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ABSTRAK Nama : Isti Dariah Program Studi : Kesehatan Reproduksi Judul : Faktor yang Berhubungan dengan Kematian Neonatal di Wilayah Kerja Dinas Kesehatan Kota Cimahi Tahun 2016 Latar Belakang: Kondisi pembangunan kesehatan secara umum dapat dilihat dari status kesehatan dan gizi masyarakat, yaitu salah satunya Angka Kematian Bayi. Penyumbang Angka Kematian bayi di kota Cimahi adalah Angka Kematian neonatal dimana pada tahun 2013 sebesar 83% Kematian bayi terjadi pada periode neonatal dan pada tahun 2014 sebesar 76,9% .Pada Tahun 2016 terjadi kematian neonatal 50 orang dan kematian bayi 66 dan sebagaian besar terjadi pada periode neonatal. Dalam 7 tahun ke belakang ( Tahun 2009 – 2015) program penurunan kematian bayi khususnya kematian neonatal di Kota Cimahi kurang signifikan bahkan cendrung naik pada Tahun 2016 dan belum adanya analisis mendalam terhadap penyebab kematian bayi. Metode: Penelitian bersifat observasional dengan desain kasus kontrol. Kasus adalah bayi meninggal usia 0 sampai dengan 28 hari. Sedangkan kontrol adalah bayi lahir hidup. Sampel dalam penelitian sebanyak 86 yang terdiri dari 43 kasus dan 43 kontrol. Data penelitian data berupa data sekunder dari hasil laporan otopsi verbal kematian neonatal, buku KIA dan data primer yang diperoleh langsung dari responden melalui wawancara tertulis dan formulir. Analisa data secara univariate dan bivariate dengan uji chi square. Hasil Penelitian: Analisi faktor risiko menunjukkan variable pendidikan (Nilai P=0,828), sosial ekonomi (Nilai P=0,008; OR=4,440), Umur Ibu (Nilai P=0,471; OR= 1,5930), paritas (Nilai P = 0,375; OR= 1,640 ), Jarak persalinan (nilai P= 0,009; OR= 7,935), Pekerjaan (Nilai P= 0,000; OR= 15,333), Status Gizi (nilai P = 0,016; OR=7.047), pengetahuan ibu tentang tanda bahaya kehamilan (Nilai P=0,015; OR= 4,032), pengetahuan tentang tanda bahaya bayi baru lahir (Pvalue= 0,001; OR= 10,982), Jenis Kelamin (Nilai P= 0,512), Usia Getasi (Nilai P=0,000; OR= 25,895), Asfiksia (Nilai P=0,000; OR=2,870), BBLR (Nilai P=0,000; OR=12,316), Infeksi (Nilai P= 0,018; OR=2,344),faktor persalinan (Nilai P= 1,000), Komplikasi (P= 0,010; OR=3,496), post natal care (nilai P= 0,023; OR=5,161), Pemeriksaan ANC (nilai P= 0,001 ; OR=5,914), IMD (P= 0,001; OR=12,500). Kesimpulan : Faktor ekonomi keluarga, jarak kehamilan, pekerjaan, status gizi, pengetahuan tentang bahaya kehamilan, pengetahuan tentang bahaya BBL, usia getasi, asfiksia, BBLR, infeksi, komplikasi post natal care, pemeriksaan ANC dan intervensi (IMD) berhubungan dengan kematian neonatal. Kata kunci: Faktor Risiko; Kematian Neonatal; Kasus Control
ABSTRACT Name : Isti Dariah Study Program : Reproductive Health Title : Factors Associated with Neonatal Mortality in the Work Territory of Health Region in Cimah City 2016 Background:Health development conditions in general can be seen from the health status and nutrition of the community, one of which is the Infant Mortality Rate (IMR). The contributor of the Infant Mortality Rate in Cimahi city is neonatal mortality rate. In 2013 the incidenceof infant mortality in neonatal period is 83%and 76.9% in 2014. In 2016, there are 50 of infant mortality and 60 of neonatal mortality. In the past 7 years (from 2009 to 2015)program to decreaseinfant mortality, especially neonatal mortality in Cimahi City is not significant,yet tend to increasein 2016 and there has not any deep analysis to what causes the infant mortality. Methods: The study was observational with case control design. Cases are infants dying from 0 to 28 days. While the controls arethe infants-bornalive. Samples in this study were 86 consisting of 43 cases and 43 controls. The data collected were secondary data from verbal autopsy report of neonatal death, KIA book and primary data obtained directly from respondents through written interview and forms. Data analysis used univariate and bivariate data with chi square test. Results: Risk factor analysis showed educational variables (P value = 0.828), socioeconomic (P value = 0.008 OR = 4.440), maternal age (P value = 0.471, OR = 1.5930), parity (P value = 0.375 ; OR = 1,640), Gestational Distance (P value = 0.009; OR = 7,935), Occupation (P = 0,000; OR = 15,333), Nutritional Status (P = 0.016; OR = 7.047), maternal knowledge about pregnancy alert (P = 0.015; OR = 4,032), knowledge of the newborn hazard (Pvalue = 0.001; OR = 10,982), Gender (P value = 0.512), Age Gestation (P = 0,000; OR = 25,895) Asphyxia (P = 0,000; OR = 2,870), BBLR (P = 0,000; OR = 12,316), Infection (P = 0.018; OR = 2,344), labor factor (P = 1,000), Complications (P = 0.010 ; OR = 3,496), post-natal care (P value = 0.023; OR = 5,161), ANC examination (P value = 0.001; OR = 5,914), IMD (P = 0.001; OR = 12,500). Conclusions: Family economic factors, gestational distance, occupation, nutritional status, knowledge of pregnancy hazards, knowledge of BBL dangers, age of gestation, asphyxia, LBW, infections, postnatal care complications, ANC and intervention (IMD) are associated with neonatal mortality. Keywords: Case control; Risk Factors; Neonatal Mortality.
