Analisis Perbedaan Faktor Determinan Pemilihan Tempat Persalinan Ibu (Fasilitas Kesehatan dan Non Fasilitas Kesehatan) di Kabupaten Kendal

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan 2015 ABSTRAK Sri Ekowatiningsih Analisis Perbedaan Faktor Determinan Pemilihan Tempat Persalinan Ibu (Fasilitas Kesehatan dan Non Fasilitas Kesehatan) di Kabupaten Kendal xvii + 90 halaman + 28 tabel + 3 gambar + 6 lampiran AKI Kabupaten Kendal masih tinggi (164,9/100.000 kh tahun 2011). Meski persalinan ditolong nakes, namun persalinan non faskes juga tinggi sebesar 14,5% di pedesaan dan 7,7% di perkotaan. Tujuan penelitian menganalisis perbedaan faktor determinan dalam memilih tempat persalinan di faskes atau non faskes oleh ibu di Kabupaten Kendal. Jenis penelitian observasional dengan pendekatan cross sectional. Responden penelitian 104 ibu bersalin yang dipilih secara purposive dari 12 Puskesmas yang cakupan persalinan non faskes tinggi. Pengumpulan data dengan wawancara menggunakan kuesioner terstruktur. Analisis data dengan uji non parametric Mann-Whitney distribusi data tidak normal dan uji Chi-Square untuk data berskala nominal. Rerata umur ibu yang melahirkan di faskes atau non faskes 25,3tahun, memiliki 2 orang anak. Pekerjaan ibu terutama ibu rumah tangga dan sebagian besar persalinan ditolong nakes.Tidak ada perbedaan lama sekolah antara ibu yang melahirkan di non faskes maupun faskes. Pada ibu yang melahirkan di faskes, pengetahuan (p=0,001), sikap (p=0,001), dukungan keluarga (p=0,001), dukungan nakes (p=0,001) dan dukungan masyarakat (p=0,001) lebih baik dari pada ibu yang melahirkan di non fasilitas kesehatan. Jarak rumah ke fasilitas kesehatan lebih jauh (p=0,001) pada ibu yang melahirkan di non fasilitas kesehatan. Ibu yang mengikuti kelas ibu hamil lebih banyak yang melahirkan di fasilitas kesehatan. Perlu peningkatan sosialisasi tentang persalinan yang aman, pengembangan kelas ibu hamil, dan konseling secara langsung kepada ibu & keluarga. Advokasi lintas sektor yang melibatkan tokoh agama, tokoh masyarakat dan perangkat wilayah sebagai panutannya serta peningkatan kelengkapan sarana prasarana perlu ditingkatkan oleh Dinas Kesehatan Kabupaten. Kata Kunci : Faktor Determinan, Tempat Persalinan, Fasilitas kesehatan, Non fasilitas kesehatan Pustaka : 45 (1982 - 2011) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Administration and Health Policy 2015 ABSTRACT Sri Ekowatiningsih Difference Analysis of Determinant Factors of Choosing a Delivery Place (Health and Non-Health Facilities) in Kendal District xvii + 90 pages + 28 tables + 3 figures + 6 enclosures Maternal Mortality Rate (MMR) in Kendal District was high in 2011 namely 164.9/100,000 live births. Most of delivery process was assisted by health workers. However, delivery place in non-health facilities was also high namely 14.5% in rural areas and 7.7% in urban areas. The aim of this study was to analyse difference of determinant factors among mothers in choosing a delivery place at health or non-health facilities in Kendal District. This was an observational study using cross-sectional approach. Number of respondents were 104 maternal selected purposively from 12 health centres with high coverage of delivery process in non-health facilities. Data were collected using structured questionnaires and analysed using non-parametric tests, namely Mann-Whitney and Chi-Square. Respondents had average age of 25.3 years old, had two children, worked as a housewife, and most of delivery processes were assisted by health workers. There was no difference in educational background between mothers who gave birth in health facilities and mothers who gave birth in non-health facilities. Among mothers who confined in health facilities, variables of knowledge (p=0.001), attitude (p=0.001), family support (p=0.001), health worker support (p=0.001), and community support (p=0.001) were better than that of mothers who confined in non-health facilities. Distance of a house to health facilities was more (p=0.001) among mothers who gave birth in non-health facilities. Most of mothers who attended a pregnant women class confined in health facilities. There needs to socialise regarding safe delivery process, develop pregnant women class, and provide direct counselling for mothers and families. Inter-sector advocacy needs to be conducted by involving religion leaders, community leaders, and local government officers. In addition, District Health Office needs to complete facilities. Key Words : determinant factor; delivery place; health facility; non-health facility Bibliography : 45 (1982-2011)