Analisis Determinan Kualitas PelayananAntenatal Trimester I (Satu) Kehamilan Oleh Bidan Desa Di Kabupaten Temanggung

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Manajemen Kesehatan Ibu dan Anak 2017 ABSTRAK Retno Wulandari Analisis Determinan Kualitas PelayananAntenatal Trimester I (Satu) Kehamilan Oleh Bidan Desa Di Kabupaten Temanggung xvi+ 115 halaman + 27 tabel + 4 gambar + 13 lampiran Tingginya capaian cakupanprogram pelayanan kesehatan ibu dan anak (KIA) belum berpengaruh terhadap penurunan jumlah kasus kematian ibu di Kabupaten Temanggung. Penyebab kematian ibu terbanyak adalah karena penyakit penyerta yang seharusnya dapat terdeteksi pada pemeriksaan antenatal trimester pertama yang dilakukan oleh bidan desa. Penelitian ini bertujuan untuk menganalisis kualitas pelayanan antenatal trimester 1 kehamilan oleh bidan desa di Kabupaten Temanggung. Metode penelitian adalah survey analitik dengan design cross sectional. Subjek penelitian adalah 60 orang bidan desa yang dipilih secara systematic random sampling dari 14 Puskesmas terpilih kasus kematian ibu. Pengumpulan data dilakukan dengan angket dan observasi langsung menggunakan kuesioner terstruktur, kualitas pelayanan ANC dinilai dengan ketepatan pelayanan bidan dalam pemberian pelayanan ANC sesuai standar asuhan kebidanan dan standar operasional 10 T ANC, dan analisis data menggunakan uji chi square. Hasil penelitian menunjukkan faktor yang berhubungan dengan kualitas pelayanan antenatal trimester I kehamilan oleh bidan desa adalah beban kerja(p = 0,002), pengetahuan tentang asuhan pelayanan ANC(p = 0,006) dan persepsi supervisipelayanan KIA (p = 0,002). Faktor yang tidak berhubungan adalah dana (p = 0,570), ketersediaan dan pelaksanaan SOP(p = 0,164), dan ketersediaan peralatan(p = 0,251). Ada hubungan bersama-sama variabel beban kerja(p = 0,002)pengetahuan responden(p = 0,006) dansupervisi(p = 0,002)dengan kualitas pelayanan Antenatal Trimester I Kehamilan. Hasil uji analisis regresi logistik berganda menunjukkan bahwa beban kerja, pengetahuan dan supervisi secara bersama – sama mempunyai hubungan signifikan terhadap kualitas pelayanan antenatal trimester I Kehamilan. Disimpulkan bahwa determinan kualitas pelayanan antenatal trimester I kehamilan oleh bidan desa di Kabupaten Temanggung adalah beban kerja, pengetahuan, dan supervisi. Disarankan kepada Dinas Kesehatanuntuk mengatur kembali tugas pokok dan fungsi utama bidan, meningkatkan kemampuan bidan dalam mendeteksi penyakit penyerta pada ibu hamil serta meningkatkan kualitas supervisi fasilitatif dengan melakukan umpan balik terhadap permasalahan yang ditemukan. Kata Kunci Pustaka : Kualitas Pelayanan, Antenatal, Bidan Desa : 50 (1992-2015)Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health Management 2017 ABSTRACT Retno Wulandari Determinant Analysis of Antenatal Care Services Quality at the First Trimester of Pregnancy provided by Village Midwives in Temanggung Regency xvi + 115 pages +27 tables + 4 figures + 13 appendices High coverage of a maternal and child health (MCH) service program did not influence to the decrease of maternal mortality rate in Temanggung Regency. The most maternal mortality was due to an accompanying disease that was supposed to be detected in antenatal care (ANC)at the first trimester undertaken by village midwives. This study aimed at analysing a quality of antenatal care at the first trimester of pregnancy provided by village midwives in Temanggung Regency. This was an analytical survey using a cross-sectional approach. Number of respondents were 60 village midwives selected using a technique of systematic random sampling from selected 14 health centres with maternal mortality cases. Data were collected using a questionnaire and direct observation using a structured questionnaire. A quality of ANCservices was assessed by accurateness of ANC services provided by midwives in accordance with a standard of midwifery care and an operational standard of 10 T ANC. Data were analysed using a Chi-Square test. The results of this research showed that factors statistically significantly related to the quality of ANC services at the first trimester of pregnancy provided by village midwives were work burden(p=0.002), knowledge of ANC services (p=0.006)and perception of MCH service supervision (p=0.002). In contrast, factors that were statistically insignificant were funding (p=0.570), availability and implementation of SOP(p=0.164), and availability of equipment (p=0.251). The factors of work burden(p=0.002), knowledge(p=0.006), and supervision(p=0.002)jointly influenced to the quality of ANC services at the first trimester of pregnancy. The results of a logistic regression test demonstrated that work burden, knowledge, and supervision jointly influenced to the quality of ANC services at the first trimester of pregnancy. To sum up, determinants of the quality of ANC services at the first trimester of pregnancy provided by village midwives in Temanggung Regency consisted of work burden, knowledge, and supervision. Health office needs to rearrange main tasks and main functions of midwives, improve midwives’ skills in detecting a companying disease on pregnant women, and improve a quality of facilitative supervision by providing feedback to identified problems. Keywords: Quality of Service, Antenatal, Village Midwife Bibliography: 50 (1992-2015)