FAKTOR PENENTU PEMBERIAN ASI EKSKLUSIF PADA PENGGUNA KONTRASEPSI HORMONAL DAN NON HORMONAL

WIDANINGSIH, Prof. dr. Siswanto Agus Wilopo, SU, MSc., Sc.D.

2013 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Program ASI eksklusif sudah 20 tahun, target 80% sulit dicapai. Data Riskesdas tahun 2007 cakupan ASI eksklusif di Indonesia sebesar 15,3%, dan tahun 2010 sebesar 27,2%. Disinyalir rendahnya pemberian ASI eksklusif karena perubahan pola menyusui. Berdasarkan hasil penelitian payungan capaian ASI eksklusif sebesar 44,3%. Penggunaan kontrasepsi pasca persalinan masih relatif rendah karena kurangnya kesadaran dan informasi yang diterima masyarakat terutama bagi ibu postpartum, sehingga mengakibatkan beredarnya kesalahpahaman informasi alat kontasepsi. Di sisi lain kepercayaan masyarakat terhadap pola menyusui sangat erat hubungannya dengan kelangsungan menyusui secara eksklusif. Tujuan Penelitian: Memahami perilaku dan faktor faktor apa saja yang menentukan pemberian ASI eksklusif pada ibu postpartum pengguna kontrasepsi hormonal dan non hormonal. Metode Penelitian: Penelitian yang dilakukan adalah penelitian kualitatif dengan desain etnografi terfokus menggunakan teknik “observation”. Cara pengumpulan data dengan wawancara mendalam (in-depth interview) tidak terstruktur dan mengobservasi perilaku ibu pengguna kontrasepsi hormonal dan non hormonal dalam memberikan ASI pada bayi mulai dari lahir sampai dengan bayi diperkenalkan makanan pendamping ASI maksimal umur 6 bulan secara holistik. Hasil: Faktor yang mempengaruhi pemberian ASI eksklusif adalah: 1) faktor anak menangis/rewel dan melepas puting; 2) faktor ibu karena masalah puting, tidak yakin ASI cukup, anggapan salah terhadap MP-ASI, ibu bekerja, menjaga penampilan tubuh, latihan ditinggal, kurang informasi, kerepotan memeras ASI, pendidikan dan pengetahuan, kepercayaan, niat, kesempatan, peran keluarga/masyarakat, dan peran petugas kesehatan Kesimpulan: Kemauan bayi untuk menyusu, niat ibu, adanya kesempatan, informasi, dukungan petugas kesehatan, keluarga/masyarakat, tegasnya kebijakan pemerintah dan perlindungan terhadap wanita bekerja merupakan kunci keberhasilan ASI eksklusif.

Background: The program of exclusive breastfeeding has been initiated for 20 years, but the target of 80% is difficult to achieve. Data of Basic Health Research (Riskesdas) 2007 showed that coverage of exclusive breastfeeding in Indonesia was 15.3%, and in 2010 the coverage was 27.2%. It is assumed that low coverage of exclusive breastfeeding supplementation is caused by change in breastfeeding pattern. Based on the result of umbrella research, coverage of exclusive breastfeeding was 44.3%. Use of post partum contraception is still relatively low due to lack of awareness and information obtained by the community particularly postpartum mothers that leads to misunderstood information on contraception device. In one side the community believes that breastfeeding pattern is closely associated with sustainability of exclusive breastfeeding. Objective: To identify behavior and factors determining exclusive breastfeeding supplementation in postpartum mothers acceptors of hormonal and non hormonal contraception. Method: This was a qualitative study with ethnographic design and observation technique. Data were obtained through non structured in-depth interview and through observation on behavior of mothers acceptors of hormonal and non hormonal contraception in breastfeeding infants from birth to the period when the infants were introduced to complementary breastfeeding maximum at the age of 6 months holistic. Result: Factors affecting exclusive breastfeeding supplementation were: 1) factor of the baby /whining, refuses the nipple; 2) factor of the mother (problem with the nipple, uncertainty with adequacy of breast milk, misunderstanding on complementary breastfeeding, career mother, concern on physical appearance, exercise, lack of information, trouble in squeezing breastmilk, education and knowledge, belief, intention, opportunity, role of the family/community, and health staff). Conclusion: Willingness to breastfeed infants, mothers intentions, opportunity, information, support from health staff, family/community, clear government policy and protection to career women were keys to the success of exclusive breastfeeding supplementation.

Kata Kunci : ASI Eksklusif, kontrasepsi Hormonal, Non hormonal; exclusive breastfeeding, contraception hormonal, non hormonal