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Pelayanan antenatal bertujuan untuk menjaga agar ibu hamil dapat melalui masa kehamilan, persalinan dan nifas dengan baik, dapat melahirkan bayi yang sehat dan mempersiapkan ibu untuk pemberian ASI eksklusif. Kehamilan merupakan suatu proses reproduksi yang perlu perawatan khusus. Kehamilan walaupun merupakan peristiwa yang normal namun bersifat dinamis yang secara tiba-tiba dapat menjadi berisiko termasuk ancaman terhadap kelangsungan hidup ibu.Penelitian ini bertujuan untuk mendapatkan gambaran tentang kualitas layanan antenatal pada Puskesmas di Kota Jambi. Sampel penelitian ini adalah delapan Puskesmas yang melaksanakan pelayanan antenatal. Karena Kota Jambi terdiri atas delapan kecamatan, maka dari setiap kecamatan dipilih secara acak satu Puskesmas dari Puskesmas yang ada. Penelitian ini menggunakan rancangan cross sectional. Metode pengumpulan data mencakup: (1) pengamatan terhadap 96 spot kegiatan pelayanan antenatal ; (2) wawancara terhadap 96 klien segera setelah selesai menerima pelayanan (exit interview); (3) penilaian terhadap kegiatan manajemen pelayanan antenatal berdasarkan keberadaan perangkat dan produk manajemen; dan (4) pengamatan terhadap sarana penunjang.Hasil pengamatan terhadap spot pelayanan kualitasnya masih kurang terlihat pada puskesmas yang diteliti penyediaan pelayanan TT dan Fe hanya 78%, pemberian informasi kesehatan ibu hamil hanya 55%, 60% mempunyai tenaga terampil, 49% responsif terhadap klien, ulang kepada klien dan 35% menggunakan waktu lebih dari 10 menit untuk pemeriksaan kehamilan kepada klien.Berdasarkan wawancara dengan klien sebagian besar merasa "puas" terhadap pelayanan yang telah diberikan. Kepuasan disini didasarkan kepuasan dari pelayanan TT dan Fe 65%, pemberian informasi 71%, kompetensi teknis petugas 97%, interaksi petugas-klien 96%, melaksanakan tindak lanjut 93%, waktu tunggu kurang dari 10 menit 64%. Walaupun pengetahuannya tentang pelayanan antenatal masih rendah hanya 23%. Dari aspek manajemen, hanya 13% puskesmas yang melaksanakan manajemen pelayanan antenatal dengan baik. Namun 88% Puskesmas mempunyai kelengkapan sarana dasar pelayanan antenatal.Dari hasil penelitian dapat disimpulkan kualitas layanan yang diberikan masih kurang, walaupun mayoritas klien mengatakan "puas" dengan pelayanan yang diberikan. Namun pengetahuan klien pada umumnya masih kurang. Manajemen pelayanan antenatal masih belum baik, walaupun sarana pelayanan antenatal relatif lengkap.Untuk memperbaiki kualitas pelayanan antenatal di Puskesmas disarankan sebagai berikut: Kepada Kepala Dinas Kesehatan Kota Jambi untuk membuat kebijakan tertulis tentang pelayanan antenatal dan menggunakan waktu pada saat pertemuan bidan bulanan sebagai sarana meningkatkan pengetahuan dan ketrampilan serta melaksanakan pelatihan konseling pelayanan antenatal. Kepada Kepala Puskesmas meneruskan kebijakan kepala dinas dengan membuat prosedur kerja secara tertulis tentang pelayanan antenatal serta melengkapi sarana yang masih kurang. Kepada petugas pelayanan antenatal agar melaksanakan kegiatan pelayanan sesuai dengan prosedur yang telah ditetapkan, mengikuti pertemuan bulanan dan pelatihan konseling serta memberikan informasi (konseling) kepada klien tentang pelayanan antenatal. Kepada institusi pendidikan Poltekkes Jambi diharapkan dapat menambahkan materi kuliah tentang mutu layanan kesehatan sebagai muatan lokal. Kepada peneliti lain dapat meneruskan penelitian ini dengan pendekatan kualitatif untuk menggali lebih mendalam variabel kualitas pelayanan dan kepuasan klien dalam pelayanan antenatal.
