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Background: There are many problems in the implementation of maternal and neonatal health information system at Banggai Kepulauan District such as too many record form, the type of information was only descriptive matter, using computer on data management was not optimally, lack of timely reporting, and incompleteness of reporting. These problems make the data quality is low and not adequately support the management of maternal and neonatal health program in Banggai Kepulauan District. Objective: The purpose of this system development is to develop an application of Maternal and Neonatal Health Program Management Information System that provided good quality of information to support maternal and neonatal health programs management in Banggai Kepulauan District. Methodes: The method for this research using system development life cycle approach that consist of planning, analysis, design and implementation stages. Data and information needed were collecting by depth interview, focused group disccusion and document observation. The object of research are the office of Banggai Kepulauan Health and Social Prosperity and four selected health centers. Results: This research had been created a prototype of Maternal and Neonatal Health Program Management Information System at District and Health Center that hoped to help on providing good quality of maternal and neonatal health data and information to support maternal and neonatal helath program management in Banggai Kepulauan District. Conclution: Good and continuity of system implementation need the policy and commitment of decision maker, clear regulation of system organization, good motivation of the system operator and continuity of financial support. Keywords: Information system, maternal, neonatal
The effort to improve maternal and neonatal health care is a priority program, principally focused on improving antenatal care services in all facilities with good quality and maximum service coverage, improving aid delivery by health personnel, improving early detection of high risk by health workers, improved neonatal care with good quality. This must be supported by quality performance of health workers, particularly midwifes. Coverage of deliveries by midwifes in the Serang City 54.8%, 64.4% coverage K1, K4 coverage 54.5%. KN1 coverage 62.2%, KN2 coverage 58.5% and is below the national target. Quality performance can be affected by the midwife predisposing factors (age, working time, employment status, marital status, knowledge, education) enabling factors (training, tools), reinforcing factors (supervision, leadership support, community support). This study aimed at obtaining information about the characteristics and performance quality of midwifes in maternal and neonatal health services in the city of Serang Year 2009. The research design was chosen in this research is quantitative analytical survey with cross sectional approach. Population is all the midwives at health centers in the city of Serang.
Background : Maternal mortality rate due to the pregnancy and delivery has close related to delivery process. The utilization of health professional providing services to delivery mothers in Palembang, based on data profile DHO of Palembang in 2003 is illustrated by performance of the KIA activities, delivery process which is assisted by the health professional 83,48% and the remaining is 16,52% helped by the non-health professional. The Sub District of Seberang Ulu I is a subdistrict within the lowest amount of delivery process assisted by the health professional compared by other sub district in Palembang as much of 69,24%. Objectives : To identify the factors that correlate to the utilization of health professional by delivery mothers in Sub District of Seberang Ulu Palembang in 2005. Methods : This research is a cross sectional, with survey method. Samples taken are a group of mothers who have ever delivered in the range of time in the end of 2003 until the beginning of 2005. On this rapid survey, the sample taken are as many of 30 x 7 (30 RW, 7 people in each cluster/RW) = 210 samples. Data analysis uses univariate and multivariate to determine factors that influence the utilization of health professional using the software from UPT FKM UI. Conclusion : Based on the rapid survey, it was for dominate that midwives as an assistance of the delivery mothers in the Sub District of Seberang Ulu I (71,9%). Result of statistical test shows a variable of education, attitude toward delivery provided by professional health care, (OR=235,67), variable of knowledge about delivery (OR=7,25) and variable of delivery assistance cost (OR=1) has the relationship and utilization health professional in the Sub District of Seberang Ulu I. The determining factor that mostly affects the usage of health professional based on the analysis result of logistic regression multivariate is the delivery cost within OR=6,673 (95%CI: 2,067 – 21,554). Suggestion that can be recommended on this research is the necessity of the health professional that regularly provide the health counselling to the community, especially to the mothers about reproduction health include about scrutinize and the delivery care. Improving the health service quality such as the availability of sufficient and high quality and accessible by the the community, increasing a range of targets on the warranty program of health preservation and social insurance for the community in the Sub District of Seberang Ulu I.
