Abstrak: Kondisi geografis dan akses yang sulit masih menjadi kendala dalamefektifitas pelayanan kesehatan ibu dan anak di NTT yang menyebabkan munculnyamasalah 3T dan tingginya AKI dan AKB. Jalan keluar yang ditempuh antara lainadalah Revolusi KIA NTT dengan penyediaan rumah tunggu kelahiran (RTK).Tujuan dari penelitian ini adalah mengetahui efektivitas pemanfaatan RTKoleh ibu hamil di Manggarai Barat NTT tahun 2016. Pemanfaatan rumah tungguberhubungan faktor predisposisi (predisposing factors), faktor pemungkin (enablingfactors) dan faktor penguat (reinforcing factors).Metode penelitian ini adalah Mixed Method Research dengan desaineksplanatoris. Penelitian ini mengambil jumlah sampel survey sebanyak 100responden dengan metode multistage random sampling jumlah respondenwawancara mendalam 29 responden. Analisis data menggunakan program StatisticalProduct and Service Solutions (SPSS) program Nvivo 11 Plus. Analisis kuantittatifmenggunakan metode Chi Square Test.Hasil penelitian terdapat 19% ibu hamil menggunakan RTK di ManggaraiBarat tahun 2016. Wawancara mendalam menunjukkan bahwa keberadaan RTKberdampak positif bagi banyak ibu hamil dari geografis sulit dan ibu hamil yangberesiko tinggi.
Hasil analisis kuantitaf dari faktor predisposisi (predisposing factors)menunjukkan bahwa umur (p=0.38), pendidikan (p=0.301), pengetahuan (p=0.201),pekerjaan (p=0.68), kondisi ekonomi (p=0.592), sikap (p=0.452) dan faktor sosialbudaya tidak mempunyai hubungan yang bermakna dengan pemanfaatan RTK diManggarai Barat. Faktor ketersediaan sarana dan tenaga kesehatan mempunyaihubungan bermakna (p=0.038) serta ketersediaan sarana transportasi juga bermakna(P=0.04). Faktor ketersediaan kendaraaan dijelaskan oleh faktor jarak dan faktorgeografis. Faktor-faktor penguat (reinforcing factors) seperti keluarga (p=0.201), masyarakat (p=1), tenaga kesehatan (p=0.26) dan pemerintah (p=0.345) tidak bermakna terhadap pemanfaatan RTK di Manggarai Barat tahun 2016.

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Bad goegraphic condition and bad access to health facility still remain to bethe big problem in effectivity of maternity care in NTT Province, Indonesia. The badaccess to the facility causes the problems of 3 Lates (Tiga Terlambat) and still highof MMR and IMR. One of the wayouts of the problems is the revoluiton of Motherdan Infant Health care in NTT since 2009 with providing maternity waiting houses(MWH) near facility of health care.The aim of the study is to determine the effectivity of using maternity waitinghouses in district of Manggarai Barat, Province of NTT, in 2016. The use of MWHlink to the factors of: predisposing factors, enabling factors and reinforcing factors.This research uses Mixed Method Research with explanatory design. Totalsurvey samples are 100 respondents using multistage random sampling method andtotal indepth interview samples are 29 respondents. The analisys of data using thesoft ware program of Statistical Product and Service Solutions (SPSS) and Nvivo 11Plus.The result of the survey is 19% pregnant women used MWH in ManggaraiBarat in 2016. Indepth Interview shows the fact that the use of MWH have a positiveimpact for many pregnant women from the villages with bad geographic conditionsand the pregnant women with high risk maternity. The quantitative analysis showingthe result that the predisposing factors: age (p=0.38), education (p=0.301),knowledge (p=0.201), work (p=0.68), socio-economic condition (p=0.592), attitude(p=0.452) and socio-cultural factors had no significant relation with the use of MWHin Manggarai Barat in 2016. The factors of heath facility and healt care provider(p=0.038) and the presence of transportation facility (car or vehicles) (p=0.04) havesignificat relation with the use of MWH. The reinforcing factors: family (p=0.201),public figures (p=1), health care provider (p=0.26) and government (p=0.345) had nosignificant relationship with the use of MWH in Manggarai Barat, 2016.

Abstrak: Kasus Covid-19 semakin meningkat hingga pada 30 Januari 2020, WHO menetapkan KMMD. Bahkan, sampai 22 Juni 2021 sebanyak 23,8% kasus terkonfirmasi berada di Provinsi DKI Jakarta dan 6.393 jiwa berada di wilayah PKC Pademangan. Selain menangani Covid-19, Puskesmas tentunya tidak meninggalkan pelayanan yang menjadi fungsi Puskesmas salah satunya pelayanan KIA. Penelitian ini bertujuan untuk menganalisis dampak pandemi terhadap pelayanan KIA di PKC Pademangan. Penelitian kualitatif dengan desain rapid assessment prosedur ini menggunakan data primer dari wawancara mendalam dan data sekunder dari telaah dokumen. Hasil penelitian menunjukkan adanya perbedaan komponen input, proses, dan output pada sebelum dan selama pandemi. Pada komponen input, perbedaan pada refokusing anggaran sehingga berkurang dari tahun sebelumnya, serta dibukanya RB yang menjadikan SDM di KIA terbagi untuk pelayanan RB. Pada komponen proses, metode perencanaan menjadi daring serta meminimalisir kegiatan outdoor dan sesuai protokol kesehatan. Pandemi menjadikan adanya tim tersendiri untuk rujukan dan penanganan Covid-19. Pada komponen output, sebagian besar capaian bulanan tahun 2020 lebih rendah daripada tahun 2019. Puskesmas sebagai pembinaan wilayah dapat merangkul aparat daerah, masyarakat, dan fasilitas kesehatan yang berada di wilayah Kecamatan Pademangan, serta meningkatkan peran keluarga dengan memberikan pendidikan kesehatan agar semakin banyak ibu termotivasi dan sadar akan pentingnya pemeriksaan KIA secara teratur

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As the increasing of the covid-19 case by January 30, 2020, WHO makes the final decision as the PHEIC. According to the data, by June 22, 2021, 23% of cases have been confirmed in Jakarta and 6.393 people have been infected in Pademangan district. This research aims to analyze the covid 19 impacts on the Maternal and Child Health in Pademangan district. This is qualitative research that uses a design of rapid assessment procedure with primary data of inclusive interview and secondary data from the documents that have been analyzed. The result of this research shows that there are distinctions from the input, process, and output before and during pandemic. In the input component, there is the main distinction in refocusing the cost budget as the result the budget for Maternal and Child Health has been reduced from the previous year, they also provide delivery rooms that cause the healthcare workers has been split up for dealing the patients in delivery rooms. In-process component, planning method becomes a non-face to face to minimize the outdoor activity and to follow health protocol. In the output component, most of the monthly work target in 2020 is lower than in the year 2019

Abstrak:

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.

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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.