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"Provinsi Sumut sebagai Provinsi ke-enam penyumbang kematian ibu terbanyak di Indonesia, penyebab tertinggi kematian ibu 33% karena perdarahan yang dapat dicegah dengan penerapan Manajemen Aktif Kala III dalam pertolongan persalinan. Berdasarkan penelitian pendahuluan, ditemukan hanya 25% bidan yang menerapkan Manajemen Aktif Kala III sesuai standar. Sisanya 75% tidak melaksanakan Manajemen Aktif Kala III, padahal bidan sebagai tenaga kesehatan utama (70%) yang melakukan pertolongan persalinan.Penelitian ini analitik dengan pendekatan kualitatif, menggunakan metode pengumpulan data melalui wawancara mendalam, observasi dan telaah dokumen. Tujuan dari penelitian ini adalah untuk mengetahui aspek komunikasi, sumberdaya, struktur birokrasi, dan disposisi dalam implementasi kebijakan untuk penerapan Manajemen Aktif Kala III pada bidan di Kota Padangsidimpuan Tahun 2015.Hasil penelitian menunjukkan belum adanya kebijakan yang mengakomodir penerapan MAK III pada bidan, rendahnya pengetahuan bidan tentang MAK III, belum adanya sistem pengawasan terhadap penyelenggaraan bidan praktik swasta menjadi faktor yang sangat mempengaruhi mengapa MAK III sebagai suatu kompetensi penting bagi bidan belum diterapkan. Kedepannya diharapkan adanya kebijakan yang secara tegas mengatur penerapan MAK III pada bidan dari dinas kesehatan dan IBI dalam menurunkan angka kematian Ibu.

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Sumatra Utara Province is the sixth Province of highest Maternal Mortality Rate in Indonesia, this large number of maternal mortality rate is partly caused by bleeding 33%. Bleeding can be prevented by implementing Active Management of the Third Stage of Labor (AMTSL) in childbirth delivery service. However, based on prior research, it shows that only 25% of midwifery implements Active Management of the Third Stage of Labor (AMTSL) according to standards. The rest about 75% of midwives do not perform it, 7% among them has even got APN training, whereas midwives as the main health personnel (70%) do childbirth delivery service.This research is analytic with qualitative approach, the method use in collecting data by doing in-depth interview, observation, and document analysis. The aims of this study are; (1) Getting know about the factors influence the implementation of Active Management of the Third Stage of Labor (AMTSL) at midwives (2) to provide the analysis of policy development to implement Active Management of the Third Stage of Labor (AMTSL) at midwives in Padangsidimpuan city year 2015.The result of study shows that there is no policy that accommodate the implementation of Active Management of the Third Stage of Labor (AMTSL) at midwives yet, less knowledge of midwives about MAK III, and there is no monitoring system related to the implementation of private midwives that tends to be potential factor influence why the Third Stage of Labor as an important competition for midwifery has ignored. Hopefully, the policy development of the implementation Active Management of the Third Stage of Labor (AMTSL) can be as a real effort of District Health Office and IBI in decreasing the Maternal Mortality Rate."

"[Penelitian ini bertujuan membandingkan pengelolaan program P2TB pada dua Puskesmas kecamatan dengan pencapaian CDR TB tinggi dan rendah di Wilayah Kota Administrasi Jakarta Timur. Metode penelitian adalah kualitatif didukung dengan data kuantitatif faktor individu dan sosial dengan pendekatan cross sectional.Hasil penelitian menunjukkan perbedaan manajemen dimana Puskesmas dengan pencapaian CDR TB tinggi mempunyai kepala puskesmas dengan kemampuan manajerial program P2TB yang lebih baik, mekanisme transfer of knowledge yang lebih baik (Komponen Input); mempunyai perencanaan target berdasarkan permasalahan yang ada dan bertujuan meningkatkan CDR TB, melakukan penjaringan kasus secara aktif dengan melibatkan kader dan lintas sektor, adanya antisipasi hasil mutu laboratorium serta monitoring dan evaluasi yang lebih baik (Komponen Proses); telah memenuhi seluruh target indikator penemuan penderita TB (Komponen Output). Perbedaan pada sisi manajemen diperkuat dengan hasil penelitian dimana faktor individu (pengetahuan, sikap suspek terhadap bahaya dan cara pencegahan TB, persepsi suspek terhadap pelayanan kesehatan) dan faktor sosial (dukungan kader, KIE oleh petugas) lebih baik pada Puskesmas dengan pencapaian CDR TB tinggi. Disarankan agar melaksanakan pelatihan TB kepada top manajemen, melakukan penjaringan kasus secara aktif dengan melibatkan kader dan sektor non kesehatan, serta meningkatkan jejaring dan kerjasama lintas sektor.