Angka kematian bayi (AKB) sebagai salah satu indikator mortalitas derajat kesehatan di Indonesia telah menurun cukup berarti, namun masih jauh lebih tinggi bila dibandingkan dengan beberapa negara ASEAN serta negara-negara maju. Angka kematian neonatal merupakan sekilar 40% dari AKB, dengan penyebab utama adalah bayi berat lahir rendah (BBLR) sebesar 29% (SKRT, 2001). Berbagai studi menyebutkan banyak faktor yang menyebabkan terjadinya BBLR, faktor kualitas pelayanan antenatal merupakan salah satu faktor risiko yang sangat penting, disamping faktor-faktor lain seperti paritas, jarak kelahiran, riwayat kehamilan terdahulu, pertambahan berat badan selama hamil, tingkat aktifitas fisik ibu, komplikasi selama hamil, perilaku merokok, umur ibu, tinggi badan ibu, tingkat pendidikan ibu, etnis atau ras, tingkat sosial ekonomi dan jenis kelamin bayi yang dilahirkan. Tujuan penelitian ini adalah untuk mengetahui pengaruh faktor kualitas pelayanan antenatal (berdasarkan frekuensi pelayanan, jadwal pelayanan, dan konseling) terhadap kejadian BBLR di Indonesia. Penelitian dirancang secara kasus kontrol dengan menggunakan data terdokumentasi basil SDKI 2002-2003. Kasus adalah subjek dengan atribut efek positif (BBLR) dicarikan kontrolnya yaitu subjek dengan atribut efek negatif (Tidak BBLR). Populasi studi adalah seluruh sampel SDKI 2002-2003 yaitu semua wanita berusia 15-49 tahun yang sudah pernah kawin dan melahirkan dengan lahir hidup dalam lima tahun terakhir sebelum survei, dengan kriteria inklusi kasus dan kontrol adalah kelahiran tunggal, ditimbang saat lahir, dan bapak juga diwawancarai, sedangkan kriteria eksklusinya adalah data terdokumentasi tidak tersedia lengkap. Dengan menggunakan rumus Batas minimal sampel untuk kasus kontrol tidak berpadanan didapatkan kasus sebanyak 82 dan kontrol 328. Dengan analisis regresi logistik ganda, model akhir pengaruh kualitas pelayanan antenatal terhadap kejadian BBLR didapatkan nilai OR = 2,71 (95% CI: 1,60-4,58), artinya bahwa responden yang mendapatkan kualitas pelayanan antenatal (berdasarkan frekuensi pelayanan, jadwal pelayanan, dan konseling) dengan kualitas buruk kemungkinan berisiko 2,71 kali lebih besar untuk melahirkan BBLR dibandingkan dengan ibu yang mcndapatkan kualitas pelayanan antenatal balk setelah dikontrol dengan komplikasi selama hamil, umur ibu, dan jenis kelamin bayi. Variabel yang terbukti signifikan secara statistik dengan kejadian BBLR adalah komplikasi selama hamil (OR = 3,98 atau 95% CI: 2,06-7,67), umur ibu (OR = 1,98 atau 95% CI: 1,02-3,85), dan jenis kelamin bayi (OR = 1,93 atau 95% CI: 1,14-3,28), sedangkan variabel yang tidak terbukti berpengaruh signifikan secara statistik adalah paritas, riwayat kehamilan, dan pendidikan ibu. Dapat disimpulkan bahwa kualitas pelayanan antenatal (berdasarkan frekuensi pelayanan, jadwal pelayanan, dan konseling) terbukti mempunyai pengaruh bermakna secara statistik terhadap kejadian BBLR setelah dikontrol dengan variabel komplikasi selama hamil, umur ibu, dan jenis kelamin bayi, sehingga perlu menjadi bahan pertimbangan oleh para pengambil kebijakan dalam upaya menurunkan kejadian BBLR di Indonesia.
