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Angka kematian bayi (AKB) di Kabupaten Garut mencapat 54,8 per l000 kelahiran hidup pada tahun 2005 dan anglca ini masih jauh diatas AKB Provinsi Jawa Barat (44 per 2000 kelahiran hidup). Rendahnya status kesehatan neonatal di Kabupaten Garut dapat dilihat dari masih banyak ditemukan kasus kematian neonatal dalam tiga tahun temkhir. Tahun 2003 ditemukan ada sebanyak 272 kasus kematian neonatal, dan meningkat pada tahun 2005 menjadi 297 kasus. Penyebab tidak langsung dari kasus kematian neonatal ini adalah karena perilaku masyarakat yang belum mendukung dalam penanganan bayi baru lahir secara adekuat. Tujuan pcnelitlan ini adalah diketahuinya determinan praktek ibu dalam perawatan neonatal di Kabupaten Garut Provinsi Jawa Barat Tahun 2007. Penelitian ini menggunakan data sekunder dari hasil Survei Data Dasar Kesehatan Bayi Baru Lahir Esensial di Kabupaten Gantt Provinsi Jawa Barat Tahun 2007. Metode penelitian yang digunakan adalah Cross sectional, dengan populasi adalah ibu yang mempunyai bayi berumur 1-ll bulan yang tinggal menetap di 10 kccamatan di Kabupaten Garut. Sampel berjumlah 577 ot-ang, diambil menggunakan vmetode cluster probability proportionate size. Hasil penelitian memmjukkan dari 577 ibu, baru 48,5% yang melakukan praktek pcrawatan neonatal baik. Pengetahuan ibu lentang pemwatan neonatal berhubungan dengan praktek ibu dalam perawatan neonatal, dimana ibu bcrpengetahuan baik bepeluang 2,2 kali melakukan praktek perawatan neonatal secara baik dibanding dengan ibu yang berpengetahuan tidak baik, setelah dikontrol penyuluhan oleh tenaga kesehatan, duktmgan keluarga, pendidikan ibu dan pckerjaan ibu (OR = 2,2; 95% Cl = 1,2 ~ 3,7). Dukungan keluarga berhubungan dengan praktek ibu dalam perawatan neonatal, dimana ibu yang mcnilai dukungan keluarganya cukup, berpeluang 1,7 kali melakukan praktek perawatan neonatal sccara baik dibanding dengan ibu yang menilai dukungan kcluarganya kurang, setelah dikontrol oleh pengetahuan ibu, penyuluhan oleh tenaga kesehatan, pendidikan ibu dan pekerjaan ibu (OR = l,7; 95% Cl = 1,0-3,0). Oleh karena pcngetahuan ibu merupakan faktor yang paling dominan berhubungan dengan praktek ibu dalam perawatan neonatal maka disarankan kepada Dinas Kesehatan Kabupaten Garut uutuk berupaya meningkatkan pengetahuan ibu mclalui pelatihan komunikasi, informasi dan edukasi (KIE) bagi bidan di desa (BdD) dan tokoh masyarakat, sebingga bidan di desa dan tokoh masyarakat terampil dalam menyampaikan intbrmasi tentang perawatan neonatal. Biden di desa perlu meningkatkan kegiatan penyampaian informasi tentang perawatan neonatal yang benar menurut kesehatan dengan lebih memanfaatkan buku KIA dan gambar-gambar dalam lembar balik, pada saat berkunjung ke rumah maupun dilcunjungi para ibu hamil serta ibu nifas dan keluarganya. Kcgiatan pemberian informasi ini agar dilakukan bertahap dan berulang sampai ibu tersebut bcnar-bcnar memahami dan mampu mempralctekkan perawatan neonatal sesuai kesehatan. Bidan di desa juga pcrlu meningkatkan upaya motivasi kepada para ibu hamil dan ibu nifas, agar mereka dapat mengadopsi perilaku sehat untuk diri dan bayinya, melalui kegiatan penyuluhan di posyandu dan di pengajian ibu-ibu.
