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Tesis ini membahas tentang perilaku pemilihan tempat persalinan oleh ibu bersalin di wilayah Puskesmas Liwa Kabupaten Lampung Barat tahun 2012. Di wilayah Puskesmas Liwa tahun 2012, pelayanan kesehatan dan fasilitas kesehatan sudah tersedia, pertolongan persalinan oleh tenaga kesehatan sudah tinggi namun masih sedikit persalinan yang dilakukan di fasilitas kesehatan. Penelitian ini adalah penelitian kuantitatif, yang menggunakan pendekatan kasus kontrol/case control.
Background: Maternal mortality can be prevented by delivering in a health care facility. Women who are not involved in decision making are barriers to using health facilities. Pregnant women often cannot determine the place of delivery because the decision is determined by their husband, parents-in-law or other family members. The delays of decision- making at the family level results in delays in getting help at health facilities. Objective: To determine the relationship between women's participation in household decision making with the selection of place of delivery based on analysis of the 2017 Indonesian Demographic Health Survey data. Methods: Designs study was sross-sectional and data was obtained from the Indonesia Demographic Health Survey 2017. Sample was women of childbearing age 15-49 years who had given birth to the last child in 2012-2017 with complete data, total 14,310 respondents. Data were analyzed using Cox regression and the effect was expressed by prevalence ratio (PR) with a 95% confidence interval (CI). Results: The proportion of women giving birth in non-health facilities was 26.5%, and 30.7% of women were not involved in in household decision making. After controlling residence and economic status, women who did not participate in household decision making had a risk of 1,633 (1,531-1,741) times to give birth in non-health facilities compared to women who participated in household decision making. Conclusion: Women who did not participate in household decision making were significantly related to deliveries in non-health facilities. Therefore, the government needs to promote women's reproductive, gender equality, and conduct a study of regions that still birth in dukun.
It is estimated that about 73% of neonatal mortalities occur in the early neonatal period. Commonly, the cause of early neonatal mortalities could be prevented and treated in newborns, one of the approach is by giving birth with skilled birth attendants. However, previous studies reported inconsistent results regarding the association between place and birth attendant on early neonatal mortality. Therefore, this study aims to determine the effect of place and birth attendants (health facility birth, home birth with skilled birth attendants, and home birth without skilled birth attendants) on early neonatal mortality in Indonesia. The study used a cross-sectional design and analyzed 2007, 2012, and 2017 IDHS data. The samples were all respondents/women of reproductive age who gave birth to their last live-born baby. The results of the study found that the early neonatal mortality rate was 8.40 per 1000 live births. Delivery at the health facility, or at home with skilled birth attendants, did not reduce early neonatal mortality compared to delivery at home without skilled birth attendants. The association for delivery at health facility was 1.95 (95% CI 0.83-4.51), while delivery at home with skilled birth attendants was 1.97 (95% CI 0.99-3.90). Efforts to reduce early neonatal mortality need to consider planned referrals, the quality of health facilities, the competency of health workers, also synergies with other programs such as prenatal and postnatal checks
Tesis ini membahas tentang pemilihan tempat persalinan di rumah oleh ibu dengan riwayat ANC lengkap di Kecamatan Cimanuk Kabupaten Pandeglang, pada tahun 2012. Pelayanan kesehatan, fasilitas dan informasi kesehatan sudah tersedia, pemanfaatan terhadap pelayanan ANC dan bidan sebagai penolong persalinan sudah tinggi namun belum sepenuhnya dapat mendorong masyarakat untuk memilih fasilitas kesehatan sebagai tempat persalinannya. Penelitian ini adalah penelitian kualitatif, yang menggunakan pendekatan Rapid Assesment Procedures (RAP). Hasil dari penelitian ini menemukan bahwa sebagian dari masyarakat memilih rumah sebagai tempat persalinannya, namun sebagiannya lagi memilih fasilitas kesehatan sebagai tempat persalinannya. Penelitian ini juga menyarankan untuk meningkatkan peran lingkungan keluarga, masyarakat dan petugas dalam mendukung pemanfaatan fasilitas kesehatan untuk persalinan.
This thesis discusses the selection of the delivery at home by mothers with a history of complete ANC in Cimanuk sub district, Pandeglang District, year 2012. Health services, facilities and health information is available, the utilization of the ANC and the midwife as a birth attendant is high but has not been fully able to encourage people to choose a health facility as a place of confinement. This research is a qualitative study, which uses the approach of Rapid Assessment Procedures (RAP). The results of this study found that the majority of people choosing a home as a place of confinement, but partly choosing health facility as a place of confinement. This study also suggested to increase the role of the family, the community and staff in supporting the utilization of health facilities for delivery.