SURVEILANS KESEHATAN IBU DAN ANAK : STUDI PENGGUNAAN WAKTU BEKERJA BIDAN DESA DI KABUPATEN SORONG

Sunarwan, dr. Ova Emilia, Sp.OG (K), M.Med, PhD,

2013 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Sistem surveilans dalam pelayanan kesehatan ibu dan anak dengan pemanfaatan PWS KIA dapat membantu sistem pelayanan kesehatan yang ada. Bidan desa memiliki peran penting dalam monitoring kesehatan ibu dan anak diwilayah kerjanya. Dalam kenyataannya informasi PWS KIA tidak tepat waktu terjadi karena pengiriman laporan dari bidan desa terlambat hal ini disebabkan bidan desa sudah sibuk dengan tugas sehari-hari melaksanakan pelayanan KIA dan pelayanan kesehatan lainnya. Tujuan : Secara umum untuk mendiskripsikan penggunaan waktu bekerja bidan desa dalam pelaksanaan pemantauan wilayah setempat kesehatan ibu dan anak Metodologi : Penelitian deskriptif dengan pendekatan kombinasi kuantitatif dan kualitatif (mixed method). Sebagai subyek dan sampel adalah bidan desa yang bertugas di desa di wilayah kerja Dinas Kesehatan Kabupaten Sorong. Jumlah sampel sebanyak 34 orang, penentuan sampel dilakukan dengan teknik keseluruhan sampel (exhaustive sampling). Data kualitatif yang diperoleh melalui observasi, telaah kearsipan dan wawancara untuk mengidentifikasi masalah pencatatan dan pelaporan KIA. Hasil dan Pembahasan: Diperoleh data bahwa dari 34 responden menggunakan waktu bekerja yang tercatat dalam log book aktivitas harian antara 14 sampai 30 hari kerja rata-rata 21 hari kerja dengan penggunaan waktu sebanyak 88.670 menit (rata-rata 2.607 menit) per orang atau 2 jam per hari. Waktu terbanyak digunakan untuk pelayanan KIA sebanyak 51.275 menit (57,8%) dengan rata-rata 1.508 menit per orang, waktu untuk pelayanan medis non KIA sebanyak 32.550 menit (36,7%) dengan rata-rata 957 menit per orang dan waktu untuk dokumentasi kegiatan sebanyak 5.320 menit (6,0%) dengan jumlah waktu ratarata 156 menit per orang. Dalam penggunaan waktu untuk pelayanan KIA termasuk waktu untuk kunjungan rumah sebanyak 8.475 menit (16,5%) dari total waktu pelayanan KIA atau rata-rata per orang menggunakan waktu untuk kunjungan rumah sebanyak 249 menit. Analisis bivariat diketahui waktu kunjugan rumah mempunyai hubungan yang signifikan dengan cakupan persalinan oleh tenaga kesehatan (Pn), diperoleh nilai RR sebesar 2 (95% CI;0,98-4,08) dan p=0,04. Diketahui juga waktu kunjungan rumah berhubungan secara signifikan dengan cakupan kunjungan neonatus (KN) lengkap, diperoleh RR sebesar 2,17 (95% CI; 1,08-4,34) dan p = 0,02. Kesimpulan: Proporsi penggunaan waktu dalam kunjungan rumah memberikan kontribusi besar pada upaya meningkatkan cakupan kunjungan neonatus (KN) lengkap. Pentingnya melakukan perbaikan sistem pencatatan dan pelaporan KIA dan memaksimalkan pemanfaatan data PWS KIA.

Background: Surveillance system in maternal and child health service by utilizing PWS KIA (local area monitoring of maternal and child health) able to help the available health service system. Village midwife has important role in the monitoring of maternal and child health in her work area. In the fact, information on local area monitoring of maternal and child health (PWS KIA) was not in time because the sending of the report from village midwife was often late, this because the village midwife was already busied by their daily task performing maternal and child health service and other health service. Objectives: To describe the utilization of work time by village midwife in performing local area surveillance of maternal and child health. Methods: This was descriptive study by combination of quantitative and qualitative approach (mixed method). As subject and sample was village midwife who was assigned in the village in the work area of Health Office of Sorong Regency. The number of sample was 34 midwifes, sampling was performed by exhaustive sampling (all of the population). Qualitative data was obtained by observation, archive review, and interview to identify further on the utilization of work time based on log book on daily activity of the respondent. Results and discussion: Out of 34 respondents, they used time work that was recorded in log book on daily activities between 14 to 30 work days in average was 21 work days with the utilization of work time about 88,670 minutes (average was 2,607 minutes) per respondent or 2 hours per day. Most time was used for maternal and child health (KIA) service that was about 51,275 minutes (57.8%) with average of 1,508 minutes (36.7%) with average was 957 minutes per respondent and time for activities documentation was 5,320 minutes (6.0%) with the average number of time was 156 minutes per respondent. Time utilization for KIA service includes a time for home visiting that was 8,475 minutes (16.5%) out of total time for maternal and child health service (MCH service) or in average per respondent used time for home visiting about 249 minutes. Bivariate analysis showed that time for home visiting had significant correlation to the coverage of delivery that was attended by health worker (Pn), RR value was 2 (95% CI: 0.98- 4.08) and p=0.04. It was also known that time for home visiting had significant correlation to the coverage of complete neonates visiting (KN). It was obtained RR= 2.17 (95%CI= 1.08-4.34) and p=0.02. Conclusion: Most of work time of village midwife was for maternal and child health (MCH) service. In the MCH service, includes times for home visiting that made great contribution to the increasing of the coverage of complete neonates visiting (KN).

Kata Kunci : penggunaan waktu bekerja, surveilans kesehatan ibu dan anak, bidan desa.