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Pencapaian cakupan imunisasi hepatitis B1 pada bayi 0-7 han merupakan salah satu indikator mutu pelayanan yang dilakukan oleh penolong persaliman. (bidan), indikator tersebut menunjukan tamptlan kerja bidan apakah semua bayi yang persalinanya ditolong oleh bidan diberikan imunisasi hepatitis B1 atau tidak. Tampilan hasil kerja merapakan salah satu gambaran perilaku individu atau kelompok dari tingkat kepatuhannya terhadap standar pelayanan yang ada. Di Kabupaten Pandeglang angka pencapaian imunisasi hepatitis B1 pada bayi 0 - 7 hari masth sangat rendah (34.2%) tahun 2004, sementara angka cakupan persalinan yang ditolong oleh bidan sebesar 57,6 % . Dengan kondisi ini dapat diasumsikan adanya faktor -faktor yang berpengaruh terhadap pemberian imunisasi Hepatitis B1 pada bayi 0-7 hari oleh bidan pada pertolongan persalinan. Salah satu faktor yang berpengaruh adalah standar pelayanan imunisasi befum sepenuhnya dilaksanakan oleh bidan khususnya imunisasi hepatitis B1 pada bayi 0 - 7 hari. Penelitian ini dilakukan untuk melihat kepatuhan bidan dalam melaksanakan standar pelayanan imunisasi hepatitis B! pada bayi 0-7 hari. Penelitian ini menggunakan 2 (dua) pendekatan yaitu pertama kualitatif dilakukan dengan elaborasi kepustakaan dan elaborasi dikalangan pelaksana dengan wawancara mendalam. Hasil elaborasi ini menghasilkan kerangka empiris dan kuesioner final yang akan digunakan untuk tahap berikutnya. kedua tahap kuantitatif dengan menggunakan desain cross sectional. Hasil penelitian menggambarkan bahwa responden (bidan) yang menunjukan kepatuhan terhadap standar pelayanan imunisasi hepatitis B pada bayi 0-7 hari iebih banyak yang patuh dibandingkan dengan responden yang tidak patuh. Sedangkan variabel independent yang mempunyai hubungan bermakna terhadap kepatuhan responden (bidan) dalam melaksanakan standar pelayanan imunisasi hepatitis B pada bayi 0-7 hari adalah variabel pengetahuan, sarana, imbalan, supervisi, motivasi dan pandangan bidan terhadap tradisi masyarakat, Dart semua variabel yang berhubungan signifikan, variabel motivasi merupakan variabel yang paling dominan. Memang dalam kaitanya dengan pelaksanaan imunisasi, seorang petugas akan termotivasi untuk melaksanakan standar pelayanan imunisasi, bila diyakini benar bahwa tindakannya akan menghantarkan ke suatu penilaian kinerja, penilaian yang baik akan mendorong untuk mendapatkan kebutuhan yang diharapkan, dimana kebutuhan tersebut akan memuaskan pribadi petugas. Sehingga upaya peningkatan mutu pelayanan dalam penelitian ini, faktor yang paling penting dalam perbaikan adalah dengan pendekatan pada proses. Identifikasi, penentuan prioritas dan penentuan penyebab potensial masalah dalam penelitian ini difokuskan kepada motivast petugas yang akan mempengaruhi terhadap kepatuhanya dalam melaksanakan standar pelayanan imunisasi hepatitis B pada bayi 0-7 hari. Upaya perbaikan mutu pelayanan yang berkesinambungan ini menggunakan siklus PDCA(Plan-Do-Check-Action). Dalam penelitian ini penulis memberikan saran kepada Dinas Kesehatan dan Puskesmas di Kabupaten Pandeglang agar dalam meningkatkan mutu pelayanan kesehatan selalu berorientasi pada perbaikan yang terus-menerus dan berkesinambungan pada simpul proses, sehingga tidak memberikan dampak pemborosan. Dalam memenuhi semua Kebutuhan fasilitas, sarana dan dukungan sebaiknya lebih meningkatkan advokasi kepada semua pengambil kebijakan di setiap jenjang, schingga semua yang diperlukan dapat menunjang keberhasilan program imunisasi tersebut.
