Analisis kualitas pelayanan antenatal di wilayah kerja Puskesmas Namlea Kabupaten Buru Propinsi Maluku
KARIYADI, dr. Kristiani, SU
2008 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang: Secara kuantitas, hasil pelayanan antenatal yang dapat dilihat dari cakupan pelayanan KIA di Kabupaten Buru selama tiga tahun terakhir semakin meningkat, menunjukkan pelayanan antenatal dapat dianggap cukup baik, namun angka kematian neonatal pada tahun yang sama justru terjadi sebaliknya. Masih tingginya angka kematian neonatal kemungkinan disebabkan karena kualitas pelayanan antenatal yang belum memadai. Kualitas pelayanan antenatal dapat dilihat dari sisi pemberi jasa, yaitu tenaga bidan sebagai pelaksanan pelayanan antenatal dan dari sisi pelanggan. Dari sisi konsumen / pengguna jasa, kualitas pelayanan antenatal menyangkut dimensi tangibles, reliability, assurance, responsiveness dan empathy. Kesenjangan ini yang menuntut perlunya diteliti persepsi pelanggan terhadap kualitas pelayanan antenatal saat ini dan yang diharapkan. Tujuan penelitian: mengetahui kualitas pelayanan antenatal di wilayah kerja Puskesmas Namlea. Metode penelitian: Penelitian ini merupakan penelitian kuantitatif dan kualitatif dengan rancangan cross sectional dan dilakukan terhadap pemberi jasa (bidan) dan pelanggan yang melakukan pemeriksaan kehamilan di posyandu atau Puskesmas. Lokasi penelitian di wilayah kerja Puskesmas Namlea Kabupaten Buru Propinsi Maluku. Pengambilan sampel ibu hamil dilakukan secara insidential sampling, ditentukan dengan rumus oleh Lemeshow dan diperoleh 67 sampel, untuk tenaga bidan diambil secara total sampling sebanyak 15 orang, sedangkan stakeholder sebanyak 4 orang. Alat penelitian berupa kuesioner, Check List dan panduan wawancara mendalam. Hasil penelitian: Terdapat perbedaan yang bermakna antara kualitas pelayanan antenatal yang diharapkan dengan kualitas pelayanan antenatal yang dipersepsikan responden (p<0,05). Namun untuk dimensi empathy menunjukkan tidak ada perbedaan yang bermakna (p>0.05). Tingkat kepatuhan terhadap pelaksanaan standar operasional sebesar 71,15 persen, sarana/peralatan yang tersedia sebesar 58,6 persen dan kemampuan bidan dalam pelayanan antenatal sebesar 52,42 persen. Kesimpulan: Kualitas pelayanan antenatal oleh bidan di wilayah kerja Puskesmas Namlea masih rendah, belum sesuai dengan standar, baik pada kemampuan, fasilitas dan kepatuhan pelaksanaan prosedur operasional. Kualitas pelayanan antenatal yang masih rendah mengakibatkan pelayanan tidak efektif dan belum memenuhi harapan pelanggan.
Background: The result of antenatal service from the service coverage of KIA (maternal and perinatal health) in Buru district showed improvement in quantity in the past three years. It showed that the antenatal service was quite good and yet neonatal mortality in the same year was contradicted.The high neonatal mortality rate was caused by the quality of insufficient antenatal service.The quality of antenatal service could be seen from the perspective of service provider, that was midwife as the implementor of antenatal service and from the perspective of customer. From the perspective of customer/service user, the quality of antenatal care involved dimension of tangibles, reliability, assurance, responsiveness and empathy. This gap demanded the need to further examine customer’s perception toward the quality of antenatal care recently and what was expected. Objective: This study was aimed to find out the quality of antenatal care in working area of Namlea Primary Health Care. Method: This was a quantitative and qualitative approaches that used cross sectional design and implemented toward service provider (midwife) and customers who had their pregnancy check up in integrated service post (Posyandu) or Primary Health Care. The study was located in working area of Namlea Primary Health Care of Buru district, Maluku province. The sample was chosen with simple random sampling technique and determined with formulation of Lemeshow and obtained 67 sample, there was 15 midwives who were chosen in total sampling, while 4 persons for stakeholders. The research instrument was questioner, check list and indepth interview guidance. Result: There was a significant difference between the expected quality of antenatal service with perceived quality of antenatal service by respondent (p<0,05). However, empathy dimension showed that there was no significant diference (p>0.05). The compliance level toward the implementation of operational standard was 71,15 %, the availability of facility or equipment was 58,6 % and midwife ability in antenatal service was 52,42 %. Conclusion: The quality of antenatal service by midwife in working area of Namlea primary health care was still low, and did not suitable with the existing standard in ability, facilty and compliance in the implementation of operational procedure. The quality of antenatal service was still low and caused ineffective service and did not fulfilled customer’s expectation.
Kata Kunci : Kualitas antenatal,Kepatuhan standar antenatal, Antenatal quality, antenatal standard compliance.
