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Komplikasi merupakan penyebab utama kematian ibu di Kota Depok. Continuum of Care (CoC) memiliki peranan untuk mendeteksi dini risiko komplikasi dan mencegah kematian ibu. Penelitian ini bertujuan untuk mengetahui dampak CoC pada ibu hamil, bersalin dan nifas terhadap Adverse Pregnancy Outcomes (APOs) pada ibu bersalin dan nifas di 6 Puskesmas mampu PONED Kota Depok dengan desain studi kohort retrospektif. Data dikumpulkan pada Maret sampai Mei 2024. Data sekunder yang digunakan bersumber dari data register kohort ibu (dari masa kehamilan-nifas). Data dianalisis menggunakan chi square, dilanjutkan Regresi Logistik dan dikoreksi dengan OR corrected. Hasil Analisis multivariat menunjukkan pada populasi ibu multipara dan Grande multipara yang melaksanakan CoC adekuat berisiko lebih rendah untuk mengalami APOs (RRcorrected= 1,46, 95%CI: 0,96-1,86). Sedangkan, Ibu hamil dengan kondisi primipara yang melaksanakan CoC adekuat memiliki risiko lebih rendah untuk mengalami APOs (RRcorrected 1,41, 95%CI: 1,00-1,67). APOs dapat dicegah sebesar 39,81% dan 40,11% masing-masing pada populasi umum dan populasi ibu primipara apabila layanan CoC di optimalkan. Asuhan ANC dan PNC yang dilaksanakan adekuat dapat menurunkan APOs sebesar 21,97% dan 19,51%. CoC perlu dilaksanakan secara adekuat untuk mencegah APOs. CoC yang dilaksanakan sesuai rekomendasi akan memberikan manfaat yang baik bagi ibu maupun bayi nya.
Keywords: Antenatal Care; Continuum of Care; Maternal Mortality; Postnatal Care; Pregnancy Complication
Complications are the main cause of maternal mortality in Depok City. Continuum of Care (CoC) has a role in detecting early risk of complications and preventing maternal mortality. This study aimed to determine the impact of CoC on Adverse Pregnancy Outcomes (APOs) in pregnant, delivery, and postpartum women at 6 PONED capable health centers in Depok City with a retrospective cohort study design. Data were collected from March to May 2024. Secondary data were sourced from maternal cohort register data (from pregnancy to postpartum). Data were analyzed using chi-square, followed by Logistic Regression, and corrected with OR corrected. Results Multivariate analysis showed in the population of multiparous and Grande multiparous mothers who implemented adequate CoC had a lower risk of experiencing APOs (RRcorrected = 1.46, 95%CI: 0.96-1.86). Meanwhile, pregnant women with primiparous conditions who carry out adequate CoC have a lower risk of experiencing APOs (RRcorrected 1.41, 95%CI: 1.00-1.67). APOs could be prevented by 39.81% and 40.11% in the general population and primipara population respectively if CoC services were optimized. Adequately implemented ANC and PNC care can reduce APOs by 21.97% and 19.51%. CoC needs to be implemented adequately to prevent APOs. CoC implemented according to recommendations will benefit both mothers and their babies. Keywords: Antenatal Care; Continuum of Care; Maternal Mortality; Postnatal Care; Pregnancy Complication
Pneumonia merupakan penyebab kematian terbesar pada anak di seluruh dunia. Setiap tahunnya diestimasikan sekitar 18% kematian anak di bawah usia 5 tahun di seluruh dunia disebabkan oleh pneumonia. Faktor risiko pasti yang berkontribusi diantaranya yaitu balita yang tidak mendapatkan ASI eksklusif.
Tujuan studi ini untuk mengetahui hubungan pemberian ASI eksklusif terhadap kejadian pneumonia balita usia 12 -23 bulan setelah dikontrol terhadap confounder. Studi kasus kontrol ini dilakukan di tiga wilayah puskesmas Kota Cimahi berdasarkan angka insidens kasus pneumonia balita yang tertinggi di tahun 2012. Kasus adalah balita usia 12 - 23 bulan yang berkunjung ke sarana puskesmas penelitian periode Januari - Desember 2012 dan didiagnosa sebagai kasus pneumonia. Kontrol merupakan tetangga dari kasus, dengan perbandingan jumlah kasus dan kontrol yaitu 1:1. Besar sampel minimal sebanyak 133 untuk masing - masing kelompok. Analisis multivariat dengan menggunakan regresi logistik. Besar asosiasi balita yang tidak mendapat ASI eksklusif memiliki OR untuk terjadinya pneumonia sebesar 3,58 kali (95% CI: 2,08 - 6,19) dibandingkan yang mendapat ASI eksklusif setelah dikontrol terhadap confounder.
Penelitian ini memperkuat penelitian terdahulu yang membuktikan kekuatan hubungan pemberian ASI eksklusif terhadap kejadian pneumonia pada balita. Berfokus pada daerah dengan angka insiden kasus penumonia yang tinggi, pihak dinas kesehatan dan puskesmas dapat lebih meningkatkan upaya promosi dan fasilitasi ASI eksklusif, menciptakan kawasan tanpa asap rokok di tingkat rumah tangga, pengurangan adanya paparan asap pembakaran di dalam rumah, peningkatan pengetahuan ibu berkaitan faktor risiko pneumonia.
Pneumonia is the biggest cause of death in children worldwide. Each year approximately 18% of estimated deaths of children under five worldwide are caused by pneumonia. Definite risk factors that contribute to them are children under five who are not exclusively breastfed.
The purpose of this study to determine the relationship of exclusive breastfeeding on the incidence of pneumonia children under five age 12 -23 months after controlling for confounders.Case-control study was conducted in three areas of public health centers Cimahi City based incidence rates were highest children under five cases of pneumonia in 2012. Cases were children aged 12-23 months who visited the research public health centers means the period of January to December 2012 and was diagnosed as a case of pneumonia. Control is a neighbor of the case, the ratio of the number of cases and controls is 1:1. Minimum sample size for each of as many as 133 - each group. Multivariate analysis using logistic regression. Major association children under five who are not exclusively breastfed for the occurrence of pneumonia had an OR of 3.58 (95% CI: 2.08 to 6.19) than those who are breastfed exclusively after controlling for confounders.
This study reinforces previous research that proves the strength of association of exclusive breastfeeding on the incidence of pneumonia in infants. Focusing on areas with a number of high incidence of cases of pneumonia, the health department and public health center could further enhance the promotion and facilitation of exclusive breastfeeding, creating a smoke-free area at the household level, reduction in exposure to combustion fumes in the house, increasing maternal knowledge of risk factors associated pneumonia.
Kata kunci : stunting, ASI eksklusif, balita 6-59 Bulan.
Stunting is a state of body short and very short to beyond the deficit -2SDbelow the median length or height. Stunting in children can be fatal to their futureproductivity of adults. Stunting associated with impaired immune function andincrease the risk of death. The general objective of this study is known picture ofthe behavior of exclusive breast-feeding mothers in the incidence of Stunting intoddlers (6-59 months) at the district health center Kilasah Kasemen. Cross-sectional studies have been conducted on the behavior of exclusive breastfeedingwith events Stunting with bivariate results obtained meaningful relationships ofknowledge, attitudes and practices towards exclusive breastfeeding Stuntingevents.
Key Words : stunting, exclusive breastfeeding, toddlers 6-59 month.
