KINERJA BIDAN DESA DALAM DETEKSI DINI KASUS MALARIA PADA KEHAMILAN DI KABUPATEN BENGKULU TENGAH
AFRINA MIZAWATI, Prof. dr. Mohammad Hakimi, SpOG (K), Ph.D
2015 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang: Malaria merupakan satu masalah kesehatan yang dapat menyebabkan kematian terutama kelompok risiko tinggi yaitu bayi, anak balita dan ibu hamil. Angka kejadian malaria di Bengkulu Tengah Provinsi Bengkulu cukup tinggi. Kejadian malaria di Kabupaten Bengkulu Tengah dalam 3 tahun terakhir mengalami peningkatan dari tahun 2011-2013. Annual Malaria Incidence tahun 2011 sebesar 75,68/00 positif, Annual Malaria Incidence tahun 2012 66,13/00 dan Annual Parasite Incidence 1,440/00 penderita positif dan Annual Malaria Incidence tahun 2013 sebesar 52,34/00. Pada tahun 2013 jumlah ibu hamil yang mencapai 2.016 orang dilakukan skrining malaria pada kunjungan K1 pemeriksaan kehamilan hanya mencapai 784 orang ibu hamil (39%). Tujuan penelitian: Untuk mengetahui gambaran kinerja deteksi dini kasus malaria pada kehamilan oleh bidan desa di Kabupaten Bengkulu Tengah. Metode penelitian: Jenis penelitian observasional dengan rancangan cross sectional. Subjek penelitian semua bidan desa di wilayah kerja Kabupaten Bengkulu Tengah. Pengambilan sampel menggunakan total population. Variabel dalam penelitian ini adalah variabel terikat yaitu kinerja bidan desa dalam deteksi dini malaria pada kehamilan, variabel bebas adalah pelatihan tata laksana kasus malaria dan ketersediaan rapid diagnostic test serta variabel luar: usia, pendidikan dan masa kerja bidan. Instrumen penelitiannya adalah kuesioner dan lembar observasi. Analisis data terdiri dari analisis univariabel, bivariabel, dan multivariabel dengan uji independen t-test, korelasi, chi-square dan regresi linear. Hasil: Kinerja deteksi dini kasus malaria kehamilan pada bidan desa yang telah dilatih lebih baik daripada bidan desa yang belum dilatih dengan perbedaan rerata 2,2 (95% CI 1,71-2,51) dan kinerja deteksi dini kasus malaria kehamilan pada bidan desa dengan ketersediaan RDT cukup lebih baik daripada bidan desa dengan ketersediaan RDT tidak cukup yaitu dengan perbedaan rerata 1,5 (95% CI 1,01-1,94 ) Kesimpulan: Kinerja deteksi dini kasus malaria kehamilan pada bidan desa yang telah dilatih lebih baik daripada bidan desa yang belum dilatih, kinerja deteksi dini kasus malaria kehamilan pada bidan desa dengan ketersediaan RDT cukup lebih baik daripada bidan desa dengan ketersediaan RDT cukup. Ada hubungan pendidikan dengan kinerja bidan desa dalam deteksi dini kasus malaria kehamilan, tetapi tidak ada hubungan umur dan masa kerja dengan kinerja bidan desa dalam deteksi dini kasus malaria kehamilan
Background: Malaria is a health problem that can cause death, especially for high risk groups such as infants, under-five children and pregnant women. The incidence of malaria in Central Bengkulu of Bengkulu Province is quite high. The incidence in the last 3 years (2011-2013) has increased. Annual Malaria Incidence in those three years was 75.68/00, 66.13/00 and 52.34/00 positive patients, respectively. In 2013 of the total number of 2,016 pregnant women, only 784 pregnant women (39%) participated in malaria screening in antenatal visit I. Objective: To determine the performance of early detection of gestational malaria cases by village midwives in Central Bengkulu District. Method: This was an observational study with a cross sectional design. Research subjects were all village midwives in the region of Central Bengkulu District. Sampling used total population. The variables in this study were the dependent variable which was midwives’ performance in the early detection of gestational malaria, the independent variable which was training of malaria case management and rapid diagnostic tests (RDT) availability and the extraneous variables which were age, education and midwives’ years of service. Research instruments were a questionnaire and observation sheet. Data analysis consisted of univariable, bivariable, and multivariable analysis with t-test, correlation, chi-square and multiple linear regression. Results: The performance on early detection of gestational malaria cases by midwives who had been trained was better than that by midwives who had not been trained with mean difference of 2,2 (95% CI 1,71-2,51). The performance on early detection of gestational malaria cases by midwives with the sufficient availability of RDT was better than that by midwives with the insufficient availability of RDT with a mean difference of 1,5 (95% CI 1,01-1,94) Conclusion: The performance on early detection of gestational malaria cases by trained midwives and with sufficient availability of RDT was better than those having not been trained and with sufficient availability of RDT. There was a relationship between education and the midwives’ performance in the early detection of gestational malaria cases, but there was no correlation between age and years of service and the midwives’ performance in the early detection of gestational malaria cases.
Kata Kunci : Kinerja Bidan Desa, Deteksi Dini, Pelatihan dan Ketersediaan RDT
