Implementasi Sepuluh Langkah Menuju Keberhasilan Menyusui: Studi Terhadap Kecukupan ASI dan Pengalaman Menyusui Ibu Nifas

NISRINA AFIFATURROHMAH, Dr. Diah Wulandari, M. Keb, Dr. dr. Ekawaty Lutfia Haksari, MPH., Sp. A(K)

2026 | Tesis | MAGISTER KEBIDANAN

Latar Belakang : Data cakupan ASI di Indonesia berkisar pada angka 68,6%, menunjukkan bahwa keberhasilan menyusui belum optimal. Organisasi Kesehatan Dunia (WHO) merekomendasikan Langkah Menuju Keberhasilan Menyusui (LMKM) menjadi upaya berbasis bukti dalam meningkatkan keberhasilan menyusui dan pemberian ASI berkelanjutan. Meskipun secara internasional implementasi LMKM berkaitan dengan manfaat menyusui, penelitian dengan menilai pada kecukupan ASI dan pengalaman menyusui ibu masih terbatas.

Metode : Penelitian ini menggunakan desain mixed-methods dengan pendekatan sequential explanatory. Penelitian dilakukan dalam 2 tahap, yakni kuantitatif  untuk menilai kecukupan ASI dan pengalaman menyusui pada ibu menyusui, dengan pengambilan sampel purposive sampling sebanyak 34 responden. Penilaian kecukupan ASI diukur menggunakan instrumen Breastfeeding Assessment Tool (BAT) parents’ version dan pengalaman menyusui dinilai menggunakan kuesioner Maternal Breastfeeding Evaluation Scale (MBFES). Data kuantitatif dianalisis menggunakan uji chi-square. Tahap kedua, kualitatif dilakukan dengan wawancara 8 petugas kesehatan di puskesmas yang dipilih sesuai dengan kriteria dalam partisipasi implementasi 10 LMKM. Data kualitatif dianalisis menggunakan analisis tematik. Penelitian dilakukan di puskesmas kota Yogyakarta dan Kabupaten Sleman pada Desember 2025-Januari 2026.

Hasil : Penerapan 10 LMKM secara lengkap memiliki hubungan yang bermakna secara statistik terhadap kecukupan ASI ibu nifas (p = 0,006). Tidak ditemukan hubungan yang bermakna secara statistik antara implementasi LMKM dengan pengalaman menyusui ibu nifas (p = 1,000). Temuan kualitatif mengidentifikasi bahwa pelaksanaan implementasi 10 LMKM telah terintegrasi dalam pelayanan rutin, didukung oleh komitmen pimpinan melalui kebijakan, monitoring dan evaluasi, namun dipengaruhi oleh efisiensi anggaran serta kapabilitas staf dan menghadapi tantangan dalam keberlanjutan program

Simpulan : Implementasi 10 LMKM meningkatkan kecukupan ASI, namun tidak menunjukkan hubungan bermakna dengan pengalaman menyusui ibu. Perlu mempertimbangkan aspek multifaktorial dalam menyusui. 

Background: Breastfeeding coverage data in Indonesia is around 68.6%, indicating that breastfeeding success is not yet optimal. The World Health Organization (WHO) recommends Steps to Successful Breastfeeding (SSB) as an evidence-based effort to improve breastfeeding success and sustainable breastfeeding. Although internationally the implementation of LMKM is associated with the benefits of breastfeeding, research assessing breast milk adequacy and mothers' breastfeeding experiences is still limited.

Methods: This study used a mixed-methods design with a sequential explanatory approach. The study was conducted in two stages, namely quantitative to assess breast milk adequacy and breastfeeding experiences in breastfeeding mothers, with purposive sampling of 34 respondents. Breast milk adequacy was measured using the Breastfeeding Assessment Tool (BAT) parents' version, and breastfeeding experiences were assessed using the Maternal Breastfeeding Evaluation Scale (MBFES) questionnaire. Quantitative data were analyzed using the chi-square test. The second stage, qualitative, was conducted by interviewing 8 health workers at health centers selected according to the criteria for participation in the implementation of the TSSB. Qualitative data were analyzed using thematic analysis. The study was conducted at health centers in Yogyakarta City and Sleman Regency from December 2025 to January 2026.

Results: The complete implementation of the TSSB had a statistically significant relationship with the adequacy of breast milk in postpartum mothers (p = 0.006). No statistically significant relationship was found between the implementation of TSSB and the breastfeeding experience of postpartum mothers (p = 1.000). Qualitative findings identified that the implementation of the 10 BMS has been integrated into routine services, supported by leadership commitment through policies, monitoring, and evaluation, but influenced by budget efficiency and staff capabilities and faces challenges in program sustainability.

Conclusion: Implementation of the TSSB improves breast milk adequacy, but does not show a significant relationship with mothers' breastfeeding experience. Multifactorial aspects of breastfeeding need to be considered. 

Kata Kunci : Implementasi 10 LMKM, Kecukupan ASI, Pengalaman Menyusui, Mixed-methods