Kompetensi bidan praktek swasta dalam penanggulangan persalinan berdasarkan standar praktek kebidanan di Kabupaten Indragiri Hulu Propinsi Riau

RISMAWATI, Venny, Prof dr. M. Hakimi, SpOG(K), Ph.D

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Proses melahirkan oleh bidan terlatih Skilled Birth Attendant (SBA) disajikan sebagai salah satu indikator kemajuan untuk mengurangi angka kematian maternal dunia – tujuan pembangunan milenium kelima. Pedoman Integrated Management of Pregnancy and Childbirth WHO (IMPAC) digunakan sebagai standar kompetensi. Evaluasi kompetensi biasanya meliputi uji pengetahuan tertulis, studi kasus partograf (digunakan untuk mencatat seluruh observasi wanita melahirkan) dan penilaian prosedur yang mendemonstasikan model anatomi. Angka kematian bayi Kabupaten Indra Giri Hulu tahun 2005 mencapai 60 per 1.000 kelahiran hidup.Pada tahun 2005 persentase balita yang ditolong oleh bidan sebesar (60,1%), dokter (15,3%), tenaga medis lainnya (1,7%), dukun (19,1%), dan lain-lain (0,88%) (Profil Dinas Kesehatan Indra Giri Hulu, 2006). Tujuan: Untuk mengetahui hubungan pendidikan, pelatihan, umur, lama praktek dan frekwensi kasus per bulan dan kompetensi bidan dengan menggunakan pendekatan materi APN, partograf dan resuscitsai. Metode: Disain penelitian adalah cross sectional design. Data dikumpulkan dengan menggunakan kuesioner. Populasi dalam penelitian ini adalah bidan praktek swasta yang ada di wilayah kerja Dinas Kesehatan Kab. Indragiri Hulu, berjumlah 169 orang. Selanjutnya diambil sampel 100 orang. Hasil: Sebagian besar (67%) bidan adalah dengan pendidikan D1, 73% berumur dibawah 40 tahun, sebagian besar (71%) tanpa pengalaman pelatihan, dan sebagian besar (73%) belum lama buka praktek (<10 tahun) dan sebagian besar (75%) dengan frekwensi kasus rendah (<7 kasus/bulan). Skore kompetensi sebagian besar (64%) bidan adalah rendah (<65%), dan 34% bidan dengan skore tinggi (>65%) dengan rerata 56.93% (tergolong rendah). Terdapat hubungan signifikan antara latarbelakang pendidikan, pengalaman pelatihan, dan frekwensi kasus yang dijumpai, dengan skore kompetensi bidan; Bidan dengan pendidikan D1 memiliki kemungkinan lebih besar (R=; 41.830 95%CI = 9.418- 185.825) daripada bidan dengan pendidikan D3, bidan tanpa pengalaman pelatihan memiliki kemungkinan lebih besar (OR= 4.201; 95%CI =1.161- 15.195) daripada bidan dengan pengalaman pelatihan, bidan dengan frekwensi kasus rendah (<7 kasus per bulan), memiliki kemungkinan lebih besar (OR=16.572; 95%CI=3.607-76.133) daripada bidan dengan frekwensi kasus tinggi (8-14 kasus per bulan), untuk memiliki skore kompetensi rendah. Kesimpulan: Terdapat hubungan antara latarbelakang pendidikan bidan, pengalaman pelatihan, dan frekwensi kasus per bulan, dengan nilai kompetensi bidan.

Background: The delivery wicht attended by skilled birth attendant (SBA) had presented as indicator of advancement to reduce maternal mortality in the world – the fifth goal of millenium development. Integrated Management of Pregnancy and Childbirth WHO (IMPAC) Guidelines had used as competency standard. The competency evaluation, usually include written test, partograph case study and procedure assessment which demonstrated an anatomic model. In 2005, the percentage of underfive that relief by midwifes was (60.1%), physician (15.3%), other medical staff (1.7%), herbalis (19.1%), and others (0.88%) (The Profil of Dinas Kesehatan Indra Giri Hulu, 2006). Objectives: To knowing the correlation between education, training, age, practice duration, and case frequency per month with midwifes competency using content from Normal Delivery Management, partograph, and newborn resuscitation. Method: The research was cross sectional design. Data was collected using questionnaire. The population was midwifes that open private practice in work area of Health Department of Indragiri Hulu Regency, was about 169 midwifes, and then, take a sampling of 100 midwifes. Results: The most (67%) of midwifes had D1 degree, 73% age under 40 years old, most (71%) was without training, and most (73%) was not long open practice yet (<10 years) and most (75%) with low (<7 case/months). of case frequency. Most (64%) of midwifes with low (<65%) of competency score and 34% midwifes with high (>65%) competency score. There was significant correlation between education, training, and case frequency with competency score; midwifes with D1 degree, had higher probability (R=; 41.830 95%CI = 9.418-185.825) than midwifes with D3 degree, midwifes with training experience had higher probability (OR= 4.201; 95%CI =1.161-15.195) than midwifes without training experience, midwifes with less case frequency (<7 case/months), had higher probability (OR=16.572; 95%CI=3.607-76.133) than midwifes with higher case frequency (8-14 case/months), to get low competency score. Conclusion: There was significant correlation between educational background, training experience, and case frequency per month, with competency score of the midwifes.

Kata Kunci : Kompetensi Bidan,Karateristik bidan,midwifes competency, midwife characteristics