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This study examined the comparison of TB program management between two Community Health Centers (CHC) with high and low CDR of TB achievement in East Jakarta. This is a qualitative study supported by quantitative study on individual and social factors with cross sectional study design.From the management point of view, CHC with high CDR of TB achievement was proven has the CHC’s head which is better capability in TB management, better mechanism on transfer of knowledge (Input Component); the planning based on fields problem analysis, active case finding involving cadres and related stakeholders, there is anticipation on laboratory results’s quality, better monitoring and evaluation (Process Component); achieved all target indicators of TB case detection (Output Component). The differences on TB management strengthened by different result between the value of individual factors (knowledge, attitudes, and TB suspect perseption of CHC service) and the value of social factors (support by cadres, Communication Information and Education by CHC officers) which was better in CHC with high CDR of TB achievement. This study suggested to carry out trainings on TB management for top management, to conduct active case finding by involving cadres and non-health sectors, and promoting networking and cross-sector cooperation., This study examined the comparison of TB program management between twoCommunity Health Centers (CHC) with high and low CDR of TB achievementin East Jakarta. This is a qualitative study supported by quantitative study onindividual and social factors with cross sectional study design. From themanagement point of view, CHC with high CDR of TB achievement wasproven has the CHC’s head which is better capability in TB management, bettermechanism on transfer of knowledge (Input Component); the planning based onfields problem analysis, active case finding involving cadres and relatedstakeholders, there is anticipation on laboratory results’s quality, bettermonitoring and evaluation (Process Component); achieved all target indicatorsof TB case detection (Output Component). The differences on TB managementstrengthened by different result between the value of individual factors(knowledge, attitudes, and TB suspect perseption of CHC service) and the valueof social factors (support by cadres, Communication Information and Educationby CHC officers) which was better in CHC with high CDR of TB achievement.This study suggested to carry out trainings on TB management for topmanagement, to conduct active case finding by involving cadres and non-healthsectors, and promoting networking and cross-sector cooperation]"

"Tesis ini membahas teori institutional analysis pada manajemen heat stress di perusahaan konstruksi. Kompleksnya teori institutional analysis yang dikembangkan memicu penulis untuk melakukan penelitian karena banyaknya faktor yang teridentifikasi, selain itu terdapat pula beberapa institutional level eksternal perusahaan yang tidak dapat diintervensi langsung oleh perusahaan konstruksi. Penelitian ini bersifat kualitatif menggunakan tinjauan sistematis dengan metode analisis tematik. Didapatkan hasil penelitian berupa gambaran tematik mengenai underlying factors dan tools and tecnhiques pada setiap institutional level dan keseluruhannya sebagai salah satu metode dalam manajemen heat stress. Penelitian ini menyarankan agar perusahaan konstruksi menerapkan teori institutional analysis dan mengaplikasikan gambaran tematik yang dihasilkan penelitian dalam pelaksanaan manajemen heat stress pada institutional level yang dapat diintervensi langsung oleh perusahaan.

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This study mainly discussing about institutional analysis theory for managing heat stress in construction company. The complexity of that theory urge Author to conduct this research because of many identified factors and some institutional levels that have been identified are an external factors that could not be interfeared directly by construction company. Systematic review with thematic analysis are the methods for this research. The results show thematic analysis about underlying factors and tools and techniques of each institutional level and altogether as one method to manage heat stress. This research recommends the application of institutional analysis combined with thematic analysis from this research to manage heat stress in construction company."

"Pendahuluan: Selama pandemi COVID-19, terjadi peningkatan beban kerja, serta kewaspadaan dan kepatuhan yang lebih besar dalam bekerja. Tenaga kesehatan harus menjalankan tugasnya dalam menghadapi ketakutan terhadap infeksi COVID-19 yang dapat memicu dan/atau memperparah stres. Penelitian ini bertujuan untuk mengetahui faktor determinan stres petugas kesehatan pada masa pandemi dengan menekankan pada perubahan situasi psikososial di rumah sakit.Metode penelitian: Studi potong lintang ini dilakukan dari bulan Januari sampai Maret 2021 dengan menggunakan kuesioner online yang terdiri dari kuesioner pribadi dan pekerjaan, serta kuesioner stres dan stres yang divalidasi menggunakan uji validitas dan reliabilitas (Cronbach's alpha 0,8 dan 0,9). Untuk analisis multivariat, digunakan regresi logistik multinomial untuk mengidentifikasi faktor determinan (p<0,05). Data dianalisis menggunakan software SPSS versi 20 (IBM Corp, USA).Hasil: Gambaran perubahan stresor pada responden adalah peningkatan stresor ringan 59,7%, peningkatan stresor sedang 20,6%, peningkatan stresor berat 5,1%, stresor tetap 11.1%, penurunan stresor 3,3%. Dengan gambaran persepsi stres adalah stres sedang 56,1%, stres berat 27,2%, stres ringan sebanyak 16,7%. Faktor determinan pada kejadian stres berat adalah tingkat perubahan stresor sedang berat dibandingkan dengan stresor menetap [aOR 8(95% CI, 2.2–29.7)], stresor tetap dibandingkan dengan stresor yang menurun [aOR 11(95% CI, 0.01–0.9)] dan lokasi kerja zona merah[aOR 3.2(95% CI, 0.1–0.8)], faktor determinan pada kejadin stres sedang adalah stresor menetap dibandingkan dengan yang menurun [aOR 25(95% CI, 0.7–0.9)], lokasi kerja zona merah[aOR 2.6(95% CI, 0.2-0.9)] dan usia kurang dari 3030[aOR 1.8(95% CI, 1.1-3.2)].Kesimpulan: Faktor determinan kejadian stres berat pada tenaga kesehatan adalah perubahan stresor kerja dan zona kerja, untuk kejadian stres sedang adalah perubahan stresor kerja, zona kerja dan usia

