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Abstrak: Laporan Sidang Dunia Kedua tentang Lanjut Usia (2002) memperkirakan jumlah lansia di Indonesia menempati urutan ke empat terbesar di dunia dalam abad 21. SKRT 2001 menunjukan angka disabilitas 88,9% lansia, termasuk disabilitas ringan, yang merupakan masalah besar bagi Indonesia. Di Amerika layanan kesehatan telah menurunkan angka disabilitas lansia dari 22,1% pada tahun 1984 menjadi 16% pada tahun 2002 (DHHS, 2003). Studi menggunakan data Indonesian Family Life Survey (SAKERTI) yang didisain panel di 13 provinsi dari tahun 1993 - 2000, dengan tiga kali pengambilan data. Studi bertujuan membuktikan hubungan antara medical check-up dengan pemeliharaan aktifitas fisik dasar pada lansia. Populasi dan sampel adalah pra-lansia aktif (aktif fisik dasar lansia) yang berusia 55 tahun atau lebih pada tahun 1993. Analisis yang digunakan adalah regresi logitik multi-level. Hasil studi didapatkan bahwa dari 1541 pra-lansia (pada tahun 1993), 1464 (89,54%) lansia masih dapat melakukan aktifitas fisik dasar pada tahun 2000. Angka insiden kejadian limitasi aktifitas fisik dasar sebesar 3,2/tahun, yang berarti dari 100 lansia sekitar 3 - 4 lansia akan mengalami disabilitas (memiliki limitasi aktifitas fisik dasar) setiap tahunnya. Hasil analisis mendapatkan bahwa rasio odds peran medical check-up terhadap aktifitas fisik dasar sebesar 1,85 ( 95% CI= 1,64 - 2,13) berarti lansia yang tidak melakukan medical check-up teratur berisiko mengalami disabilitas 1,85 kali dibandingkan dengan lansia yang melakukan medical check-up dengan teratur.

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The Effect of Medical Check-up and Basic Physical Activities Daily Living: Panel Study on among Indoesian Elderly 1993-2000. In the 21st Century, Indonesia becomes the fourth biggest ageing country in the World as reported by the Second World Assembly on Ageing (2002). The Indonesian Household Health Survey (2001) reported 88,9% of the elderly suffered from disability (including mild disability). In the US health services, medical check-up had significantly reduced disability from 22,1% in 1984 to 16% in 2002 (DHHS, 2003).The study has aims to confirm the relationship between medical check-up and basic physical activities daily living among elderly in Indonesia. Data used the Indonesian Family Life Survey. Those who were 55 years or older and active in 1993 were included for the study. In total, 1,541 were sampled. Multilevel logistic regression analyses were applied for modeling basic physical activities daily living. Among the sample, there were 1464 (89,54 %) in 2000 still active on basic physical activities daily living, and giving an incidence rate of 3.2% per year for limitation on basic physical activities daily living. This rate indicates that in a year, out of every 100 active elderly in Indonesia, between three and four elderly would have developed limited physical activity. The multivariate analysis showed that there were significant effects of medical check-up on maintaining in basic physical activities daily living among elderly (OR=1,85; 95% CI: 1,64 - 2,13). This suggests that elderly with routine medical check-up would have a chance to maintain their ability to perform daily activity almost twice compared to those who did not receive routine medical check-up.

Abstrak: Skripsi ini membahas mengenai analisis pengaruh sikap dan tingkat pendidikan pada Program Indonesia Sehat Pendekatan Keluarga di Kelurahan Beji. Penelitian ini adalah penelitian kuantitatif dengan desain studi Cross Sectional. Jumlah responden penelitian ini adalah 51 responden. Hasil penelitian menunjukkan bahwa secara parsial terdapat pengaruh sikap pada PIS-PK terhadap kesehatan keluarga dengan nilai t hitung = 9,631 > nilai t tabel = 2,011. Secara parsial tidak terdapat pengaruh tingkat pendidikan terhadap kesehatan keluarga dengan nilai t hitung = 0,068 < nilai t tabel = 2,011.Sikap pada PIS-PK dan tingkat pendidikan secara bersama-sama berpengaruh terhadap kesehatan keluarga di Kelurahan Beji dengan nilai F hitung =47,290 > nilai F tabel = 3,191.

