Analisis Implementasi Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dalam Menyiapkan Calon Pendonor Darah Siap Pakai oleh Bidan Desa di Kabupaten Pekalongan

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Nur Hidayati Analisis Implementasi Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dalam Menyiapkan Calon Pendonor Darah Siap Pakai oleh Bidan Desa di Kabupaten Pekalongan xvii + 92 halaman + 11 tabel + 3 gambar + 12 lampiran Pekalongan menduduki urutan nomor tujuh kematian Ibu tertinggi di tingkat Jawa Tengah. Adapun penyebab kematian terbanyak kedua 28% karena terjadi perdarahan. Dalam rangka percepatan penurunan AKI dan AKB dengan menfasilitasi dan menyediakan 5 calon pendonor darah siap pakai bagi 1 ibu hamil/bersalin sejak tahun 2013. Untuk itu perlu dilakukan analisis implementasi untuk mengetahui seberapa jauh implementasi kegiatan persiapan calon pendonor darah siap pakai bagi ibu bersalin dalam P4K. Jenis Penelitian adalah kualitatif dengan wawancara mendalam kepada bidan desa aktif dan tidak aktif sebagai Informan utama. Informan triangulasi yaitu Kepala Puskesmas, Kader Kesehatan, Ibu Hamil, dan Donatur. Teknik analisis data dengan analisis konten. Hasil penelitian bahwa implementasi persiapan calon pendonor darah siap pakai telah berjalan di Puskesmas Kesesi I dan Karanganyar. Jumlah sasaran ibu hamil di Kabupaten Pekalongan tahun 2013 sebanyak 16.553 orang. Apabila 1 ibu hamil mendapatkan 5 pendonor darah maka harapan stok darah adalah 82.755 pendonor/tahun. Jika 20% dari jumlah harapan pendonor/tahun maka stok darah untuk ibu hamil/bersalin dan stok darah di Kabupaten Pekalongan aman. Akan tetapi pada kenyataannya masih sangat jauh dari angka aman, pasokan darah sebanyak 5.876 s/d 6.759 kantong. Sedangkan pengeluaran darah sebanyak 5.365 s/d 7.897 kantong. Jumlah pendonor relatif sedikit. Sedangkan untuk Puskesmas Wiradesa dan Tirto I belum melakukan implementasi calon pendonor darah siap pakai hanya pada sebatas sosialisasi. Hal ini membuktikan bahwa pasokan darah di Kabupaten Pekalongan mengalami kekurangan sehingga tidak lepas dari peran bidan desa untuk membantu memperbanyak pasokan darah melalui program persiapan pendonor siap pakai dengan pertimbangan angka kejadian perdarahan pada ibu hamil/bersalin di Kabupaten Pekalongan cukup tinggi. Untuk Dinas Kesehatan dan PMI cenderung kurang aktif dalam melakukan kontrol kegiatan. Puskesmas mempunyai pengaruh cenderung lemah dalam mendukung kegiatan. Disarankan untuk meningkatkan kerjasama antara Dinas Kesehatan, PMI, Puskesmas, bidan desa, penyuluh KB, kader PKK dan tokoh masyarakat dalam melakukan sosialisasi kegiatan. Ada penetapaan prosedur pelaksanaan dan reward bagi bidan desa yang melaksanakan tugasnya. Kata kunci : P4K, Donor Darah, Bidan Desa Kepustakaan : 36 (1992-2013) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Nur Hidayati Implementation Analysis of Delivery Planning and Complication Prevention Program (P4K) in Preparing Prospective Blood Donors by Village Midwife in District of Pekalongan xvii + 92 pages + 11 tables + 3 figures + 12 appendices District of Pekalongan placed seventh rank on maternal mortality in Central Java. The second cause of mortality was due to bleeding (28%). In order to expedite the decrease of maternal mortality rate and infant mortality rate, five prospective blood donors have been provided for each pregnant woman/maternal since 2013. Therefore, implementation analysis needs to be conducted to find out to what extent the activity implementation of preparing prospective blood donors for maternal in a delivery planning and complication prevention program (P4K). This was a qualitative study by conducting indepth interview to both active and inactive village midwives as main informants. Meanwhile, informants for triangulation purpose consisted of head of health centre, health cadres, pregnant women, and donators. Data were analysed using content analysis. The results of this research showed that preparing prospective blood donors had been implemented at Kesesi I and Karanganyar Health Centres. Number of targeted pregnant women in District of Pekalongan in 2013 were 16,553 persons. If each pregnant woman obtained five prospective blood donors, the expected blood stock was 82,755 prospective blood donors/year. If the available stock was 20% of the total prospective blood donors, blood stock for pregnant women/maternal was sufficient. In fact, number of required blood bags were insufficient. It was only 5,876 – 6,759 blood bags whereas the required blood bags were approximately 5,365 – 7,897 blood bags. This problem was due to lack of donators. In contrast, Wiradesa and Tirto I Health Centres had not implemented preparing prospective blood donors. Notwithstanding, socialisation had already been conducted. This means that amount of required blood in District of Pekalongan was insufficient. Therefore, village midwives needed to be actively involved in preparing prospective blood donors. District Health Office (DHO) and Indonesian Red Cross (IRC) were prone to be passive in monitoring the activity. Health Centres tended to be weak in supporting the activity. Cooperation between DHO, IRC, health centre, village midwife, family health field workers, PKK cadres, and community leaders needs to be established and improved in conducting socialisation of the activity. Implementation procedures and rewards for village midwives in doing their duties need to be provided. Keywords : P4K, Blood Donor, Village Midwife Bibliography: 36 (1992-2013)