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"Angka kematian ibu (AKI) di Indonesia masih relatif tinggi bila dibandingkan dengan negara- negara ASEAN yaitu 373/100.000 kelahiran hidup (SKRT 1995). Hasil penilaian "Safe Motherhood" di Indonesia menyebutkan bahwa yang mempengaruhi AKI antara lain kualitas pelayanan antenatal yang masih rendah. Pemerintah telah mencanangkan program Making Pregnancy Safer (MPS) untuk menurunkan AKI, dengan meningkatkan cakupan dan kualitas pelayanan antenatal seperti telah ditargetkan, untuk cakupan K1 95% dan cakupan K4 90%. Di Propinsi Nanggroe Aceh Darussalam, khususnya Kota Banda Aceh AKI mencapai 11/4.598 kelahiran hidup, sementara cakupan K1 mencapai 93,3% dan K4 83,1%. Namun bagaimana kualitas pelayanan antenatal yang diberikan masih belum diketahui. Tujuan penelitian ini adalah untuk memperoleh informasi tentang kualitas pelayanan antenatal dan hubungannya dengan kepuasan pasien, karena bila kualitas pelayanan baik dapat mempengaruhi kepuasan pasien. Penelitian ini dilakukan di puskesmas di wilayah Kota Banda Aceh yang hanya mempunyai enam puskesmas. Desain penelitian yang digunakan adalah non eksperimental dengan pendekatan cross-sectional. Unit penelitian adalah ibu hamil, dan populasi yaitu ibu hamil trimester II dan III yang telah berkunjung ke Puskesmas minimal dua kali. Metode pengambilan sampel secara purposive sampling dengan jumlah sampel 100 respoden. Pengumpulan data dilakukan dengan mewawancarai responden. Kualitas pelayanan yang diukur yaitu hubungan antar manusia, meliputi keramahan, komunikasi petugas dengan pasien serta tindakan pelayanan antenatal yang diberikan. Hasil penelitian melaporkan, proporsi ibu hamil yang menyatakan puas 44%, petugas ramah 44%, petugas berkomunikasi dengan baik 43 % dan pelayanan antenatal baik sebanyak 41%. Hasil uji chi-square menunjukkan ada hubungan yang bermakna (p < 0,05) antara kualitas pelayanan antenatal yaitu keramahan dan komunikasi dengan kepuasan pasien, sedangkan variabel tindakan pelayanan antenatal secara statistik tidak menunjukkan hubungan bermakna. Sementara karakteristik pasien sebagai variabel kontrol meliputi umur, pendidikan, pekerjaan dan gravida, tidak satupun menunjukkan hubungan bermakna (P > 0,05) dengan kepuasan pasien. Hasil analisis regresi logistik menunjukkan bahwa faktor yang paling dominan mempengaruhi kepuasan pasien adalah keramahan (OR: 3,64) pada CI95 %: (1,58- 8,37). Dari hasil penelitian dapat disimpulkan bahwa kepuasan pasien terhadap kualitas pelayanan antenatal di puskesmas di wilayah Kota Banda Aceh masih sangat rendah. Untuk itu perlu peningkatan kualitas pelayanan antenatal terutama dalam hal keramahan dan komunikasi, dengan cara meningkatkan motivasi dari pimpinan, perbaikan system reward dan pelatihan yang berkelanjutan.

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The Relationship of Antenatal Care Quality with Patient Satisfaction at the Health Center of Banda Aceh City, 2002The Maternal Mortality Rate (MMR) in Indonesia is still high if it compared with the ASEAN countries that are 373/100,000 live births (Household Health Survey, 1995). The result of assessment on Safe Motherhood in Indonesia mentioned that the one influence on MMR is the quality of antenatal care was still low. The government has decided a program on Making Pregnancy Safer (MPS) to lowering the MMR, by increasing the coverage and the quality of antenatal care such as targeted, for first visit of antenatal care / K1 the coverage was 95% and for fourth visits of ANC / K4 was 90%0. In Aceh Province, especially Banda Aceh City the MMR reached 11/4.598 live births, while the coverage of K1 reached 93% and K4 was 83,1%. However, how about the antenatal care quality that given is still unknown. The objective of this study was to obtain information on antenatal care quality and its relation with patient satisfaction, since if the quality is good, it can influence to patient satisfaction.

