Pengetahuan, Sikap dan Praktek Bidan Praktek Swasta (BPS) dalam Pelaksanaan Inisiasi Menyusu Dini (IMD) di Kota Semarang Tahun 2012

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Hermeksi Rahayu Pengetahuan, Sikap dan Praktek Bidan Praktek Swasta (BPS) dalam Pelaksanaan Inisiasi Menyusu Dini (IMD) di Kota Semarang Tahun 2012 xiv + 67 halaman + 2 tabel + 5 lampiran Cakupan ASI Eksklusif di kota Semarang turun dari 40,07% (2006) menjadi 38,44% (2009). Sebenarnya, capaian ASI dapat ditingkatkan ketika bayi lahir dengan tatalaksana IMD. Bidan sebagai pelaku pertolongan persalinan sangat berperan dalam keberhasilan pemberian ASI Eksklusif. Penelitian ini bertujuan untuk mendapatkan gambaran tentang pengetahuan dan sikap bidan terkait IMD dengan praktek IMD di BPS kota Semarang Jenis penelitian ini kualitatif.Pengumpulan data yang dilakukan dengan menggunakan wawancara mendalam . Informan utama 4 bidan praktek swasta dan informan triangulasi ibu bersalin, IBI dan Dinas Kesehatan. Data terkumpul dan dianalisis dengan analisis isi. Penelitian menunjukkanbahwa, pelaksanaan IMD selama ini belum optimal, karena tidak semua bidan melaksanakan IMD dengan benar pada setiap pertolongan persalinan. Pengetahuan bidan tentang IMD sudah baik dan sikap bidan tentang IMD sudah mendukung, namun di dalam pelaksanaannya tidak sesuai dengan langkah – langkah IMD. IMD dilakukan hanya untuk menemukan puting ibu dengan cara mulut bayi langsung ditempelkan pada puting ibu hanya beberapa menit saja. Bidan senior yang mempunyai pengalaman kerja yang cukup lama, relatif sulit berubah, walau sudah mendapatkan pelatihan tentang APN. Selain itu, adanya kepentingan finansial, yang menjanjikan dari berbagai produk susu formula,tidak ada pembatasan pengiklanan produk susu dan tidak didukung adanya peraturan dan sanksi dari Dinas Kesehatan dan IBI selaku profesi. Sanksi hanya berupa teguran dan himbauan. Perlu dilakukan sosialisasi dan penyegaran terus menerus terkait IMD, termasuk upaya pembinaan, monitoring dan evaluasinya secara rutin. Kata kunci : Pengetahuan, sikap, praktek bidan, Inisiasi Menyusu Dini, Bidan Praktek Swasta. Referensi : 37 (1989-2009) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2012 ABSTRACT Hermeksi Rahayu Knowledge, Attitude, and Practice of Independent Practice Midwives (IPM) in Implementing Early Initiation of Breastfeeding (EIB) in Semarang City in 2012 xiv + 67 pages + 2 tables + 5 enclosures Coverage of exclusive breastfeeding in Semarang City declined from 40.07% (2006) to 38.44% (2009). It could be increased by implementing early initiation of breastfeeding (EIB). Midwives as birth attendants played an important role in the success of providing exclusive breastfeeding. The aim of this study was to identify knowledge and attitude of midwives regarding EIB associated with practice of EIB at Independent Practice Midwives (IPM) in Semarang City. This was qualitative study. Data were collected by conducting indepth interview. Main informants consisted of 4 IPM. Meanwhile, informants for triangulation purpose consisted of maternal, Indonesian Midwives Association (IMA), and City Health Office. Furthermore, data were analysed using content analysis. The results of this study showed that EIB had not been optimally implemented because not all midwives well practiced in each delivery process. Midwives had good knowledge and positive attitude to support EIB. Notwithstanding, the practices had not followed the procedures of EIB. EIB was done to find mother’s nipples using infant’s mouth for a while. Senior midwives were difficult to change their practices even though they had been trained about APN. In addition, there was any conflict of interest particularly related to money incentive from formula milk industries. There were no limitation for advertising milk products and no regulations or punishments from the Health Office and IMA. Provided punishments were only warning and appealing. As suggestions, there needs to socialise and refresh sustainably related to EIB including to supervise, monitor, and evaluate regularly. Key Words : Knowledge, Attitude, Midwife’s Practice, Early Initiation of Breastfeeding, Independent Practice Midwives Bibliography : 37 (1989-2009