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"Trends of cesarean section trend in Indonesia (2007-2012) have doubled the risk of long-term and short-term health problems. This study was aimed to determine relation between antenatal care provider and cesarean section. This quantitative study used cross-sectional design with a total sample of 5,143 women aged 15-49 years who gave birth to the last child through cesarean section or not as in urban areas selected in samples of 2012 Indonesia Demographic and Health Survey. Logistic regression multivariate analysis was used to determine relation between antenatal care provider and section cesarean, which was controlled by maternal age, antenatal care facility, parity, and place of birth. Results showed that antenatal care at obstetrician was 6.6 times higher, while antenatal care at obstetrician and midwife was 2.1 times higher for cesarean section compared to women who had antenatal care at midwife after controlled by maternal age, antenatal care facility, parity, and place of birth. There is interaction between socioeconomic status and obstetrician for a cesarean section. Regulation on cesarean section by health authority, as well as protective and preventive labor applied towards on the high economic class community may reduce unnecessary cesarean section. Trends of cesarean section trend in Indonesia (2007-2012) have doubled the risk of long-term and short-term health problems. This study was aimed to determine relation between antenatal care provider and cesarean section. This quantitative study used cross-sectional design with a total sample of 5,143 women aged 15-49 years who gave birth to the last child through cesarean section or not as in urban areas selected in samples of 2012 Indonesia Demographic and Health Survey. Logistic regression multivariate analysis was used to determine relation between antenatal care provider and section cesarean, which was controlled by maternal age, antenatal care facility, parity, and place of birth. Results showed that antenatal care at obstetrician was 6.6 times higher, while antenatal care at obstetrician and midwife was 2.1 times higher for cesarean section compared to women who had antenatal care at midwife after controlled by maternal age, antenatal care facility, parity, and place of birth. There is interaction between socioeconomic status and obstetrician for a cesarean section. Regulation on cesarean section by health authority, as well as protective and preventive labor applied towards on the high economic class community may reduce unnecessary cesarean section."

"Pendahuluan: Angka Kematian Ibu (AKI) di Indonesia masih jauh dari target Sustainable Development Goals (SDGs) tahun 2030 yaitu 70 per 100.000 kelahiran hidup. Penyebab kematian ibu diantaranya adalah tiga terlambat dan empat terlalu. Sebagian besar penyebab kematian ibu dapat dicegah dengan pelayanan kesehatan yang berkualitas selama kehamilan dan persalinan. Hampir 98% ibu telah melakukan Antenatal Care minimal 1 kali di tenaga kesehatan professional. Namun, cakupan K4 pada 11 provinsi di Indonesia masih rendah. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi ANC pada ibu sudah memenuhi K1 namun tidak melanjutkan ANC minimal empat kali (K4).Metode: penelitian ini menggunakan pendekatan kuantitatif dengan desain studi cross sectional. Hasil penelitian dianalisis menggunakan complex sample analysis dengan tiga tahap yaitu univariat, bivarat dan multivariat.Hasil: Faktor yang berhubungan dengan kunjungan ANC adalah predisposisi (paritas), pemungkin (akses fisik, akses ekonomi, dan paparan media informasi), dan penguat (dukungan suami), sedangkan faktor kebutuhan tidak berhubungan. Dukungan suami merupakan faktor yang paling berpengaruh terhadap kunjungan ANC pada 11 provinsi di Indonesia.Kesimpulan: Pemerintah perlu menyediakan anggaran untuk pengembangan strategi promosi kesehatan terutama di pedesaan. Penyuluhan tentang pentingnya ANC dapat dilakukan melalui media yang mudah diakses seperti televisi. Peningkatan dukungan suami dalam kunjungan ANC dapat dilakukan dengan mengirimkan undangan lewat pesan sms atau whatsapp.

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Introduction: Maternal Mortality Rate (MMR) in Indonesia is still far from the target of the 2030 Sustainable Development Goals (SDGs) of 70 per 100,000 live births. Things related to maternal death are three late and four too. Most causes of maternal death can be prevented by quality health services during pregnancy and childbirth. The Ministry of Health makes the ANC service standard at least 4 times, namely 1 time in the first trimester, 1 time in the second trimester, and 2 times in the third trimester. Based on the Indonesian Health Profile in 2017, the coverage of pregnant women visiting health services, especially K4, is still low in eleven provinces in Indonesia or has not reached the target of 76%. Therefore, an analysis needs to be carried out relating to the factors that influence ANC visits.