Background: Nutrition aspect is one of the most important factors on human resources development. On the other hand the prevalence of malnutrition in South Jakarta District in year 2003 was still very high, there were 2,250 (12.56 %) and 354 (1.98 %) under-five children at severe malnutrition condition. If we refer to those numbers it could assume that everyday there was malnutrition outbreak in that area. In its implementation, the nutrition surveillance (nutritional status monitoring) is supported by an information system called early warning system for food and nutrition problems (SKPG) which has already available in every health center in sub-district level in Jakarta Province. However up to now the system could not implement due to some constraints. Objective: The purpose of the study is to develop an information system for nutritional status monitoring among under-five children that prover, meet the requirement, and user friendly in Pesanggrahan Sub-District. Methodology: The study was conducted based on system development live cycle which consist of planning phase, analyses, and scheme of system tryout. Examination of system only conducted in laboratory by using data of sampel. Results: This research was resulted a prototype of information system to monitor the nutritional status among under-five children in Puskesmas Pesanggrahan (SIPSG). Conclution: SIPSG is expected to supply any needed information effectively. The system is designed to provide relevant, quick, precise and accurate data. Hopefully the system will be more useful in alleviating the nutrition problem through routine nutrition status monitoring in the area. Key words: SIPSG
Beberapa studi menunjukkan adanya penurunan rata-rata usia menarche di seluruh dunia, termasuk Indonesia. Rata-rata usia menarche wanita di Amerika menurun sebesar 0,9 tahun dari tahun 1920 hingga 1980an (McDowell, 2007). Berdasarkan survei nasional pada tahun 1992 – 1995 rata-rata usia menarche remaja putri di Indonesia adalah 12,96 tahun dengan prevalensi menarche dini sebesar 10,3 % dan menarche terlambat sebesar 8,8 % (Batubara, 2010). Faktor determinan dari menarche dini dan menarche terlambat adalah status gizi, lemak tubuh, asupan makronutrien, asupan mikronutrien, sosial ekonomi, rangsangan psikis, hormonal, umur menarche ibu, outcome kelahiran, dan aktivitas fisik. Penelitian ini menggunakan data Riskesdas tahun 2010 dan mengikutsertakan 5358 remaja putri (10-19 tahun) diseluruh wilayah Indonesia sebagai populasi eligible. Studi ini menggunakan metode penarikan sampel non simple random sampling, strata, dan cluster sehingga menggunakan desain complex sample dalam analisisnya. Analisis model akhir menggunakan regresi logistik multinomial. Pada hasil multivariat, faktor risiko untuk menarche dini adalah kegemukan/obesitas (POR 3.03, 95% CI 2.39-3.83), hormonal banyak (POR 1.57, 95% CI 1.21-2.05), umur menarche ibu cepat (POR 1.74, 95 % CI 1.39 – 2.19) dan jumlah anak dalam keluarga sedikit (POR 1.64, 95 % CI 1.21-2.23). Sementara itu faktor protektif untuk menarche dini adalah asupan energi kurang (POR 0.73, 95 % CI 0.56-0.94). Faktor risiko untuk menarche terlambat adalah usia menarche ibu yang lambat (POR 2.1 95 % CI 1.68-2.61). Sementara itu faktor protektif untuk menarche terlambat adalah kegemukan/obesitas (POR 0.42, 95% CI 0.27 to 0.63), hormonal banyak (POR 0.7, 95% CI 0.62-0.95), asupan protein rendah (POR 0.68, 95% CI 0.51-0.91), asupan lemak tinggi (POR 0.75, 95 % CI 0.59- 0.95), umur menarche ibu yang lebih muda (POR 0.6, 95 % CI 0.44 – 0.84), pendidikan bapak yang tinggi (POR 0.73, 95 % CI 0.57-0.92) dan jumlah anggota keluarga yang besar (POR 0.75, 95 % CI 0.57-0.99). Pentingnya upaya meningkatkan program pencegahan kegemukan/obesitas anak dan remaja serta meningkatkan program penyuluhan kesehatan reproduksi dengan sasaran usia yang lebih muda yaitu murid sekolah dasar (SD) dan sekolah lanjutan tingkat pertama (SLTP) baik di unit pemerintah maupun swasta.
