Pengelolaan anemia dalam pelayanan antenatal terhadap kejadian anemia ibu hamil di Kota Pontianak

SUDARTO, dr. Siswanto Agus Wilopo, SU, MSc, ScD

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Anemia pada masa kehamilan merupakan masalah kesehatan masyarakat yang dapat menyebabkan kesakitan dan kematian pada ibu dan anak, terutama di negara berkembang. Upaya pencegahan anemia pada pada ibu hamil telah dilakukan dengan pemberian tablet besi, peningkatan status gizi dan konsultasi gizi pada pelayanan antenatal. Di kota Pontianak integrasi pengelolaan anemia dalam pelayanan antenatal sudah dilakukan sesuai standar pelayanan kebidanan Departemen Kesehatan tahun 2003 namun prevalensi anemia masih tinggi. Tujuan Penelitian: Diketahuinya hubungan kualitas pelayanan antenatal dan faktor-faktor lain terhadap kejadian anemia ibu hamil di Kota Pontianak. Metode Penelitian: Jenis penelitian ini adalah observasional dengan rancangan cross sectional. Kualitas pelayanan antenatal dengan kuesioner, pemeriksaan haemoglobin darah dengan metode Stat Site Mhgb.. Sampel sebanyak 150 responden. Analisis yang dilakukan uji statitistik chi-square dan multivariabel menggunakan regresi logistic α=0,05 dan interval kepercayaan 95 persen. Hasil Penelitian: ibu hamil dengan pelayanan antenatal tidak sesuai standar mempunyai peluang anemia 6,8 kali lebih besar dibandingkan ibu dengan pelayanan antenatal sesuai standar (OR=6,8; 95%CI=2,9-16,1). Ibu dengan paritas ≤1&>4 memilki peluang mengalami anemia 4,5 kali lebih besar dibandingkan ibu dengan paritas 2-4 (OR=4,5; 95%CI=1,6- 12,2). Ibu dengan status ekonomi rendah memiliki peluang mengalami anemia 2,6 kali lebih besar dibandingkan ibu dengan satus ekonomi cukup (OR=2,6; 95%CI=1,1-6,1), Ibu dengan komsumsi tablet Fe kurang kemungkinan mengalami anemia 3,9 kali lebih besar dibandingkan ibu dengan komsumsi Fe cukup (OR=3,9; 95%CI=1,7-8,3). Kesimpulan: Terdapat hubungan kualitas pelayanan antenatal dengan kejadian anemia kehamilan. Faktor lain yang berhubungan adalah paritas, status ekonomi dan komsumsi tablet Fe.

Background: Anemic pregnancy is a health problem that can result in maternal and child morbidity and mortality particularly in developing countries. Several efforts to prevent anemic pregnancy have been conducted, such as iron supplementation, improvement of nutritional status, and nutrition consultation in antenatal care. The integrated management of anemia prevention in antenatal care in Pontianak Municipality has actually been done in accordance with the standard of antenatal care recommended by the Ministry of Health; however, the prevalence of anemia in this municipality remains high. Objective: The identified relationship between antenatal care quality and other factors toward the prevalence of anemic pregnancy in Pontianak Municipality. Method: This was an observational study with a cross-sectional study design. The antenatal care quality was measured through a questionnaire and hemoglobin examination was done with Stat Site Mhgb method. Subjects were pregnant women in the first, second and third trimester. The sample size was 150 respondents. The analysis used chi-square test and multivariable analysis with logistic regression, α=0.05, and confidence interval (CI) 95%. Results: The prevalence of anemic pregnancy was 6.8 times greater in pregnant women who did not receive standard antenatal care than those who received standard antenatal care (OR=6.8; 95% CI=2.9-16.1). Other factors that had a significant relationship with anemia were parity (OR=4.50; 95%CI=1.6-12.2), economic status (OR=2.6; 95%CI=1.1-6.1), and iron supplementation (OR=3.9; 95%CI=1.7-8.3). In addition, maternal education did not have a significant relationship with anemia. Conclusion: There was a relationship between antenatal care quality and the prevalence of anemic pregnancy. Other factors that affected the prevalence of anemic pregnancy were parity, economic status, and iron supplementation.

Kata Kunci : Kualitas pelayanan antenatal,Ibu hamil,Anemia, antenatal care quality, pregnant women, anemia