Hubungan pelaksanaan standar pelayanan antenatal oleh bidan di desa dengan kejadian anemia di Kabupaten Purworejo

LONTAAN, Anita, Prof.Dr. Djaswadi Dasuki, MPH.,Sp.OG.,PhD

2002 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Setiap tahun sekitar 20.000 wanita Indonesia meninggal karena komplikasi obstetri. Lebih 90 persen disebabkan trias klasik, yaitu perdarahan 40-60 persen, preeklamsia/eklamsia 20-30 persen dan infeksi 20-30 persen. Hal ini dapat dicegah Secara efektif bila masyarakat diberi informasi tentang tanda dari gejala kegawatdaruratan serta tersedia pelayanan kesehatan yang bermutu ditingkat pelayanan dasar. World Health Organization mengembangkan standar pelayanan kebidanan dan pemakaiannya diadaptasikan di Indonesia. Di Kabupaten Purworejo, morbiditas ibu hamil untuk anemia, yaitu antara 40-50 persen. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan pelaksanaan standar pelayanan antenatal yang dilakukan oleh bidan di desa terhadap kejadian anemia. Metode : Jenis penelitian adalah penelitian observasional menggunakan rancangan historical cohort. Penelitian ini menggunakan 2 metode. Metode kuantitatif untuk mengetahui pelaksanaan standar pelayanan antenatal dengan kejadian anemia. Subjek penelitian diwawancarai setelah mendapat pelayanan antenatal. Metode kualitatif untuk melengkapi hasil temuan penelitian dengan melakukan Focus Group Discussion (FGD) pada bidan Puskesmas Purwore jo dan Puskesmas Kutoarjo tentang pelaksanaan standar pelayanan antenatal menurut Departemen Kesehatan Tahun 2000. Pengolahan data kuantitatif yakni: analisis univariable, bivariable, stratifikasi dan multivariable. Pengolahan data kualitatif dengan thematic analysis. Hasil: Hasil penelitian membuktikan bahwa ibu hamil yang mendapatkan pelayanan antenatal tidak sesuai standar pelayanan antenatal berisiko anemia dengan dengan OR=3,404 (CI 95%:1,303<0R<8,890), hasil analisis model regresi logistik. Data kualitatif memberikan gambaran bahwa standar pelayanan antenatal menurut Departemen Kesehatan Tahun 2000 sudah dilaksanakan oleh bidan di Kabupaten Purworejo. Kesimpulan: Pelayanan antenatal sesuai standar baik dipakai pada unit pelayanan kesehatan ibu dan anak. Terdapat hubungan antara pelaksanaan standar pelayanan antenatal dengan kejadian anemia.

Background:Every year an estimate of 20.000 Indonesian women die due to obstetric complication. More than 90 percenrt: is caused by trias classic; bleeding 40-60 percent, preeclampsia/eclampsia 20-30 percent and infection 20-30 percenc. It can be effectively prevented if comcnities are well informated about emergency signs as well as the prmision of qualified health service in primary care. WHO has developed standard of midwifery service which had been ac:usted for its application in Indonesia. In Purworejo reTency, morbidity of pregnant mother for anaemia is between 40-50 percent. Objectives: This research was aimed to know the relationship between implementation of antenatal service stindard that was done by village midwife with the incident of anemia. Methods: This was an observational research with historical cohort design. Two methods were used: quantitative methode to examine the implementation of antenatal service standard with the incident of anaemia. The subjects were interviewed after having antenatal service. Qualitative methode was used to conform the research results by doing focus group discussion with midwives of primary health care of Purworejo and Kutoarjo about inylementation of antenatal service standard according to Department of Health 2000. Data were analysed using univariable, bivariable, stratification, and multivariable analysis. Qualitative data were analysed using thematic analysis. Results: The result showed that pregnant mothers who received non standard antenatal service had risk of anaemia with OR=3.404 (95% CI: 1.303<0R<8.890), analysed using logistic regression model. Qualitative data revealed thsc standard of antenatal service according to department of nealth 2000 has already implemeted by midwives in Pcrworejo Regency. Conclusions: Standardized antenatal service was appropriate to be used in maternal perinatal health service unit. This research showed that pregnant mothers who re-eived non standard antenatal service had risk of suEfering anaemia than those with standard antenatal service.

Kata Kunci : standar pelayanan antenatal, anemia, bidan, standard of antenatal service, anaemia, midwife