Audit maternal perinatal Kabupaten Parigi-Moutong Propinsi Sulawesi Tengah

MASILA, Feronica, Prof.dr. Djaswadi Dasuki, MPH,SpOG(K).,PhD

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kes. Ibu dan Anak-Ke

Latar Belakang: Kematian ibu disebabkan oleh komplikasi kehamilan, persalinan, dan nifas. Adapun faktor-faktor yang mempengaruhi kematian ibu dan perinatal adalah: (1) faktor medis yaitu usia ibu hamil yang terlalu muda, terlalu tua, terlalu banyak anak, jarak antara waktu melahirkan terlalu terdekat (<2 th), (2) faktor-faktor non medis antara lain: kurangnya kesadaran ibu, suami, dan keluarga untuk mendapatkan pelayanan antenatal, terbatasnya pengetahuan tentang bahaya kehamilan risiko tinggi, ketidak berdayaan sebagian besar ibu hamil dalam pengambilan keputusan untuk dirujuk, faktor-faktor geografis dan transportasi yang sulit. Di Propinsi Sulawesi Tengah berdasarkan survei angka kematian sebesar 517 per 100.000 kelahiran hidup, walaupun berdasarkan pencatatan dan pelaporan program angka kematian ibu tercatat 373 per 100.000 kelahiran hidup. Di Kabupaten Parigi-Moutong sendiri berdasarkan program tahun 2004 dan pelaksanaan audit maternal perinatal terdapat 24 kasus kematian maternal. Tujuan Penelitian: Mengetahui apakah pelaksanaan audit maternal perinatal di Kabupaten Parigi Moutong telah sesuai dengan pedoman teknis maternal perinatal, mengetahui apakah dilaksanakan tindak lanjut rekomendasi, Metode Penelitian: Penelitian ini merupakan penelitian deskriptif, lokasi penelitian di Kabupaten Parigi Moutong, sampel penelitian berjumlah 33 orang (total sampel). Variabel dalam penelitian ini adalah frekwensi, rekomendasi tindak lanjut, alat pengambilan data adalah kuesioner, laporan tahunan Januari–Desember 2004, dan pengamatan pada saat pelaksanaan audit maternal perinatal. Hasil: Dalam Satu tahun pelaksanaan audit maternal perinatal 5 kali (6%) struktur atau kelengkapan administrasi (30%) dilengkapi dengan surat keputusan, keterlibatan Kepala Puskesmas dan pengelola KIA dalam pelakasnaan AMP (24%) dan membuat rangkuman notulen 18%, rekomendasi tindak lanjut (18%), sebanyak (21%) memberi umpan balik ke puskesmas. Kesimpulan: Proses pelaksanaan audit maternal perinatal tingkat puskesmas Kabupaten Parigi Moutong belum sesuai dengan standar yang terdapat pada pedoman teknis terpadu AMP, kepatuhan terhadap standar (3%), frekuensi (6%), (18%) puskesmas melaksanakan rekomendasi tindak lanjut dan (18%) membuat rangkuman notulen.

Background: Maternal mortality is caused by complication in pregnancy, childbirth and parturition. Factors affecting maternal and perinatal mortality are: 1) medical factors, i.e. being pregnant too young or too old, having too many children, short birth spacing (<2 years); 2) non medical factors i.e, lack of awareness of mothers, husbands and families to have antenatal service, limited knowledge about the danger of high risk pregnancy, helplessness of the majority of pregnant mothers in making decision for referral, geographical factors and problems in transport. Objective: To find out compliance in the implementation process of maternal perinatal audit and follow up of maternal perinatal audit recommendation at District of Parigi Moutong. Method: This was a descriptive study carried out at District at Parigi Moutong. There were as many as 33 total samples. Variables of the study were frequency of audit and recommendation for a follow up. Research instruments used were questionnaires, annual report 2004 and observation during the implementation of maternal perinatal audit. Result: Within a year of implementation there were 5 times (6%) of maternal perinatal audit, structural and administrative process was supported with a decree (3%), heads of community health center and managers of mother and child health were involved in the implementation of maternal perinatal audit (29%), there were summaries of minutes (18%), recommendation for a follow up (18%), and feedback to the health center (21%). Conclusion: The process of maternal perinatal audit implementation at the level of health centers at District of Parigi Moutong had not adopted the standard of integrated technical guidelines of maternal perinatal audit, compliance to the standard was 30%, the health center carried out recommendation for a follow up (18%), and there were summaries of minutes (18%).

Kata Kunci : Audit Maternal Perinatal,Kebijakan dan Strategi