Factors Related to the Midwives Work Performance on the Implementation of Obstetric Care Standard in Antenatal Care (Study in Primary Healthcare Centers with in Patient Unit in Gresik District)

Maternal mortality rate (AKI) in Gresik district in 2011 slightly decreased compared to 2010, from 20 maternal deaths (105.91/100.000 live births) to 19 maternal deaths (98.82/100.000 live birth). Thenumber of death infants in 2010 was 47 infants (2.48%), and it became 140 infants (7.49/1000 live birth)in 2011. Result of MP showed that besides direct cause of death, it was also resulted from indirect causesuch as delay in conducting early detection of pregnancy complication. Obstetric standard of care (SAK)for ante natal care (ANC) was a task that should be implemented by all midwives. A monitoring done byIBI of Gresik district showed that 50% of midwives had not conducted ANC according to the standard.Objective of the study was to identify factors affecting work performance of midwives in the implementationof SAK ANC in the inpatient primary healthcare centers of Gresik district.This was a quantitative study with cross sectional approach. Data were collected using structuredquestionnaire and by conducting documentation observation toward results of ANC performance.Study population was all 119 midwives in the inpatient primary healthcare centers in Gresik district.Study samples were 87 midwives who were selected using simple random sampling method. Chisquare test was applied in the bivariate analysis, and multiple logistic regressions were applied in themultivariate analysis.Results of the study showed that work performance of midwives in the implementation of SAK ANCwas inadequate (44.8%), SAK management system was inadequate (55.2%), and knowledge onSAK was insufficient (56.3%). No association was found between work performance of midwives inthe implementation of SAK ANC and leadership, creativity, knowledge. Significant association wasfound between SAK ANC management system and work performance of midwives in theimplementation of SAK ANC (p: 0.031). There was an influence of SAK management system towardwork performance of midwives in the implementation of SAK ANC (p: 0.045).District health office is suggested to review PerMenKes no. 938/SK/MenKes/VIII/2007, to adviceheads of primary healthcare centers to implement the SAK ANC, to facilitate organizationmanagement training and SAK ANC training, to do more intensive monitoring of the workperformance of midwives. Suggestions for IBI were to monitor, to evaluate, and to follow up theimplementation of SAK ANC continuously