This study was conducted at the Health Center of Banda Aceh City, which only has six Health Centers. The study designs that use was non-experimental by cross-sectional approach. Research unit was pregnant mothers, and the population was pregnant mothers who's having trimester II and III that visiting those Health Centers at least twice. The method of collecting sample was purposive sampling, with the number of sample 100 respondents. The data collected by interviewing the respondents. The quality of service that measured was the relation between human being, covering: kindness, health worker communication with the patient and also the action that given on ANC.

The result of study shows that the proportion of pregnant mothers that mentioning satisfaction was 44%, ones whose saying that health worker was kind 44%, ones whose mentioned that the health worker have good communication was 43%, and ones whose mentioned that ANC service was good only 41%. The result of chi square test shows that there was significant relationship (p < 0,05) between the quality of ANC service, that were the kindness and communication with patient's satisfaction, while variable of action on ANC service based on statistic was not showing the significant relationship. Whereas patient characteristic as control variable, covering: age, education, profession and gravida, was not showing the significant relationship (p > 0,05) with the patient satisfaction. The result of logistic regression multivariate analysis shows that the factor which is the most dominant influence to patient satisfaction was kindness (OR: 3,64) on Cl 95%: (1,58-8,37).

Based on the result of this study it can be concluded that the patient satisfaction to the quality of ANC service at the Health Center of Banda Aceh City is still very low. It is needed to improve the quality of ANC service, especially on the kindness and communication, by increasing the motivation from the leader, make better the reward system and training continually."

"Kematian perinatal di Kabupaten Tulang Bawang tahun 2012 cenderung meningkat, dan kunjungan antenatal (K-4) belum mencapai target. Penelitian bertujuan mengetahui hubungan pemanfaatan antenatal care dengan kematian perinatal di Kabupaten Tulang Bawang tahun 2011 - 2012. Menggunakan data sekunder otopsi verbal kematian perinatal. Desain penelitian kasus kontrol. Kasus adalah bayi lahir hidup dan meninggal pada periode 0-7 hari. Kontrol adalah bayi lahir hidup sampai usia 7 hari pada periode sama. Sample kasus 65 dan kontrol 130. Analisis regresi logistik menunjukkan pemanfaatan antenatal yang tidak sesuai mempunyai OR 15,6 (95% CI: 4,1 -60,2) terhadap kematian perinatal setelah di kontrol pendidikan ibu, paritas, jarak kelahiran, penolong persalinan, komplikasi kehamilan. Pemanfaatan antenatal perlu ditingkatkan untuk penurunan kematian perinatal.

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Number of perinatal mortality in Tulang Bawang tend to have increased in 2012 compared to the previous year, utilization of antenatal care is still below the national target. This study aims to determine the relationship utilization of antenatal care with perinatal mortality in Tulang Bawang in 2011 - 2012. Research using secondary data perinatal death verbal autopsy and was designed a case control study. Case were infants born alive and died during the early neonatal periode (0-7 days), and Controls were infant born and stay alive during that period. Number of cases was 65 and control was subject was 130 calculated. Analysis method used was logystic regression analysis. Theresults showed that the utilization of antenatal care which does not have the appropriate program OR 15.6 (95% CI: 4.1- 60.2) for perinatal mortality after being adjusted by maternal education, parity, birth spacing, birth attendants, and complications of pregnancy. Utilization of antenatal care needs to be improved in order to decrease perinatal mortality."

