Motivasi bidan serta dukun bayi dalam pelaksanaan program kemitraan pertolongan persalinan di Kabupaten Bangka

YANDRA, Boy, Dra. Ira Paramastri, M.Si

2010 | Tesis | S2 IKM-Perilaku dan Promosi Kesehatan

Latar Belakang: Lebih dari setengah juta ibu di dunia yang meninggal setiap tahun sebagian besar 43% persalinannya ditolong oleh dukun bayi. Provinsi Bangka Belitung merupakan wilayah yang memiliki permasalahan serupa, yaitu persalinan oleh dukun bayi. Dinas Kesehatan setempat telah mengembangkan program kemitraan bidan – dukun bayi dalam rangka menurunkan risiko kematian ibu dan bayi. Program telah dijalankan selama 2 tahun, namun belum semua bidan dan dukun bayi dapat menjalankan kemitraan. Motivasi bidan dan dukun bayi memiliki peran penting dalam penyelenggaraan program kemitraan. Tujuan penelitian: Untuk mendalami permasalahan motivasi bidan dan dukun bayi pada wilayah yang belum menjalankan program kemitraan dalam pertolongan persalinan di Kabupaten Bangka. Metode: Penelitian ini menggunakan metode kualitatif, data disajikan secara deskriptif. Penelitian dilakukan di 3 puskesmas, yaitu Puskesmas Belinyu, Riau Silip dan Sungailiat. Informan utama penelitian adalah dukun bayi dan bidan desa. Informan tambahan adalah bidan koordinator, dokter puskesmas, kepala bidang KIA serta kepala seksi KIA. Instrumen penelitian adalah panduan wawancara mendalam. Analisis data dilakukan dengan membuat transkrip, menganalisa transkrip, melakukan coding , kategori, menggaris bawahi, penyajian dan penarikan kesimpulan. Hasil Penelitian: 1) Adanya keinginan dukun bayi menjadi kader dan bidan menambah dana persalinan pribadi serta membuat anggaran rutin untuk dukun bayi, 2) Bidan dan dukun bayi tertarik dengan model kemitraan, 3) Dukun bayi sudah mulai memahami tugas dan fungsinya serta bidan masih banyak tugasnya sebagai pemeriksa kesehatan ibu bayi, 4) Imbalan yang diterima oleh dukun dari bidan secara garis besar belum mencukupi, 5) Masih kurangnya pembinaan dari dinas kesehatan dan puskesmas terhadap bidan desa dan dukun bayi. Kesimpulan: Motivasi bidan dan dukun bayi dalam meningkatkan cakupan persalinan oleh tenaga kesehatan bervariasi, pemberian insentif menjadi ketertarikan dukun bayi terhadap kemitraan. Pembinaan bidan dan dukun bayi yang sangat kurang, memicu kegagalan program.

Background: More than half a million of mothers that die world annually are mainly (43%) assisted by traditional childbirth attendants. The Province of Bangka Belitung has similar problem whereby the majority of childbirth is assisted by traditional childbirth attendants. Bangka Health Office has developed a program of midwives – traditional childbirth attendant partnership to minimize risk of maternal and infant mortality. The program has been implemented for two years, however not all midwives and traditional childbirth attendants can implement partnership. Motivation of midwives and traditional childbirth attendants has an important role in the implementation of partnership program. Objective: To study the problem of motivation of midwives and traditional birth attendants in the areas that could not implement partnership program in childbirth assistance at District of Bangka. Method: The study used qualitative method and data were presented descriptively. The study was undertaken in three health centers Belinyu, Riau Silip, Sungailiat. Main subject of the study were traditional childbirth assistants and village midwives and support subject were coordinating midwives, doctors in health centers, head of mother and child health department, and head of mother and child health section. Data were obtained through indepth interview and analyzed by making transcript of interview result, coding, category, underlines, presentation and conclusion. Result: 1) There was willingness of traditional childbirth attendants to become cadres and of midwives to raise cost of childbirth and allocate budget for traditional childbirth attendants; 2) Midwives and traditional childbirth attendants were interested in partnership model; 3) Traditional childbirth attendants began to understand their duties and function and midwives were mainly concerned with the health of mothers; 4) Reward provided by midwives for traditional childbirth attendants was inadequate; 5) Supervision from the health office and health centers for midwives and traditional childbirth attendants was insufficient. Conclusion: Motivation of the majority of midwives and traditional childbirth attendants to increase coverage of childbirth by health staff was relatively high due to the provision of incentives. Minimum supervision for midwives and traditional childbirth attendants could trigger program failure.

Kata Kunci : Motivasi,Kerjasama,Bidan,Dukun bayi, motivation, partnership, midwives, traditional childbirth attendants