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There is an increase in maternal mortality in Indonesia. In 2023, only 57.8% of pregnant women received standardized antenatal care (ANC). In 2022, there were 5 maternal deaths in Pematangsiantar City. The coverage of ANC K6 reached 81.6%, but there were still 230 cases of complications in pregnancy and public health centers (PHC) whose coverage was still below the target. The following study aims to determine the factors that contribute to the low coverage of ANC in several PHCs in Pematangsiantar City. This study used a non-experimental design with a comparative descriptive study. Research informants were selected using purposive sampling and exit poll techniques. Research informants consisted of heads of PHCs, midwives, doctors and pregnant women. The variables are structure (human resources, facilities, disposable medical materials, funding, guidelines) and processes (planning, organizing, implementing, supervising). Data collection through in-depth interviews, observations and document reviews. The results of the study indicate that there is sampling bias. Factors that contribute are planning and implementation of ANC. Cooperation with the Population and Civil Registration Agency (Dukcapil) is needed to access the latest pregnant women data. Also, socialization of the importance of routine ANC visits to increase ANC participation of pregnant women.
Breast milk (ASI) is the liquid secreted by the mother's breast glands in the form of natural food or the best nutritious and high-energy milk produced since the mother's pregnancy (Wiji, 2013). Nationally, from the 2017 Ministry of Health data, the coverage of exclusive breastfeeding for babies is 61.33%, but there are still some provinces that have not reached this coverage. This study aims to determine the factors that influence exclusive breastfeeding in Indonesia. This study used a quantitative approach with a cross sectional study design. The results of the study were analyzed using univariate, bivariate, and multivariate analysis. In this study, the results of the bivariate analysis showed that the variables that had a relationship with exclusive breastfeeding were the mother's working status variable (p value 0.013), health facilities during childbirth (p value 0.001), information exposure (p value 0.044), and IMD. (p value 0,000). Broadly speaking, the coverage of exclusive breastfeeding in this study is quite good, amounting to 61.0%. From the results of the multivariate analysis, it was found that the variables that had the most association with exclusive breastfeeding were maternal occupational status and BMI.
Kata kunci: AIDS; HIV; Implementasi Kebijakan; Kota Tangerang;
PPIA PMTCT is part of a series of HIV and AIDS control efforts. The ultimate goal is that infants born to mothers with HIV are released from HIV, and mothers and infants remain alive and well. Currently with the Regulation of the Minister of Health No. 43 of 2016 on Minimum Service Standards (MSP) of the health sector for the District / City explicitly states that everyone is at risk of HIV infection (pregnant women, TB patients, STI patients, transgender, drug users, and prisoners) get standard HIV testing with 100% achievement targets. This target is quite heavy when looking at data PMTCT achievement during this time is still very low. Regular data of Tangerang City Health Office in 2017, coverage of first antenatal visit to health worker of Tangerang City has reached 100% but the number of pregnant women tested by HIV is only 4,230 people or only 10% (SIHA, 2017). Therefore, the researcher conducted analysis of policy implementation of Prevention of Mother to Child of HIV Transmission (PMTCT) to get in-depth information how the implementation of PMTCT policy in Tangerang City 2017. This research is a qualitative research with data collection technique in depth interview and focus group discussion. Triangulation of sources is done by comparing data obtained from one informant with another informant. The study of the documents produced, as well as the literature study done as a comparison to the information that has been obtained. The results showed that the implementation of PMTCT policy in Tangerang City in 2017 still not in accordance with the policy in PMTCT Program Management Guidelines and Implementation Guidelines of PMTCT, so that the output has not depicted the implementation of PMTCT as a whole. Communication factors are factors that affect implementation, especially communication with clinics, private hospitals and independent midwives. Resource factors, especially facilities, need to be considered for the distribution of reagents and RDT not only in puskesmas but also to private health care facilities. Disposition factors, especially the commitment to Tangerang City Hospital is able to become a reference hospital PPIA. Bureaucratic structural factors need to be established cross-program / cross-sectoral teams in PPIA services joining HIV topics, as well as strengthening the recording and reporting of independent midwives on indicators of pregnant women tested for HIV and HIV-positive pregnant women. Socio-economic conditions support PMTCT services with a free health insurance program through Universal Health Coverage (UHC) for all citizens of Tangerang City. However, there are still stigma and discrimination that can prevent pregnant women from testing HIV.
Key words: AIDS; HIV; PMTCT; policy implementation; Tangerang City
