Faktor-faktor yang mempengaruhi rendahnya minat Bidan bekerja di desa terpencil :: Studi kasus di Kabupaten Bungo Propinsi Jambi
SOLIKIN, dr. Mubasysyir Hasanbasri, MA
2004 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang masalah. Untuk mempercepat penurunan AKI dan AKB pemerintah mengeluarkan kebijakan program bidan desa tahun 1989 dan dilanjutkan dengan program pengangkatan bidan sebagai pegawai tidak tetap. Memperhatikan contoh kasus di Kabupaten Bungo, program ini masih belum berhasil, hal ini dapat dilihat dari banyaknya bidan di desa yang meninggalkan desa dan bertugas di puskesmas/puskesmas pembantu atau rumah sakit dan bidan PTT yang telah diangkat sebagai CPNS berupaya untuk dapat ditempatkan di puskesmas dan enggan untuk bertugas kembali di desa. Dari 125 desa, 43 desa diantaranya merupakan desa terpencil sebanyak 57 (45,6%) desa tidak memiliki bidan. Bidan desa sebanyak 78 orang bertugas di desa biasa 38 orang, desa terpencil 10 orang dan 30 orang di puskesmas/puskesmas pembantu. dari 43 desa terpencil yang ada 33 (76,74%) desa tidak ada bidan. Penelitian ini ingin Mempelajari kondisi-kondisi yang mempengaruhi tidak tersedianya bidan sesuai harapan terutama yang berkaitan dengan minat bidan bekerja di desa terpencil. Metode Penelitian. Penelitian studi kasus dengan rancangan kasus tunggal holistik.Subyek penelitian 9 orang bidan di desa dengan informan stakeholders di Dinas Kesehatan Kabupaten Bungo dan 2 orang kepala puskesmas. Pengumpulan data primer melalui wawancara dan diskusi kelompok terarah dengan panduan kuesioner, dan data skunder melalui telaah dokumen, data yang terkumpul dideskripsikan dengan cara kualitatif. Hasil. Rekrutmen dengan mengangkat kembali bidan yang telah habis masa bakti sesuai formasi pusat, penempatan ke desa berdasarkan kriteria dan keberadaan bidan di desa sekitarnya. Pembayaran gaji terlambat 2-3 bulan diawal pengangkatan. Frekuensi supervisi ke desa oleh puskesmas 1-2 kali setahun dan belum terjadwal, Kompensasi berupa tunjangan khusus dan biaya operasional serta penghargaan yang diberikan belum sesuai dengan harapan bidan, tidak ada prioritas diangkat sebagai CPNS, pemondokan belum layak, dan fasilitas penunjang sangat terbatas. Kesimpulan. Minat bidan bekerja di desa terpencil tidak dipengaruhi oleh pengelolaan di Dinas Kesehatan Kabupaten Bungo, melainkan oleh kompensasi yang diberikan, terbatasnya sarana dan fasilitas serta sulitnya mengembangkan karir pasca PTT
Background. To accelerate the decreasing of MMR and IMR, government issued a policy of village midwife program in the year of 1989 and continued with the program of appointing midwife as temporary staff. Bungo district consists of 125 villages which 43 villages among them were isolated villages. Total of 78 village midwives were divided into 38 people who work in normal village, 10 people in isolated village and 30 people in Primary Health Care/chapter of Primary Health Care. Temporary person midwife who were appointed as candidate of civil servant did not want to work in the village again and caused there was no midwife in 57 (45,6%) villages, as well as there was no midwife in 32 (76,2%) villages out of 43 isolated villages. Indeed, this fact showed the lack of interest of midwife to work in isolated village. Objective: To find out factors that influenced the low interest of midwife to work in an isolated village. Method: This was a case study with single holistic case. The subject of the research was stakeholder in District Health Office of Bungo, 9 village midwives and 2 head of Primary Health Care. Primary data was collected through interview and Focus Group Discussion with guidance of questioner. Secondary data was collected through document observation and the collected data were described in qualitative. Result: Recruitment by reappointing midwives who have finished the working period that suitable with central formation by placing to a village was based on criteria and existence of midwife in the surrounding village. The salary payment was late 2-3 months in the beginning of appointment. Frequency of supervision to the village by Primary Health Care was 1-2 times a year and not yet being scheduled, and the given compensation was special funding and operational fee that was not suitable with the expensive price of major need in isolated village. The appreciation toward village midwife still less, and there was no priority to be appointed as candidate of civil servant. Housing was not proper enough and supporting facility was very limited. Midwife determining the practice fee, and community’s capacity to pay the service of midwife in isolated village was lower. Conclusion: The lack of attention, supervision, facility limitation and the low capacity of community in paying the midwife fee as well as the difficulty in developing the career of post PTT were factors that influenced the low interest of midwife who work in isolated village.
Kata Kunci : Kebijakan Layanan Kesehatan,Minat Bidan,Daerah Terpencil, The low midwife’s interest to work in isolated village