Several studies have shown a decrease mean age of menarche in the world, including in Indonesia. The mean age of menarche in U.S. women declined by 0.9 years from 1920 to the 1980s (McDowell, 2007). Based on National Suveys conducted in 1992-1995, the mean age of menarche in Indonesian girls was 12.96 years with prevalence of early menarche was 10.3% and late menarche was 8.8% (Batubara, 2010). Determinant factors of early and late menarche was nutritional status, body fat, macronutrient intake, micronutrient intake, social economy, psycological stimulate, height/hormonal, maternal age of menarche, birth outcome, family structural, and phisical activity. This study used data of Basic Health Survey 2010 and include 5358 girls (10-19 years) in all region of Indonesia as eligible population. This study used non simple random sampling, strata, and cluster sampling method so that the analysis using complex sample design. In multivariate, this study using multinomial logistic regression. The risk factors of early menarche is overweight/obesity (POR 3.03, 95% CI 2.39-3.83), more height girls (POR 1.57, 95% CI 1.21-2.05), early maternal age of menarche (POR 1.74, 95 % CI 1.39 – 2.19), small number of children in families (POR 1.64, 95 % CI 1.21-2.23). Meanwhile the protective factors of early menarche is low energy intake (POR 0.73, 95 % CI 0.56-0.94). The risk factors of late menarche is late maternal age of menarche (POR 2.1 95 % CI 1.68-2.61). Meanwhile the protective factors of late menarche is overweight/obesity (POR 0.42, 95% CI 0.27 to 0.63), more height girls (POR 0.7, 95% CI 0.62-0.95), low protein intake (POR 0.68, 95% CI 0.51-0.91), high fat intake (POR 0.75, 95 % CI 0.59-0.95), early maternal age of menarche (POR 0.6, 95 % CI 0.44 – 0.84), high level of father education (POR 0.73, 95 % CI 0.57-0.92), small number of families (POR 0.75, 95 % CI 0.57-0.99). So, this is important to improve prevention programs of child/adolescent obesity and reproductive health education for elementary and junior high school students both in government and private sectors.
ABSTRAK Derajat kesehatan suatu Negara dilihat dari beberapa indikator kesehatan salah satunya adalah Angka Kematian Ibu (AKI). Sebagian besar penyebab utama kematian ibu di Indonesia (60-80%) adalah akibat komplikasi persalinan (perdarahan, diikuti oleh eklampsia, infeksi, komplikasi aborsi dan persalinan lama). Salah satu target Millennium Development Goals (MDGs) adalah meningkatkan kesehatan ibu yaitu dengan mengurangi angka kematian ibu sampai tiga perempatnya antara tahun 1990 sampai 2015 Sekitar 80% penduduk Indonesia tinggal di daerah perdesaan yang pelayanan kebidanan masih banyak bersifat tradisional dan lebih dari 75% persalinan masih di tolong oleh dukun bayi. Penelitian ini bertujuan untuk mengetahui hubungan pelayanan antenatal dengan komplikasi persalinan wilayah perdesaan di Indonesia. Desain penelitian yang digunakan adalah cross sectional. Responden merupakan ibu yang pernah hamil dan melahirkan bayi berdasarkan data Survey Demografi dan Kesehatan Indonesia (SDKI) tahun 2007. Prevalensi kejadian komplikasi persalinan wilayah perdesaan di Indonesia adalah sebesar 43,5% dan prevalensi kualitas antenatal yang tidak sesuai kriteria adalah 67,5%. Analisis bivariat menunjukkan tidak ada hubungan kualitas pelayanan antenatal dengan komplikasi persalinan dengan PR=0,991 (pvalue<0,05). Analisis multivariat yang digunakan adalah cox regression. Hasil akhir hubungan kualitas pelayanan antenatal dengan komplikasi persalinan setelah dikontrol variabel paritas, komplikasi kehamilan dan penolong persalinan didapat prevalence ratio (PR) sebesar 0,933 (CI 95% : 0,868-1,003). Kondisi akses, infrastruktur jalan dan transportasi yang tidak memadai serta biaya yang tidak murah menyebabkan perlunya penempatan tenaga kesehatan di desa khususnya bidan di setiap desa dalam upaya mencegah komplikasi persalinan di perdesaan dengan memberikan asuhan antenatal seoptimal mungkin.