The quality of Antenatal care at Community Health Center of Jambi in 2002The purpose of antenatal care is to keep the pregnant woman safe during pregnancy, experiences proper labor and healthy postpartum, delivers a healthy baby and prepares mother to give exclusive breast feeding. Pregnancy is a reproduction process that needs some special treatment. Even though pregnancy is normal process, it is dynamic which is risky to mother live.The research objective is to obtain the description on antenatal care quality at Community Health Center (CHC) in Jambi Municipality. The samples of this research are taken from 8 CHC. Jambi Municipality has eight sub districts then each sub district was considered for one CHC randomly. This research design is cross sectional. Its method covers : observation of 96 spot services which gives antenatal care, interview to the 96 clients after receiving the service (exit interview), assessment on antenatal service management in view of facility and product management availability and supervision on supporting facility.On the spot supervision of CHC reveals that the quality is quantity low, there are 78% of CHC providing TT immunization and Fe tablet, 55% giving the information of the health pregnancy, 60% having skilled antenatal care provider, 49% responsive to the client, 95, 8% reminding client to go visiting CHC again, and only 35% using more than I0 minutes to examine pregnant woman.Based on the interview, most of respondents satisfied with the services. This satisfaction is based on TT immunization and Fe tablet (65%), giving information (71 %), provider technical competency (97%), and provider-client interaction (96%), doing the follow up (93%), waiting time less than 10 minutes (64%). However, only 23% of the respondent knows the antenatal care. From management view, only 13% of CHC has conducted good antenatal care management. However, 88% of CHC has good basic facility of antenatal care.It is concluded that antenatal care is still unqualified although most patients are satisfied with the service. Generally, client's knowledge about antenatal care is limited. The management of antenatal care is not fair enough while its facility is much more complete.To improve antenatal care quality, it is recommended that the Head of Jambi Health Department to make a written procedure of antenatal care and to hold a monthly meeting with the midwife to maintain their skill and knowledge and also to give counseling training of antenatal care. To the Head of CHC is suggested to continue that policy by providing written standard of recommended antenatal service and to make the facility much more complete. To antenatal care provider, it is recommended to follow` the standard operational procedure, to give monthly meeting and counseling training, as well as to inform the client about antenatal care. To Health Polytechnic Jambi, hopefully can provide a lecture about public health service quality as a local load. To the other researchers, it is advised great fully to follow up this study based on qualitative approach to explore the service quality variable and client satisfaction of antenatal care.
Angka kematian ibu (AKI) di Indonesia masih relatif tinggi bila dibandingkan dengan negara- negara ASEAN yaitu 373/100.000 kelahiran hidup (SKRT 1995). Hasil penilaian "Safe Motherhood" di Indonesia menyebutkan bahwa yang mempengaruhi AKI antara lain kualitas pelayanan antenatal yang masih rendah. Pemerintah telah mencanangkan program Making Pregnancy Safer (MPS) untuk menurunkan AKI, dengan meningkatkan cakupan dan kualitas pelayanan antenatal seperti telah ditargetkan, untuk cakupan K1 95% dan cakupan K4 90%. Di Propinsi Nanggroe Aceh Darussalam, khususnya Kota Banda Aceh AKI mencapai 11/4.598 kelahiran hidup, sementara cakupan K1 mencapai 93,3% dan K4 83,1%. Namun bagaimana kualitas pelayanan antenatal yang diberikan masih belum diketahui. Tujuan penelitian ini adalah untuk memperoleh informasi tentang kualitas pelayanan antenatal dan hubungannya dengan kepuasan pasien, karena bila kualitas pelayanan baik dapat mempengaruhi kepuasan pasien. Penelitian ini dilakukan di puskesmas di wilayah Kota Banda Aceh yang hanya mempunyai enam puskesmas. Desain penelitian yang digunakan adalah non eksperimental dengan pendekatan cross-sectional. Unit penelitian adalah ibu hamil, dan populasi yaitu ibu hamil trimester II dan III yang telah berkunjung ke Puskesmas minimal dua kali. Metode pengambilan sampel secara purposive sampling dengan jumlah sampel 100 respoden. Pengumpulan data dilakukan dengan mewawancarai responden. Kualitas pelayanan yang diukur yaitu hubungan antar manusia, meliputi keramahan, komunikasi petugas dengan pasien serta tindakan pelayanan antenatal yang diberikan. Hasil penelitian melaporkan, proporsi ibu hamil yang menyatakan puas 44%, petugas ramah 44%, petugas berkomunikasi dengan baik 43 % dan pelayanan antenatal baik sebanyak 41%. Hasil uji chi-square menunjukkan ada hubungan yang bermakna (p < 0,05) antara kualitas pelayanan antenatal yaitu keramahan dan komunikasi dengan kepuasan pasien, sedangkan variabel tindakan pelayanan antenatal secara statistik tidak menunjukkan hubungan bermakna. Sementara karakteristik pasien sebagai variabel kontrol meliputi umur, pendidikan, pekerjaan dan gravida, tidak satupun menunjukkan hubungan bermakna (P > 0,05) dengan kepuasan pasien. Hasil analisis regresi logistik menunjukkan bahwa faktor yang paling dominan mempengaruhi kepuasan pasien adalah keramahan (OR: 3,64) pada CI95 %: (1,58- 8,37). Dari hasil penelitian dapat disimpulkan bahwa kepuasan pasien terhadap kualitas pelayanan antenatal di puskesmas di wilayah Kota Banda Aceh masih sangat rendah. Untuk itu perlu peningkatan kualitas pelayanan antenatal terutama dalam hal keramahan dan komunikasi, dengan cara meningkatkan motivasi dari pimpinan, perbaikan system reward dan pelatihan yang berkelanjutan.
