aim of this study was to evaluate the implementation of EIB program at Dr. R. Soetijono Public Hospital in Blora viewed from aspects of input and process. This was an observational-qualitative study. Main informants consisted of five persons who were practitioners of EIB at Dr. R. Soetijono Public Hospital in Blora and team of nursing services. Informants for triangulation purpose consisted of four mothers who were normal delivery and pathology. Data were collected using indepth interview and analysed using content analysis. The results of this research showed that the implementation of EIB program at the hospital was applied if patients requested and had not followed a procedure. Every baby was put on mother’s breast, baby’s mouth was directed to mother’s nipple. This condition was due to input aspect, namely lack of human resource’s competency. Most of EIB practitioners had not been received training of lactation management or breast milk counsellor and did not obey SOP. There was any limitation in facilities, lack of marketing, and lack of coordination between midwives and perinatal nurses. In addition, there was lack of actuating and no monitoring and evaluation. There was no support group of breast milk at the hospital as a requirement of baby care hospital. In process aspect, there was no written policy of a director. Head of service department did not know the EIB program at the hospital because it was not implemented since working at the hospital in which it influenced the processes of planning and implementing. Key Words : implementation; early initiation of breastfeeding; evaluation Bibliography : 53 (2001-2013)