Method: this study uses a quantitative approach using a cross sectional study design. Data was analyzed using complex sample analysis through three stages, which are univariate, bivariate, and multivariate.

Results: factors associated with ANC visit are predisposing (parity), enabling (physical access, economic access, and information media exposure), and reinforcing (husband's support), whereas need factor didn't associated with ANC visits. Husband support is the most important factor towards ANC visits in 11 provinces in Indonesia.

Conclusion: The government needs to provide a budget for developing health promotion strategies, especially in rural areas. Counseling about the importance of ANC can be done through the media which can be accessed easily such as television. Increasing husband's support during ANC visits can be done by sending invitations via SMS or WhatsApp messages."

"Lebih dari 90% kasus anak terinfeksi HIV, ditularkan melalui proses penularan dari ibu ke anak. Tujuan penelitian mengetahui hubungan antara keteraturan pelayanan antenatal dengan tes HIV pada ibu hamil di Indonesia berdasarkan data Riset Kesehatan Dasar (Riskesdas) Tahun 2018. Penelitian ini merupakan penelitian observasional metode survei (cross sectional) dengan menggunakan data yang bersumber dari Riskesdas tahun 2018. Sampelnya wanita usia subur di Indonesia yang memiliki riwayat kehamilan dan terpilih yang menjadi responden Riskesdas tahun 2018 serta memenuhi kriteria inklusi dan eksklusi. Besar sampel pada penelitian ini adalah 12.383 responden. Variabel dependen dalam penelitian ini adalah tes HIV pada ibu hamil, variabel independen utama yaitu keteraturan pemeriksaan antenatal (ANC) dan variabel kovariat yaitu umur, tempat tinggal, pendidikan, status bekerja, paritas, pengetahuan HIV, sikap terhadap orang dengan HIV/AIDS (ODHA), pelayanan antenatal 10T, tenaga kesehatan (nakes) pemberi layanan dan fasilitas kesehatan (faskes) tempat ibu periksa hamil. Variabel keteraturan pemeriksaan antenatal dan variabel fasilitas kesehatan memiliki efek yang hampir sama dalam mempengaruhi rendahnya cakupan tes HIV pada ibu hamil. Tes HIV pada ibu yang teratur periksa hamil ditemukan 1,8 kali lebih banyak di perkotaan dan 2,2 kali lebih banyak di perdesaan dibandingkan dengan yang tidak teratur periksa hamil. Selanjutnya tes HIV pada ibu yang teratur periksa hamil lebih banyak ditemukan 1,5 kali yang periksa di rumah sakit, 2,8 kali yang periksa di puskesmas dan 2,2 kali yang periksa di klinik/praktek mandiri dibandingkan dengan yang tidak teratur periksa hamil. Saran kepada tenaga kesehatan dan pengelola program KIA untuk meningkatkatkan keteraturan dan kelengkapan pelayanan Antenatal serta meningkatkan ketersediaan fasilitas tes HIV.

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More than 90% of cases of children infected with HIV are transmitted through the process of mother-to-child transmission. The purpose of the study was to determine the relationship between the regularity of antenatal care and HIV testing in pregnant women in Indonesia based on data from the 2018 Basic Health Research (Riskesdas). This study was an observational survey method (cross sectional) using data sourced from Riskesdas in 2018. The sample was women. of childbearing age in Indonesia who have a history of pregnancy and were selected as Riskesdas respondents in 2018 and met the inclusion and exclusion criteria. The sample size in this study was 12,383 respondents. The dependent variable in this study was HIV testing for pregnant women, the main independent variable was the regularity of antenatal check-ups (ANC) and the covariates were age, place of residence, education, work status, parity, knowledge of HIV, attitudes towards people living with HIV/AIDS (PLWHA). ), 10T antenatal care, health workers (nakes) who provide services and health facilities (faskes) where mothers check for pregnancy. The variables of regularity of antenatal check-ups and variables of health facilities have almost the same effect in influencing the low coverage of HIV testing in pregnant women. There were 1.8 times more HIV tests in women who had regular pregnancy check-ups in urban areas and 2.2 times more in rural areas compared to those who did not regularly check for pregnancy. Furthermore, HIV tests for mothers who regularly check for pregnancy are found to be 1.5 times more checked at the hospital, 2.8 times are checked at the puskesmas and 2.2 times are checked at the clinic/independent practice compared to those who do not regularly check for pregnancy. Suggestions to health workers and MCH program managers to improve the regularity and completeness of Antenatal services and increase the availability of HIV testing facilities."