The Relationship of Antenatal Care Quality with Patient Satisfaction at the Health Center of Banda Aceh City, 2002The Maternal Mortality Rate (MMR) in Indonesia is still high if it compared with the ASEAN countries that are 373/100,000 live births (Household Health Survey, 1995). The result of assessment on Safe Motherhood in Indonesia mentioned that the one influence on MMR is the quality of antenatal care was still low. The government has decided a program on Making Pregnancy Safer (MPS) to lowering the MMR, by increasing the coverage and the quality of antenatal care such as targeted, for first visit of antenatal care / K1 the coverage was 95% and for fourth visits of ANC / K4 was 90%0. In Aceh Province, especially Banda Aceh City the MMR reached 11/4.598 live births, while the coverage of K1 reached 93% and K4 was 83,1%. However, how about the antenatal care quality that given is still unknown. The objective of this study was to obtain information on antenatal care quality and its relation with patient satisfaction, since if the quality is good, it can influence to patient satisfaction. This study was conducted at the Health Center of Banda Aceh City, which only has six Health Centers. The study designs that use was non-experimental by cross-sectional approach. Research unit was pregnant mothers, and the population was pregnant mothers who's having trimester II and III that visiting those Health Centers at least twice. The method of collecting sample was purposive sampling, with the number of sample 100 respondents. The data collected by interviewing the respondents. The quality of service that measured was the relation between human being, covering: kindness, health worker communication with the patient and also the action that given on ANC. The result of study shows that the proportion of pregnant mothers that mentioning satisfaction was 44%, ones whose saying that health worker was kind 44%, ones whose mentioned that the health worker have good communication was 43%, and ones whose mentioned that ANC service was good only 41%. The result of chi square test shows that there was significant relationship (p < 0,05) between the quality of ANC service, that were the kindness and communication with patient's satisfaction, while variable of action on ANC service based on statistic was not showing the significant relationship. Whereas patient characteristic as control variable, covering: age, education, profession and gravida, was not showing the significant relationship (p > 0,05) with the patient satisfaction. The result of logistic regression multivariate analysis shows that the factor which is the most dominant influence to patient satisfaction was kindness (OR: 3,64) on Cl 95%: (1,58-8,37). Based on the result of this study it can be concluded that the patient satisfaction to the quality of ANC service at the Health Center of Banda Aceh City is still very low. It is needed to improve the quality of ANC service, especially on the kindness and communication, by increasing the motivation from the leader, make better the reward system and training continually.