In Garut District Infant Mortality Rate (IMR) is still low, 54,8_/ 1000 live births in 2005. lt’s higher than Ill/ill in West .lava44 I 1000 live births). The neonatal status in Garut district was still low wich was indicated by high neonatal deaths in the last three years. 'I`he neonatal mortality rate was increased from 272 cases in 2003 to 297 cases in 2005. Indirect causes of neonatal deaths was inadequate newborn care. The objective of this research is to know the determinants of mother’s pmotico on neonatal sore in Garut district in 2007. This study using data from Baseline Survey of Neonatal Care Essential in Gantt District in 2007. Cross sectional design was used with 577 mothers with babies I-11 months as a sample. Sample design was 2 stages cluster and sample were selected using probability proportionate to size (PPS). This research showed only 48,5% of mothers practice on neonatal care well. There was a significant relationship between mother’s knowledge and practice on neonatal care after adjusted by education and conselling from health provider, family support. mothers education and motl;or’s worklrlg status. Mothers who had good knowledge about neonatal care had chance 2,2 times to practice well on neonatal care compare to mother with not good of knowledge (OR = 2,2; 95% CI = 1,2-3,7). There was a significant relationship between families support and practice on neonatal care alle: adjusted by mother’s knowledge, education and conselling from health provider, mother‘s education and mother’s working status. Mothers who had enough of families support had chance 1,7 times to practice well on neonatal care compare to mother with not enough families support (OR = l,7; 95% Cl = 1,0-3,0). Because of mothers knowledge is the most dominant factor significant relationship with practice on neonatal care, suggestions to do like communication skill training, communication, information and education process to increase village midwives’s and community leaders skill ability to give infomation about neonatal care to pregnant women and their ti-smilies, postnatal mother and their families need to be done. information about essential neonatal care, by using Mother and Child books, pictures folds, while health workers visiting mother and her family is important. These activities need to be done repeatedly until mother and her family could adopt and do neonatal care correctly based on health standard. Improve regnant and postnatal women motivation to adopt health behaviour in Posyandu and women religion meeting are very important to be done.
Masalah kematian maternal dan noenatal masih merupakan masalah pokok yang dihadapi oleh bangsa Indonesia, dimana AKI di Indonesia tahun 2005 sebesar 262 per seratus ribu kelahiran hidup. Salah satu penyebab kematian tersebut akibat masih rendahnya cakupan persalinan oleh tenaga kesehatan dan masih tingginya persalinan ditolong oleh tenaga non kesehatan (dukun bayi). Proporsi angka cakupan persalinan oleh tenaga kesehatan di Kabupaten Garut tahun 2006 adalah 67,4% sementara sisanya oleh dukun bayi. Pencapaian tersebut tidak sejalan dengan pencapain hasil cakupan K4 pada tahun yang sama sebesar 85,4%, hal ini menunjukkan adanya kesenjangan antara kedua hasil cakupan tersebut. Idealnya, kenaikan cakupan K4 diikuti pula oleh kenaikan cakupan persalinan. Kesenjangan tersebut telah mengindikasikan telah terjadinya unmet need persalinan, yaitu ketidaksesuaian antara keinginan dengan kenyataan mengenai tenaga penolong persalinan. Tujuan penelitian ini adalah untuk mengetahui determinan unmet need persalinan di Kabupaten Garut tahun 2007. Penelitian menggunakan data sekunder dari hasil survei data dasar pengembangan model pelayanan kesehatan neonetal esensial di Kabupaten Garut tahun 2007 oleh Pusat Penelitian Kesehatan (PPK-UI) dan Pusat Kajian Promosi Kesehatan FKM-UI. Metode penelitian adalah Cross Sectional, dengan populasi adalah ibu-ibu yang mempunyai bayi 0-11 bulan yang tinggal menetap di 10 Kecamatan di Kabupaten Garut. Sampel yang berjumlah 246 orang, diambil menggunakan metode cluster probability proportionate size. Hasil penelitian menunjukkan dari 246 responden yang mempunyai keinginan untuk melahirkan oleh tenaga kesehatan 21,1% terjadi unmet need persalinan dan 78,9% sesuai dengan keinginannya (met need). Paritas merupakan faktor yang berhubungan dengan unmet need persalinan (p = 0,049), dimana iu yang mempunyai paritas tinggi berpeluang 2 kali untuk unmet need persalinan dibandingkan dengan ibu yang mempunyai paritas rendah setelah dikontrol oleh faktor pendidikan ibu, status ANC dan status ekonomi (OR = 2, 95% CI = 1,0 ? 3,8). Berdasarkan hal di atas, disarankan untuk lebih meningkatkan kegiatan KIE pada saat pemeriksaan kehamilan (ANC) sehigga pengetahuan ibu hamil tentang kehamilan, persalinan dan KB dapat lebih meningkat, disamping meningkatkan kegiatan penyuluhan kesehatan secara berkesinambungan kepada masyarakat, terutama tentang tanda bahaya kehamilan dan persalinan.