"Derajat kesehatan masyarakat merupakan salah satu indikator kesejahteraan suatu bangsa. Upaya yang dilakukan di bidang kesehatan adalah dengan meningkatkan umur harapan hidup, dengan cam menurunkan Angka Kcmatian Ibu (AKI) dan Angka Kematian Bayi (AKB). Dibanding ncgara- negara ASEAN, AKI dan AKB di Indonesia masih tinggi, demikian juga kondisi AKI dan AKB di Jawa Barat, termasuk di Kabupatcn Karawang. Pelayanan antenatal merupakan salah satu intervensi kesehatan yang paling cfektif untuk pencegahan kesakitan dan kematian ibu. Kematian ibu dapat dicegah bila komplikasi dan keadaan resiko tinggi kehamilan dapat dideteksi sejak dini melalui pemeriksaan antenatal sedini' mungkin. Hasil kegiatan yang dilakukan oleh bidan di desa Kabupaten Karawang dalam pelayanan antenatal (cakupan ANC KI dan K4}, menunjukkan adanya kesenjangan yang tinggi. Hal ini merupakan indikator bahwa kincda bidan di desa masih belum baik. Tujuan peneiitian ini untuk mengetahui hubungan antara pengetahuan, pengalaman, tempat tinggal, motivasi, kelengl-:apan alat, supervisi dan klasiiikasi desa dengan kinerja bidan di desa dalam pelayanan antenatal. Penelitian ini menggunakan rancangan cross sectional, dengan populasi semua bidan di desa sebanyak 305 respondcn. Sampel penelitian semua populasi, yang berhasil didata sebanyak 289 responden. Pengumpulan data dilaksanakan pada bulan Maret-April 2008, di Kabupatcn Karawang, dengan wawancara dan menggunakan kuesioner. Analisis univariat dengan mcmbuat distribusi frekuensi masing-masing variabel, analisis bivariat dengan uji kai kuadrat dan analisis multivariat dengan uji regresi logistik ganda dengan kriteria kemaknaan p<0,0S. Hasil penelitian menunjukkan bahwa proporsi bidan di desa yang mempunyai kinerja kurang (49,8%),. sedikit Iebih rendah dibanding bidan di desa yang mempunyai kinerja baik (50,2%). Hasil analisis bivariat menunjukkan bahwa variabel pengetahuan tentang umur kehamilan dan fokus supervisi berhubungan signifikan dengan kinerja bidan di desa. Hasil analisis multivariat menunjukkan bahwa variabel fokus supervisi bcrhubungan signifikan dengan kinerja bidan di desa. Bidan di desa dengan fokus supervisi kurang akan berpeluang mempunyai kineqja kurang, 1,7 kali lcbih besar dibanding bidan di desa dengan fokus supervisi baik. Berdasarkan basil pcnelitian, penulis merekomendasikan saran sebagai berikut: Bagi Puskesmas dan Dinas Kesehatan perlu meningkatkan supervisi dengan cara mcmbuat jndnval supervisi, cek list, kemudian didiskusikan, sampai terbentuk formulasi tentang masalah yang ada, menentukan penycbab masalah, prioritas dan membuat langkah- langkah perbaikan, membuat komitmen bersama untuk pcrbaikan, melakukan pelatihan bagi pctugas supervisi, kemudian melakukan uji coba, menilai hasi I yang dicapai dan menentukan tindak Ianj ut bcrikutnya. Bagi bidan di desa perlu memahami kembali tentang tujuan, wewenang, lugas pokok dan fungsi sebagai bidan di desa, meningkatkan kerjasama, lebih proaktif dan meningkatkan .sq/T skiil. Bagi masyarakat perlu kexjasama dan partisipasinya dalam pelayanan antenatal. Bagi peneliti lain perlu dilakukan penelitian tentang fokus supervisi untuk meninkatkan kinerja bidan di desa dalam pelayanan antenatal dengan wawancara independen dan tentang kinerja bidan di desa secam komprehensif.

