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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
Background: Patient dissatisfaction with long waiting times is one consequence of an inefficient service delivery system. Long waiting times have a significant correlation with patient satisfaction levels. Excessive waiting can lead to boredom and fatigue, which diminishes satisfaction with the provided services. Objective: This study aims to analyze waiting times and the factors associated with prescription service waiting times at the Outpatient Pharmacy Installation of Hermina General Hospital Depok. Research Methodology: This study employs both quantitative and qualitative methods. Data on waiting times and prescriptions were collected through observations of prescription service workflows and officer interview in the outpatient pharmacy. Results: The findings indicate that the waiting time for non-compounded (patent) drug prescriptions still does not meet the established standard due to the high number of drug items per prescription. Prescription backlogs and delays in dispensing completed medications frequently occur. Factors related to prescription service waiting times in this study include patient status, prescription type, number of drug items, shift schedules, and human resources. Inefficient human resources distribution across shifts contributes to prolonged waiting times in each prescription service workflow. The most dominant factor affecting prescription service waiting times is human resources . Proper human resources allocation across shifts, particularly during peak days, can help reduce excessive waiting times.