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A good quality ANC can reduce maternal mortality.The background of this research is the unknown midwives compliance in Bruno health centers and the unavailability of the baseline data. This study aims to determine the factors that affect midmives compliance in Bruno health centers, Purworejo in 2013. This study used a cross sectional design and quantitative methods.Based on bivariate analysis, there is a significant association between longer working with midwives compliance, very strong association in variable attitudes, strong association in variable facilities and supervision While variable knowledge and training was moderate associaton.
Minimum Service Standards MSS are provisions concerning the quality and type ofbasic services that are mandatory government affairs that are eligible for citizens to beeligible. Based on the profile of the District Health Office of Tanah Bumbu Regency in2017, the achievement of MSS in pregnant women 39 s health service is 72.3 , maternalhealth service 73,8 and newborn health service 64,82 is still under 100 target.This study aims to analyze the determinants of the implementation of Minimum ServiceStandards of Maternal and Child Health MCH Services and the obstacles and effortsare undertaken. This research is a qualitative research with Rapid Assessment Procedure RAP descriptions through primary data collection and secondary data. The result ofthe research shows that the implementation of MSS in the field of health service ofMCH in Tanah Bumbu Regency based on 4 factors affecting the implementation ofcommunication, resources, disposition and bureaucratic structure has not run optimally.The determinant factors affecting the implementation of MSS in Health Service ofMCH Service in Tanah Bumbu Regency is in human resource aspect but influenced byother aspect. Input for Local Government to make regional policy related MSS FieldHealth Service MCH for implementation can be run maximally and thorough.
Tesis ini membahas analisis Pelaksanaan Standar Pelayanan Minimal Rumah Sakit Pada Instalasi Rawat Inap Di RSUD Kabupaten Ciamis Sebelum Dan sesudah Menjadi Badan Layanan Umum Daerah di Tahun 2013. Penelitian ini menggunakan pendekatan kualitatif dengan melakukan wawancara mendalam dari informan terpilih.
Hasil penelitian menunjukkan dari aspek SPO, SDM, sarana prasarana pada instalasi rawat inap sesudah menjadi BLUD lebih lengkap dari segi kuantitas maupun kualitas meskipun dari aspek SPO masih ada tindakan yang tidak sesuai dengan SPO, sedangkan dari aspek SDM masih kekurangan dokter spesialis, dan dari aspek sarana dan prasarana masih kurang dalam sistem pemeliharaannya. Kesimpulannya, pelaksanaan Standar Pelayanan Minimal di instalasi rawat inap belum dilaksanakan secara maksimal, karena keadaan rumah sakit yang masih mempunyai kelemahan dan kekurangan.
Saran peneliti bagi RSUD Kabupaten Ciamis diharapkan dapat lebih bekerja sama dan melakukan koordinasi yang baik dengan pihak Pemerintah Daerah agar dapat dicarikan solusi yang terbaik, dan diperlukan evaluasi berkala SPM agar pelaksanaannya lebih baik.
This thesis studied an analysis of the implementation of Hospital Minimum Service Standards of Ciamis District General Hospital at Inpatient Care Unit which was held before and after becoming Local Public Service Institution in 2013. This research used a qualitative approach by conducting detailed interview to selected interviewees.
The result of the research showed that aspects of SPO, Human Resources, infrastructures at Inpatient Care Unit, viewed after the hospital's becoming Local Public Service Institution are more quantitatively and qualitatively complete although if viewed from SPO there are still acts which are not appropriate with SPO, meanwhile viewed from Human Resources, it is still lack of specialists, and from its infrastructures, it’s maintenance system is regarded still inadequate. The Minimum Service Standards implementation at Inpatient Care Unit has not been maximally implemented because of the hospital's weaknesses and lack.
The researcher suggestion for Ciamis District General Hospital is that hopefuly there will be more cooperative good coordination with the local government in order to find the best solution, and the Minimum Service Standards periodic evaluations is required so that the implementation will be better conducted.
There is an increase in maternal mortality in Indonesia. In 2023, only 57.8% of pregnant women received standardized antenatal care (ANC). In 2022, there were 5 maternal deaths in Pematangsiantar City. The coverage of ANC K6 reached 81.6%, but there were still 230 cases of complications in pregnancy and public health centers (PHC) whose coverage was still below the target. The following study aims to determine the factors that contribute to the low coverage of ANC in several PHCs in Pematangsiantar City. This study used a non-experimental design with a comparative descriptive study. Research informants were selected using purposive sampling and exit poll techniques. Research informants consisted of heads of PHCs, midwives, doctors and pregnant women. The variables are structure (human resources, facilities, disposable medical materials, funding, guidelines) and processes (planning, organizing, implementing, supervising). Data collection through in-depth interviews, observations and document reviews. The results of the study indicate that there is sampling bias. Factors that contribute are planning and implementation of ANC. Cooperation with the Population and Civil Registration Agency (Dukcapil) is needed to access the latest pregnant women data. Also, socialization of the importance of routine ANC visits to increase ANC participation of pregnant women.
