EVALUASI PELAYANAN ANTENATAL TERPADU PADA DETEKSI DAN PENANGANAN ANEMIA IBU HAMIL DI PUSKESMAS KOTA YOGYAKARTA

MARKHISTUN NADHIROH, Prof. dr. Moh.Hakimi, SpOG, Ph.D;Dr. Retna Siwi Padmawati, MA

2020 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Anemia merupakan permasalahan kesehatan masyarakat global dan nasional. Prevalensi anemia ibu hamil di Kota Yogyakarta mengalami peningkatan signifikan, yaitu dari 22,78 % pada tahun 2016 menjadi 30,81% pada tahun 2017. Kebijakan pelayanan antenatal terpadu sebagai salah satu upaya pencegahan masalah anemia sudah diterapkan. Tercapainya indikator pelayanan antenatal, yaitu cakupan K1(100%) dan K4 (90,2%), tidak menurunkan prevalensi anemia ibu hamil di Kota Yogyakarta. Tujuan: Melakukan evaluasi pelayanan antenatal terpadu pada deteksi dan penanganan anemia di puskesmas Kota Yogyakarta. Metode: Penelitian ini merupakan penelitian deskriptif kualitatif dengan desain studi kasus tunggal, untuk mengetahui lebih dalam fenomena pelayanan antenatal terpadu pada deteksi dan penanganan anemia di puskesmas Kota Yogyakarta. Pengumpulan data dengan cara mengumpulkan data primer yang diperoleh melalui wawancara mendalam dan diskusi kelompok terarah, data sekunder diperoleh melalui studi dokumen, observasi pelayanan langsung dan dengan menggunakan checklist. Keabsahan data diperoleh melalui triangulasisumber dan metode. Hasil : Tantangan dan hambatan pelaksanaan pelayanan antenatal terpadu deteksi dan penanganan anemia pada komponen input adalah ketersediaan SDM yang masih kurang. Pada komponen proses diketahui proses sosialisasi, pelaksanaan konseling, tatalaksana kasus anemia, serta pencatatan dan pelaporan belum optimal, sedangkan pada komponen output indikator Fe1, Fe3 dan K4 belum mencapai target. Kesimpulan : Pelaksanaan pelayanan antenatal terpadu pada deteksi dan penanganan anemia ibu hamil di puskesmas secara umum belum optimal pada komponen input, proses dan output. Diperlukan peran dan upaya dari Dinas Kesehatan Kota Yogyakarta serta puskesmas, untuk mengoptimalkan input dan proses pelaksanaan pelayanan antenatal terpadu, deteksi dan penanganan anemia ibu hamil sehingga dapat menjadi salah satu strategi pencegahan masalah yang ditimbulkan akibat anemia selama kehamilan

Background: Anemia is a global and national public health problem. The prevalence of anemia among pregnant women in Yogyakarta City experienced a significant increase of 22.78% in 2016 to 30.81% in 2017. An integrated antenatal care policy as an effort to prevent anemia problems has been implemented. Despite antenatal care indicators have been reached, namely coverage of K1 (100%) and K4 (90.2%), yet, it does not reduce the prevalence of anemia among pregnant women in Yogyakarta City. Objective: To evaluate integrated antenatal care in detection and treatment of anemia in Yogyakarta City health centers. Method: This research is a qualitative descriptive study with a single case study approach which aimed to discover more deeply the phenomenon of integrated antenatal care in the detection and treatment of anemia in Yogyakarta City health centers. Data collection by collecting primary data were obtained through in-depth interviews, as well as focus group discussions. While secondary data were gained through observation of documents, direct observation and using a checklist. Data validity were obtained through triangulation of sources and methods. Results: Challenges and obstacles in the implementation of integrated antenatal care in the detection and treatment of anemia on the input component are the lack of human resources. In the process component it was known socialization, implementation of counseling, management of anemia cases, and recording and reporting are not yet optimal. While the output component indicators namely Fe1, Fe3 and K4 have not reached the target. Conclusion: The implementation of integrated antenatal care in the detection and treatment of anemia among pregnant women in Yogyakarta City health centers is generally not optimal in the input, process and output components. The role and efforts of the Yogyakarta City Health Office and health centers are needed to optimize the inputs and implementation of integrated antenatal care, detection and treatment of anemia for pregnant women, thus it can become one of the strategies to prevent problems caused by anemia during pregnancy.

Kata Kunci : Pelayanan antenatal terpadu, anemia ibu hamil, ibu hamil, studi kasus