"Salah satu cara menurunkan angka kematian ibu adalah meningkatkan kualitas pelayanan antenatal. Penelitian ini mencari hubungan kualitas pelayanan antenatal dengan pengetahuan, sikap, dan perilaku ibu hamil mengenai pemeriksaan kehamilan. Penelitian ini menggunakan desain cross-sectional. Penelitian dilakukan di Puskesmas Kecamatan Koja pada Maret 2013. Sampel diambil sebanyak 109 orang dengan metode konsekutif. Kualitas pelayanan antenatal dinilai melalui daftar tilik. Sedangkan pengetahuan, sikap, dan perilaku melalu kuesioner. Data dianalisis dengan uji chi-square. Mayoritas ibu hamil dalam golongan tidak berisiko, berpendidikan lebih tinggi, tidak bekerja, beban finansial keluarga di bawah rata-rata, paritas tidak lebih dari dua, dalam trimester ketiga, memiliki kunjungan yang lebih, ditemani saat berkunjung, dan tidak memiliki pengalaman pemeriksaan kehamilan. Kualitas pelayanan antenatal yang baik 42,2% dan tenaga kesehatan belum mencuci tangan, menggunakan sarung tangan, dan memberi edukasi menyusui. Pengetahuan, sikap, dan perilaku ibu hamil baik. Ada hubungan kualitas pelayanan antenatal (p=0,010) dan pendidikan (p=0,020) serta pekerjaan (p=0,039) ibu hamil terhadap pengetahuan mengenai pemeriksaan kehamilan. Ditambah, ada hubungan antara pendidikan (p=0,017) ibu hamil dengan perilaku mengenai pemeriksaan kehamilan. Kualitas pelayanan antenatal di Puskesmas Kecamatan Koja perlu ditingkatkan dengan memperketat aturan mencuci tangan dan menggunakan sarung tangan serta edukasi menyusui untuk meningkatkan keamanan dan wawasan pasien.

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One way to reduce maternal mortality rate is to improve antenatal care (ANC) quality. This research finds association between quality of ANC with knowledge, attitude, and practice about pregnancy assessment. Research design is cross-sectional. Data collection was performed at Puskesmas Kecamatan Koja on March 2013 and 109 subjects taken with consecutive sampling method. Quality of ANC is valued in checklist, while knowledge, attitude, and practice is valued by questionnaire. Data was analyzed with chi-square test. The majority of pregnant women there are in unrisk, higher education level, unemployed, below average finance, not more than two parities, in third trimester, have more visits, accompanied while visiting ANC, and no pregnancy assessment?s experience. Good quality of ANC is 42,2% and healthcare giver haven?t washed their hands, wore gloves, and given lactacy education. Knowledge, attitude, and practices is good. There is significant difference between quality of ANC (p=0,010), education level (p=0,020), and occupation (p=0,039) with knowledge about pregnancy assessment. In addition, there is siginificant differences between education level and pregnant women?s knowledge (p=0,017). Quality of ANC at Puskesmas Kecamatan Koja needs improving by strict policy in washing hands, wearing gloves, and lactacy education in order to increase patient safety and knowledge."

"Angka kematian ibu di Indonesia masih tergolong tinggi. Penyebab langsung kematian ibu umumnya adalah trias pendarahan-infeksi-eklampsia yang berhubungan dengan rendahnya status gizi dan kesehatan ibu hamil yang diakibatkan berbagai faktor. Pelayanan antenatal merupakan komponen yang diperlukan bagi upaya mempertahankan kesehatan ibu yang perlu terus dimantapkan, bahkan lebih ditingkatkan baik cakupan maupun kualitas pelayanan dalam upaya akselerasi penurunan angka kematian ibu. Oleh karena itu, diperlukan suatu penelitian mengenai kualitas pelayanan antenatal yang kali ini dihubungkan dengan pengetahuan, sikap, perilaku ibu hamil mengenai nutrisi kemilan. Penelitian ini menggunakan desain survei dengan pendekatan cross-sectiona lterhadap ibu hamil di Puskesmas Kecamatan Koja Kodya Jakarta Utara, pada Januari 2013 hingga Juli 2013, dengan menggunakan convenience sampling. Analisis korelasi Spearman digunakan untuk melihat keterkaitan antar variabel. Hasil menunjukan tidak terdapat hubungan antara kualitas pelayanan antenatal dengan pengetahuan, sikap dan perilaku ibu hamil mengenai nutrisi kehamilan. Mayoritas ibu hamil (57,8%) belum mendapatkan pelayanan antenatal yang baik, namun demikian mayoritas ibu hamil (63,3%) sudah mendapatkan kualitas pelayanan antenatal yang baik mengenai nutrisi kehamilan. Tidak terdapat hubungan antara kualitas pelayanan antenatal mengenai nutrisi kehamilan dengan pengetahuan, sikap dan perilaku ibu hamil mengenai nutrisi kehamilan. Mayoritas ibu hamil memiliki pengetahuan, sikap, dan perilaku yang baik mengenai nutrisi kehamilan.

