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ABSTRAK
Perilaku tidak selamat oleh operator dan customer merupakan perilaku yang dapat menyebabkan terjadinya kecelakaan kerja di lingkungan SPBU. Penelitian ini bertujuan untuk mengidentifikasi jenis-jenis perilaku tidak selamat oleh operator dan customer SPBU. Metode yang digunakan untuk penelitian ini yaitu cross sectional pada SPBU COCO dan DODO terpilih berdasarkan mayoritas customernya yaitu kendaraan pribadi dan kendaraan umum di Wilayah DKI Jakarta. Pengambilan data dilakukan dengan observasi dan kuesioner di delapan lokasi SPBU COCO dan DODO. Hasil analisis data secara keseluruhan bahwa sebanyak 36,6% operator dan customer berperilaku tidak selamat, sedangkan 63,4 % berperilaku selamat. Selanjutnya dari hasil analisis pada operator dan customer untuk tiap SPBU di temukan jenis-jenis perilaku yang menyimpang dari prosedur standard operasi, sehingga beberapa perilaku ini yang menjadi karakteristik untuk harus dihindari oleh operator dan customer SPBU. Maka dari
itu, langkah awal yang harus dilakukan oleh manajeman SPBU adalah melakukan pengawasan terhadap perilaku kerja dari operator dan customer di lingkungan SPBU, sehingga tercipta budaya kerja yang sudah mencerminkan managemen keselamatan dan kesehatan kerja.
ABSTRACT
Unsafe behaviour an operator or customer that is a behavior at caused the accident s at Gas Station Fuelling Sistem. The purpose of research to identificating the unsafe behavior abaut the operators or customers at Gas Station. This research use of cross sectional Methode at gas station COCO and DODO choosen with the major of customers is private vehicles and public vehicles in DKI Jakarta. Observation abaout it is take at eight gas statioan in COCO and DODO. The analysis result for all responden have 36,6% operators dan customers doing the unsafe behavior but 63,4 % doing safe behavior. So for the analysis result an operators and customers at each gas station has been know the others unsafe behavior for the prosedur operation standar. The first solution to solved the problem is give a monitoring for operators and cutomers behavior, and to make the safety cultures at the gas station anf the operatora and customers can be doing the safe behavior.
Perubahan iklim berpotensi meningkatkan risiko penyakit berbasis lingkungan, termasuk diare. Di Indonesia, prevalensi diare balita masih tergolong tinggi, meskipun menurun dari 12,3% (Riskesdas 2018) menjadi 9,8% (SSGI 2020). Kondisi ini menunjukkan adanya faktor lain yang memengaruhi, termasuk parameter iklim yang belum banyak diteliti secara spesifik dalam konteks Indonesia.
Penelitian ini bertujuan untuk mengembangkan model prediksi risiko diare secara komparatif pada dua zona iklim berbeda: monsunal (Nusa Tenggara Barat) dan ekuatorial (Sumatera Barat). Desain penelitian adalah studi ekologi, dengan data sekunder tahun 2017-2021 yang diperoleh dari Kementerian Kesehatan (kasus diare), BPS (akses air minum tidak aman, sanitasi terbatas, higiene terbatas, status ekonomi dan kepadatan penduduk), dan BMKG (suhu udara, kelembapan, curah hujan). Analisis dilakukan menggunakan regresi binomial negatif.
Hasil menunjukkan bahwa curah hujan berhubungan signifikan terhadap kejadian diare di Sumbar (IRR=0,998) dan NTB (IRR=1,002). Suhu udara hanya signifikan di Sumbar (IRR= 0,955), sedangkan kelembapan hanya signifikan di NTB (IRR=0,954). Akses air minum tidak aman dan sanitasi terbatas berhubungan signifikan di kedua provinsi, sedangkan higiene terbatas tidak menunjukkan hubungan signifikan. Tingkat kemiskinan berpengaruh signifikan hanya di NTB (IRR=1,025). Model prediksi menunjukkan performa yang baik, meskipun akurasinya berada pada kategori rendah hingga sedang.
Kesimpulannya, variabilitas iklim berkontribusi terhadap risiko diare dengan pola yang berbeda antarwilayah. Faktor lokal seperti letak geografis, infrastruktur, dan ketersediaan layanan dasar—khususnya akses terhadap air minum aman dan sanitasi layak—memegang peran penting. Diperlukan penguatan kolaborasi lintas sektor dan keterlibatan masyarakat untuk pengendalian diare yang adaptif terhadap perubahan iklim.
Climate change can exacerbate environment-related disease, including diarrhea. In Indonesia, diarrhea prevalence among children under five remains high, although it declined from 12,3% (Basic Health Research, 2018) to 9,8% (National Health Survey, 2020). This indicates the influence of additional factors, including climatic parameters that have not been thoroughly examined in the Indonesian context.
This study developed a comparative diarrhea risk prediction model across two climate zones: monsunal (West Nusa Tenggara) and equatorial (West Sumatera). An ecological design was employed using 2017-2021 secondary data from the Ministry of Health (diarrhea cases), the Central Bureau of Statistics (BPS) (unsafe drinking water access, sanitation, hygiene, economic status, population density), and the Meteorology, Climatology, and Geophysics Agency (BMKG) (temperature, humidity, rainfall). Data were analyzed using negative binomial regression.
Rainfall was significantly associated with diarrhea incidence in both provinces (West Sumatera IRR = 0,998; West Nusa Tenggara IRR = 1,002). Air temperature was significant only in West Sumatera (IRR = 0,955), while humidity was significant only in West Nusa Tenggara (IRR = 0,954). Unsafe water access and poor sanitation were significant in both provinces, whereas hygiene showed no association. Poverty was significant only in West Nusa Tenggara (IRR = 1,025). The model performed well, with accuracy in the low-to-moderate range.
In conclusion, climate variability contributes to diarrhea risk, with distinct patterns across regions. Local factors such as geography, infrastructure, and the availability of basic services— particularly access to safe drinking water and adequate sanitation—play a crucial role. Strengthening cross-sectoral collaboration and community engangement is essential for developing climate-adaptive diarrhea control strategies.
ABSTRAK
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.
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.
