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Sisca Rusmawati; Pembimbing: Kemal Nazaruddin Siregar; Penguji: Martya Rahmaniati M., Sabarinah, Mularsih Restianingrum, Nunung Nurhayati
Abstrak:
Angka Kematian Ibu (AKI) merupakan salah satu alat ukur untuk menilai keberhasilan pencapaian pembangunan kesehatan, berdasarkan data Angka Kematian Ibu Kota Tangerang tahun 2021 melebihi target RENSTRA yaitu 15,4/100.000 KH, sedangkan target RENSTRA 12,9/100.000 KH dan jumlah kematian ibu dari tahun 2017-2021 cenderung stagnan, berdasarkan hasil analisa AMP penyebab kematian maternal di Kota Tangerang tahun 2016-2021, 89,8% kematian maternal dapat dicegah, dengan faktor penyebab terbanyak yang dapat dicegah 68,5% dari faktor penyedia layanan, kemampuan dalam melakukan tindak lanjut atas rekomendasi AMP-SR Kota Tangerang dikategorikan “menengah” karena tindak lanjut atas rekomendasi sebanyak 59,4% sehingga perlu dilakukan evaluasi pelaksanaan AMP-SR di Kota Tangerang untuk peningkatan kualitas pelayanan dan penurunan Angka Kematian Ibu. AMPSR merupakan proses yang perlu dan penting dilakukan dalam upaya menurunkan kematian maternal, baik di tingkat fasilitas maupun di tingkat kabupaten/kota. Dengan demikian perlu dipastikan proses AMP dilaksanakan dengan benar dan berkualitas sesuai Pedoman AMPSR. Penelitian ini bertujuan untuk menganalisis pelaksanaan Audit Maternal Perinatal Surveilans Respons (AMP-SR) di Kota Tangerang, jenis penelitian ini adalah penelitian kualitatif, menggunakan desain penelitian studi kasus untuk memberikan informasi detail terkait variabel input, proses dan produk dalam evaluasi pelaksanaan Audit Maternal Perinatal Surveilans Respons (AMP-SR) di Kota Tangerang Tahun 2022, penelitian dilakukan di Kota Tangerang pada bulan Mei sampai Juni 2023 dengan jumlah informan 16 orang, data diperoleh dengan wawancara mendalam dan Focus Group Discussion (FGD). Hasil penelitian menunjukkan bahwa pelaksanaan AMP-SR di Kota Tangerang sebagian besar belum optimal dan belum sesuai pedoman AMPSR terutama di komponen input yaitu regulasi dan SDM, komponen proses yaitu pencatatan, pelaporan dan pengkajian kasus kematian, serta di komponen produk yaitu respons tindak lanjut. Keberhasilan AMP-SR yang baik dan bermutu akan terwujud jika ada komitmen yang kuat dari semua pihak yang terlibat dalam pelaksanaan AMP-SR, perlu adanya intervensi berkelanjutan untuk memantau dan mengevaluasi pelaksanaan AMP-SR secara bertahap. Pentingnya siklus AMP-SR dilaksanakan secara utuh agar dapat digunakan untuk pembelajaran yang berkelanjutan sehingga tidak terjadi kematian ibu berulang dengan penyebab dan pelaku yang sama.
The Maternal Mortality Rate (MMR) is a measuring tool to assess the success of achieving health development, based on data from the 2021 Tangerang City Mortality Rate exceeding the RENSTRA target of 15.4/100,000 live births, while the RENSTRA target is 12.9/100,000 live births and the number of deaths mothers from 2017-2021 tends to be stagnant, based on the results of the AMP analysis for causes of maternal death in Tangerang City in 2016-2021, 89.8% of maternal deaths can be prevented, with the most preventable factors 68.5% from service provider factors, ability in following up on the AMP-SR recommendations, Tangerang City is categorized as "medium" because the follow-up on recommendations is as much as 59.4%, so it is necessary to evaluate the implementation of AMP-SR in Tangerang City to improve service quality and reduce maternal mortality.AMPSR is a necessary and important process in an effort to reduce maternal mortality, both at the facility level and at the district/city level. It is necessary to ensure that the AMP process is carried out correctly and with quality according to the AMPSR Guidelines. This study aims to analyze the implementation of the Maternal Perinatal Surveillance Response (AMP-SR) Audit in Tangerang City, this type of research is qualitative research, using a case study research design to provide detailed information regarding input, process and product variables in evaluating the implementation of the Maternal Perinatal Surveillance Audit Response (AMP-SR) in Tangerang City in 2022, research was conducted in Tangerang City from May to June 2023 with a total of 16 informants, data obtained by indepth interviews and Focus Group Discussions (FGDs). The results showed that the implementation of AMP-SR in Tangerang City was mostly not optimal and did not comply with the AMPSR guidelines, especially in the input component, namely regulation and human resources, the process component, namely recording, reporting and review of death cases, and in the product component, namely the follow-up response. The success of a quality AMP-SR will be realized if there is a strong commitment from all parties involved in the implementation of the AMP-SR, there is a need for continuous intervention to monitor and evaluate the implementation of the AMP-SR in stages. It is important that the AMP-SR cycle is carried out in its entirety so that it can be used for continuous learning so that there are no repeated maternal deaths with the same causes and perpetrators.
