Hubungan pelaksanaan standar pelayanan antenatal dengan keikutsertaan ibu hamil untuk konseling dan tes HIV di Kabupaten Merauke

KARTININGSIH, Titik, Prof. dr. Djaswadi D, SpOG(K), MPH, PhD

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Kasus HIV setiap tahun mengalami peningkatan, demikian pula yang terjadi pada anak. Kasus HIV pada anak di Indonesia sembilan puluh persen terjadi karena penularan dari ibu ke bayi. Penularan tersebut dapat dicegah jika ibu hamil sejak dini diketahui serostatusnya dan mendapat pengobatan dengan tepat. Integrasi program pencegahan HIV dari ibu ke bayi pada pelayanan antenatal care telah dilakukan di Kabupaten Merauke, namun keikutsertaaan ibu hamil untuk VCT masih rendah. Tujuan Penelitian: Untuk menganalis hubungan pelaksanaan standar pelayanan antenatal care yang dikaitkan dengan keikutsertaan ibu hamil untuk VCT di Kabupaten Merauke, Propinsi Papua. Metode Penelitian: Penelitian ini menggunakan desain cross sectional Study dan rancangan kuantitatif serta kualitatif. Besar sampel sebanyak 245 ibu hamil di lima puskesmas di Kabupaten Merauke. Variabel bebasnya adalah pelaksanaan standar ANC, Variabel terikatnya adalah keikutsertaan ibu hamil untuk VCT, varibel pengganggu adalah umur, status pekerjaan, tingkat pendidikan, jumlah kunjungan, pengetahuan HIV, pengetahuan PMTCT dan penerimaan. Analisis data menggunakan Chisquare( χ2) dan analisis uji regresi logistik. Hasil: Analisis bivariabel menunjukkan bahwa variabel yang berhubungan secara bermakna dengan keikutsertaan ibu hamil untuk VCT adalah: (1). variabel pelaksanaan standar ANC (RP=3,4; p=0,000), (2). variabel pengetahuan HIV (RP=1,8; p=0,016), (3). Variabel pengetahuan PMTCT (RP=2,6; p=0,012), (4). Variabel pekerjaan (RP=1,8; p=0,007). Hasil analisis multivariabel menunjukkan bahwa variabel pelaksanaan standar ANC, pengetahuan HIV dan pengetahuan PMTCT berhubungan secara bermakna dengan keikutsertaan ibu untuk VCT. Kesimpulan: Ibu hamil yang mendapatkan pelayanan ANC sesuai standar, berpeluang lebih besar mengikuti VCT dibanding dengan ibu hamil yang mendapatkan pelayanan ANC tidak sesuai standar. Pengetahuan HIV dan PMTCT “cukup” berpengaruh terhadap keikutsertaan ibu untuk VCT

Background: HIV cases are increasing each year and the incidence also affects the children. Ninety percents of HIV cases among children in Indonesia occur because of mother to child transmission. The transmission can be prevented only if the serostatus of HIV in pregnant mothers is detected earlier and receives appropriate treatments. Integration of HIV prevention program from mother to child in antenatal care has been done in Merauke District; however, pregnant mothers’ participation on VCT is considered low. Objective: To analyze the relationship between standard antenatal care implementation and pregnant mothers’ participation on VCT in Merauke District, Papua Province. Method: This was a quantitative and qualitative study with a crosssectional study design. Sample was 245 pregnant mothers in five community health centers of Merauke District. The independent variable was standard ANC implementation, the dependent variable was pregnant mothers’ participation on VCT, and the confounding variable was age, occupational status, educational level, number of visits, knowledge on HIV, knowledge on PMTCT, and acceptability. Data analysis used Chi-square (χ2) and logistic regression tests. Results: Bivariable analysis showed that variables significantly related to pregnant mothers’ participation on VCT were as follows: (1) standard ANC implementation (RP=3.4; p=0.000); (2) Knowledge on HIV (RP=1.8; p=0.016); (3) knowledge on PMTCT (RP=2.6; p=0.012); and (4) occupational status (RP=1.8; p=0.007). Multivariable analysis showed that standard ANC implementation, knowledge on HIV and knowledge on PMTCT were significantly related to mothers’ participation on VCT. Conclusion: Pregnant mothers who received standard ANC services were more likely to participate in VCT than those who did not receive standard ANC services. Knowledge on HIV and PMTCT were influential towards mothers’ participation on VCT

Kata Kunci : Antenatal care,Ibu hamil,VCT HIV/AIDS,Antenatal Care, pregnant mothers, VCT HIV/AIDS.