Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKLatar Belakang: Angka kematian ibu AKI merupakan salah satu indikator kualitas dan aksesibilitas fasilitas pelayanan kesehatan ibu. Untuk menurunkan AKI di Indonesia, kementerian kesehatan melaksanakan program PONED. Penelitian-penelitian terhadap puskesmas PONED menunjukkan pelaksanaan PONED masih belum sesuai standar kinerja PONED. AKI pada wilayah puskesmas PONED dengan layanan yang belum sesuai standar masih tinggi, padahal program PONED dilaksanakan sebagai salah satu upaya menurunkan AKI di Indonesia.Tujuan: Mengukur tingkat kepatuhan terhadap standar kinerja PONED pada puskesmas PONED yang berada di wilayah dengan AKI tinggi dan AKI rendah. Mengetahui kendala dalam pelaksanaan PONED.Metode: Mixed-method dengan embedded design. Penelitian kuantitatif menggunakan rancangan survei potong lintang untuk mendapatkan data tingkat kepatuhan terhadap standar kinerja PONED. Pengambilan data kualitatif melalui kuesioner yang diberikan kepada tim PONED dan kepala puskesmas dilakukan secara bersamaan dengan pengambilan data kuantitatif. Sampel adalah seluruh populasi puskesmas PONED di Jakarta Timur 10 puskesmas dan Jakarta Pusat 8 puskesmas . Data kuantitatif diolah dengan statistik deskriptif dan uji t untuk melihat perbedaan. Data kualitatif diolah dengan koding terbuka untuk menghasilkan kode dan kategori.Hasil: Dari 18 puskesmas, 1 sedang tidak menjalankan PONED dan dikeluarkan dari sampel penelitian. Jumlah sampel menjadi 9 puskesmas di Jakarta Timur AKI rendah dan 8 puskesmas di Jakarta Pusat AKI tinggi . Tingkat kepatuhan terhadap standar kinerja PONED pada puskesmas di Jakarta Pusat 72 secara bermakna lebih tinggi dari puskesmas di Jakarta Timur 72 64 , t=2,543, p= 0,022 . Kendala dalam pelaksanaan PONED: fasilitas fisik, perlengkapan, sumber daya manusia, manajemen dan kendala eksternal yang berhubungan dengan pelatihan lanjutan bagi tim PONED.Simpulan:Tingkat kepatuhan terhadap standar kinerja PONED pada puskesmas PONED di wilayah dengan AKI tinggi lebih tinggi dibandingkan di wilayah dengan AKI rendah, namun tingkat kepatuhan terhadap standar kinerja PONED pada kedua wilayah tergolong rendah. Kendala pelaksanaan PONED: fasilitas fisik, perlengkapan, sumber daya manusia, manajemen dan kendala eksternal.

---

ABSTRACTBackground Maternal mortality rate MMR is one of the indicator of quality and accessibility of health, especially in women. In order to lower the MMR, Indonesian Ministry of Health developed a safe motherhood program in the community health center called PONED. Studies about PONED rsquo s community health center showed that these community health centers were not yet provide the healthcare for mother and baby according to PONED rsquo s standards and the MMR in the area of these community health center were still high.Objective To measure the compliance of PONED rsquo s standards in PONED rsquo s community health center in the area of high and low mortality rate. To know the hindrance of PONED rsquo s implementation in PONED rsquo s community health center.Methods Mixed method with embedded design. Cross sectional studies for quantitative data performed along with the qualitative survey given to the PONED rsquo s team in each community health center. Sample of the study is the whole population of PONED rsquo s community health center in East Jakarta 10 and Central Jakarta 8 .Result 1 of 18 sample was excluded because of not performing PONED rsquo s care at the time of the study. Total sample were 9 in East Jakarta low MMR area and 8 in Central Jakarta high MMR area . Mean of PONED rsquo s standard index of community health center in Central Jakarta 72 is significantly higher t 2,543, p 0,022 than East Jakarta 64 , but both were below the expected standards.The hindrance of PONED rsquo s implementation in community health center are facilities, medicine, human resource, management and external hindrance related to continuing training for PONED rsquo s team.Conclusion The compliance of PONED rsquo s standards in PONED rsquo s community health center in the area of high MMR are higher than the compliance of PONED rsquo s standards in PONED rsquo s community health center in the area of low MMR, but both were below the expected standards. The hindrance of PONED rsquo s implementation in community health center are facilities, medicine, human resource, management and external hindrance related to continuing training for PONED rsquo s team."

