ALASAN - ALASAN PENOLAKAN DUKUN BAYI BERMITRA DENGAN BIDAN, STUDI KASUS DI KECAMATAN BONTOLEMPANGAN KABUPATEN GOWA SULAWESI SELATAN

TRI OCTAVIYANI D, Dr. dr. Mubasysyir Hasanbasri, MA.

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Tujuan Sustainable Development Goals (SDGs) yang akan dicapai sampai dengan tahun 2030 mengenai kematian ibu adalah penurunan AKI sampai tinggal 70 per 100 ribu kelahiran hidup. Ada beberapa faktor yang mempengaruhi masih tingginya AKI di Indonesia, salah satunya adalah persalinan dirumah dan ditolong oleh dukun. Tujuan: Tujuan penelitian ini mengetahui alasan dukun bayi menolak bermitra dengan bidan di Kecamatan Bontolempangan berdasarkan kompetisi antar provider, kesamaan cultural, social accepted terhadap bidan senior. Metode: Penelitian ini merupakan penelitian kualitatif dengan pendekatan case study deskriptif melalui desain studi kasus tunggal dengan unit analisa dukun baik yang menolak bermitra dan yang bermitra di wilayah Puskesmas Bontolempangan. Waktu penelitian bulan Maret sampai April 2017. Pengambilan data dilakukan dengan wawancara mendalam (in-depth interview) dan studi dokumentasi. Hasil: Alasan-alasan dukun menolak bermitra dengan bidan adalah: faktor kompetisi antar provider yaitu pendapatan dan posisi dukun dalam kemitraan. Faktor kesamaan cultural sehingga ibu hamil meminta pertolongan persalinan pada dukun dan social accepted pengalaman bidan yang lebih senior. Sedangkan yang bermitra dengan alasan beban kerja berkurang dan komunikasi yang baik dengan bidan dan kader. Kesimpulan: Pendapatan dukun yang lebih tinggi bila tidak bermitra, posisi dukun yang terancam dalam kemitraan, permintaan pasien yang lebih senang melahirkan dirumah dan pengalaman bidan yang masih baru di Puskesmas menjadi alasan dukun menolak bermitra dengan bidan. Sedangkan berkurangnya beban kerja, komunikasi yang baik antara bidan, dukun dan kader Posyandu menjadi alasan dukun untuk bermitra dengan bidan.

Background: The Sustainable Development Goals (SDGs) is targeting a reduction on Maternal Mortality Rate (MMR) up to 70 per 100,000 live births by 2030. There are several factors influence the high level of MMR in Indonesia, one of them is home delivery and assisted by a traditional birth attendant (TBA). Objective: The study aims to determine the factor that influences the TBAs decision to refuse the partnership with midwife in Bontolempangan sub-district based on the competition between providers, cultural equality, and social accepted against senior midwifes. Method: The study applied a qualitative research method with descriptive case study approach through a single case study design both TBAs that accepted and refused the partnership scheme with midwifes in in the work area of Bontolempangan primary health care as the unit of analysis. The study was conducted in March to April 2017. The sample was collected through an in-depth interview and documentation study. Results: : The reasons TBAs refuse to partner with midwifes are: competition between provider factor that is income of TBAs and position of TBAs in partnership. The factors of cultural equality so that pregnant women ask for help delivery to TBAs and social accepted of more senior midwife experience. While the partnership with the reasons of workload is reduced and good communication with midwives and cadres. Conclusion: Higher income achieved through private practice, patients preferences of home delivery and the midwifes level of experience were pivotal in the decision of TBAs to refused the partnership with midwifes. Meanwhile, the reduction of workload through task-shifting and good communication with the midwifes and community health workers were the main reasons that influenced their decision to accept the partnership.

Kata Kunci : Kemitraan bidan dan dukun, kompetisi antar provider, kesamaan cultural, social accepted terhadap bidan senior, Partnership between Midwifes and TBAs, competition between providers, cultural equality, and social accepted against senior midwifes