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The level of public health is one of the indicators related to the wealth of society. One of the efforts being done in the health subject is to increase the age life expectancy by reducing the matemal mortality rate (MMR) and neonatal mortality rate (NMR). Comparing to the other ASEAN countries, Indonesia’s MMR and NMR are still high, and so docs for of West .lava’s MMR and NMR, including Karawang regcncy.

Antenatal care is one of the most effective health interver' veventing the matemal morbidity and mortality. Matemal mortality ca- vented, if complication and high risk conditions are detected early by anten. are. Activity result of village midwives on antenatal care in Karawang rcgency (including ANC KI dan K4) shows high discrepancy; which indicates that village midwives performances is not yet good.

The research objective is to tind out the link between knowledge, experience, residence, motivation, full-equipments, supervision and village classification with village midwives' performances in the antenatal care. This research of cross sectional program, uses a population of all the village midwives which are 305 respondents. The sample is using all ofthe population, 289 are successiiilly recorded as data. The data collection is started from March until April 2008, in Karawang regency, through interview and questionnaire fonns. Univariate analysis by making frequency distribution of such variable, bivariate analysis by chi square test and multivariate analysis by multiregression logistic test with p va1ue<0,05.

The research result shows that the proportion of the village midwives with low performance (49,8%) is almost the same as the village midwives with good performance (50,2%). The bivariate analysis shows variable knowledge of the age of pregnancy and supervision focus has significant relationship with the village midwives’ performance. The village midwives with less supervision focus have an opportunity to perfonn less by 1.7 times greater than the village midwives with good supervision focus.

According to research results, writer recommends advises as the following: For the Public Health Center and Official Health needs an improvement on supervision by making supervision schedule, check list and continued with discussions, in order to find the formulation ofthe existing problem, the cause of the problem, priorities and developing solving steps, making commitment together to improve, conducting training for supervision officers, then conducting testing which evaluate the result and decide the next steps.

For the village midwives, they need to understand the objectives, authority, the main function and responsibilities as village midwives, to improve teamwork, be more proactive and to improve soft skill. For the surrounding society, its teamwork and participation are importantly needed in the antenatal care. For other researchers, it is needed to carry on further researches about supervision focus to improve the village midwives performance in the antenatal care with independent interview and about comprehensive of the village midwives performance."