"ABSTRAK Pencegahan kematian maternal merupakan salah satu tujuan terpenting dari pelayanan maternal dan neonatal. Intervensi untuk menurunkan angka kematian ibu adalah kombinasi dari adanya tenaga terlatih, pelayanan obstetri emergensi dan tersedianya sistem rujukan. Saat ini usaha untuk menurunkan kematian maternal lebih mengarah pada penyediaan pelayanan obstetri dan neonatal emergensi dasar (PONED). Tingginya rujukan dari puskesmas dan angka kematian ibu di daerah kotamadya Jakarta Timur pada tahun 2012 menjadi perhatian peneliti sehingga kinerja puskesmas mampu PONED perlu dievaluasi.Jenis penelitian observasional dengan menggunakan pendekatan cross-sectional. Jumlah sampel yang diteliti adalah 8 puskesmas PONED yang berada dikotamadya Jakarta Timur.Pengumpulan data menggunakan kuosioner. Data dianalisa secara kuantitatif dengan menggunakan program statistik komputer stata 21. Penelitian inimengambil 8 sampel puskesmas PONED dan didapatkan faktorkinerja masukan yaitu struktur fisik ruangan, peralatan dan obat dan sumber daya manusia tidak memiliki hubungan yang bermakna dengan kelengkapan paket rujukan dan ketepatan waktu rujukan (0.196;0,196; 0,107; 0,107; 1,000; 0,143).Hubungan antara kinerja proses yaitu standard operating procedure (SOP), catatan medis dan tindakan PONED dengan kinerja keluaran pada puskesmas PONED di wilayah Jakarta Timur tidak dapat dianalisis secara statistik karenahasil sebaran data kinerja proses di puskesmas PONED wilayah Jakarta Timur seragam. Faktor lain yang mempengaruhi kinerja keluaran adalah keaktifan warga siaga, umpan balik rujukan dan adanya maklumat pelayanan yang belum ditelaahpada penelitian ini.

---

ABSTRAK Prevention of maternal mortality is one of the most important goals of maternal and neonatal care. Interventions to reduce maternal mortality rate involve several aspects, including presence of trained personnel, obstetric emergency care andavailability of referral system. Current efforts to reduce maternal mortality rate are focused on the provision of Basic Emergency Obstetric and Newborn Care (BEmONC). However, the number of referral from community health centers andmaternal mortality rate in East Jakarta in 2012 are still high. Thus, it’s importantto evaluate the performance of community health centers which provide BEmONC. This study used cross-sectional design and involved 8 communityhealth centers which provide BEmONC in East Jakarta. The collected data were analyzed quantitatively by using statistical program Stata 21. We found that the performance indexes in input sector, including physical structures of the building, equipment, drugs and human resources, have no significant relationship with the completeness of referral documents and time of referral (p= 0196; 0.196; 0.107; 0.107; 1.000; 0.143). Performance in process sector, including standard operating procedure (SOP), medical records and BEmONC care, at community healthcenters in East Jakarta were couldn’t analyzed due to similarity of data. We also identified several factors affecting performance in output sectors which have not been explored in this study. They are activity of warga siaga (communityprogram involving husbands to support his pregnant wife), referral feedback, and availability of notice service"

"The complication of pregnancy and labor is not always predictable before it was happened , so pregnant woman must have access nearly Basic Emergency Obstetric Services. Puskesmas were hoped to give basic emergency services. Increased the pregnancy woman access to Puskesmas will decrease Maternal Mortality Rate and Child Mortality Rate fast. The objective of the research asses the innovation of basic obstetric and neonatal emergency services (PONED) at the Puskesmas and comprehensive obstetric and neonatal emergency services (PONEK) at the hospital. The function of PONED puskesmas and PONEK hospital were influenced by human resource, facility, drugs."