Abstrak: Pendidikan kesehatan pada ibu dapat meningkatkan praktik perawatan bayi berat lahir rendah (BBLR), namun kemampuan ibu untuk melakukan praktik perawatan BBLR di rumah belum banyak digali. Penelitian ini bertujuan untuk menilai pengaruh paket pendidikan kesehatan pada ibu terhadap praktik perawatan BBLR di Jakarta Pusat. Penelitian dilakukan terhadap 159 ibu dengan BBLR yang bayinya dinyatakan boleh pulang dari ruang Perinatologi dengan pendekatan quasi eksperimen (78 ibu kelompok intervensi dan 81 ibu kelompok kontrol) dan teknik pengambilan sampel secara consecutive sampling. Ibu dengan BBLR yang berdomisili di wilayah intervensi mendapatkan paket pendidikan kesehatan yang diberikan oleh perawat puskesmas.Paket pendidikan kesehatan terdiri dari penyuluhan tentang perawatan BBLR, yang diberikan pada 3-5 hari setelah BBLR keluar RS dan pendampingan pada ibu dan keluarga pada minggu ke-2 dan ke-6 setelah penyuluhan atau pengukuran awal. Ibu yang berdomisili di wilayah kontrol mendapatkan booklet tentang perawatan BBLR. Kedua kelompok dilakukan pengukuran dengan waktu yang sama sebanyak 4x yaitu 3 hari setelah keluar RS, 2, 6 dan 12 minggu setelah penyuluhan atau pengukuran awal. Pengumpulan data kualitatif juga dilakukan untuk melengkapi informasi yang diperlukan setelah mendapatkan gambaran hasil kuantitaif. Analisis multvariat dilakukan dengan Regresi Linier Ganda General Estimating Equation (GEE).Hasil memperlihatkan pemberian paket pendidikan kesehatan pada ibu dengan BBLR memberikan efek peningkatan praktik ibu dalam perawatan BBLR sebesar 25,19%. Praktik perawatan BBLR pada ibu di kelompok intervensi lebih tinggi dibandingkan kelompok kontrol pada setiap waktu pengukuran (p=0,000). Variabel sikap dan dukungan kader kesehatan yang dilatih merupakan konfonder yang mempengaruhi hubungan pendidikan kesehatan terhadap praktik ibu dalam perawatan BBLR.Kesimpulan: Pemberian paket pendidikan kesehatan yang dilakukan berkelanjutan selama 6 minggu berdampak efektif terhadap peningkatan praktik perawatan BBLR di rumah dan terhadap peningkatan status kesehatan bayi. Paket pendidikan kesehatan dapat dikembangkan di komunitas dengan melibatkan kader kesehatan untuk memberikan pendampingan pada ibu dengan BBLR diwilayahnya. Pelatihan ataupun sosialisasi tentang perawatan BBLR perlu diberikan pada tenaga kesehatan puskesmas dan kader kesehatan, sehingga dapat melakukan pendampingan secara tepat pada ibu dengan BBLR.

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Health education for mothers can improve low birth weight (LBW) infant care practices. Yet, the ability of mothers to exercise LBW infant care at home has not been much explored. This study aims to assess the effect of health education packages on mothers towards LBW infant care practices in Central Jakarta. The study was conducted on 159 LBW mothers whose babies were permitted to return from the perinatology room with a quasi-experimental approach (78 mothers in the intervention group and 81 mothers in the control group). The sampling technique of this study was consecutive sampling. LBW mothers who were domiciled in the intervention areas received health education packages provided by nurses in health centers.The health education package consisted of counseling on LBW care given in 3-5 days after LBW infant out of the hospital and mentoring for mothers and families at the 2nd and 6th weeks after counseling or initial measuring. Mothers who lived in the control area received a booklet on LBW infant care. The two groups were measured with the same time as much as 4 times, which was 3 days after leaving the hospital, 2, 6 and 12 weeks after counseling or the initial measurements. Qualitative data collection were also done to complete the information needed after getting a picture of the quantitative results. Multivariate analysis was carried out with Multiple Linear Regression General Estimating Equation (GEE).The results showed the provision of health education packages to mothers with LBW have an effect to increase the practice of mothers in LBW infant care by 25.19%. The practice of LBW infant care among mothers in intervention group were higher than those in control groups at each measurement (p = 0,000). The attitude and support of trained health cadres variable are confounders that influence the relationship of health education to the practice of mothers in LBW care.Conclusion: The provision of health education packages carried out continuously for 6 weeks has an effective impact on improving the practice of LBW infant care at home and has an impact on improving the health status of infants. Community-based health education packages developed by involving health cadres to provide assistance to mothers with LBW infant in their area. Training or socialization of LBW infant care to be given to health center workers and cadres, so they could provide appropriate assistance to LBW mothers.

