MODEL PROMOSI KESEHATAN IBU HAMIL GUNA MENINGKATKAN PERAWATAN KEHAMILAN DAN PERSALINAN PADA TENAGA KESEHATAN
Shrimarti Rukmini Devy, Dra.,M.Kes., dr. M.Hakimi, Sp.OG 1. Prof. (K),Ph.D.
2013 | Disertasi | S3 Kedokteran Umummerupakan Latar Belakang: Angka kematian Ibu (AKI) di Indonesia tertinggi di ASEAN. Berbagai program guna peningkatan kesehatan ibu, khususnya ibu hamil telah dilakukan oleh Departemen Kesehatan RI. Namun, hingga saat ini capaian program-program tersebut belum maksimal. Upaya preventif pada kesehatan ibu hamil salah satu solusi penurunan AKI. Promosi kesehatan merupakan salah satu upaya preventif tersebut. Penelitian ini merancang model promosi kesehatan yang tepat guna sesuai dengan kearifan lokal setempat. Tujuan: 1. Mengidentifikasi model promosi kesehatan bagi ibu hamil pada kondisi pra intervensi); 2. Merancang model promosi kesehatan yang tepat guna bagi ibu hamil; 3. Menerapkan rancangan model promosi kesehatan KIM.; 4. Mengevaluasi hasil penerapan rancangan model promosi kesehatan KIM; Studi pendahuluan 1 tahun (pendekatan ke masyar Metode: Penelitian ini menggunakan rancangan penelitian Quasi Experiment Nonequivalent Pretest-Postest Control Group Design. Penelitian ini menggunakan pendekatan kuantitatif dan kualitatif. Penelitian ini dilakukan di Desa Rapa Laok dan Desa Tabak yang merupakan wilayah kerja Puskesmas Omben, Kab. Sampang, Madura. Waktu penelitian Januari 2008-Juli2011. Responden penelitian adalah ibu hamil dengan kriteria usia kehamilan trisemester 1 dan 2. Subjek penelitian adalah ibu hamil, bidan desa, tokoh agama, tokoh masyarakat dan kader. Teknik pengumpulan data: 1. Kuantitatif (wawancara terstruktur), 2. Kualitatif (indepth interview, observasi, FGD, NGT). Teknik pelaksanaan penelitian: 1. akat dan birokrasi setempat), 2. Perencanaan dan pelaksanaan intervensi 2,5 tahun(merencanakan, melaksanakan dan mengevaluasi KIM). abupaten Sampang; 6. Evaluasi mengacu teori HBM: ada perbedaan signifikan Hasil: 1. Perawatann kehamilan oleh ibu belum maksimal, karena kesehatan bukan prioritas. Kontribusi budaya dominan pada perawatan kehamilan merupakan upaya preventif yang penting untuk keselamatan ibu dan bayi; 2. Faktor pola tempat tinggal dengan keluarga luas bersama orang tua atau mertua merupakan faktor pendukung dominasi orang tua atau mertua terhadap ibu hamil dan suami, khususnya pada pemilihan penolong persalinan pada dukun; 3. Pemahaman dan aplikasi promosi kesehatan bagi ibu hamil pada kondisi awal tidak mengacu pada misi promosi kesehatan (advokasi, pemberdayaan, social support); 4. Merancang model promosi KIM; Penerapan KIM 8 kali: 7 agustus 2010-8 Januari 2011. Launching KIM: 21 Maret 2011 oleh Ketua Penggerak PKK K antara kelompok intervensi dan kelompok kontrol; ibu hamil anggota KIM 17 orang semua bersalin pada tenaga kesehatan; terlaksananya kegiatan produktif berupa penanaman sayur organik dan pupuk organik. Prokesima Kesimpulan: Model promosi kesehatan berpengaruh bagi ibu hamil guna meningkatkan perawatan kehamilan dan persalinan pada tenaga kesehatan.
Background: Maternal mortality rate in Indonesia is the highest in ASEAN. A variety of programs to improve maternal health, particularly pregnant mother, have been carried out by Department of Health, the Republic of Indonesia. However, to date the achievement of programs is not optimum. Preventive effort for the health of pregnant mother is one of the solutions to reduce the maternal mortality rate. Health promotion is one of the preventive efforts. This study designed an appropriate health promotion model in accordance with local wisdom. . Objective: 1 Identify health promotion model for pregnant mother before intervention; 2. Design the right health promotion model for pregnant mother; 3. Apply health promotion model for KIM (Kelompok Ibu Mandiri); 4.Evaluating the application result of health promotion model for KIM; -KIM). Method: The study used a Quasi Experiment Non-equivalent Pre-test–Pos-test Control Group Design with quantitative and qualitative approaches. It was conducted in Rapa Laok village and Tambak village in the work areas of Public Health Center „Omben‟, Sampang Regency, Madura. Time of the study was from January 2008 to July 2011. The respondents of the study were pregnant mothers with the following criteria: pregnancy of trimesters 1 and 2. Subjects of the study were pregnant mother, village midwife, religious figure, social figure, and cadre. Data collection was done using: 1) quantitative technique by structured interview; 2) qualitative technique by in-depth interview, observation, FGD, and NGT. The study was conducted through: 1) a preliminary study for 1 year by approaches to society and local bureaucracy; and 2) the planning and performance of intervention for 2.5 years by planning, implementing, and evaluating the Independent Mother Group (Kelompok Ibu Mandiri Prokesima Result: 1) Maternal treatment by the pregnant mothers was not maximal yet, because for them the health is not the priority. The dominant cultural contribution to the maternal treatment was a preventive effort, which is important for them for the safety of mother and infant; 2) Residence pattern with the extended family, consisting of parent or parent-in-law, was a supporting factor for the domination of parent or parent-in-law on pregnant mother and her husband, particularly in the selection of the traditional midwife; 3) The understanding and application of the health promotion for the pregnant mothers in initial condition did not refer to the missions of health promotion: advocacy, empowerment, social support; 4) The designing of health promotion model of „KIM‟; 5) The application of KIM for 8 times from August 7, 2010-January 8, 2011. The launching of KIM was in March 21, 2011 by the Chief of PKK, Sampang Regency; 6) Results of the evaluation referring to the health belief model (HBM) theory indicate that there was a significant difference between intervention group and control group; all of 17 pregnant mothers as members of KIM gave birth in health personnel; the performance of productive activity was indicated the planting of organic vegetables and the making of organic fertilizers. Conclusion: The health promotion model of has a significant effect on pregnant mothers for the improvement of maternal treatment and delivery among health personnel.
Kata Kunci : kesehatan ibu hamil, model promosi kesehatan, KIM