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Nowadays, Maternal Mortality Rate (MMR) in Indonesia is still high. The direct cause of maternal death is the triage haemorrhage-infection-eclampsia. Further findings show that this direct cause are related to the low nutrition and health status which caused by many factors. Antenatal care is a component needed to sustain maternal health must be established even improved. Therefore, a research on quality of antenatal care toward knowledge, attitude and practice of pregnant woman about nutrition during pregnancy is needed.

This research used survey design and cross-sectional approach toward pregnant women in Puskesmas Kecamatan Koja Kodya Jakarta Utara, from January 2013 to July 2013 by using convenience sampling. Spearman’s correlation analysis is used to measurecorrelation between variables.

The result shows that there is no correlation between quality of antenatal care toward knowledge, attitude and practice of pregnant woman about nutrition during pregnancy. Majority of the respondents (57.8%) do not get a good quality of antenatal care, but the majority of respondents(63,3%)have received a good quality of antenatal care about nutrition during pregnancy. Most of the respondents have good knowledge, attitude and practice about nutrition during pregnancy."

"Angka kematian ibu (AKI) di Indonesia masih jauh dari target Millenium Deveopment Goals (MDGs). Untuk menurunkan AKI serta menekan jumlah pertumbuhan penduduk, Indonesia telah menjalankan program KB. Pelayanan antenatal (ANC) memberikan pelayanan dalam upaya kesehatan ibu dan bayi termasuk diantaranya konseling KB. Penelitian ini dilakukan untuk mengetahui tingkat pengetahuan, sikap, dan perilaku ibu hamil mengenai KB dan hubungannya dengan kualitas pelayanan antenatal serta latar belakang responden. Penelitian ini dilakukan secara potong lintang analitik. Sebanyak 109 ibu hamil yang dipilih secara consecutive sampling. Kualitas ANC dinilai dengan observasi ANC. Pengetahuan, sikap dan perilaku ibu hamil dinilai melalui kuesioner yang ditanyakan secara terpimpin. Terdapat 42,2% pelayanan berkategori baik dan 57,8% pelayanan berkategori buruk. Dari 109 responden, terdapat 71,6% berpengetahuan baik, 87,2% bersikap baik, tetapi hanya 55% berperilaku baik mengenai KB. Tidak terdapat hubungan antara kualitas pelayanan antenatal dengan pengetahuan, sikap, dan perilaku ibu hamil mengenai keluarga berencana (p>0,05). Meskipun demikian, terdapat hubungan antara kualitas pelayanan antenatal terkait KB dengan sikap ibu hamil mengenai KB (p=0,002). Selain itu, pendidikan dengan pengetahuan ibu hamil mengenai KB (p= 0,038). Terdapat pula hubungan antara edukasi KB dengan perilaku ibu hamil mengenai KB (p= 0,028). Perlu dilakukan peningkatan kualitas ANC di Puskesmas Koja. Edukasi KB pada perempuan usia reproduktif perlu dilakukan karena terbukti memiliki hubungan dengan perilaku mengenai KB. Selain itu, pendidikan formal yang tinggi juga memiliki hubungan dengan pengetahuan ibu hamil mengenai KB.

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Maternal Mortality Rate (MMR) in Indonesia is still high compare to MDGs target. To decrease MMR and reduce high population growth, Indonesia has implemented Family Planning (KB) proram. Antenatalcare (ANC) is giving service for mother and infant health, one of the service is KB. This study conducted to find relationship between quality of ANC and also background of responden with pregnant women’s knowledge, attitude, and practice about KB. A cross sectional study has been conducted. A total of 109 pregnant women were selected consecutively. Quality of ANC were valued by observing ANC. Pregnant women’s knowledge, attitude, and practice about family planning were valued by questionnaire filled by researcher. The obseravation finds that 42,2% services are good and 57,8% services are bad. From 109 respondends, there are 71,6% have good knowledge, 87,2% have good attitude, but only 55% have good practice of family planning. The finding shows that there is no significant difference between quality of ANC and pregnant women’s knowledge, attitude, and practice about family planning (p>0,05). However, there is significant difference between quality of ANC about KB and pregnant women’s attitude (p=0,002). There is significant difference between education and pregnant women’s knowledge about KB (p=0,038). Besides that, there is significant difference between experience educated about KB with their practice on family planning (p=0,028). Quality of ANC in Primary Health Care Kecamatan Koja needs to be improved. Education about family planning for woman with reproductive age is needed because there is significant difference with practice on family planning."