Attainment of Coverage immunize hepatitis BI at baby 0-7 day represent one of indicator quality of service conducted by birth helper (midwife), this indicator as performance of midwife work, whether all baby which helped by midwife given to by immunize hepatitis B1 or not. Appearance result of job represent one of behavioral picture of individual or group of people from level of his compliance to standard of existing service. In Pandeglang District the number of attainment immunize hepatitis Bi at baby 0 - 7 day still be very low ( 34,2%) year 2004, whereas number of coverage is copies with helped by midwife of equal to 57,6 . With this condition can be assumed by a factor existence factor having an effect on to gift immunize Hepatitis Bl at baby 0-7 day by midwife that help the birth. One of factor having an effect on standard of service immunize not yet full executed by midwife specially immunize hepatitis Bi at baby 0 - 7 day. This research is conducted to see compliance of midwife in executing standard of service immunize hepatitis B1 at baby 0-7 day. This research use 2 ( two) of phase that is first of phase is qualitative conducted by elaborasi is reference and elaborasi of among executor with circumstantial interview. result of this Elaborasi yield empirical framework and kuesioner of final to be used for the next phase. second of quantitative phase by using desain cross sectional. The result of research that responder (midwife) which compliance to service standard immunize hepatitis B at baby 0-7 day, proportional compliance responder more than which not compliance, While variable independent having relation have a meaning to responder compliance in executing service standard immunize hepatitis B at baby 0-7 day, is knowledge vanable, reward, supervise, midwife view and motivation to tradition socialize, From all coresponding variable of signifikan, variable motivate to represent most dominant variable. It is true that the relationship immunization activities, a worker will be motivated to do service standard immunize, 1f believed by correctness that his, action will send to a performance assessment, good assessment will push to get requirement expected, where the requirement will gratify worker person. So that, the improvement quality of service in research, the determinant this improvement factor in repair is with approach of process. Identify, potential cause determination and priority determination of internal issue this research is focussed to worker motivation to influence to compliance in service standard immunize hepatitis B at baby 0-7 day. Strive repair of quality of continual service use cycle PDCA (Plan-DoCheck-Action). In this reaserch, the writer suggest to health District office and public health service in Pandeglang District to increase the quality health service that focus to continous improvement ai processing, so that not extravagance impact. In fulfilling all facility requirement, support and medium better more improve advokasi to all policy taker in every ladder, so that all that is needed can support efficacy program to immunization
The health service for people suspected of having TB is one of the minimum service standards (MSS) in the health sector that must be met by the district/city government. The Public Health Center is the leading unit in achieving the MSS performance targets in the health sector. TB MSS achievement in Depok city in 2021 only reached 36.17% and became the second lowest achievement of the 12 MSS in Depok City Health. The aim of this study was to analyze in depth aspects of the structure, aspects of the quality and performance improvement process using the PDSA (Plan-do-study-act) approach as well as outputs in an effort to increase the achievement of health services for people suspected of having TB at the Depok City Health Center in 2022. This research used a qualitative approach using a case study design through in-depth interviews with 31 informants, field observations and document searches. The results of the study, not all Public Health Centers have established TB Dots Teams, lack of trained personnel, not all facilities are up to standard, medicinal materials are not adequate, use of information technology is not optimal, leadership and staff commitment is still lacking. In terms of process factors, not all Public Health Centers have conducted monitoring and evaluation of TB MSS achievements at the study stage. On output; there has been an increase in the achievement of services for people suspected of having TB in 2022 compared to 2021, but not all Public Health Centers have reached the set TB MSS target. Conclusion: structural factors and quality and performance improvement processes carried out influence success in achieving TB MSS at the Public Health Centers