ABSTRACT One of several health indicator in every country is Maternal Mortality Rate (MMR). The most several factors of maternal mortality in Indonesia about 60- 80% because of delivery complications (excesive vaginal bleeding followed by eclampsia, infection, abortus complication and prolonged labour). One of Millennium Development Goals (MDGs) target is increase the mother?s health with decrease maternal mortality rate for almost three quarters from years 1990 until 2015. About 80% Indonesia citizen live in rural area with traditional maternal care and almost 75% delivery still help with traditional attendance. The purpose of this study to know the relationship between quality of antenatal care with delivery complication in rural area of Indonesia using Indonesia Demographic and Health Survey year 2007 data. Design study is cross sectional. Respondents of this study are mothers that have been pregnant and delivery. Prevalence of delivery complication in this study are 43,5% and bad quality of antenatal care prevalence are 67,5%. Bivariate analysis proven there is no relationship between quality of antenatal care and delivery complications with Prevalence Ratio (PR) = 0,991 (pvalue<0,05). Multivariate analysis using cox regression model analysis. The final result relationship between between quality of antenatal care and delivery complications after controlled by parity, pregnancy complications and delivery attendance show that prevalence ratio (PR) is 0,933 (CI 95% : 0,868-1,003). It is need policy to located minimal one midwife for one village to decrease the incidence of delivery complications with utilization of optimal antenatal care because of the poor access, infrastructure, transportation and expensive payment to reach health facility in rural area.
ABSTRAK Penelitian ini bertujuan untuk memperoleh informasi yang mendalam tentang Peran Kelas Ibu Hamil Terhadap Praktik Inisiasi Menyusu Dini Pada Ibu Bayi Usia 0-12 Bulan, di Wilayah Kelurahan Tengah, Kramatjati, Tahun 2012. Penelitian ini menggunakan metode kualitatif dengan Rapid Assesment Procedures. Total informan dalam penelitian adalah 26 orang dengan jumlah informan kunci sebanyak 4 orang. Pada penelitian ini diperoleh hasil bahwa Kelas Ibu Hamil kurang cukup berperan Terhadap Praktik Inisiasi Menyusu Dini. Praktik IMD yang berhasil dilakukan oleh informan lebih besar disebabkan oleh adanya kebijakan penyedia layanan bersalin serta kondisi pasca bersalin baik ibu maupun bayinya. Hampir seluruh informan telah memiliki niat, telah mendapat dukungan sosial, dan telah menerima informasi mengenai IMD. Namun hampir semua informan belum memiliki otonomi pribadi dan situasi yang paling mendukung melakukan IMD adalah adanya kebijakan penyedia layanan bersalin serta kondisi pasca persalinan. Hampir semua informan tidak memiliki pengetahuan yang baik mengenai IMD, namun telah memiliki sikap yang positif terhadap IMD. Perlu upaya untuk meningkatkan peran Kelas Ibu Hamil agar dapat meningkatkan pengetahuan ibu hamil mengenai IMD.
Abstract This study aims to gain an in-depth information on the role of antenatal class and its correlation with mother?s infant behavior of immediate breastfeeding at Kelurahan Tengah, Kramatjati, East Jakarta. This study used qualitative methods with Rapid Assessment Procedures. Total informants in the study were 26 people with a number of key informants as many as 4 people. In this study obtained results that the antenatal class is not enough against Immediate Breastfeeding Practices. Immediate Breastfeeding Practice that successfully carried out by the informant is greater due to the policy of the maternity service providers as well as post-partum condition of both mother and baby. Almost all the informants had had the intention, has received social support, and has received information on the Immediate Breastfeeding. But almost all the informants do not have personal autonomy and the situation most favorable to the Immediate Breastfeeding is the policy of the maternity service providers and postpartum conditions. Almost all the informants had no knowledge of the Immediate Breastfeeding, but have had a positive attitude to it. Necessary efforts to enhance the role of class in order pregnant mothers can increase their knowledge about Immediate Breastfeeding.