"Penelitian yang dilaksanakan ini menyanglcut masalah perilaku dalam organisasi dan upaya pemberdayaan Sumber Daya Manusia Kesehatan, Perrnasalahan yang diajukan adalah apakah terdapat hubungan antara komponen Quality of Work LM: (QWL) yang terdiri dari keterlibatan pegawai, kompensasi yang seimbang, :asa aman terhadap pekerjaan, keselamatan lingkungan kerja, rasa bangga terhadap institusi, fasilitas yang tersedia, penyelesaian masalah dan komunikasi dengan upaya peningkatan pelayanan antenatal oleh Bidan Puskesmas di Kota Tasikmalaya Tahun 2007. Tujuan Penelitian adalah didapatkannya gambaran dan informasi mengenai Kl.lBH\&$ Kehidupan Kerja Bidan di Unit KIA dan hubungannya dengan Pcnatalaksanaan Antenatal Care Bidan Puskesmas di Kota Tasikmalaya Tahun 2007. Metodologi Penelirian yang digunakan adalah Analisis Deskriptif secara Cross Sccnbnal dengan mernakai rnetode kuantitatif dan kualitatif. Obyek Penelitian adalah seluruh Bidan Puskesmas di Kota Tasikmalaya Tahun 2007, dimana didapatkan Sampel penelitian adalah 53 Bidan Puskesmas di Kota Tasikmalaya. Data primer diperoleh dengan mcmakai instnmlcnt kucsioncr tcrstruktur, yaitu satu variabel dependen dan sembilan variabel independen, wawancara dan studi pustaka. Uji statistik untuk mengetahui hubungan komponen QWL dengan Penatalaksanaan ANC Bidan Puskesmas dipakai Analisis Korelasi dan Regresi Linier Ganda. Hasil Analisis Bivariat dengan mcmakai uji stgfistik Pearson Correlation, didapatkan 3 komponcn QWL yang mernpunyai hnbungan signifkan dengan penatalaksanaan antenatal care (p Value S 0,05), yailu ras# bangga terhadap institusi (r = 0,405}, kornpcnsasi yang scimbang (r = -0,392) dan kogiunikasi (r = -0,267). Hal ini dapat diinterprctasikan bahwa antam rasa' bangga terhadap institusi dengan penatalaksanaan antenatal care terdapat Hubungan sedang dan berpola positjj; sedangkan antara kompcnsasi yang seimbang dan komunikasi dcngan pcnatalaksanaan antenatal care tcrdapat hubungan scdang dan berpola ncgatifl Hasil Analisis Regresi Linier Ganda, didapatkan 3 komponen QWI. yaitu 1). Komponen Rasa bangga terhadap institusi dan Keselamatan Linglcungan Kezja dengan nilai Slope (B) positif, artinya terdapat hubungan yang positif antara rasa bangga terhadap institusi dan keselamatan lingkungan kerja dengan upaya peningkatan pelayanan antenatal. 2). Komponen kompensasi yang seimbang dengan nilai Slope (B) negatif; artinya terdapat hubungan yang negatif antam kompensasi yang seimbang dengan penalalaksanaan antenatal care oleh Bidan Puskesmas di Kota Tasikmalaya tahun 2007. Kesimpulan Penelitian adalah dari 9 komponen QWZ terdapat 3 komponen QWL (Kompénsasi yang seimbang, Rasa bangga terhadap institusi dan Keselamatan Lingkungan Kerja) yang berhubungan signiiikan terhadap upaya peningkatan pelayanan _ayuenarat oleh Bidan Puskesmas di Kota Tasikmalaya, dan komponen yang paling besar pengamhnya terhadap upaya peningkatan pelayanan antenatal adalah koxnpensasi yang seimbang. Saran yang dapat diberikan terutama bagi pihak Manajemen Puskwmas/Dinas Kesehat/an Kota Tasikmaiaya adalah agar melaksanakan peningkatan Kualitas Kehidupan -Qgja Bidan di Unit KIA melalui pemfferian pcrhatian, domngan dan scmangat kerja kepma para Bidan untuk bekexja lebih giat Iagi dan melengkapi baik sarana dan prasarana pendukung pelayanan, terciptanya siszem kompensasi befdasarkan leebenamn, kewajaran dan rasa keadilan, system reward and punishment ynxg baik dan terlakkan-anya pembinaan, pengawasan dan evaluasi kerja progmm yang berkesinambnmgan.

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The research done is about behaviour problem in organization and the effort of using Health of Human Resource. The problem is if there are some relations among Quality of Work Life (QWL) consisted of officials, balancing conpensation, feeling safe of the job, working environvent safety, feeling proud of institution, available facilities, problem solving and communication to increase antenatal service by Public Health Center Midwife in the city of Tasikmalaya in 2007.

The aim of the research is to get the description and information about the quality of midwifes working life in KIA Unit and the relation with the implementation of Antenatal Care in the city of Tasikmalaya in 2007.

The methodology of this research used is Cross Sectional Descriptive Analysis by using quantitative and qualitative method. The object of the research is all of the Midwife in Public Health Center in the city of Tasikmalaya in 2007, where 53 Midwife in Tasikrnalaya become a sample. Primer data found by using structured questionnaire instrument is one dependent variable and nine independent variable, interview and devining manual study. Statistic test is to know the relation between QWL component and the implementation of ANC of Midwife in Public Health Center used Correlation analysis and Double Linear Regression.