"Tolok ukur pelayanan kesehatan ibu dan anak di suatu negara dapat dilihat dari Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB). Semakin kecil AKI dan AKB maka menunjukan semakin baik pelayanan kesehatan ibu dan anak. AKI dan AKB di Indonesia masih tinggi yaitu 307 per 100.000 Kelahiran Hidup (KID), dan AKB 35 per 1000 KH. Lebih dari 90% penyebab kematian ibu dan bayi karena komplikasi obstetri dimana komplikasi ini tidak bisa diduga sebelumnya, Untuk itu perlu adanya sarana rujukan untuk menangani kasus kegawatdaruratan obstetri dan neonatal. Pukesmas sebagai tempat rujukan terdekat dari desa dan sebagai pembina bidan di desa, diharapkan mampu melaksanakan Pelayanan Obstetri Neonatal Emergensi Dasar (PONED).Penelitian ini dilakukan di kabupaten Indramayu, dengan metode kualitatif melalui wawancara mendalam dan fokus group diskusi yang melibatkan kepala puskesmas, tenaga pelaksana PONED, bidan di desa wilayah kerja puskesmas yang diteliti, tenaga kesehatan dari puskesmas tetangga, tokoh masyarakat yang berada diwilayah kerja puskesmas yang diteliti.Penelitian ini dilakukan untuk memperoleh gambaran sistem manajemen masukan yang meliputi sumber daya manusia, dana, sarana dan kebijakan. Selain itu, untuk memperoleh gambaran sistem manajemen proses yang meliputi sosialisasi PONED, supervisi suportif, AMP sosial untuk kinerja cakupan komplikasi maternal dan neonatal ditangani, jugs AMP Medis dan kerjasama dengan DSOG dan DSA untuk kinerja cakupan komplikasi maternal dan neonatal ditangani selamat dan dirujuk. Hasil penelitian ini diolah dengan menggunakan bentuk matriks, teknis analisisinya berupa analisis isi yaitu menganalisa sesuai dengan topik bahasan.Hasil penelitian mengenai gambaran input menunjukkan bahwa jumlah tenaga kesehatan yaitu jumlah bidan desa dan tenaga yang bertugas di PONED sudah cukup. Untuk kriteria maupun pendidikan dari tenaga kesehatan masih belum memenuhi syarat. Untuk pengetahuan tenaga kesehatan maupun camat masih kurang, begitu juga motivasi bidan desa maupun tenaga yang bertugas di PONED kurang, yaitu kepala Puskesmas Widasari belum ada kiat-kiat untuk meningkatkan motivasi, sedangkan di Puskesmas Sindang sudah ada.Tipe gaya kepemimpinan kepala Puskesmas Widasari adalah gaya misionari sedangkan gaya kepemimpinan kepala Puskesmas Sindang merupakan gaya kepemimpinan kompromis, dimana kedua tipe gaya kepemimpinan tersebut keduanya termasuk gaya kepemimpinan yang kurang efektif Dana dan sarana untuk rujukan dari Puskesmas Sindang tidak ada masalah, sedangkan untuk Puskesmas Widasari sarana rujukan masih menjadi masalah karena sopir tidak selalu slap, dan kelembagaan ambulans desa juga tidak berjalan lancar. Dana khusus untuk operasional PONED di kedua Puskesmas tidak ada, sedangkan sarana di kedua PONED sudah cukup memadai. Kebijakan pelayanan terhadap orang miskin dikedua Puskesmas walaupun tidak berjalan dijalankan secara optimal. Kebijakan penguatan sistem rujukan di Puskesmas Sindang sudah lebih baik dan Puskesmas Widasari walaupun tidak berjalan lancar, sedangkan untuk pelaksanan PONED dikedua Puskesmas belum dijalankan sebagaimana mestinya.Mengenai gambaran proses hasil penelitian ini menunjukkan, sosialisasi PONED dikedua Puskesmas belum dilaksanakan secara baik, begitu juga dengan supervisi suportif yang harus dilaksanakan oleh bidan koordinator belum dilaksanakan sebagaimana mestinya. AMP sosial, baik dari kecamatan maupun puskesmas belum ada komitmen dan kesadaran untuk melakukan AMP sosial. AMP medis ditingkat puskesmas di kedua Puskesmas tidak pernah dilaksanakan, hanya otopsi verbal masih sebatas untuk laporan, dan tidak ada kesadaran untuk membahas otopsi verbal. Kerjasama dengan DSOG dan DSA belum pernah dilaksanakan karena tidak tabu bagaimana caranya.Berdasarkan hasil penelitian ini, disarankan kepada dinas kesehatan untuk memprioritaskan pendidikan maupun pelatihan seperti APN, PPGDON, MTBM untuk bidan desa dan uelaksana PONED, pelatihan manajemen dan kepemimpinan untuk kepala puskesmas khususnya kepala Puskesmas PONED. Perlu pemberian pelatihan ESQ bagi semua jajaran kesehatan sehingga dapat meningkatkan empati dan kepeduliannya dalam pelayanan kesehatan terutama terhadap orang miskin dan juga untuk meningkatkan kembali nilai-nilai luhur, inti ajaran manajemen, inti kepemimpinan dan etika sehingga mampu bekerja dengan baik. Disarankan juga agar partograf dan MTBM dijadikan sebagai salah satu kriteria akreditasi bidan. Perlu juga adanya kesepakatan dengan rumah sakit untuk pembinaan PONED oleh DSOG dan DSA, dan pemberikan dam operasional khusus untuk PONED untuk menghindari tarif yang terlalu tinggi.

