Evaluasi pelaksanaan perawatan kesehatan masyarakat oleh bidan desa di Kabupaten AGam

NURMALIS, dr. Kristiani, SU

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

Latar Belakang. Angka kematian ibu dan balita di Agam pada tahun 2005 masih cukup tinggi. Target Bumil Resti yang ditangani dan yang dirujuk belum tercapai, walaupun telah diupayakan dengan menugaskan bidan desa untuk menjalankan program Perawatan Kesehatan Masyarakat (Perkesmas). Tujuan. Untuk mengetahui pengelolaan program perawatan kesehatan masyarakat oleh Bidan desa di Kabupaten Agam . Metode Penelitian. Penelitian ini merupakan penelitian analitik, dengan rancangan cross sectional serta menggunakan metode kuantitatif dan kualitatif. Unit analisis adalah bidan desa, dengan subjek penelitian: bidan desa, kepala puskesmas, pemegang program perkesmas. Data primer diperoleh dari wawancara mendalam, kuesioner, observasi dokumen Hasil. Pengetahuan bidan desa berhubungan dengan kepatuhan asuhan perkesmas (r=0,326, p<0,05), namun tidak berhubungan dengan kepatuhan administrasi asuhan perkesmas (r=0,079, p>0,05). Keterampilan bidan desa berhubungan dengan kepatuhan asuhan perkesmas (r=0,360, p<0,05), dan kepatuhan administrasi asuhan perkesmas (r=0,277, p<0,05). Motivasi bidan desa berhubungan dengan kepatuhan asuhan perkesmas (r=0,395, p<0,05), namun tidak berhubungan dengan kepatuhan administrasi asuhan perkesmas (r=0,188, p>0,05). Ketersediaan sarana dan dana berhubungan dengan kepatuhan asuhan perkesmas (r=0,518, p<0,05) dan kepatuhan administrasi asuhan perkesmas (r=0,425, p<0,05). Persepsi manajemen perkesmas bidan desa juga berhubungan dengan kepatuhan asuhan perkesmas (r=0,559, p<0,05), dan kepatuhan administrasi asuhan perkesmas (r=0,265, p<0,05). Faktor yang dominan mempengaruhi kepatuhan asuhan perkesmas adalah pengelolaan perkesmas dari puskesmas, sedangkan kepatuhan administrasi asuhan perkesmas adalah sarana dan dana. Kualitas pengelolaan program Perkesmas di sebagian besar Puskesmas belum baik. Kesimpulan. Kualitas pelaksanaan program Pelayanan Perkesmas di Kabupaten Agam belum berkualitas karena Pengelolaan dari Puskesmas yang belum optimal dan keterbatasan ketersediaan sarana dan dana dalam pelaksanaan Perkesmas.

Background. The mother and under five year old children mortality rate at Agam District in the year 2005 was still high.The number of high risked pregnant women handled and referred to hospitals has not achieved the target even though village midwives have been assigned to carry out the public health nursing programs. Objective. This research was conducted to get an overview of management of public health nursing programs implementation. Methods. This research was an analytical research,with cross sectional design,using quantitative and qualitative methods. The research subjects were village midwives, head of health center, and the coordinator of public health nursing programs, with village midwives as the unit of analysis. The research instruments were in-depth interview guide, questionnaires, and document checklist. Result. The knowledge of village midwives was correlated to the compliance towards public health nursing standard operational procedures (p<0,05,r=0,326), but was not correlated to the compliance towards public health nursing administration procedures (p>0,05,r=0,079). The skill of village midwives was correlated to the compliance towards public health nursing standard operational procedures (p<0,05,r=0,360), and also to the compliance towards public health nursing administration procedures (p<0,05,r=0,277). The motivation of village midwives was correlated to the compliance towards public health nursing standard operational procedures (p<0,05,r=0,395), but was not correlated to the compliance towards public health nursing administration procedures (p>0,05,r=0,188). The availability of facilities and fund was correlated to the compliance towards public health nursing standard of procedures (p<0,05,r=0,518), and also to the compliance towards public health nursing administration procedures (p<0,05,r=0,425). The perception of public health nursing management by village midwives was correlated to the compliance towards public health nursing standard operational procedures (p<0,05,r=0,559), and also to the compliance towards public health nursing administration procedures (p<0,05,r=0,265). The most dominant factor correlated to the compliance towards public health nursing standard of procedures was public health nursing management, while the most dominant factor correlated to the compliance towards public health nursing administration procedures was facilities and fund. Overall,the quality of public health nursing management is the most health centers at Agam District was considered poor. Conclusion. The quality of public health nursing programs implementation at Agam District was considered poor because of its inappropriate management, besides the limited facilities and fund.

Kata Kunci : Layanan Kesehatan,Perawatan Kesehatan,Bidan Desa