The problem of neonatal and maternal deaths.is still the main problem faced by indonesian people, where the maternal death rate in Indonesia, in the year of 2005 was 262 per one hundred thousand of living birth.one of the mentioned death causes was that the child-birth coverage carried out by medical workers was still low and child- birth performed by non medical workers was still high. The percentage of child-brith coverage rate by medical workers in Garut regency in 2006 was 67,4 % meanwhile the rest was performed by conventional midwives. The mentioned achievement was not in accordance with that of the result of K4 coverage in the same year as much as 85,4 %, this case showed the presence of discrepancy between both mentioned coverage results.ideally, the raise of K4 coverage should have been followed by the raise of child-birth coverage as well. This discrepancy had indicated that unmet need child-birth had occured, that is the unconformity between desire and fact concerning medical workers for child- birth. The objectives of this research is to recognize the determinant of unmet need of child- birth in Garut regency in 2007.The kind of the research used secondary data from the result of base data survey for the development of essential neonatal health service model in Garut regency in the year of 2007 performed by Health Research Centre ( PPK-UI ) and Health Promotion Study Centre of FKM-UI.the method of the research is Cross Sectional . Population consists of the women having 0-11 month babies who settle in ten sub-districts with sample selection follows the method of 30 cluster, cluster is the rural-district with dursion criteria based on the number of population (probability proportionate size). by using c-survey, it is obtained 30 rural- districts, later 16 women are selected at random from every rural-district so that it fulfills the sample of 640 people. The number of respondents who fulfill criteria of unmet need child-birth is 246 people. The result of the research shows that from 246 respondents who have desire to give birth to by medical workers, 21.1% is unmed need child-birth and 78,9% is in accordance with their desire (met need) that is medical workers as the helper of child-birth. The result of statistics test shows significantcorrelation between parity and unmet need child-birth (p=0.049). In the meantime, the result of valid final modeling is model without interaction, later the most dominant factor as the determinant of unmet need child-birth is parity with the value of odds ratio as much as 2.0 respectively after being controlled by the factors of mothers education, ANC status and economics status (OR = 2, 95% CI = 1,0 ? 3,8). Based on the case above, it is suggested that the effort of health promotion program raise need to be performed by having health guidance acturties continuously to the community about reproduction health especially in the case of recognition towards child-birth danger signal. One of them is to raise the acturty of KIE at the time of pregnancy examination which along this time it forms education facility to improve mothers knowledge concerning their pregnancies and child-births.