---

The success on the maternal and child health services of a country can be seen at its Maternal Mortality Ratio (MMR) and Infants Mortality Rate (IMR). The less MMR and IMR they have, the better they have services on maternal and child health. The level on MMR and IMR in Indonesia is still high, namely 307/100,000 live birth for MMR and 35/1,000 live birth for IMR. It has known that 90% of the cause of the death on maternal and the infant was undetected obstetric complication. Therefore, a referral facility is needed in response to any obstetric and neonatal emergency case. Puskesmas, as the nearest referral facility in the village and tutor for midwives village, is expected to be capable on dealing with Basic Emergency Obstetric and Neonatal Services (BEONS/PONED).

The study is carried out at the district of Indramayu. The research method used with qualitative approach through in-depth interview and focused group discussion (FGD) towards the head of Puskesmas, personnel who Implement the PONED, village midwives of the working area of Puskemas Widasari and Sindang, health providers from neighborhood's puskesmas, and community leaders at the working area of Puskesmas Widasari and Sindang.

The purpose of the study is to find out the description of the input and process management system of the PONED. The input management system is consisting of the human resources, budgeting, facility, and policy. And the process management system will look at its PONED socialization, supportive supervision, the social audit maternal and perinatal (AMP) of the performance on the coverage of maternal and neonatal complication that has managed the medical AMP and the collaboration with obgyn and pediatrician for the performance on the coverage of maternal and neonatal complication that has managed, rescued and referred.