Infant Mortality Rate (IMR) as one of mortality indicators of health level degraded in Indonesia significantly, but it is higher than many countries in ASEAN and also development countries. Neonatal mortality is almost 40% of infant mortality rate with main reason of low birth weight is 29% (SKRT, 2001). Various study mentioned many factors which caused a low birth weight occurrence, antenatal service quality factor is one of the important risk factors compared with other factors such as parity, birth interval, past pregnancy history, weight increased during pregnancy, activity level of mother's physic. Complication during pregnancy, smoking behavior, mother's age, mother's tall, education level of mother, ethnic or race, social and economic level, and baby gender which is born. This Research purpose is to know effect of antenatal service quality factor (according to service frequency, service schedule, and counseling) to low birth weight occurrence. Research designed with a control case by using result of documentation data SDKI 2002-2003. Case is subject with positive effect attribute (low birth weight) by looking for its control that is subject with negative effect attribute (no low birth weight). Study population are all samples of SDKI 2002-2003 that are all women 15-49 years old who have married and born with life birth in last five years before survey, with inclusion criterion of case and control are single birth, weighted when she born, and father is also held an interview, while its inclusion criterion of available documentation data is not complete. By using a minimum limit formula of samples for non match control case, it founded 82 cases and 328 controls. By analysis of multiple logistic regression, final model effect of antenatal service quality to low birth weight occurrence got a value of OR = 2,71 (95% CI: 1,60-4,58), this means responders who got antenatal service quality (according to service frequency, service schedule, and counseling) with a bad quality of risk possibility are 2,71 times bigger to bear with low birth weight compared with mother who got good quality of antenatal service after controlled with a complication during pregnancy, mother's age, and baby gender. Significant variable with a low birth weight occurrence statistically is complication during pregnancy (OR = 3,98 atau 95% CI: 2,06-7,67), mother's age (OR = 1,98 or 95% Cl: 1,02-3,85), and baby gender (OR = 1,93 or 95% CI: 1,14-3,28), while variables who does not significant effect statistically are parity, pregnancy history, and mother?s education. It is concluded that antenatal service quality (according to service frequency, service schedule, and counseling) have significant effects statistically to low birth weight occurrence after controlled with complication variable during pregnancy, mother?s age, and baby gender, so it is important to become consideration for all policies makers decreasing effort of low birth weight occurrence in Indonesia.
Tolok ukur keberhasilan pembangunan adalah peningkatan kesejahteraan penduduk. Sesuai dengan komitmen pembangunan nasional yang pada hakekatnya bersifat adil, demokrasi, terbuka, partisipatif dan terintegrasi, maka pada saat ini, pemerintah berupaya mengurangi kesenjangan pembangunan yang terjadi antar daerah, terutama pada daerah-daerah yang sulit dijangkau, rawan konflik/bencana, aksesibilitas yang rendah serta infrastruktur yang terbatas yang dikenal dengan Daerah Tertinggal. Salah satu faktor yang berpengaruh pada tingkat kesejahteraan adalah besarnya beban yang ditanggung oleh satu keluarga. Semakin banyak jumlah anak, berarti semakin besar tanggungan kepala rumah tangga dalam memenuhi kebutuhan material dan spiritual anggota rumah tangganya. Bagi daerah tertinggal, angka pertambahan jumlah penduduk akan menjadi beban tersendiri, padahal sumber daya daerah tersebut sangat terbatas. Dengan demikian, program yang perlu diprioritaskan oleh Daerah Tertinggal adalah program KB. Dan hasil analisis SDKI 2002-2003, menunjukkan bahwa prevalensi pemakaian kontrasepsi di Indonesia sebesar 60%, sedangkan untuk Daerah Tertinggal, belum ada data tentang prevalensi pemakaian kontrasepsi. Dengan penelitian ini, diharapkan akan didapatkan gambaran tentang pemakaian kontrasepsi, faktor-faktor yang berhubungan, serta faktor dominan yang berhubungan dengan pemakaian kontrasepsi pada wanita usia subur di Daerah Tertinggal Indonesia yang terdaftar dalam SDKI 2002-2003. Penelitian ini merupakan analisis lanjut dari data SDKI 2002-2003 dengan desain cross sectional, dengan populasi berjumlah 1315 wanita usia subur yang tersebar di 9 propinsi. Pengolahan dan analisis data menggunakan aplikasi analisis regresi logistic ganda. Analisis mencakup analisis univariabel, analisis bivariabel dengan Khi Kuadrat dan regresi logistik sederhana serta analisis multivariabel dengan regresi logistik multivariat. Hash analisis menunjukkan prevalensi pemakaian kontrasepsi pada wanita usia subur di Daerah Tertinggal masih rendah (45,9%) dan faktor sosiodemografi yaitu pendidikan responder, pekerjaan responden, jumlah anak yang dilahirkan mempunyai hubungan bermakna dengan pemakaian kontrasepsi, sedangkan faktor akses terhadap media/informasi yang mempunyai hubungan bermakna dengan pemakaian kontrasepsi adalah akses media televisi, akses informasi melalui keluarga, teman/tetangga serta akses informasi melalui tokoh masyarakatlagama. Dui 6 faktor tersebut, faktor jumlah anak yang dilahirkan merupakan faktor dominan yang berhubungan dengan pemakaian kontrasepsi. Berdasarkan hasil di atas, untuk percepatan peningkatan kesejahteraan masyarakat di Daerah Tertinggal, disarankan agar dibentuk kerjasama lintas sektoral antara Kementerian Negara Pembangunan Daerah Tertinggal, BKKBN dan Depkes dalam penguatan kelembagaan dan jaringan KB serta perlunya peningkatan promosi dan informasi KB, balk melalui media televisi, peningkatan peran tokoh masyarakatlagama dan petugas kesehatan/KB. Sedangkan dari hasil penelitian terhadap faktor pendidikan, disarankan bagi Departemen Pendidikan bekerjasama dengan Kementerian PDT untuk lebih memperhatikan tingkat pendidikan masyarakat di Daerah Tertinggal.
