KESIAPAN PUSKESMAS PONED (PELAYANAN OBSTETRI NEONATAL EMERGENSI DASAR) DI LIMA REGIONAL INDONESIA

Abstrak<br />Kesiapan peran Puskesmas sangat penting dalam mencapai target Angka Kematian Ibu di Indonesia. Oleh karena itu,<br />Kementerian Kesehatan RI menyediakan Puskesmas PONED, yang mampu memberikan pelayanan obstetrik neonatal<br />emergensi dasar 24 jam, dengan tenaga terlatih, peralatan dan perbekalan yang memadai (termasuk di dalamnya<br />adalah alat kesehatan, obat, dan alat transportasi). Sumber data dari hasil Riset Fasilitas Kesehatan tahun 2011.<br />Variabel tenaga kesehatan terlatih, pelayanan 24 jam, alat kesehatan dan obat serta alat transportasi dikelompokkan<br />berdasarkan 5 regional (Sumatera, Jawa-Bali, Kalimantan, Sulawesi, dan Indonesia Bagian Timur). Dari 1.446<br />Puskesmas PONED, sebanyak 88,7% Puskesmas memberikan pelayanan 24 jam, melibatkan dokter 79,9%, bidan<br />96,1%, dan perawat 32,8%. Dari 17 jenis obat dan 26 alat kesehatan (alkes) standar pelayanan PONED, rata-rata angka<br />ketersediaan di Puskesmas PONED hanya 6,06 jenis obat dan 14,12 alkes PONED, sedangkan untuk angka<br />kecukupan, rata-ratanya adalah 5,54 jenis obat dan 12,43 alkes PONED. Sebanyak 53,3% Puskesmas PONED memiliki<br />Puskesmas Keliling, 43,0% memiliki ambulans, dan hanya 3,7% yang memiliki perahu bermotor. Berdasarkan lima<br />regional di Indonesia, terdapat perbedaan kesiapan Puskesmas PONED dalam hal pelayanan 24 jam, tenaga kesehatan<br />terlatih, obat dan alkes, serta alat transportasi. Namun secara keseluruhan, regional Jawa-Bali lebih siap dibandingkan<br />dengan regional lain. Perlu perhatian dan intervensi untuk meningkatkan kesiapan puskesmas PONED, terutama<br />meningkatkan ketersediaan dan kecukupan alat dan obat PONED, melibatkan tenaga bidan dan perawat dalam<br />pelayanan PONED, serta menyediakan dan memfungsikan pusling dan ambulans untuk pelayanan PONED.<br />Kata Kunci: PONED, pelayanan, tenaga kesehatan, alat, obat, transportasi<br />Abstract<br />Roles of primary health care center (HC) are very important to achieve Maternal Mortality Rate (MMR) target in<br />Indonesia. The Ministry of Health Indonesia provides Basic Emergency Obstetric Care (BEmOC), in which the HC is<br />capable with appropriate facilities (trained personnel, equipment, logistics, drugs, and transportation) to carry out basic<br />emergency maternity and 24-hours neonatal services. The data obtained from The Indonesian Health Facility Survey<br />2011 (Rifaskes 2011). All variables were grouped based on 5 regions in Indonesia (Sumatera, Jawa-Bali, Kalimantan,<br />Sulawesi, and Eastern Region). There are 1,446 Basic Emergency Obstetrict Care (BEmOCs). As much as 1,283<br />(88.7%) BEmOCs have been carrying out 24-hours service. Service in BEmOC has involved the doctors (79.9%), the<br />midwives (96.1%), and the nurses (32.8%). As much as 53.3% of BEmOC have mobile health care, 43.0% have<br />ambulance, and only 3.7% have motor boat. There are variations of 24-hours service, trained personnel, drugs,<br />equipment, and transportation in BEmOC based on five regions in Indonesia. Java-Bali region is more prepared<br />compared to others. Attention and intervention are needed to improve availability and adequacy of equipment and drugs,<br />involvement of nurse and midwife in BEmOC services, as well as providing of well functioned mobile health care and<br />ambulance.<br />Keywords: BEmOC, trained personnel, service, drugs, equipment, transportatio