The result of the study is analyzed by using matrices, and the technique analysis is using content analysis which analyzes on each topics of subject study. The result study on input management system found that the number of health personnel, i.e. number of village midwives and PONED personnel is adequate. But for the criterion for health personnel's education is still have not reach the standard. The level of knowledge for health personnel and the head of sub-district are still low. The reason for work or motivation to work as village midwives and PONED personnel are minor. From two puskesmas studied, the head of Widasari Puskesmas is still have no attempt on elevating the motivation on his staffs, but the head of Sindang Puskesmas is having it. The leadership style of Widasari is missionary style, while Sindang is a compromise leadership style. Both of those leadership styles above are known as less effective leadership style. For Sindang Puskesmas, there are no difficulties found on budgeting and facility for referral, but for Widasari Puskesmas, a problem found in regard to facility for referral, as the ambulance driver is not always ready to work and the ambulance institution body is also found unmanageable. There is no special budget for PONED operational duty in both puskesmas, but both of them has reached the adequacy for PONED facilities. Policy on services for poor people in both puskesmas is still not run in optimal way. Although it's not run so well, the policy on referral system enhancement on Sindang is better than Widasari. However, the implementation on PONE') in both puskesmas is far from the expectation.

For process management system, the study found that the socialization on PONED in both puskesmas is still not well implemented. Supportive supervision by coordinator midwife is also not employed as it should be. Of social AMP, there is no commitment or awareness on doing social AMP in both from sub-district office or puskesmas. Medical APM in both puskesmas is also never carried out Verbal autopsy is only the activity that implemented in both of puskesmas, and it's solely for the reporting and has no awareness to discuss the verbal autopsy findings. The collaboration between obgyn and pediatrician is never carried out because they do not know how to do collaboration.

Suggestion addressed to the head of health authority office that he has to prioritize the education or trainings on medical techniques for village midwives and PONED personnel. A management and leadership training for the head of puskesmas, especially for PONED Puskesmas. There is a need on ESQ training for all health personnel in order to raise the empathy and awareness on addressing health services to poor people, and also to increase the noble values, management principals, leadership principals and ethic cores for having a better work environment. Partograph fulfillment and MTBM is a criterion for midwives accreditation. Establish an agreement with hospital for obgyn and pediatrician guidance and training for PONED personnel. Lastly, to have a special budget for PONED operational in order to avoid a very high expenses for having PONED."

"Penelitian ini menggunakan desain cross sectional yang bertujuan untuk mengetahui faktor - faktor yang berhubungan dengan rujukan kasus kegawatdaruratan oleh bidan desa ke puskesmas PONED di Kabupaten Maluku Tengah. Penelitian ini adalah penelitian kuantitatif. Hasil penelitian menyarankan kepada puskesmas PONED yaitu memperbaiki manajemen program agar lebih baik yang meliputi perencanaan, pengorganisasian, penggerakan, pemantauan dan pengendalian serta penilaian. Sedangkan saran untuk Dinas Kesehatan Kabupaten Maluku Tengah selain memperbaiki manajemen program juga mengembangkan puskesmas rawat inap yang telah memenuhi persyaratan menjadi puskesmas PONED sehubungan dengan Maluku Tengah merupakan daerah kepulauan yang mempunyai tantangan terbesar yaitu keadaan alam dan letak geografi yang tidak mendukung.

---

This study uses cross-sectional design that aims to determine factors - factors related to the reference case of emergency by the midwife to the health center in Central Maluku District PONED. The study was a quantitative study. The results suggest that health centers improve the management PONED the program for the better that includes planning, organizing, mobilization, monitoring and control and assessment. As for advice to the Central Maluku District Health Office in addition to improving the management of the program is also developing inpatient centers that have met the requirements of a health center with respect PONED Central Maluku archipelago is an area that has the biggest challenge is the natural and geographical circumstances that does not support."