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The Maternal Mortality Rate (MMR) is a measuring tool to assess the success of achieving health development, based on data from the 2021 Tangerang City Mortality Rate exceeding the RENSTRA target of 15.4/100,000 live births, while the RENSTRA target is 12.9/100,000 live births and the number of deaths mothers from 2017-2021 tends to be stagnant, based on the results of the AMP analysis for causes of maternal death in Tangerang City in 2016-2021, 89.8% of maternal deaths can be prevented, with the most preventable factors 68.5% from service provider factors, ability in following up on the AMP-SR recommendations, Tangerang City is categorized as "medium" because the follow-up on recommendations is as much as 59.4%, so it is necessary to evaluate the implementation of AMP-SR in Tangerang City to improve service quality and reduce maternal mortality.AMPSR is a necessary and important process in an effort to reduce maternal mortality, both at the facility level and at the district/city level. It is necessary to ensure that the AMP process is carried out correctly and with quality according to the AMPSR Guidelines. This study aims to analyze the implementation of the Maternal Perinatal Surveillance Response (AMP-SR) Audit in Tangerang City, this type of research is qualitative research, using a case study research design to provide detailed information regarding input, process and product variables in evaluating the implementation of the Maternal Perinatal Surveillance Audit Response (AMP-SR) in Tangerang City in 2022, research was conducted in Tangerang City from May to June 2023 with a total of 16 informants, data obtained by indepth interviews and Focus Group Discussions (FGDs). The results showed that the implementation of AMP-SR in Tangerang City was mostly not optimal and did not comply with the AMPSR guidelines, especially in the input component, namely regulation and human resources, the process component, namely recording, reporting and review of death cases, and in the product component, namely the follow-up response. The success of a quality AMP-SR will be realized if there is a strong commitment from all parties involved in the implementation of the AMP-SR, there is a need for continuous intervention to monitor and evaluate the implementation of the AMP-SR in stages. It is important that the AMP-SR cycle is carried out in its entirety so that it can be used for continuous learning so that there are no repeated maternal deaths with the same causes and perpetrators.
T-6713
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Renata Philipa Plate; Pembimbing: Milla Herdayati; Penguji: Martya Rahmaniati M., R. Sutiawan, Teti Tejayanti, Fajar Nugraha
Abstrak:
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Di Jawa Timur, terdapat disparitas prevalensi hipertensi antarkabupaten/kota yang disebabkan oleh perbedaan determinan prevalensi hipertensi di setiap wilayah. Sejalan dengan itu, keterikatan sosial dan ekonomi antarwilayah dapat menyebabkan saling pengaruh mekanisme determinan hipertensi. Kondisi ini menimbulkan kendala dalam pelaksanaan program kesehatan dan alokasi sumber daya kesehatan, termasuk pengalokasian Dana Alokasi Khusus (DAK) sebagai salah satu sumber dana program pencegahan dan pengendalian hipertensi. Di Jawa Timur, terdapat lima Badan Koordinasi Wilayah (Bakorwil) yang bertugas membuat rekomendasi usulan DAK untuk kabupaten/kota dalam wilayah kerja masing-masing Bakorwil. Penelitian ini bertujuan untuk melihat keterkaitan spasial prevalensi hipertensi dan variasi determinan prevalensi hipertensi antarkabupaten/kota di Jawa Timur. Analisis spasial dengan menggunakan indeks Moran dan Geographically Weighted Regression (GWR) dilakukan terhadap 38 kabupaten/kota di Jawa Timur. Hasil analisis menunjukan bahwa prevalensi hipertensi di suatu kabupaten/kota dipengaruhi oleh kabupaten/kota tetangganya. Selain itu, 38 kabupaten/kota tersebut memiliki variasi determinan prevalensi hipertensi berupa proporsi bekerja, proporsi pengeluaran untuk minyak dan lemak, proporsi perokok, serta prevalensi diabetes. Adanya efek kewilayahan pada nilai prevalensi hipertensi dan determinannya menunjukan bahwa pelaksanaan program pencegahan dan pengendalian hipertensi di tingkat daerah memerlukan koordinasi antardinas kabupaten/kota. Lebih lanjut, rekomendasi usulan DAK bidang kesehatan juga memerlukan koordinasi antar Bakorwil.