Derajat kesehatan masyarakat merupakan salah satu indikator kesejahteraan suatu bangsa. Upaya yang dilakukan di bidang kesehatan adalah dengan meningkatkan umur harapan hidup, dengan cara menurunkan Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB). Dibanding negara- negara ASEAN, AKI dan AKB di Indonesia masih tinggi, demikian juga kondisi AKI dan AKB di Jawa Barat, termasuk di Kabupaten Karawang. Pelayanan antenatal merupakan salah satu intervensi kesehatan yang paling efektif untuk pencegahan kesakitan dan kematian ibu. Kematian ibu dapat dicegah bila komplikasi dan keadaan resiko tinggi kehamilan dapat dideteksi sejak dini melalui pemeriksaan antenatal sedini mungkin. Hasil kegiatan yang dilakukan oleh bidan di desa Kabupaten Karawang dalam pelayanan antenatal (cakupan ANC K1 dan K4), menunjukkan adanya kesenjangan yang tinggi. Hal ini merupakan indikator bahwa kinerja bidan di desa masih belum baik. Tujuan penelitian ini untuk mengetahui hubungan antara pengetahuan, pengalaman, tempat tinggal, motivasi, kelengkapan alat, supervisi dan klasifikasi desa dengan kinerja bidan di desa dalam pelayanan antenatal. Penelitian ini menggunakan rancangan cross sectional, dengan populasi semua bidan di desa sebanyak 305 responden. Sampel penelitian semua populasi, yang berhasil didata sebanyak 289 responden. Pengumpulan data dilaksanakan pada bulan Maret-April 2008, di Kabupaten Karawang, dengan wawancara dan menggunakan kuesioner. Analisis univariat dengan membuat distribusi frekuensi masing-masing variabel, analisis bivariat dengan uji kai kuadrat dan analisis multivariat dengan uji regresi logistik ganda dengan kriteria kemaknaan p<0,05. Hasil penelitian menunjukkan bahwa proporsi bidan di desa yang mempunyai kinerja kurang (49,8%), sedikit lebih rendah dibanding bidan di desa yang mempunyai kinerja baik (50,2%). Hasil analisis bivariat menunjukkan bahwa variabel pengetahuan tentang umur kehamilan dan fokus supervisi berhubungan signifikan dengan kinerja bidan di desa. Hasil analisis multivariat menunjukkan bahwa variabel fokus supervisi berhubungan signifikan dengan kinerja bidan di desa. Bidan di desa dengan fokus supervisi kurang akan berpeluang mempunyai kinerja kurang 1,7 kali lebih besar dibanding bidan di desa dengan fokus supervisi baik. Berdasarkan hasil penelitian, penulis merekomendasikan saran sebagai berikut: Bagi Puskesmas dan Dinas Kesehatan perlu meningkatkan supervisi dengan cara membuat jadwal supervisi, cek list, kemudian didiskusikan, sampai terbentuk formulasi tentang masalah yang ada, menentukan penyebab masalah, prioritas dan membuat langkah- langkah perbaikan, membuat komitmen bersama untuk perbaikan, melakukan pelatihan bagi petugas supervisi, kemudian melakukan uji coba, menilai hasil yang dicapai dan menentukan tindak lanjut berikutnya. Bagi bidan di desa perlu memahami kembali tentang tujuan, wewenang, tugas pokok dan fungsi sebagai bidan di desa, meningkatkan kerjasama, lebih proaktif dan meningkatkan soft skill. Bagi masyarakat perlu kerjasama dan partisipasinya dalam pelayanan antenatal. Bagi peneliti lain perlu dilakukan penelitian tentang fokus supervisi untuk meningkatkan kinerja bidan di desa dalam pelayanan antenatal dengan wawancara independen dan tentang kinerja bidan di desa secara komprehensif. Daftar bacaan : 49 (1980-2008) Kata kunci : Kinerja, Bidan di Desa, Pelayanan Antenatal, Cross Sectional
ABSTRACT The level of public health is one of the indicators related to the wealth of society. One of the efforts being done in the health subject is to increase the age life expectancy by reducing the maternal mortality rate (MMR) and neonatal mortality rate (NMR). Comparing to the other ASEAN countries, Indonesia’s MMR and NMR are still high, and so does for of West Java’s MMR and NMR, including Karawang regency. Antenatal care is one of the most effective health intervention in preventing the maternal morbidity and mortality. Maternal mortality can be prevented, if complication and high risk conditions are detected early by antenatal care. Activity result of village midwives on antenatal care in Karawang regency (including ANC K1 dan K4) shows high discrepancy; which indicates that village midwives performances is not yet good. The research objective is to find out the link between knowledge, experience, residence, motivation, full-equipments, supervision and village classification with village midwives’ performances in the antenatal care. This research of cross sectional program, uses a population of all the village midwives which are 305 respondents. The sample is using all of the population, 289 are successfully recorded as data. The data collection is started from March until April 2008, in Karawang regency, through interview and questionnaire forms. Univariate analysis by making frequency distribution of such variable, bivariate analysis by chi square test and multivariate analysis by multiregression logistic test with p value<0,05. The research result shows that the proportion of the village midwives with low performance (49,8%) is almost the same as the village midwives with good performance (50,2%). The bivariate analysis shows variable knowledge of the age of pregnancy and supervision focus has significant relationship with the village midwives’ performance. The village midwives with less supervision focus have an opportunity to perform less by 1.7 times greater than the village midwives with good supervision focus. According to research results, writer recommends advises as the following: For the Public Health Center and Official Health needs an improvement on supervision by making supervision schedule, check list and continued with discussions, in order to find the formulation of the existing problem, the cause of the problem, priorities and developing solving steps, making commitment together to improve, conducting training for supervision officers, then conducting testing which evaluate the result and decide the next steps. For the village midwives, they need to understand the objectives, authority, the main function and responsibilities as village midwives, to improve teamwork, be more proactive and to improve soft skill. For the surrounding society, its teamwork and participation are importantly needed in the antenatal care. For other researchers, it is needed to carry on further researches about supervision focus to improve the village midwives performance in the antenatal care with independent interview and about comprehensive of the village midwives performance. References : 49 (1980-2008) Key words : Performance, The Village Midwives, Antenatal Care, Cross Sectional