DETERMINAN KUNJUNGAN ANTENATAL CARE DI DAERAH KUMUH PERKOTAAN DI INDONESIA

TUMAJI, Dr. Mubasysyir Hasanbasri, MA.

2013 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Antenatal care telah diketahui penting bagi kesehatan ibu hamil dan janin yang dikandungnya. Indikator kecukupan antenatal care di perkotaan lebih baik dibandingkan di pedesaan. Namun tidak semua masyarakat perkotaan kondisinya lebih baik dibanding masyarakat pedesaan. Ada diantara mereka yang tinggal di daerah-daerah kumuh. Tujuan: Menganalisis determinan kunjungan antenatal care di daerah kumuh perkotaan di Indonesia. Metode: Penelitian ini menggunakan data Riskesdas 2010. Didapatkan 2318 perempuan usia 10-59 tahun, hamil dan melahirkan antara tahun 2005-2010 yang tinggal di daerah kumuh perkotaan. Data yang dianalisis meliputi data sosio demografi dan perilaku antenatal care. Memadai tidaknya antenatal care diukur dari K1 trimester pertama, K4 (1-1-2), dan komponen antenatal care 5T dengan menggunakan analisis bivariat dan regresi logistik multivariat. Hasil: Sebanyak 40% melakukan antenatal care di bidan praktek swasta, sedangkan yang ke puskesmas hanya 16,9%. Persentase K1, K4 (1-1-2) dan komponen antenatal care masing-masing 84,6%; 72,6% dan 60,0%. Hanya 45,9% saja yang antenatal care nya memadai. Analisis bivariat menunjukkan bahwa komponen antenatal care yang diperoleh ibu secara lengkap, persentasenya lebih tinggi di puskesmas dibanding fasilitas kesehatan yang lain. Analisis regresi logistik menunjukkan bahwa umur ≤ 19 tahun, pendidikan rendah, jumlah anak ≥ 3, jarak kehamilan ≤ 2 tahun, keluarga miskin, tidak memiliki asuransi kesehatan dan jenis provider dikaitkan dengan antenatal care yang kurang memadai. Kesimpulan: Kecukupan antenatal care di daerah kumuh perkotaan masih sangat rendah. Termasuk kualitas layanan komponen antenatal care, terlebih di fasilitas kesehatan swasta. Untuk meningkatkan pemanfaatan dan kualitas antenatal care intervensi perlu difokuskan pada perempuan berpendidikan rendah, miskin dan tidak memiliki asuransi kesehatan. Selain itu, diperlukan adanya peraturan dan kontrol yang lebih baik guna meningkatkan kepatuhan penyedia layanan antenatal care sesuai standar yang berlaku terutama bagi fasilitas kesehatan swasta.

Background: Antenatal care is known to be important for the health of the mother and the fetus. Indicators of the adequacy of antenatal care in urban areas is better than in the rural areas. However, not all urban communities are better than rural communities. Some of them are living in slums areas. Objective: Analyze the determinants of antenatal care visits in urban slum in Indonesia. Method: This study used data Riskesdas 2010. Obtained in 2318 women 10-59 years old, pregnant and gave birth between 2005-2010 who live in urban slums. The data analyzed include socio-demographic and antenatal care behavior. Adequacy of prenatal care was measured from K1 first trimester, K4 (1-1-2), and components of antenatal care 5T using bivariate and multivariate logistic regression. Result: As many as 40% do antenatal care in private practice midwives, while only 16,9% to the public health care. Percentage K1, K4 (1-1-2) and the components of antenatal care 5T respectively 84.6%; 72.6% and 60,0%. Only 45,9% that it is adequate antenatal care. Bivariate analysis showed that the components of antenatal mothers obtained in full, percentage is higher in the public health care than any other health facility. Logistic regression analysis showed that age less than 19 years, low education, number of children over 3, spacing pregnancies less than 2 years, poor families, do not have health insurance and type of provider is associated with inadequate antenatal care visits. Conclusion: The adequacy of antenatal care in urban slums is still very low. Including the quality components of antenatal care services, especially in private health facilities. To improve the utilization and quality of antenatal care, targeted focus interventions on low-educated women, poor and do not have health insurance. In addition, it is necessary to regulation and better control to improve compliance antenatal care providers according so the standard applies primarily to private health facilities.

Kata Kunci : Antenatal care, kumuh perkotaan, Indonesia