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Background: During the COVID-19 pandemic, there has been an increase in workload, as well as greater vigilance and compliance at work. Healthcare workers must perform their duties while facing fear of COVID-19 infection, which can trigger and/or aggravate stress. This study aimed to obtain the determinant factor of stress among the healthcare workers during the pandemic by emphasizing the change in the psychosocial situation at the hospital.

Methods: This cross-sectional study was conducted from January to March 2021 using an online questionnaire consisting of personal and occupational questionnaires, as well as a validated stressor and stress questionnaires using validity and reliability tests (Cronbach's alpha 0.8 and 0.9). For the multivariate analysis, multinomial logistic regression was used to identify the determinants factor (p<0.05). Data were analyzed using SPSS software version 20 (IBM Corp., USA).

Results: More than half of respondents had a moderate stress (56.1%) and then followed by severe and mild stress. Determinant factors in the occurrence of severe stress are the alteration of stressors, moderate-severe stressors compared to constant stressors [aOR 8(95% CI, 2.2–29.7)] constant stressors compared to decreased stressors [aOR 11(95% CI, 0.01–0.9)], and working in the red zone [aOR 3.2(95% CI, 0.1–0.8)].The determinants of moderate stress events were constant stressors compared to decreased stressors [aOR 25(95% CI, 0.7–0.9)], working in the red zone [aOR 2.6(95% CI, 0.2-0.9)] and age less than 30[aOR 1.8(95% CI, 1.1-3.2)].

Conclusions: The determinant factors for the occurrence of severe stress in health workers are changes in work stressors and work zones, for moderate stress events are changes in work stressors, work zones and age."

"Prinsip dan tujuan manajemen mutu dapat dilaksanakan dengan membuat suatu sistem pemastian mutu. Pemastian mutu dibuat dengan konsep yang menyeluruh dan didesain berdasarkan tujuan pemakaiannya. Desain dan pengembangan obat yang dibuat dengan memperhatikan persyaratan yang tercantum pada CPOB, dan perlunya dokumentasi, serta validasi pada setiap prosesnya. Pada proses pengembangan produk tablet XXX dibuatlah protokol verifikasi metode analisa penetapan kadar. Pembuatan protokol verifikasi metode analisa penetapan kadar dibuat untuk memastikan bahwa pada proses analisa penetapan kadar tablet XXX tidak terjadi bias, yang dapat menyebabkan kegagalan pemastian mutu pada produk. Protokol veifikasi metode analisa penetapan kadar dibuat dengan mengacu pada monografi tablet XXX dari British Pharmacopoeia tahun 2020 dan The International Council For Harmonisation (ICH) guideline.

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Quality management principles and objectives can be implemented by creating a quality assurance system. Quality assurance is made with a comprehensive concept and designed based on its intended use. The design and development of drugs is made by taking into account the requirements stated in the CPOB, and the need for documentation and validation in each process. In the process of developing the XXX tablet product, a verification protocol for the assay analysis method was created. The creation of a verification protocol for the assay analysis method was created to ensure that in the analysis process for assaying XXX tablets there was no bias, which could cause failure to ensure the quality of the product. The verification protocol for the assay analysis method was made by referring to the XXX tablet monograph from the British Pharmacopoeia in 2020 and the International Council For Harmonization (ICH) guideline."