The parameter of a successful development of the nation is a noted of the increasing on its citizen's well being. As the national development commitment, which has characteristics on fairness, democracy, openness, participated, and integrated, the government is try to reduce the disparity of the development between regions in Indonesia, especially to those area that remote, at risk for natural disaster or conflict, having low accessibility, and Iimited on infrastructures, that we know as underprivileged areas. One of factor that influence the level of citizen's well being is the dependency ratio of the family has. The more they have children, the more they likely to have greater family members dependency and have to responsible in fulfilling the need for their family members, materially and spiritually. In case of underprivileged areas, the increase on population number will be another burden, as they only have limited resources. Therefore, a program that has to be prioritized is a Family Planning Program. Results from the prior analyses of Indonesia DI-IS 2002 - 2003 showed that the contraceptive use prevalence of Indonesia is as high as 60%, but there in no figure for the underprivileged areas. Therefore, a continuation analyses of the data has been conducted in order to describe on factors related on contraceptive uses, as well as the most factors related to the contraceptive uses among women at reproductive age (WRA) at underprivileged areas that Iisted on Indonesia DHS 2002 - 2003. There are 9 (nine) provinces listed as underprivileged areas that comprises in number of population on WRA as 1315 people. The data is analyzed using double logistic regression, which consists of univariable analyses, bivariable analyses with Chi-square and simple logistic regression, and multivariable analyses with multivariate logistic regression. Analyses has showed that contraceptive use prevalence among WRA at underprivileged areas is still low (45.9%) and socio-demographic factors such as education, occupation, and number children ever born (CEB), is related significantly with the contraceptive use. While factors on access to media/information that also have significantly related with contraceptive use are television, family/friends/neighbors, and community/religious leaders. From those 6 (six) factors, CEB is the most or dominant factor that related to contraceptive uses. Regarding to the analyses results, in order to accelerate the people's well being at the underprivileged areas, it is suggested that there should be a strong inter-sectors collaboration between National Ministry on The Development of Underprivileged Areas, National Family Planning Coordination Board and Ministry of Health to enhance the institutional and networking on promoting and dissemination of the information on Family PIanning through television, increase the role of community/religious leaders, as well as its FP providers. Another important findings upon education factors, it is suggested that collaboration between Ministry of National Education and National Ministry on The Development of Underprivileged Areas is also needed in order to increase the level of education among people at the underprivileged areas.