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Latar Belakang: Tingginya angka kematian ibu dan neonatus di Indonesia dipengaruhi oleh berbagai faktor, termasuk kualitas pelayanan kesehatan ibu dan anak (KIA) yang belum mencapai target. Kinerja bidan desa, sebagai ujung tombak pelayanan, dipandang sebagai salah satu faktor krusial yang dapat ditingkatkan melalui supervisi dari bidan koordinator puskesmas. Meskipun demikian, data menunjukkan pelaksanaan supervisi fasilitatif KIA di provinsi Jambi pada tahun 2022 dan 2023 baru mencapai 10.86% dan 17.38% dari target 90%. Khususnya di kabupaten Muaro Jambi, capaiannya lebih rendah lagi, yaitu 11.64% (2022) dan 15.07% (2023). Kesenjangan ini menunjukkan perlunya intervensi strategis untuk meningkatkan kualitas supervisi demi mengoptimalkan kinerja bidan dalam pelayanan KIA.
Tujuan: Mengetahui pengaruh model integrasi midwifery opinion leader dan supervisi fasilitatif terhadap kinerja bidan dan dampaknya pada cakupan pelayanan kesehatan ibu dan anak di Provinsi Jambi tahun 2025.
Metode Penelitian: Penelitian ini merupakan penelitian mixed methods exploratory sequential design terdiri dari 3 tahap yaitu tahap I diawali scoping review, studi pendahuluan dan uji coba instrumen dilanjutkan identifikasi kebutuhan model menggunakan metode kualitatif dengan desain phenomenology. Tahap II meliputi pengembangan model, panel expert, pelatihan dan uji coba model. Tahap III dilakukan uji model terhadap kinerja bidan dengan indikator standar kompetensi kinerja (SKK) dan cakupan pelayanan KIA dengan penelitian quasi experiment pretest-posttest with control designs. Populasi adalah seluruh bidan desa/pustu di provinsi Jambi. Sampel yaitu kelompok intervensi sebanyak 60 responden (di kabupaten Muaro Jambi) dilakukan intervensi model integrasi MOL dan supervisi fasilitatif, sedangkan kelompok kontrol 60 responden (di kota Jambi) dilakukan hanya supervisi fasilitatif. Waktu penelitian pada bulan Mei 2024 hingga Agustus 2025, analisis data dengan univariat, bivariat dan multivariat (Difference in Difference).
Hasil: Berdasarkan identifikasi kebutuhan ditemukan subtema: kinerja bidan, kebutuhan supervisi dan model supervisi. Selanjutnya dilakukan pengembangan model supervisi dengan pendekatan teori COM-B, supportif supervision, midwifery leadership dan coaching sehingga diperoleh model midwifery opinion leader (MOL) yang dapat diintegrasikan dengan program supervisi fasilitatif KIA puskesmas. Hasil uji penerimaan model diperoleh hasil skor tertinggi yaitu sikap terhadap penggunaan rata-rata 4.9 dan terendah yaitu persepsi manfaat dengan skor 4.71. Hasil analisis diff in diff diketahui pada 2 kelompok sebelum dan sesudah intervensi terhadap skor standar kompetensi kerja: penataan pelayanan 1.36(0.24-1.60), asuhan bayi baru lahir 2.36(0.75-3.12) pemeriksaan kehamilan 1.33(0.48-1.82), pemeriksaan ibu bersalin 1.93(1.72-3.65) dan asuhan ibu nifas 1.43(0.30-1.74).Uji dampak model terhadap cakupan KIA yaitu: kunjungan ibu hamil ke-4 (K4)18.25(3.83-22.08), persalinan nakes (PN) 15.53(3.47-19.00), kunjungan nifas (KNF) 15.59(3.41-19.00), kunjungan neonatal lengkap (KNL) 14.35(9.97-24.33), kunjungan bayi (KBY) 19.08 (7.26-26.35) dan kunjungan balita (KBAL) 5.81 (16.14-21.95).
Kesimpulan dan Saran: Model integrasi Midwifery Opinion Leader (MOL) dan supervisi fasilitatif berpengaruh dalam meningkatkan kinerja bidan dalam pelayanan KIA. Disarankan mempertimbangkan model ini dalam kegiatan program supervisi kesehatan ibu dan anak di Puskesmas.