The result of Bivariat Analysis by using statistic test Pearson Correlation, founded 3 QWL component which has the significant relation with the implementation antenatal care (p Value 5 0,05}, is the proud feeling of institution (r = 0,405), balancing compensation (r = -0,392) and communication (r = -0,267). This case can be interpreted that there are sufficient and positive pattern relation between the proud feeling to the institution and the implementation of antennal care, besides that there are sufficient and negative pattem relation between balancing compensation with communication and the implementation of antenatal care.

The result of Double Linear Regression Bivariat Analysis has been found 3 QWL component, as follows: 1). Proud feeling component to the institution and Working Environment Safety with the value of positive Slope (B), it means there are the relations between the proud feeling to the institution and working environment safety in order to increase antenatal service. 2). The balanced component with the value of negative Slope (B). lt means that there are negative relation between balanced compensation and the implementation of antenatal care by Midwife at Public Health Center in the city of Tasikmalaya in 2007.

The conclusion of this research is, there are 3 QWL components (balanced compensation, proud feeling of institution and working environment safety) from 9 QWL components which have significant relation to the effort of increasing antenatal service by Midwife at Public Health Center in the city of Tasikmalaya, and the component which has biggest influence to the effort of increasing antenatal service is balanced compensation.

The suggestion to the Public Health Center I Health Institution Management in the city of 'l`asik.malaya is the implementation of increasing Midwifes working life quality in KIA Uni! by giving more attention, motivation, working spirit to Midwife to work hard and also by completing structure and inhastructure, creating realistic fair proper compensation system, using good reward and punishment system and doing continual program of counselling, controlling and working evaluation."

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Fasilitas pelayanan kesehatan merupakan tempat persalinan ideal untuk mendapatkan kesehatan optimal bagi ibu maupun bayi. Hampir seluruh ibu di Indonesia telah memiliki akses ke pelayanan kesehatan namun 20% persalinan tidak dilakukan di fasilitas pelayanan kesehatan (Balitbangkes, 2019). Studi ini membahas tentang pengaruh performa dan jenis pelayanan kesehatan ibu terhadap perilaku pemilihan tempat bersalin berdasarkan data SIRKESNAS 2016 dengan analisa regresi logistik. Beberapa temuan diantaranya adalah antenatal care (ANC), program perencanaan persalinan dan asuransi kesehatan memiliki pengaruh signifikan dalam pilihan tempat bersalin. Lebih dalam lagi, pelayanan ANC yang memiliki pengaruh signifikan pada pemilihan fasilitas pelayanan kesehatan sebagai tempat bersalin adalah tenaga kesehatan yang melakukan pemeriksaan ANC, pemeriksaan tekanan darah dan ultrasonografi (USG) maternal. Edukasi kesehatan maternal selama ANC juga memiliki pengaruh pada pemilihan tempat bersalin namun tidak signifikan. Oleh karena itu, peningkatan kualitas pelayanan ANC terutama penyediaan tenaga kesehatan yang tepat dan pelayanan pemeriksaan maternal terutama pemeriksaan tekanan darah dan USG serta pelaksanaan program perencanaan persalinan dan peningkatan cakupan asuransi kesehatan hendaknya menjadi konsen utama dalam kebijakan program kesehatan maternal terutama untuk mendorong persalinan di fasilitas kesehatan.

 

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Health facility is an ideal place for child birth to obtain optimum outcomes for maternal and neonatal health. Most of mothers in Indonesia have access to healthcare but 20% of them do not give birth in a healthcare facility (Balitbangkes, 2019). This study discusses the influence of the maternal health services on choosing a healthcare facility for birth. This research utilized the SIRKESNAS 2016 data and analyzed it using logistic regression. Some findings shown that antenatal care (ANC), birth planning, and health insurance have a significant influence on the decision of a healthcare-facility birth, and the service of ANC particularly the health professional provider and maternal examination such as in the form of blood pressure test and ultrasonography (USG) substantially affect the decision regarding the place of birth. Although maternal education during ANC also influences it, but it statistically has weak significance. Thus, to encourage mother to deliver in a healthcare facility, improving the quality of ANC services including the availability health professional as an ANCs provider, providing blood pressure tests and USG maternal examination, and expanding the coverage of delivery insurance are the prominent concerns for healthcare policy

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