Implementasi otopsi verbal kematian maternal pernatal di Kabupaten Pesisir Selatan Propinsi SUmatera Barat

WIBAWA, Satria, dr. Mubasysyir Hasanbasri, MA

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kebij. dan Manaj. Pe

Latar belakang. Program Audit Maternal Perinatal di Indonesia dimulai pertama kali tahun 1994, tapi di Kabupaten Pesisir Selatan pelaksanaannya baru dimulai pada tahun 2001. Otopsi verbal di Kabupaten Pesisir Selatan dilakukan oleh perawat/bidan. Sejak dilaksanakan, kegiatan otopsi verbal belum pernah dievaluasi. Tujuan. Peneltian ini bertujuan untuk mendapatkan informasi tentang pelaksanaan otopsi verbal yang dilakukan oleh perawat/bidan di Kabupaten Pesisir Selatan Metode. Penelitian ini merupakan rancangan studi kasus dengan pendekatan kualitatif. Subyek penelitian adalah semua perawat dan bidan yang melaporkan kematian maternal dan perinatal dan pemegang program KIA serta Dokter puskesmas, Kasubdin KIA, Kasie KIA, Dr Spesialis Kebidanan dan Penyakit Kandungan dan Ketua Ikatan Bidan Indonesia cabang Kabupaten. Data dikumpulkan dengan instrumen wawancara terstruktur melalui Kuesioner dan wawancara mendalam terhadap responden terpilih dengan pedoman wawancara mendalam serta cek dokumentasi. Hasil. Pelaksanaan otopsi verbal belum dijalankan dengan baik karena formulir otopsi verbal belum terisi sesuai standar yang ditetapkan. Dari 50 bidan yang melakukan otopsi verbal, hanya 4 persen yang lengkap. Data yang paling banyak tidak terisi dengan lengkap adalah identitas pasien (62%) dan riwayat penyakit (66%). Pengetahuan perawat dan bidan mengenai otopsi verbal baik, namun sikap dan perilaku perawat dan bidan masih dalam kategori sedang (tidak mendukung atau menolak). Hal tersebut dikarenakan pukesmas dan Dinas Kesehatan belum melakukan kegiatan monitoring dan supervisi. Dinas Kesehatan juga belum melakukan koordinasi dengan dokter spesialis Kebidanan dan Penyakit Kandungan Rumah Sakit Umum Daerah Dr. M. Zein Painan sebagai tim ahli. Kesimpulan. Pelaksanaan otopsi verbal belum dijalankan dengan baik sebab formulir otopsi verbal belum terisi sesuai standar yang ditetapkan karena manajemen program di puskesmas dan dinas kesehatan menjalankan fungsinya secara administratif saja.

Background: The program of maternal perinatal in Indonesia is firstly starting in the year of 1994, but in the district of South Pesisir the implementation just started in year of 2001. Verbal autopsy in the district of South Pesisir is implementation by nurse and midwife. Since the implementation, verbal autopsy activity was never been evaluated. Objective: This research was aimed to obtained information regarding the implementation of verbal autopsy which has implemented by nurse/midwife in the district of South Pesisir. Method: This research is device research of case study, with qualitative approaches. The research subject was all nurse/midwife who were reported maternal and perinatal mortality and KIA program holder as well as doctor of Primary Heath Care, head of KIA subdivision, head of KIA section, doctor specialist of obstetric and gynecology and the head of IBI in the district level. Data was collected was structured interview instrument through questioner and in-deep interview toward selected respondent with guidance at in-depth interview as well as documentation check. Result: The implementation of verbal autopsy was not well implemented as the form of verbal autopsy was not yet filled out based on the started standard. Out of 50 nurse and midwife who had verbal autopsy, only 4% who were completed. Data that was not completely filled out was patient’s identity (62%) and disease history (66%). Knowledge of nurse/midwife still in the category of neutral (not supporting or rejecting). This is caused by Primary Health Care and Health Office who were not having monitoring and supervision activities. Health office was not yet implementing coordination with doctor of obstetric and gynecology specialist of Dr. M. Zein Painan hospital as the expert team. Conclusion: The Implementation of verbal autopsy was not well implemented because the verbal autopsy form was not yet filled out based on the stated standard as program management in Primary Health Care and Health Office run his function is only administrative.

Kata Kunci : Layanan Kesehatan,Otopsi Verbal,Kematian Maternal,Audit, Verbal autopsy, maternal perinatal audit