"Seven interviews with leading climate scientists cover both fundamental research (climate modeling, global warming, sea level change, melting of the ice caps, natural hazards) and impact assessment (adaption, mitigation, economic impacts and costs of climate change). Experts on different aspects of the topic explain their own field and give their opinion on general questions concerning climate change. The goal is to provide the reader with first-hand information on the current state of climate research."

"Pelayanan antenatal merupakan salah satu upaya untuk menurunkan Angka Kematian u di Indonesia. Pelayanan antenatal adalah memeriksa keadaan ibu dan janin secara berkala dengan upaya koreksi terhadap penyimpangan yang ditemukan. Memanfaatkan pelayanan antenatal yang teratur yaitu minimal 1 kali pada trimester I, 1 kali pada trimester II dan 2 kali pada trimester III (pola 1-1-2) bertujuan menjaga agar ibu hamil dapat melalui masa kehamilan, persalinan dan nifas dengan baik dan sehat serta melahirkan bayi yang sehat. Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan pemanfaatan pelayanan antenatal, meliputi faktor-faktor umur, pendidikan, pekerjaan, pengetahuan, sikap, status ekonomi keluarga, biaya pelayanan antenatal, jarak rumah dan persepsi Desain penelitian menggunakan rancangan cross-sectional. Responden adalah ibu-ibu yang baru melahirkan dengan partus aterm sebanyak 100 orang di wilayah kerja Puskesmas Pulau Temiang. Hasil penelitian menunjukkan 40% teratur memanfaatkan pelayanan antenatal. Faktor pengetahuan, persepsi ibu, status ekonomi keluarga dan umur ibu mempunyai hubungan yang bermakna dengan pemanfaatan pelayanan antenatal. Pengetahuan ibu merupakan faktor yang paling dominan berhubungan dengan pemanfaatan pelayanan antenatal. ibu dengan pengetahuan tinggi 31,18 kali lebih teratur memanfaatkan pelayanan antenatal dibandingkan dengan ibu yang berpengetahuan rendah setelah dikontrol oleh faktor persepsi ibu, status ekonomi keluarga dan umur ibu. Untuk peningkatan pemanfaatan pelayanan antenatal yang teratur di Puskesmas Pulau Temiang, Dinas Kesehatan Kabupaten Tebo dan Puskesmas Pulau Temiang perlu menetapkan kegiatan Promosi Kesehatan sebagai program prioritas.

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Antenatal care is one of the efforts to decrease Maternal Mortality Rate in Indonesia. Antenatal care is to examine condition of the mother and the fetus regularly completed with correction against identified deviation. The purpose of regular antenatal care utilization, which are minimum once in first trimester, once is second trimester, and twice in third trimester, is to keep the mother healthy during the pregnancy, giving birth, and parturition, so that she can give birth a healthy baby.

The purpose of this research is to find out factors that are related with antenatal care utilization, namely age, education, occupation, knowledge, behavior, family economy status, antenatal care cost, house-distance, and mother's perception. Research design used cross-sectional arrangement The respondents are mothers who have just given birth with aterm partus 100 people in the work field Puskesmas (Public Health Center) Pulau Temiang.

The result of the research indicates that 40% of the respondents use antenatal care regularly. Factor of knowledge, mother's perception, family economy status, and mother's age, has a meaningful relation with antenatal care utilization. Mother's knowledge is the most dominant factor related with antenatal care utilization. Mothers with high knowledge use antenatal care 31.18 times more regularly than those with low knowledge, controlled by factors of mother's perception, family economy status, and mother's age. In order to increase regular antenatal care utilization at Puskesmas Pulau Temiang, Dinas Kesehatan (Health Division) of Kabupaten Tebo and Puskesmas Pulau Temiang needs to hold health promotion activities as a priority program."