Audit maternal perinatal di Kabupaten Kupang Provinsi Nusa Tenggara Timur
HANDAYANI, Wiri, dr. Mubasysyir Hasanbasri, MA
2009 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: Angka Kematian Ibu (AKI) dan Angka Kematian Perinatal (AKP) di Kabupaten Kupang masih tinggi. Salah satu cara untuk mempercepat penurunan AKI dan AKP adalah dengan meningkatkan mutu dan jangkauan pelayanan di berbagai fasilitas pelayanan kesehatan dasar dan pelayanan rujukan primer. Hal ini dapat dicapai melalui kegiatan Audit Maternal Perinatal (AMP), secara berjenjang mulai dari lini pelayanan terdepan (bidan di desa) sampai pada pengambil keputusan. Tujuan Penelitian: Untuk mendapatkan informasi tentang pengetahuan, sikap-perilaku tim AMP, pelaksanaan AMP di Kabupaten Kupang, bagaimana pelaksanaan, frekuensi, kepatuhan terhadap stándar, bagaimana pelaksanaan tindak lanjut rekomendasi yang telah dibuat, dan bagaimana manajemennya. Metode Penelitian: Penelitian ini merupakan penelitian deskriptif kualitatif. Subjek penelitian adalah team AMP dari berbagai tingkat. Data dikumpulkan melalui kuesioner berstruktur yang diisi oleh 40 orang dari puskesmas dan wawancawa mendalam terhadap 21 orang dari puskesmas dan 4 orang dari dinas kesehatan. Hasil Penelitian: Sebanyak 95% anggota tim AMP mempunyai pengetahuan yang baik, dan 100% anggota tim AMP mempunyai sikap dan perilaku yang tergolong baik. Pelaksanaan AMP di tingkat Kabupaten Kupang pada tahun 2007 hanya dilaksanakan satu kali dalam satu tahun pada akhir tahun. Peserta yang diundang dalam pertemuan AMP adalah kepala puskesmas, dokter puskesmas dan bidan koordinator puskesmas dari 10 di antara 23 puskesmas. Pertemuan ini mendatangkan nara sumber dokter spesialis anak dan dokter spesialis kandungan dan kebidanan. Sudah ada puskesmas yang mengalokasikan dana untuk kegiatan AMP. Dari kajian hasil otopsi verbal 87,5 persen ibu melahirkan di rumah dan 75,5 persen kematian maternal perinatal terjadi di rumah. Proses monitoring dan supervisi sudah berjalan, meskipun secara administratif karena keterbatasan sarana, tenaga, biaya, dan waktu. Kesimpulan: Dukungan lintas sektor sangat diperlukan untuk melaksanakan tindak lanjut non-klinis.
Background: The mortality rate of maternal and perinatal in the District of Kupang was still high. One of the ways to accellerate the decreasing of maternal and perinatal mortality rate was by improving the quality and service coverage in various facilities of basic health service and primary referral service. This could be achieved through stratified development of Maternal Perinatal Audit (MPA) starting from the front liner (village midwife) up to decision maker. Objective: This research was aimed to obtain information on knowledge, and attitude-behavior of MPA team, the implementation of MPA in the District of Kupang, implementation process, frequency, obedience toward standard, the implementation of follow up recommendation, and management. Method: This was a descriptive qualitative research with the subject of MPA team from various levels. The data was collected using structured questionnaire for 40 person in community health center and indepth interview was done for 21 person in community health center and 4 person in district health office. Result: As much as 95% of the team members have good, knowledge on the implementation of MPA, as well, all (100%) have good attitude and behavior toward the MPA implementation. However MPA meeting in the District of Kupang in the year 2007 was implemented only once at the end of the year. The participant who was invited in the MPA meeting was head of community health center, doctor of community health center and midwife coordinator of community health center from 10 among 23 community health centers.There was a pediatrician and obstetry and gynecologist who attented the meeting. In addition, there was one community health center which allocate the funding for MPA activity. From the verbal autopsy result there was 87,5 % mother who delivered at home and 75,5% maternal and perinatal mortality happened at home. The monitoring and supervision process was already good and yet there was a limitation in facilities, manpower, cost, and time. Conclusion: The support of across sector was greatly needed to implement the non-clinical follow up.
Kata Kunci : Audit maternal perinatal,Kualitas pelayanan KIA,Tindak lanjut lintas sektor,Maternal Perinatal Audit, quality of maternal and perinatal health, follow up, across sector