Kata kunci: ASI Eksklusif; berpotensi; metode kualitatif
The aims of this study is to analyze exclusive breast feeding practice andits potential factors in working area of Bruno PHC, Purworejo, 2014. Qualitativeapproach with case study design and in-depth interview methods was used tocollect data from 8 mothers of baby 7-12 months and their husbands, 6 care giversand 2 midwives. Majority of mothers who did exclusive breastfeeding and did notwere around 21 years old. Mothers who did exclusive breastfeeding have bettereducation level and part-time worked, while the other have not worked. Motherswho breastfeed exclusively had good knowledge on breastfeeding and agreed tocontinue breastfeed their child up to 2 years. Contrary mothers who did notexclusive breastfeeding disagreed to breastfeed up to 2 years and agreed on givingformula milk and other foods to under 6 months baby, because they gotsuggestion from their families. Mothers who did exclusive breastfeeding get a lotof information and training about breastfeeding from midwife and doctor, but theother only get an advices from midwife.
Keywords: Exclusive breastfeeding; breastfeed; qualitative method
Kata Kunci : Kepatuhan, Kawasan Tanpa Rokok (KTR), Kawasan Tanpa Rokok di Tempat kerja, Kabupaten Bogor
Indonesia is the fourth country in the world with the highest prevalence of smokers. The Regulation of smoke free zone is an effort to protect public from the impact of exposure to secondhand smoke. Although the smoke free zone regulation is an initiative of Bogor regency government which has been established since 2012, in the implementation there are still many government employees who smoke in the working area. The government employee is the role model in implementing smoke free zone. This research was conducted to find out the factors influenced government employees in compliance smoke free workplaces regulations in order to be used as guidance in formulating strategies for enforcing smoke free zone regulations. This research was conducted in 28 units of government office in Bogor district with 321 respondents government employee. Study design is Cross sectional and sampling using probability proportional to size (pps). The results of this study found that 43.5% of smokers employee and 51.7% of non-smoker employees are comply the smoke free workplaces regulation. The result of logistic regression showed a significant correlation between age and perceived seriousness towards of smoke free workplaces regulation compliance on smoker respondent and the perceived benefits, gender and self-efficacy towards of smoke free workplaces regulation compliance on non-smoker respondents.
Keywords : Compliance, Smoke free zone, smoke free workplaces, Bogor District
Penyakit tuberkulosis merupakan penyakit menular langsung yang disebabkan oleh Mycobakterium Tuberkulosis. Di Indonesia penyakit ini merupakan masalah utama kesehatan masyarakat karena kasusnya terus meningkat setiap tahunnya tetapi tidak dapat terdeteksi dengan baik karena salah satu penyebabnya adalah perilaku pencarian pengobatan yang menjadi tersangka penderita penyakit ini tidak datang ke fasilitas kesehatan. Tujuan penelitian ini adalah untuk mengetahui perilaku pencarian pengobatan tersangka penderita TB Paru di wilayah puskesmas Tanjung Paku Kota Solok tahun 2005. Penelitian ini menggunakankan pendekatan kualitatif dengan melakukan wawancara mendalam dan diskusi kelompok terarah serta telaah dokumen. Lokasi penelitian dilakukan di wilayah kerja puskesmas Tanjung Paku. Sebagai informan adalah masyarakat yang diduga tersangka penderita TB Paru yang dibagi menjadi enam kelompok berdasarkan perilaku pencarian pengobatannya yaitu perilaku 1 adalah tidak melakukan tindakan apa-apa, perilaku 2 mengobati diri sendiri perilaku 3 berobat kedukun, perilaku 4 membeli obat warung, perilaku 5 berobat ke puskesmas dan perilaku 6 berobat ke dokter praktek swasta. Dari keenam perilaku ini diambil masingmasing satu informan untuk dilakukan wawancara mendalam dan delapan orang untuk dilakukan diskusi kelompok terarah, selain itu juga dilakukan wawancara mendalam kepada petugas kesehatan, pengawas menelan obat, dukun, warung obat, tokoh masyarakat, keluarga dan penderita TB Paru dan dokter praktek swasta. Karateristik informan yang dilihat adalah pengetahuan, persepsi, sikap, motivasi, dan niat. Hasil