"Puskesmas mampu PONED menyelenggarakan pelayanan obstetri dan neonatal emergensi dasar sebab komplikasi tidak dapat diramalkan sebelumnya sehingga ibu hamil harus berada sedekat mungkin dengan pelayanan emergensi dasar. Pelatihan keterampilan Pelayanan obstetri neonatal emergensi dasar dilaksanakan guna meningkatkan pengetahuan dan keterampilan petugas kesehatan yang diharapkan memberikan dampak langsung pada kualitas pelayanan kegawatdaruratan meternal dan neonatal.Tujuan dari penelitian ini adalah: mengetahui perbedaan pengetahuan, sikap dan keterampilan yang telah dilatih PONED dan belum dilatih PONED terhadap kinerja pada puskesmas di Kabupaten Bogor. Penelitian ini merupakan penelitian kuantitatif dengan desain cross sectional. Sampel penelitian adalah petugas yang sudah dilatih PONED dan belum dilatih PONED. Hasil studi menunjukkan adanya perbedaan bermakna pada variabel pengetahuan, keterampilan dan kinerja pada kelompok PONED dan non PONED; Pada kelompok PONED variabel sikap diduga yang paling dominan mempengaruhi variabel kinerja.

---

Puskesmas PONED able to carry out a basic emergency maternal neonatal service because the complication of pregnancy and labor is not always predictable before it was happened, so pregnant woman must have access nearly Basic Emergency obstetric services. Basic Emergency Obstetric Neonatal Care Training implemented in order to improve the knowledge and skills of health workers who are expected to have a direct impact on the quality of emergency care and maternal or neonatal services.

The study aims to know the difference of knowledge, attitudes and skills between the personnel experienced PONED training and the personnel with no training, and the effect of training on the performances of health centers in the municipality of Bogor. This is quantitative research with cross sectional study design. Samples are personnels who have been trained with PONED and personnel with non PONED training. The results showed significant differences on knowledge, skills and performance between those with PONED training and non PONED training. In the group with PONED training, varible of attitude has the strongest influence on the performances."

"Rendahnya cakupan pemberian ASI eksklusif menjadi ancaman serius meningkatnya angka kesakitan dan kematian pada bayi. Persepsi kurang cukup suplai ASI menjadi salah satu penyebab kegagalan pemberian ASI eksklusif. Status gizi ibu terutama selama hamil merupakan salah satu faktor penyebab ibu memiliki persepsi tersebut karena ibu dengan status gizi kurang akan mempengaruhi kemampuan ibu untuk mensintesisi air susu yang menyebabkan bayi tidak cukup ASI untuk pertumbuhan dan perkembangannya. Penelitian ini bertujuan untuk melihat hubungan status gizi ibu selama hamil dengan Persepsi Kemampuan Laktasi (PKL) setelah dikontrol oleh variabel umur, kenaikan berat badan selama hamil, pekerjaan, bimbingan laktasi prenatal, paritas, IMD, berat bayi lahir dan penggunaan kontrasepsi. Desain yang dipakai adalah Crossectional terhadap 87 ibu yang memiliki bayi umur >6-12 bulan diwilayah Kabupaten Karawang tahun 2010. Analisis data yang digunakan adalah uji chi square, Uji T independen dan regresi logistik. Hasil penelitian menunjukkan bahwa 58,6% ibu memiliki PKL mampu laktasi. Hasil analisis bivariat yang terbukti berhubungan secara bermakna adalah status gizi selama hamil (0,009), kenaikan berat badan selama hamil (0,002), pekerjaan (0,034) dan berat bayi lahir (0,030). Hasil analisis multivariat menjelaskan bahwa status gizi selama hamil yang sesuai rekomendasi berpeluang 2,176 kali untuk memiliki PKL mampu laktasi dibanding dengan status gizi yang tidak sesuai rekomendasi setelah dikontrol oleh variabel kontrasepsi, umur, paritas, IMD, kenaikan berat badan selama hamil dan berat bayi lahir. Disarankan untuk bidan/nakes agar memberikan konseling menyusui, mencatat dan memantau status gizi ibu, melatih ibu untuk menilai kondisi bayi yang cukup/tidak cukup ASI, mengajarkan cara penyediaan dan penyimpanan ASI bagi ibu yang bekerja. Bagi Dinas kesehatan mengadakan pelatihan konseling dan penilaian serta pengukuran status gizi, pemberian reward dan mengkaji ulang kebijakan pemberian ASI eksklusif sampai 6 bulan untuk ibu-ibu dengan status gizi kurang.