Persalinan pada dasarnya merupakan proses alamiah yang sudah merupakan tugas seorang ibu yang harus dihadapi. Namun demikian, tidak jarang terjadi penyimpangan, sehingga keadaan ini bukan saja menimbulkan risiko bagi ibu, tetapi juga berisiko terhadap bayinya. Salah satu risiko yang mungkin terjadi bagi bayi akibat persalinan ini adalah afiksia neonatorum. Departemen Kesehatan Republik Indonesia memperkirakan prevalen afisia neonatorum sedang dan berat di Indonesia setiap tahun sekitar 144.900 bayi. Sementara itu data pada Rumah Sakit Umum Dr. Adjidarmo Rangkasbitung tahun 2000 terungkap kejadian asfiksia neonatorum sedang dan berat tahun 1999 sebesar 24,9 % meningkat menjadi 45,9 % pada tahun 2000. Penelitian ini menggunakan data sekunder yang bersumber dari register ibu dan register bayi di Rumah SakitUmum Dr.Adjidarmo Rangkasbitung tahun 2000. Tujuan penelitian ini untuk memperoleh informasi tentang hubungan persalinan lama dengan kejadian asfiksia neonatorum. Faktor lain meliputi umur ibu saat bersalin, paritas, berat badan bayi lahir, kelainan plasenta, persalinan tindakan, kelainan letak dan kasus rujukan diduga mempengaruhi hubungan persalinan lama dengan kejadian asfiksia neonatorum. Desain yang digunakan adalah case control. kelompok kasus adalah bayi yang lahir di Rumah sakit Umum Dr. Adjidarmo Rangkasbitung selama tahun 2000 dengan nilai Apgar menit pertama kurang dari 7. Sedangkan kelompok kontrol adalah bayi yang lahir di Rumah sakit Umum Dr. Adjidarmo Rangkasbitung periode selama 2000 dengan nilai Apgar menit pertama 7 sampai 10. Dari keseluruhan sampel, bayi yang lahir dengan mengalami persalinan lama pada kelompok kasus proporsinya hampir lima kali lebih besar (43%) dibanding kelompok kontrol (8,5%). Terbukti adanya hubungan bermakna antara persalinan lama dengan kejadian asfiksia neonatorum. Bayi yang lahir dengan asfiksia neonatorum, setelah dikontrol persalinan tindakan dan kasus rujukan berperan sebagai confounder, atau mempunyai pengaruh terhadap hubungan persalinan lama dengan kejadian asfiksia neonatorum. Perlunya dilakukan persalinan tindakan sesegera mungkin,apabila diketahui ibu bersalin telah mengalami persalinan lama. Kegiatan lainnya adalah perlu terus dilakukan upaya penyuluhan kepada masyarakat, khususnya ibu hamil untuk selalu melakukan perawatan ante natal yang baik selama kehamilannya guna mendeteksi secara dini penyulit persalinan. The Connection Between Long Duration Childbirth rith Neonatorum Asphyxia Case to Newborn Baby at RSU Dr. Adjidarmo Rangkasbitung in 2000Delivering a baby or childbirth, basically is a natural process as a mother's duty that have to deal with. In such a case, sometimes there is childbirth deviations have risks that could be dangerously to mothers and also to newborn babies. One of this risks is Neonatorum Asphyxia. Ministry of Health Republic of Indonesia has predicted that medium and heavy cases of Neonatorum Aphyxia in Indonesia are about 144.900 cases. In the same cases, RSU Dr. Adjidarmo Rangkasbitungs Neonatorum Asphyxia in 1999 is 24,9% and increasing to 45,9% in 2002. This research was using the secondary data that sourced on numbers of mothers and babies registration data at RSU Dr. Adjidarmo Rangkasbitung in 2000.
The main goal of this research is to find out the connection between long duration childbirth and Neonatorum Asphyxia case. Others factors that could make effect are; mother's age, paritas, baby's weight, placenta disorder, breech delivery, and referral cases had presumed to influrnce the long duration childbirth with Neonatorum Asphyxia cases. The research's design that used by the writer is case control design. The cases group is numbers of babies that born at RSU Dr. Adjidarmo Rangkasbitung in 2000 with Apgar value less than 7. Whereas the control group is number of babies with Apgar value range at 7 - 10. From all samples, the babies that born with long duration childbirth at the cases group have the proportion cases five times bigger (43%) than the babies at control group (8,5%). It shows that there's connection between long duration childbirth and Neonatorum Asphyxia cases. The babies with Neonatorum Asphyxia cases from long duration childbirth have 3.053 probability odds times than the babies without Neonatorum Asphyxia cases, after being controlled by maternity acts and referral cases. Maternity acts and referral cases it also predicted had taken part as cofounder, or influence to long duration childbirth and Neonatorum aphyxia cases. The maternity acts must be conducted as soos as possible if a long duration childbirth has been detected. Another actions that should be done and continued are public information or illumination acts, especially to pregnant mothers, to always take care of their pregnancy by doing the best ane natal caring along hers/their pregnancy to pre-detect and prevent maternity or childbirth problems.