Hubungan pelaksanaan pengembangan manajemen kinerja dengan cakupan pelayanan antenatal di Kabupaten Sleman

ROYANI, Ida, Prof.dr. M. Hakimi, SpOG(K).,PhD

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

Latar Belakang: AKI di Indonesia masih tinggi, data SDKI (2002-2003) AKI masih berkisar 307 per 100.000 KH. Penyebab kematian ibu faktor langsung akibat kehamilan yakni: perdarahan (40-60%), infeksi (20-30%) dan eklampsia (20-30%) dan peran institusi pelayanan kesehatan ikut berkontribusi. Gambaran pelayanan kebidanan dan keperawatan di Indonesia (70%) bidan dan perawat memiliki skill dan pengetahuan yang kurang, (39,8%) masih melakukan tugas kebersihan, (47,4%) tidak memiliki uraian tugas secara tertulis. Untuk meningkatkan kinerja bidan dan perawat, WHO dan Depkes mengembangkan suatu model disebut pengembangan manajemen kinerja (PMK). PMK memudahkan pencapaian target indikator pelayanan kesehatan, khususnya indikator pelayanan kesehatan ibu dan anak yakni pelayanan antenatal. Tujuan: Untuk mengetahui hubungan PMK dengan cakupan pelayanan antenatal. Metoda: jenis observasional dengan desain Cross Sectional Study untuk melihat hubungan pelaksanaan PMK dengan cakupan pelayanan antenatal. Subyek penelitian seluruh Puskesmas di Kabupaten Sleman Daerah Istimewa Yogyakarta. Analisis data yang digunakan: univariabel dengan distribusi frekuensi, bivariabel chi-square (x2). Hasil: Hasil penelitian ini membuktikan ada hubungan yang bermakna antara pelaksanaan PMK dengan pencapaian cakupan pelayanan antenatal. Artinya pelaksanaan PMK berjalan optimal dapat meningkatkan cakupan pelayanan antenatal dibandingkan dengan pelaksanaan PMK belum optimal. Hal ini terbukti dengan kemaknaan statistik (RP= 2.86, CI 95%= 1,08 – 7,54) Kesimpulan: Ada hubungan yang bermakna antara pelaksanaan PMK berjalan optimal dengan pencapaian cakupan pelayanan antenatal, sehingga PMK merupakan salah satu strategi yang tepat untuk meningkatkan mutu pelayanan kesehatan.

Background: Maternal Mortality Rate (MMR) in Indonesia is still high based on Indonesia Demographic and Health Survey data (2002-2003) that is around 307 per 100,000 live births. Direct factors of maternal death related to pregnancy are hemorrhage (40-60%), infection (20-30%) and eclampsia (20-30%) and, in fact, health institution contributes to those factors causing the high rate of maternal mortality. Since the performance of nurses and midwives is still low according to the study done by WHO and Health Department (2000), a model prior to be called Clinical Performance Development Management System (CPDMS) was made and it later became Performance Management Development (PMD) through the decree of minister of health number 836/MENKES/SK/VI/2005. PMD has been tested in some districts in Indonesia including in Sleman District, Yogyakarta Province. Objective: this study was undertaken to know the correlation between PMD and antenatal service coverage. Method: it was an observational study with cross-sectional design to know the correlation between the implementation of PMD and antenatal service coverage. The samples were taken from the total population from 24 community health centers in Sleman District. Result: there was a significant correlation between the implementation of PMD and antenatal service coverage. The optimal implementation of PMD was three times higher in achieving the target of PMD than the less optimal implementation of PMD proven by chi-square test with RR = 2.86 (CI95% = 1.08 – 7.54) p = 0.005. Conclusion: there was a significant correlation between the optimal implementation of PMD and the achievement of antenatal service coverage so that PMD was a good strategy to improve the quality of maternal and child health services.

Kata Kunci : Pelayanan Antenatal,Manajemen Kinerja,performance management development, antenatal service