EVALUASI PELAYANAN KEGAWATDARURATAN MATERNAL NEONATAL PADA PUSKESMAS MAMPU PELAYANAN OBSTETRI DAN NEONATAL EMERGENSI DASAR (PONED) DI KABUPATEN BANTUL

Christina Pernatun Kismoyo, S. STT, Prof. Dr. Mohammad Hakimi, PhD, SpOG(K)

2012 | Tesis | S2 Kesehatan Masyarakat/KIA

Latar belakang: Setiap kehamilan dan persalinan merupakan kejadian berisiko, oleh karena itu setiap ibu hamil dan bersalin harus berada sedekat mungkin dengan pelayanan obstetrik emergensi dasar. Sebagai unit pelayanan kesehatan yang dekat dan mampu terjangkau oleh masyarakat Puskesmas diharapkan mampu memberikan pelayanan obstetrik neonatal emergensi dasar. Di Kabupaten Bantul ada 6 puskesmas mampu PONED. Puskesmas dalam pelaksanaannya perlu adanya suatu langkah evaluasi guna meningkatkan ataupun mempertahankan suatu mekanisme yang sudah baik atau kurang baik. Tujuan: Untuk melihat implementasi pelayanan puskesmas mampu kegawatdaruratan Obstetrik dan Neonatal Dasar (PONED) di Kabupaten Bantul. Metodologi: Penelitian diskriptif kualitatif dengan unit analisis adalah petugas (dokter, bidan, perawat, laboran dan sopir) serta kepala Dinas Kesehatan Kabupaten Bantul. Instrumen penelitian adalah peneliti sendiri, alat yang digunakan kamera, tape recorder, daftar tilik, dan pedoman wawancara. Hasil: Puskesmas PONED lebih dipandang sebagai pekerjaan rutinitas karena provider pelayanan belum mampu memahami tujuan pelayanan dengan baik. Pelayanan kegawatdaruratan obstetrik dan neonatal belum seluruhnya dapat dilayani di 6 puskesmas hanya Sewon I. sistem pendukung pelayanan PONED tersedia, namun ketersediaan pelayanan belum seluruhnya tersedia yakni; alat, obat dan infrastruktur. Hal ini karena jarangnya kasus komplikasi obstetri dan neonatus yang ditangani sehingga obat dan alat yang tersedia kadaluarsa serta rusak. Pengelolaan rujukan kasus kegawatdaruratan obstetri dan neonatal belum berjalan dengan baik sesuai dengan kasus, cenderung melakukan rujukan dini. Kesimpulan: Manajemen pelayanan puskesmas PONED lebih pada birokrasi belum berdasarkan pada setting pelayanan kegawatdaruratan obstetrik dan neonatal, sehingga orientasi petugas pelayanan dipandang sebagai pekerjaan rutinitas. Dukungan pemerintah dalam support insentif sangat berpengaruh pada motivasi kerja petugas pelayanan.

Background: Each occurrence of pregnancy and childbirth is risky, therefore every expectant mothers and maternity should be as close as possible with basic emergency obstetric care. As a health care unit close to and affordable by the community health centers are able are expected to provide basic emergency neonatal obstetric care. In Bantul have 6 health centers capable EMOC. Community Health Center in its implementation needs to be a step evaluation to improve or maintain a mechanism that has been good or less good. Objectives: To view the implementation of service centers capable of Obstetric and Neonatal Emergency Basis (EMOC) in Bantul. Methodology: A qualitative descriptive study is an analysis unit personnel (doctors, midwives, nurses, laboratory assistants and a driver) and head of the District Health Office in Bantul. Research is the researcher's own instrument, a tool used cameras, tape recorders, checklists, and interview guides. Results: Health Center EMOC more seen as a routine job for the service provider has not been able to understand the purpose of service as well. Emergency obstetric and neonatal care have not been entirely able to be served at six health centers only Sewon I. EMOC service support system available, but availability of services not yet fully available, namely: the tools, medicine and infrastructure. This is because the scarcity of cases of obstetric and neonatal complications are handled so that drugs and devices are available expired and damaged. Management of referral cases of obstetric and neonatal emergencies have not been going well according to the case, tends to make an early referral. Conclusion: The management of service centers more on the bureaucracy EMOC not based on the setting of emergency obstetric and neonatal services, so that the orientation of service workers is seen as a routine job. Support the government in support incentives are very influential on the work motivation of service staff.

Kata Kunci : Evaluasi, Puskesmas PONED