In East Java, there is a disparity in the prevalence of hypertension among districts/cities caused by differences in the determinants of hypertension prevalence in each region. Moreover, social and economic relationship between regions can lead to the mutual influence of the determinant mechanisms of hypertension. This condition creates obstacles in the implementation of health programs and the allocation of health resources, including the allocation of the Special Allocation Fund (Dana Alokasi Khusus or DAK) as a source of funds for the hypertension prevention and control program. In East Java, there are five Regional Coordinating Bodies (Badan Koordinasi Wilayah or Bakorwil) whose task is to make recommendations on DAK proposals for districts/cities within the working areas of each Bakorwil. This study aims to look at the spatial relationship between the prevalence of hypertension and the variation in the determinants of hypertension prevalence between districts/cities in East Java. Spatial analysis using the Moran index and Geographically Weighted Regression (GWR) was carried out for 38 districts/cities in East Java. The results of the analysis show that the prevalence of hypertension in a district/city is influenced by neighboring districts/cities. In addition, the 38 regencies/cities have variations in the determinants of the prevalence of hypertension, namely the proportion of working, the proportion of spending on oils and fats, the proportion of smokers, and the prevalence of diabetes. The existence of a spatial effect on the prevalence of hypertension and its determinants indicates that the implementation of hypertension prevention and control programs at the regional level requires coordination between district/city offices. Furthermore, DAK recommendations for the health sector also require coordination between Bakorwil.
T-6819
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Dini Agustini; Pembimbing: Rita Damayanti; Penguji: Martya Rahmaniati M., Sandra Fikawati, Anies Irawati, Hikmah Kurniasari
Abstrak:
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ASI adalah makanan terbaik bagi bayi. WHO menganjurkan untuk memberikan ASI eksklusif. Ibu dengan kehamilan yang tidak diinginkan berisiko untuk tidak memberikan ASI eksklusif atau bahkan tidak menyusui sama sekali. Tujuan penelitian mengetahui hubungan antara kehamilan tidak diinginkan dengan pemberian ASI eksklusif di Indonesia menurut SDKI 2017. Penelitian ini merupakan penelitian cross-sectional dengan menggunakan data SDKI 2017. Populasi dari penelitian ini adalah seluruh Wanita Usia Subur (WUS) 15-49 tahun di Indonesia, sampel penelitian 1.244 WUS dengan anak usia 0-5 bulan yang memenuhi kriteria inklusi dan eksklusi. Variabel dependen dalam penelitian ini adalah pemberian ASI eksklusif, variabel independen adalah kehamilan tidak diinginkan dan variabel kovariat yaitu usia, pendidikan, paritas, status ekonomi, pekerjaan, status pernikahan, IMD, kunjungan ANC, dan wilayah tempat tinggal. Analisis yang dilakukan yaitu analisis univariat, bivariate dan multivariate dengan uji regresi logistic ganda model faktor risiko. Hasil penelitian menunjukkan persentase ASI eksklusif di Indonesia yaitu sebesar 59,4% dan persentase kehamilan tidak diinginkan di Indonesia sebesar 19,5%. Hasil analisis multivariat menunjukkan tidak terdapat hubungan antara status kehamilan tidak diinginkan dengan pemberian ASI eksklusif setelah dikontrol oleh variabel kovariat (p=0,064), namun ditemukan interaksi variabel kehamilan tidak diinginkan dan paritas dengan OR primipara 2,78, artinya ibu primipara dengan kehamilan tidak diinginkan berisiko 2,78 kali lebih tinggi untuk tidak memberikan ASI Eksklusif dibandingkan ibu dengan kehamilan diinginkan setelah dikontrol status ekonomi. Perlu dilakukan upaya untuk meningkatkan capaian pemberian ASI eksklusif yaitu pelatihan tenaga konselor, peningkatan KIE terkait pemberian ASI eksklusif khususnya pada ibu dengan KTD dan optimalisasi penyediaan ruangan dan fasilitas yang mendukung ibu bekerja untuk tetap melanjutkan pemberian ASI eksklusif.
Breast milk is the best food for babies. WHO recommends exclusive breastfeeding. Mothers with unwanted pregnancies are at risk for not giving exclusive breastfeeding or not even breastfeeding at all. The research objective was to determine the relationship between unwanted pregnancies and exclusive breastfeeding in Indonesia according to the 2017 IDHS. This research was a cross-sectional study using data from the 2017 IDHS. The population of this study was all Women of Reproductive Age (WUS) 15-49 years in Indonesia, the study sample was 1,244 WUS with children aged 0-5 months who met the inclusion and exclusion criteria. The dependent variable in this study was exclusive breastfeeding, the independent variable was unwanted pregnancy and the covariate variables were age, education, parity, economic status, employment, marital status, IMD, ANC visits, and area of residence. The analyzes performed were univariate, bivariate and multivariate analysis with multiple logistic regression tests of the risk factor model. The results showed that the percentage of exclusive breastfeeding in Indonesia was 59.4% and the percentage of unwanted pregnancies in Indonesia was 19.5%. The results of the multivariate analysis showed that there was no relationship between adverse event status and exclusive breastfeeding after being controlled by the covariate variable (p=0.064), however, there was an interaction between the unwanted pregnancies and parity variables with OR primipara 2.78 meaning that primiparous mothers with unwanted pregnancies are at risk of 2.78 times higher for not giving exclusive breastfeeding compared to mothers with wanted pregnancies after controlling for economic status. Efforts need to be made to improve the ability of exclusive breastfeeding, namely counselors, increasing IEC related to exclusive breastfeeding, especially for mothers with unwanted pregnancies and optimizing the provision of rooms and facilities that support working mothers to continue to provide exclusive breastfeeding.
T-6681
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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