Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Penerapan Standar Asuhan Kebidanan Ibu Bersalin di Kabupaten Semarang Tahun 2012

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Setiyana Sri Subekti Faktor-Faktor yang Mempengaruhi Kinerja Bidan Desa dalam Penerapan Standar Asuhan Kebidanan Ibu Bersalin di Kabupaten Semarang Tahun 2012 xiv + 97 halaman + 23 tabel + 3 gambar + 6 lampiran Di Kabupaten Semarang, AKI meningkat dari 101,92/ 100.000 kelahiran hidup,pada tahun 2010 menjadi 146, 24 / 100.000 kelahiran hidup pada tahun 2011. Sebagian besar pasien meninggal karena keterlambatan merujuk dan mendeteksi tanda bahaya pada saat persalinan. Hal ini menunjukkan pelaksanaan standar asuhan di Kabupaten Semarang belum dilaksanakan dengan baik. Tujuan penelitian adalah untuk menganalisis faktor-faktor yang mempengaruhi kinerja bidan desa dalam penerapan standar asuhan kebidanan ibu bersalin oleh bidan desa di Kabupaten Semarang. Jenis penelitian adalah observasional analitik dengan pendekatan cross sectional. Cara pengambilan data dilakukan dengan wawancara menggunakan kuesioner. Populasi adalah 311 bidan desa di Kabupaten Semarang. Jumlah responden berjumlah 76 dipilih secara purposive dengan kriteria inklusi dan eksklusi dari tiap puskesmas. Analisis data dilakukan dengan uji product moment dan regresi linier. Hasil penelitian menunjukkan bahwa bahwa rerata umur responden 33 tahun, rerata masa kerja 11 tahun, pendidikan responden sebagian besar D III kebidanan (72,36 %). Kinerja kurang bidan desa dalam penerapan standar asuhan kebidanan ibu bersalin fisiologis adalah 83 %, kinerja kurang dalam penerapan standar asuhan kebidanan ibu bersalin patologis 87 %, pengetahuan kurang 57 %, motivasi tinggi 51%, persepsi supervisi kurang 55 %, persepsi beban kerja rendah 57 %, persepsi imbalan kurang 57 % dan persepsi sanksi kurang 55 %. Faktor yang berhubungan dengan kinerja adalah pengetahuan (p = 0,000), motivasi (p =0,007), persepsi supervisi (p = 0,008), persepsi beban kerja (p =0,012), persepsi imbalan (p = 0,000), persepsi sanksi (p= 0,000). Faktor yang berpengaruh terhadap kinerja bidan desa dalam penerapan standar asuhan kebidanan ibu bersalin adalah pengetahuan (p = 0,000), persepsi beban kerja (p = 0,027), persepsi sanksi (p = 0,000) Disarankan kepada Dinas Kesehatan Semarang untuk mengadakan penyegaran tentang pelayanan ibu bersalin sesuai standar asuhan kebidanan kepada seluruh bidan desa, Selain itu memperbaiki teknik supervisi yang diterapkan dengan supervisi fasilitatif. Kata Kunci : Standar asuhan kebidanan, bidan desa, supervisi, pengetahuan Kepustakaan : 38 ( 1994 – 2010 ) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2013 ABSTRACT Setiyana Sri Subekti Factors Related to the Work Performance of Village Midwives in the Implementation of Delivery Care Standards in Semarang District, 2012 xiv + 97 pages + 23 tables + 3 figures + 6 enclosures In Semarang district, maternal mortality rate (AKI) increased from 101.92/ 100000 live-births in 2010 to 146.24/100000 live-births in 2011. The majority of death patients were caused by referral delay and a delay in detection of in labour emergency signs. This indicated that the implementation of obstetric standard care in Semarang district was not done properly. Objective of the study was to analyze factors affecting work performance of village midwives in the application of obstetric standard care for in labour mothers in Semarang district. This was an observational analytical study with cross sectional approach. Data were collected through interview guided by questionnaire. Study population was 311 village midwives in Semarang district. The number of respondents was 76 midwives selected purposively according to inclusion and exclusion criteria in each primary healthcare center. Product moment test and linear regression were applied in the data analysis. Results of the study showed that average age of respondents was 33 years old, average working period was 11 years old, majority of respondent’s education background was D III in midwifery (72.36%). Work performance of village midwives in the implementation of obstetric standard care for physiological mother in labour was insufficient (83%), work performance of village midwives in the implementation of obstetric standard care for pathological mother in labour was insufficient (87%), respondents with insufficient knowledge was 57%, respondents with high motivation was 51%, respondent’s perception on supervision was inadequate (55%), respondent’s perception on workload was low (57%), respondent’s perception on incentive was insufficient (57%), and respondent’s perception on sanction was inadequate (55%). Factors related to work performance of village midwives were knowledge (p= 0.000), motivation (p= 0.007), perception on supervision (p= 0.008), perception on workload (p= 0.012), perception on incentive (p= 0.000), perception on sanction (p= 0.000). Factors affecting work performance of village midwives in the implementation of obstetric standard care for in labour mothers were knowledge (p= 0.000), perception on workload (p= 0.027), perception on sanction (p= 0.000). Suggestions for Semarang district health office are to conduct refreshing on maternity services according to obstetric standard care to all village midwives, to improve supervision technique by implementing facilitative supervision. Key words : obstetric standard care, village midwives, supervision, knowledge Bibliography : 38 (1994-2010