penelitian ini menunjukkan bahwa informan perilaku 1 dan 2 tidak mempunyai pengetahuan tentang TB Paru, perilaku 3 dan 4 mempunyai pengetahuan cukup baik tentang, perilaku 5 dan 6 sudah mempunyai pengetahuan yang baik terhadap penyakit TB Paru. Persepsi informan terhadap penyakit TB Pam pada perilaku 1 dan 2 kurang baik, pada perilaku 3 dan 4 cukup baik dan pada perilaku 5 dan 6 sudah baik Sikap informan terhadap penyakit TB Paru semua setuju bahwa penyakit tarsebut menular dan bisa disembuhkan bila teratur berobat ke puskesmas kecuali pada perilaku 1 dan 2 tidak setuju dengan hal tersebut. Semua informan mempunyai motivasi yang positif terhadap penyakit TB Paru kecuali perilaku 1 dan 2 yang mempunyai motivasi negatif Niat dan keinginan untuk sembuh bila menderita penyakit TB Paru semua kelompok mempunyai niat dan keinginan seperti itu kecuali sebagian kecil dari perilaku 1. Dan laporan puskesmas tahun 2005 basil penjaringan pasien tersangka TB Paru masih sangat rendah Baru mencapai 38,5% dari sasaran yang telah ditetapkan. Petugas kesehatan mempunyai pengetahuan, persepsi, sikap, motivasi dan niat yang bailk terhadap program TB Paru puskesmas demikian juga pada pengawas menelan obat dan keluarga penderita Tidak ada kerjasama puskesmas dengan tokoh masyarakat, dukun dan dokter praktek swasta dalam program penanggulangan penyakit tuberkulosis. Peneliti menyarankan kepada puskesmas Tanjung Paku untuk meningkatkan kegiatan promosi aktif program P2TB paru dan kerjasama lintas sektor dan program.
The tuberculosis is direct infection disease that caused by Mycobacterium Tuberculosis. In Indonesia this disease is the main public health problem because the case adding every year but can not good detection.. Because this case may cause by medication seeking behavior of this disease patient not coming to health facility. This research aim is to find the behavior of TB lungs patient medication seeking in Tanjung Paku primary health center Solok City West Sumatera year 2005. This research using qualitative approach by doing circumstantial interview and directional group discussion and also document analyze. Research location is done in Tanjung Paku'.primary health centre working regional. As informant is society that suspect as TB lungs patient which divided into six group based on medication seeking behavior that is behavior 1 with not doing any action, behavior 2 with curing oneself; behavior 3 of medicating to shaman, behavior 4 with buying stall medication, behavior 5 of medicating in primary health centre and behavior 6 of medicating to private doctor. From these six behaviors each one informant taken for a circumstantial interview and eight people for directional group discussion, and also done circumstantial interview to health official, medicine consumes watcher, shaman, drug store, public figure, family from TB lungs patient and private doctor. Informant characteristic seen is knowledge, perception, attitude, and intention. This research result shows that informant toward TB lungs disease in behavior 1 and 2 do not have knowledge, behavior 3 and 4 is quite good, behavior 5 and 6 is good. Informant perception toward TB lungs disease in behavior 1 and 2 is not quite good, behavior 3 and 4 is quite good, and behavior 5 and 6 is good. Informant attitude toward TB lungs disease is everyone agree that the disease contaminate and can be cured if regularly take medicine from primary health care except in behavior 1 and part of behavior 2 do not agree with it. All informants have positive motivation toward TB lungs disease except behavior 1 and 2 that has negative motivation. Intention and desire to be cured if infect by TB lungs disease is agreed by all group except part of behavior. From primary health centre report year 2005 the result of TB lungs patient screening is 30 % target exist and this still very low. Health official has good knowledge, perception, attitude, motivation, and attention toward primary health care TB lungs program and also toward medicines consumes watcher and patient family. There is no cooperation between primary health centre with public figure, shaman and private doctor in this tuberculosis disease preventative program. Researcher suggest Tanjung Paku primary health centre to increase active promotion activity of it P2TB program and cooperation across sector and program.