"Skripsi ini membahas gambaran stres dan strategi coping pada tenaga kesehatan di Puskesmas Kelurahan Klender 1 selama pandemik COVID-19 tahun 2021. Penelitian ini adalah penelitian kualitatif dengan desain studi kasus. Tujuan penelitian ini adalah mengetahui stressor, persepsi terhadap stressor, strategi coping yang digunakan untuk menghadapi stressor, dan efek langsung yang dirasakan oleh tenaga kesehatan setelah melakukan coping. Pengambilan data dilakukan dengan metode wawancara mendalam terhadap 5 orang tenaga kesehatan dan 1 orang Kasatpel Puskesmas. Hasil penelitian menunjukan bahwa stressor tenaga kesehatan selama pandemik COVID-19 berasal dari eksternal yaitu kekurangan SDM, kesulitan mencapai target SPM, berkaitan dengan pasien, penggunaan APD, pembuatan laporan, ketakutan menularkan COVID-19 ke keluarga, dan angka kematian COVID-19 yang tinggi. Sebagian besar menilai stressor tidak menghambat dan mengancam. Sedangkan sisanya menganggap bahwa stressor sebagai tantangan dan mengancam. Kemudian seluruh tenaga kesehatan merasa bahwa mereka mampu dan memiliki sumber yang cukup untuk mengatasi stressor. Sebagian besar menggunakan Emotion focused coping. Hasil jangka pendek yang dirasakan oleh informan setelah melakukan coping adalah perasaan positif yang menunjukan coping berhasil.

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.The focus of this study is description of stress and coping strategies for health workers at Klender 1 Public Health Center during the COVID-19 pandemic in 2021. The purpose of this study was to determine stressors, perceptions of stressors, coping strategies used to deal with stressors, and the direct effects felt by health workers after coping. This study is a qualitative research with case study design. Data collection was done by using in-depth interviews with 5 health workers and 1 leader of Public Health Center. The results found that the stressors of health workers during the COVID-19 pandemic came from external sources, those are the lack of human resources, difficulty in achieving MSS targets, relating to patients, use of PPE, reporting, fear of transmitting COVID-19 to families, and high COVID-19 mortality rates. Most of health workers assess stressors are not inhibiting and threatening. While the rest consider the stressor as a challenge and threat. Then all health workers felt that they are capable and have sufficient resources to deal with stressors. Most of them used Emotion focused coping as their coping strategies. The short-term results felt by the informants after coping were positive feelings that showed successful coping."

"Perempuan yang menjadi ibu sekaligus pekerja merupakan salah satu subjek yang paling terdampak dari perubahan aktivitas kerja selama pandemi COVID-19. Kemampuan resiliensi berperan penting untuk menghadapi situasi sulit, sehingga resiliensi menjadi salah satu faktor individu ibu bekerja untuk tidak mengalami dampak psikologis berkelanjutan. Penelitian ini bertujuan untuk mengidentifikasi lebih lanjut gambaran tingkat resiliensi dan stres pengasuhan serta hubungan antara resiliensi dengan stres pengasuhan pada ibu yang bekerja selama pandemi COVID- 19. Penelitian ini menggunakan metode penelitian kuantitatif dengan desain penelitian studi korelasi. Sebanyak 296 ibu bekerja terlibat pada penelitian ini dan dikumpulkan melalui teknik convenience sampling. Hasil analisis univariat menemukan bahwa lebih dari sebagian ibu bekerja memiliki tingkat resiliensi tinggi (53.7%) dan sebagian besar memiliki tingkat stres pengasuhan rata-rata (66.5%) selama pandemi COVID-19. Analisis bivariat dengan uji chi-square dilakukan untuk menganalisis hubungan antara resiliensi dan stres pengasuhan dan hasil yang dapatkan nilai p value=0.001 sehingga terdapat hubungan antara resiliensi dengan stres pengasuhan pada ibu yang bekerja selama pandemi COVID-19. Resiliensi yang tinggi perlu dipertahankan, salah satu upayanya dengan promosi kesehatan mental agar dapat menurunkan kondisi stres yang dialami ibu bekerja.

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Women who become mothers and workers are one of the subjects most affected by changes in work activities during the COVID-19 pandemic. Resilience ability plays an important role in dealing with difficult situations, so resilience is one of the individual factors for working mothers to not experience ongoing psychological impacts. This study aims to further identify the level of resilience and parenting stress and the relationship between resilience and parenting stress in working mothers during the COVID-19 pandemic. This research uses quantitative research methods with a correlation study research design. A total of 296 working mothers were involved in this study and were collected through convenience sampling technique. The results of the univariate analysis found that most of the working mothers had a high level of resilience (53.7%) and an average level of parenting stress (66.5%) during the COVID-19 pandemic. Bivariate analysis with chi-square test was conducted to analyze the relationship between resilience and parenting stress and the results obtained p value = 0.001 so that there is a relationship between resilience and parenting stress in working mothers during the COVID-19 pandemic. High resilience needs to be maintained, one of the efforts is by promoting mental health in order to reduce the stress conditions experienced by working mothers."