Upaya untuk menurunkan kematian neonatal merupakan kunci utama dalam keberhasilan penurunan kematian bayi. Meningkatkan status kesehatan bayi dengan pemberian ASI (Air Susu Ibu) secara eksklusif merupakan upaya penurunan AKB. Banyak faktor yang mempengaruhi keberhasilan pemberian ASI eksklusif, diantaranya pemahaman dan motivasi adalah faktor utama keberhasilan ibu dalam memberikan ASI eksklusif. Untuk menanamkan pemahaman pentingnya ASI eksklusif seluruh ibu setidaknya harus mendapat informasi tentang ASI eksklusif dimulai sejak masa kehamilan Dengan memperoleh konseling tentang ASI diharapkan ibu hamil akan memperoleh pengetahuan tentang manfaat ASI sehingga bila ibu memahaminya maka ia akan termotivasi untuk memberikan ASI pada bayinya Penelitian ini bertujuan untuk melihat hubungan kualitas pelayanan antenatal dan pelaksanaan ASI eksklusif setelah dikontrol oleh variabel IMD, berat bayi lahir, umur, pendidikan, pekerjaan, paritas, kontrasepsi dan dukungan suami/keluarga. Desain yang dipakai adalah Crossectional terhadap 143 ibu yang memiliki bayi umur 6-24 bulan di wilayah Kota Cirebon tahun 2013. Analisis data yang digunakan adalah uji chi square dan regresi logistik. Hasil penelitian menunjukkan bahwa 41,3% ibu memberikan ASI eksklusif/predominan. Ibu yang mendapat kualitas pelayanan antenatal baik dalam hubungannya dengan ASI eksklusif sebanyak 48,3%. Hasil analisis bivariat yang terbukti berhubungan secara bermakna adalah pekerjaan (0,004) dan IMD (0,15). Hasil analisis multivariat menjelaskan bahwa, ibu yang bekerja (OR 0,250) memiliki kemungkinan empat kali untuk melaksanakan ASI eksklusif dibandingkan ibu yang tidak bekerja dikontrol oleh variabel IMD, berat bayi lahir, umur, pendidikan, paritas, kontrasepsi dan dukungan suami/keluarga. Disarankan untuk bidan sebagai tenaga kesehatan yang terbanyak dipilih ibu untuk memberikan pertolongan kesehatan harus meningkatkan kualitas KIE terutama tentang ASI eksklusif dan IMD disamping informasi kesehatan lainnya. Bagi Dinas Kesehatan mengadakan pelatihan konselor ASI, dan setiap Puskesmas harus memiliki Pojok ASI beserta kelengkapannya serta ruang bimbingan laktasi bagi ibu hamil dan ibu menyusui.
Efforts to reduce neonatal mortality is the main key to successfully reducing infant mortality. Improving the health status of infants with breastfeeding (breast milk) exclusively, is an efforts to reduce IMR. There are many factors that affect the success of exclusive breastfeeding, including the knowledge and motivation which were the key factors of successfully mother’s breastfeeding. To embed the knowledge about the importance of exclusive breastfeeding, mothers should be informed about exclusive breastfeeding during pregnancy by obtaining the counseling about breastfeeding. The more they understand about breastfeeding, the more motivations they will get to give exclusive breastfeeding to their babies. This study aims to look at the relationship between the quality of antenatal care and the implementation of exclusive breastfeeding after it controlled by the IMD variable, birth weight, age, education, occupation, parity, contraception and support from her husband/family. The design of this research are using Cross-sectional design to 143 mothers of infants aged 6-24 months in the city of Cirebon in 2013. To analyze the data, the researcher used chi square test and logistic regression. The results of research shows 41.3% of mothers are giving breastfeed xclusively/predominantly. Mothers who received antenatal care quality related to exclusive breastfeeding are 48.3%. Results of the bivariate analysis are proven to be significantly related to employment (0.004) and IMD (0.15). Multivariate analysis explains that working mothers (OR 0.250) had four times the possibility to carry out exclusive breastfeeding than mothers who are not working is controlled by the IMD variable, birth weight, age, education, parity, contraception and support from her husband/family. Recommended for midwives as the most selected health workers by mothers to provide health aid should improve the quality of KIE, especially on exclusive breastfeeding and IMD, besides other health information. The Health Department have to held a breastfeeding counselor training, and each Health Center should have a breastfeeding corner along with the equipment as well as a lactation counseling for pregnant and nursing mothers.
Exclusive breastfeeding can provide optimal protection for babies so that they have immunities to various diseases that occur in the first year of life. Antenatal Care (ANC) is expected to increase the coverage of exclusive breastfeeding because ANC services will motivate mothers to give exclusive breastfeeding. This study aims to determine the relationship between the quality of antenatal care and the success of exclusive breastfeeding. This study used a cross-sectional study design on 169 breastfeeding mothers in the work area of Cipayung Health Center, Depok. This study uses secondary data from previous study titled Increased Breastfeeding and Breastfeeding Supplement Intervention on Implementation of the First 1000 Days of Life Program. The results of the bivariate study showed that there was a significant relation between work, knowledge, ANC quality, and milk supplementation with the success of exclusive breastfeeding. Multivariate analysis showed milk supplementation, occupation, knowledge, and ANC quality influenced the success of exclusive breastfeeding (CI 95%; OR:5,460; 3,986; 3,700; 2,540). The dominant factor associated with the success of exclusive breastfeeding was milk supplementation (OR = 5,460). Giving milk supplementation to nursing mothers would increase exclusive breastfeeding for up to 6 months