Pengaruh konseling oleh bidan terhadap keputusan ibu hamil memilih penolong dan tempat persalinan di Kabupaten Belu, NTT
KOY, Vincentia Johana Sukinem, Prof. dr. M. Hakimi, Sp.OG(K), Ph.D
2008 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang: Pelayanan Antenatal (ANC) dan pelayanan Post-natal adalah komponen utama dalam program Kesehatan Ibu dan Anak (KIA). Konseling adalah salah satu usaha yang dilakukan untuk menurunkan angka kematian ibu. Tujuan Penelitian: Untuk mengetahui apakah konseling bidan berpengaruh terhadap keputusan ibu hamil memilih penolong dan tempat persalinan di Kabupaten Belu, NTT. Metode Penelitian: Penelitian ini merupakan penelitian kuasi eksperimen. Subyek penelitian adalah 102 ibu hamil trimester III yang memenuhi kriteria inklusi. Data konseling, penolong persalinan, tempat persalinan, pendidikan, pengetahuan, sosial ekonomi dan letak geografis diukur menggunakan kuesioner. Analisis data dilakukan dengan program Stata 8 dengan uji statistik menggunakan McNemar untuk menyeleksi variabel yang secara bermakna berpengaruh (p<0,05). Hasil: Hasil analisis McNemar menunjukkan ada perbedaan yang siknifikan (p<0.05) antara variabel konseling dengan keputusan ibu hamil dalam memilih penolong persalinan tetapi konseling menunjukkan tidak ada perbedaan yang siknifikan (p>0.05) dengan keputusan ibu hamil memilih tempat persalinan. Pilihan penolong persalinan sesudah pemberian konseling 97% ke nakes dan 3% ke non nakes. Sedangkan pilihan tempat persalinan sesudah pemberian konseling 91% memilih ke fasilitas kesehatan dan 9% memilih di rumah. Pendidikan ibu tidak berhubungan siknifikan (p>0.05) dengan konseling dan keputusan ibu hamil dalam memilih penolong persalinan. Pendidikan ibu tidak berhubungan signifikan (p>0.05) dengan konseling dan keputusan ibu hamil memilih tempat persalinan. Pengetahuan ibu berhubungan siknifikan (p<0.05) dengan konseling tetapi tidak berhubungan siknifikan (p>0.05) keputusan ibu hamil memilih penolong persalinan. Pengetahuan ibu tidak berhubungan siknifikan dengan konseling (p>0.05) dan tidak berhubungan siknifikan (p>0.05) dengan keputusan ibu hamil memilih tempat persalinan. Sosial ekonomi yang miskin tidak berhubungan siknifikan (p>0.05) konseling dan keputusan ibu hamil memilih tempat persalinan. Sosial ekonomi yang tidak miskin berhubungan siknifikan (p>0.05) dengan konseling dan keputusan ibu hamil memilih tempat persalinan. Letak geografis berhubungan siknifikan (0<0.05) dengan konseling tetapi tidak berhubungan siknifikan (p>0.05) dengan keputusan ibu hamil tempat persalinan. Kesimpulan: Konseling dapat meningkatkan pilihan tenaga kesehatan sebagai penolong persalinan. Faktor ekonomi dan letak geografis berhubungan dengan konseling. Faktor sosial ekonomi berhubungan dengan keputusan ibu memilih tempat persalinan, faktor letak geografis berhubungan dengan konseling. Kemahiran konselor dalam menerapkan teknik dan ketrampilan yang dimilikinya menjadi kunci keberhasilan pelaksanaan konseling di Puskesmas/Polindes.
Background: Antenatal Care (ANC) and post-natal service are the main components of Mother and Child Health (MCH) Program. This program is intended to reduce Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR). MMR and IMR in Indonesia are still high. High MMR is caused by various medical or non-medical factors. Most deliveries in Indonesia take place at home under the assistance of traditional birth helpers or midwives. To increase the number of delivery handled by the health workers, their capability and those of the cadres must be improved so that they can provide information and establish communication with pregnant mothers through counseling because counseling is very important in the communication between the midwives and the pregnant mothers. Objective : To know whether counseling given by the midwives influence pregnant mothers' decision in choosing helper and place of delivery in Belu District of NTT. Method: It was a quasi experiment study using pretest and posttest group design. The subjects of study were 102 mothers who were in trimester III of pregnancy, fulfilled inclusion criteria, and received 6 sessions of counseling from midwives. Data about counseling, delivery helper, delivery place, education, knowledge, social-economic condition, and geographic location were obtained by using questionnaire. Data were analyzed with Stata 8 program and the statistic test was performed using McNemar analysis to select the variables that had significant influence (p >0.05). Results: The result of McNemar analysis showed that there was a significant difference (p <0.05) between counseling variable and the decision of pregnant mother to choose helpers, but counseling did not show a significant difference (p >0.05) on the pregnant mothers’ decision in choosing delivery place. After counseling, 97% pregnant mothers chose the help from health workers in their delivery and only 3% sought the help from non health workers. The choice of delivery place after receiving counseling, 91 % pregnant mothers chose health facility and 9 % chose to give birth at home. Mothers’ education had insignificant relationship (p>0.05) with the counseling and the decision of pregnant mothers to choose delivery helper. Mothers’ education had significant relationship (p<0.05) with the counseling and the decision of pregnant mothers to choose delivery helper. Mothers’ knowledge had significant relationship (p<0.05) with counseling, but it did not have a relationship with the decision of pregnant mothers to choose the place of delivery. Good socio-economic condition had significant relationship (p<0.05) with the decision of choosing delivery helper and the place of delivery, but it did not have relationship with the counseling. Geographical position had significant relationship (p<0.05) with the counseling and the decision of pregnant mothers to choose delivery helpers and place of delivery. Conclusion : Counseling increases the selection of health workers as the delivery helpers, but it cannot improve the selection for the place of delivery. Factors of economic condition and geographical location have a relationship with the counseling but they do not have relationship with the decision of pregnant mothers in choosing delivery helpers. Economic factor does not have a relationship with counseling but it has a relationship with the decision of pregnant mother in choosing place of delivery. The factor of geographical location has a relationship with counseling but it does not have relationship with the decision of pregnant mothers in choosing the place of delivery. The competence of counselors in implementing their skills is the key for the success of counseling in public health center/village policlinic.
Kata Kunci : Bidan,konseling,Persalinan,Tempat persalinan,Ibu hamil,Counseling, Decision, delivery helper and place of delivery.