---

Low adequate supply of exclusive breastfeeding becomes a serious threatment of increasing number in infant mortality and morbidity. Perception of insufficient breastmilk supply in one of the causes on a failure of exclusive breastfeeding supply. Maternal nutrition status especially during pregnancy is one of the factors that causes mother has this perception, because mother who has insufficient nutritional status will influence her ability to synthesize breastmilk that causes infant doesn't have enough breastmilk for his growth and development.

The objectives of this study were to see the correlation of maternal nutrition status during pregnancy with perceived lactation ability after controlled by age variabel, increased body weight during pregnancy, occupation, counseling prenatal lactation, parity, early initiative breastfeeding, baby birth weigh, and the used of contraception. The design crossectional study on 87 mothers who have infants age >6-7 months in Karawang Regency-West Java, Indonesia 2010. The analysis data is used by Chi Sguare Test, T independent Test and Logistic Regression.

The Result study shows that 58,6% mothers who have perceived lactational ability. The Results of bivariate analysis that proved significant correlation are nutritional status during pregnancy (0,009), increased body weight during pregnancy (0,002), Occupation (0,034), and baby birthweight (0,030). The Result of multivariate analisys explains that nutritional status during pregnancy that meets breastfeeding recommendation, has an opportunity 2,176 times to have perceived ability then nutritional status that doesn't meet breastfeeding recommendation after controlled by contraception variable, age, parity, early initiative breastfeeding, increased body weight during pregnancy and baby birth weight.

Conclusions: suggested to health professional can give lactation counseling, record it, monitor maternal nutritional status, train mother to assess baby condition whether he has enough breastmilk or not. They can teach the mother how to provide and keep breastmilk if they work. For health service, they should give a training for counseling, assessment, nutrition status measurement, give reward and recite the policy in giving exclusive breastmilk for 6 month to the mothers who have insufficient nutritional status."

"[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.

---

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]"

"ABSTRAKPenelitian ini bertujuan untuk melihat kesesuaian rujukan persalinan di tiga puskesmas PONED (Pituruh, Loano, Bragolan) ke RSUD Kabupaten Purworejo tahun 2013. Hasil penelitian menunjukkan bahwa 65 kasus rujukan (82,28%) tidak sesuai untuk dirujuk dan 14 kasus rujukan (17,72%) sesuai dirujuk. Ketidaksesuaian rujukan dipengaruhi oleh ketersediaan dan kesiapan fasilitas serta kompetensi bidan. Bidan berpengetahuan rendah mempunyaipeluang lebih besar dalam penulisan rujukan tidak sesuai. Sebanyak 25 kasus rujukan (67,57%) yang tidak sesuai dirujuk pada kelompok bidan yang pengetahuannya rendah, dan sebanyak 12 kasus rujukan (32,43%) yang tidak sesuai dirujuk pada kelompok bidan yang berpengetahuan tinggi.

---

ABSTRACT

This study aims to see the appropriateness of childbirth referrals by midwives in PONED health centers (Pituruh, Loano, and Bragolan) to Purworejo General Hospital in 2013. The result of the study shows that there were 69 inappropriate childbirth referral cases (82,28%) and 14 appropriate ones (17,72%). The referral delivery inappropriateness is influenced by the facility availability and readiness and midwives competence. Low knowledgeable

midwives have bigger chance in making inappropriate references. Furthermore, 25 inappropriate referral cases (67,57%) are made by low knowledgeable midwives and 12 inappropriate ones are referred by high knowledgeable midwives."