Implementasi making pregnancy safer di Puskesmas PONED :: Studi kasus di Kabupaten Banyuwangi

HAYATI, Nur Laila, Prof. dr. M. Hakimi, SpOG., Ph.D

2009 | Tesis | S2 Magister Kebijakan dan Manajemen Pelayanan Kese

Latar Belakang: Untuk mengatur derajat kesehatan diperlukan indikator kesehatan yakni mortalitas, morbiditas, angka usia harapan hidup serta status gizi. Masih tingginya angka kematian ibu merupakan suatu masalah yang sejak tahun 1990an. Untuk itu pemerintah menerapkan program Making Pregnancy Safer (MPS) melalui puskesmas sebagai tempat rujukan terdekat dari desa diharapkan mampu melaksanakan Pelayanan kegawat daruratan Obstetri dan Neonatal Dasar (PONED). Di Kabupaten Banyuwangi di optimalkan fungsi puskesmas untuk mampu PONED sebagai bentuk strategi utama dalam meningkatkan akses dan cakupan pelayanan kesehatan ibu dan bayi baru lahir berkualitas yang cost effective. Tujuan Penelitian: Mengetahui implementasi Making Pregnancy Safer (MPS) pada Puskesmas PONED dalam mengatasi kasus komplikasi obstetric dan neonatal di Kabupaten Banyuwangi Metode Penelitian: Penelitian ini merupakan penelitian deskriptif kualitatif dengan rancangan studi kasus. Sebagai unit analisis adalah provider Puskesmas PONED (Dokter, Bidan, Perawat). Instrumen yang digunakan dalam penelitian ini adalah peneliti sendiri. Alat yang digunakan adalah pedoman wawancara, catatan lapangan, daftar tilik, kamera dan tape recorder. Hasil: Puskesmas PONED di Kabupaten Banyuwangi pada umumnya belum mampu PONED dan belum berfokus pada penanganan kasus kegawatdaruratan obstetri neonatal, sistem pendukung PONED banyak dipengaruhi oleh kurangnya SDM yang kompeten, tata ruang yang tidak menunjang, dukungan lintas sektor dan regulasi tentang manajemen operasional PONED serta pola rujukan yang belum terstruktur dengan baik termasuk protab rujukan yang ada. Kesimpulan: Availability pelayanan PONED,Sistem pendukung, Pengelolaan rujukan PONED perlu dukungan lintas sektor dan regulasi tentang manajemen operasinal PONED.

Background: To manage health status needs health indicators such as mortality, morbidity, life expectancy and nutrition status. High maternal mortality rate has been a problem since 1990s. The government initiates the program of Making Pregnancy Safer (MPS) through health centers as the referral closest to the village that are expected to be able to provide basic obstetric and neonatal emergency service. At District of Banyuwangi the function of health centers is maximized to be able to provide basic obstetric and neonatal services as a major strategy in increasing access and coverage of quality maternal and neonatal service that is cost effective. Objective: To identify the implementation of MPS in basic obstetric and neonatal service health centers to overcome cases of obstetric and neonatal complications at District of Banyuwangi. Method: This was a descriptive qualitative study that used a case study design. Unit of analysis consisted of providers of basic obstetric and neonatal service health centers (doctors, midwives, nurses). Research instrument were the researcher, interview guide, field notes, check list, camera and tape recorder. Result: Basic obstetric and neonatal service health centers at District of Banyuwangi were mostly unable to provide basic obstetrics and neonatal service and did not focus on the management of obstetric neonatal emergency cases. The supporting system of basic obstetric and neonatal service was greatly affected by lack of competent human resources, unsupportive interior, lack of support a cross sectors and regulation on the operational management of basic obstetric and neonatal service and unstructured referral pattern and unavailability of referral operating procedure. Conclusion: Availability of service, supporting system and referral management of basic obstetric and neonatal service needed support across sectors and regulation on the operational management of basic obstetric and neonatal service.

Kata Kunci : Making pregnancy safer (MPS),Puskesmas PONED,Penanganan komplikasi obstetric dan neonatal, Making Pregnancy Safer, basic obstetric and neonatal service, obstetric and neonatal complication management