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ABSTRACT

Background: The high maternal and neonatal mortality rates in Indonesia are influenced by various factors, including the quality of maternal and child health (MCH) services, which have not yet reached their targets. The performance of village midwives, as the frontline of service delivery, is seen as a crucial factor that can be improved through supervision by health center coordinator midwives. However, data shows that the implementation of facilitative MCH supervision in Jambi province in 2022 and 2023 has only reached 10.86% and 17.38% of the 90% target. In Muaro Jambi district, in particular, the achievement was even lower, at 11.64% (2022) and 15.07% (2023). This gap indicates the need for strategic interventions to improve the quality of supervision in order to optimize the performance of midwives in MCH services.
Objective: To determine the effect of the midwifery opinion leader integration model and facilitative supervision on midwives' performance and its impact on the coverage of maternal and child health services in Jambi Province in 2025.
Research Method: This research is a mixed methods exploratory sequential design consisting of 3 stages, namely stage I, which begins with a scoping review, preliminary study, and instrument testing, followed by the identification of model requirements using a qualitative method with a phenomenology design. Stage II includes model development, expert panel, training, and model testing. Phase III involved testing the model on midwives' performance using standard competency performance (SKK) indicators and MCH service coverage using a quasi-experimental pretest-posttest with control designs. The population consisted of all village midwives/health workers in Jambi Province. The sample consisted of an intervention group of 60 respondents (in Muaro Jambi district) who underwent the MOL integration model intervention and facilitative supervision, while the control group of 60 respondents (in Jambi city) only underwent facilitative supervision. The research period was from May 2024 to August 2025, with data analysis using univariate, bivariate, and multivariate (Difference in Difference) methods.
Results: Based on the identification of needs, the following sub-themes were found: midwife performance, supervision needs, and supervision models. Subsequently, a supervision model was developed using the COM-B theory, supportive supervision, midwifery leadership, and coaching approaches, resulting in a midwifery opinion leader (MOL) model that can be integrated with the KIA puskesmas facilitative supervision program. The model acceptance test results showed the highest score for attitude toward use, with an average of 4.9, and the lowest score for perceived benefits, with a score of 4.71. The results of the diff in diff analysis showed that in the two groups before and after the intervention, the standard work competency scores were: service management 1.36 (0.24-1.60), newborn care 2.36 (0.75-3.12), pregnancy check-ups 1.33 (0.48-1.82), maternity check-ups 1.93 (1.72-3.65), and postpartum care 1.43 (0.30-1.74). The model's impact on MCH coverage was as follows: fourth antenatal visit (K4) 18.25 (3.83-22.08), skilled birth attendance (PN) 15.53 (3.47-19.00), postnatal visit (KNF) 15.59 (3.41-19. 00), complete neonatal visits (KNL) 14.35 (9.97-24.33), infant visits (KBY) 19.08 (7.26-26.35), and toddler visits (KBAL) 5.81 (16.14-21.95).
Conclusion and Recommendations: The integration model of Midwifery Opinion Leader (MOL) and facilitative supervision has an impact on improving midwives' performance in maternal and child health services. It is recommended to consider this model in maternal and child health supervision program activities at health centers.