PENGETAHUAN DAN KETERAMPILAN BIDAN DESA DALAM UPAYA PENINGKATAN KUALITAS PELAYANAN ANTENATAL CARE DI KABUPATEN LOMBOK TENGAH NUSA TENGGARA BARAT

Muhamad Zuhaeri, Prof. dr. Djaswadi Dasuki, MPH, SpOG(K), Ph.D

2011 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Berbagai kondisi struktural dalam system pelayanan mempengaruhi efektifitas program kesehatan ibu dan anak khususnya pelayanan antenatal care, berbagai upaya yang telah dilakukan untuk meningkatkan kualitas program pelayanan kesehatan ibu dan anak terutama pelayanan antenatal care, seperti peningkatan pengetahuan dan keterampilan yang didukung oleh dukungan organisasi secara optimal. Program pendidikan dan pelatihan adalah salah satu program yang ditunjukkan untuk meningkatkan penguasaan kompetensi asuhan kebidanan terutama penguasaan kompetensi antenatal care yang berdasarkan standar pelayanan. Tujuan Penelitian : Tujuan penelitian ini adalah mengevaluasi kualitas pengetahuan clinical asesment dan keterampilan clinical asesment bidan desa pada pelayanan antenatal care serta dukungan organisasi yang berupa pendidikan, supervisi dan kelengkapan peralatan. Metode Penelitian: Rancangan dalam penelitian ini adalah penelitian kuantitatif dan kualitatif dengan pendekatan cross sectional. Hasil Penelitian : Analisis univariabel menunjukkan 23.6% bidan desa tidak mengetahui tentang clinical asesment dalam antenatal care, 61.8% bidan desa tidak melakukan clinical asesment dalam praktek antenatal care, 60.0% bidan desa tidak mendapat supervisi dan 49.1% bidan desa tidak memiliki peralatan antenatal care yang lengkap. Analisis bivariabel menunjukkan hubungan yang bermakna antara pengetahuan clinical asesment dengan clinical asesment dalam praktek antenatal care (p<0.05). Analisis multivariabel menunjukkan besarnya pengaruh pendidikan dan supervisi pada pengetahuan clinical asesment dan clinical asesment dalam praktek antenatal care bidan desa (Deviance > 10). Kesimpulan : Hubungan pengetahuan tentang clinical asesment terhadap praktek clinical asesment dalam pelayanan antenatal care menunjukkan hubungan yang signifikan (p=<0.05). Dan hubungan tersebut dipengaruhi oleh faktor pendidikan bidan desa dan supervisi sehingga perlu peningkatan kualitas kinerja bidan desa melalui dukungan program pendidikan atau pelatihan dan supervisi, program akreditasi dan sertifikasi tenaga kebidanan serta penyediaan peralatan praktik klinik kebidanan.

Background: Various context and structure conditions in healthcare system will be affected the effectiveness of maternal and child health programs particularly antenatal care. More efforts have been done to improve those programs such as increasing knowledge and skills that have supported by the organization. Education and training programs is one of programs that were shown to improve the mastery of midwifery care competencies related to mastery of services standard based antenatal care competencies. Objectives: The purposes of this study were to evaluate the quality of clinical assessment knowledge and clinical assessment skills for the village midwives in antenatal care and organizational support which were education, supervision, and completeness of equipments. Methods: The design of this study was mixed methods approaches with cross-sectional study. Results: Univariable analysis indicated that 23.6% of village midwives didn’t know about clinical assessment in antenatal care, 61.8% of village midwives didn’t perform the clinical assessment in antenatal care practice, 60% of village midwives didn’t obtain supervision, and 49.1% of village midwives had no completeness equipment of antenatal care. Bivariable analysis showed that there were significantly associations between knowledge with clinical assessment in antenatal care practice (p<0.05), whereas Multivariable analysis showed that the associations between education and supervision in knowledge of clinical assessment and clinical assessment in village midwives practice of antenatal care (deviance >0.231). Conclusion: There were significantly associations between assessment clinical knowledge and assessment clinical practice in antenatal care (p<0.05). Those were determined by village midwives education and supervision. Therefore, It should be improved the performance quality of village midwives in antenatal care, particularly through supporting education, training and supervision programs, accreditation, certification of midwives and equipment suport.

Kata Kunci : Pengetahuan clinical asesment dan keterampilan clinical asesment, Antenatal care, kuantitatif-kualitatif, cross sectional, univariebel, bivariabel dan multivariabel, pendidikan dan pelatihan, supervisi, akreditasi, sertifikasi dan suport peralatan.