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"Latar belakang: Kematian ibu masih menjadi permasalahan besar di Indonesia, dimana perdarahan, infeksi, dan preeklampsia/eklampsia sebagai penyebab tersering. Sistem rujukan yang baik merupakan salah satu pendukung dalam penatalaksanaan kasus-kasus obstetri sehingga kasus komplikasi dapat terhindar. Saat ini sudah terdapat BPJS, dimana rujukan dilakukan secara berjenjang. Bidan yang berpraktik mandiri tidak termasuk dalam sistem BPJS, hanya menjadi jejaring BPJS bila tidak terdapat fasilitas persalinan pada pelayanan primer. Namun masih belum dijabarkan secara jelas kedudukan bidan pada sistem rujukan untuk kasus gawat darurat. Sehingga masih banyak yang merujuk langsung kasus obstetri dan kasus yang bermanifestasi menjadi komplikatif ke pelayanan tersier, yaitu RSCM. Karakteristik bidan ternyata dapat memberikan pengaruh terhadap keputusan seorang bidan dalam merujuk. Penelitian ini mengumpulkan informasi mengenai alasan rujuk melalui gambaran karakteristik bidan yang merujuk langsung kasus-kasus komplikatif ke RSCM. Tujuan: Mengetahui karakteristik bidan yang berpraktik di praktik mandiri bidan serta hubungannya dengan kasus komplikatif yang dirujuk langsung ke RSCM. Metode: Penelitian ini menggunakan desain deskriptif analitik kasus kontrol pada bidan yang berpraktik mandiri yang merujuk langsung kasus-kasus obstetri dan/atau kasus komplikatif pada bulan Januari 2016 hingga Juli 2017. Dilakukan pencatatan data bidan yang berpraktik mandiri, kasus obstetri, dan kasus yang bermanifestasi menjadi kasus komplikasi yang memenuhi kriteria inklusi. Kemudian dilakukan analisis terhadap enam karakteristik bidan yang merujuk, yaitu: usia, pendidikan, pelatihan yang pernah diikuti selama masa praktik, lama waktu berpraktik, jumlah pasien yang pernah ditangani selama masa kerja, serta jarak dan waktu tempuh proses merujuk.Hasil: Didapati 82 bidan yang berpraktik mandiri yang merujuk 29 kasus preeklampsia (35.3%), 40 kasus ketuban pecah dini (48.8%), dan 13 kasus perdarahan (15.9%). 28 kasus bermanifestasi menjadi kasus komplikatif (34.1%). Keseluruhan bidan merujuk karena fasilitas yang tidak memadai. Terdapat hubungan yang bermakna secara statistik antara lama waktu praktik dengan jumlah kasus komplikatif yang dirujuk langsung ke RSCM dengan p=0.001 (OR 7.036 CI95% 2.543-19.472). Terdapat pula hubungan yang bermakna antara jumlah pasien dengan perujukan langsung kasus komplikatif ke RSCM dengan p=0.001 (OR 6.032 CI95% 2.220-16.391). Tidak ada hubungan yang bermakna secara statistik antara usia, pendidikan, pelatihan yang sudah pernah diikuti selama masa praktik, serta jarak dan waktu tempuh fasilitas pelayanan kesehatan perujuk, dengan kasus-kasus komplikatif yang dirujuk langsung ke RSCM.Kesimpulan: Keseluruhan bidan merujuk langsung kasus obstetri karena fasilitas yang tidak memadai dan mereka merujuk langsung ke RSCM agar pasien dapat langsung ditangani. Karakteristik bidan yang mempengaruhi bidan yang berpraktik mandiri dalam mengirim langsung kasus-kasus komplikatif yaitu lama waktu praktik dan jumlah pasien yang pernah ditangani selama masa kerjanya. Sehingga perlu dilakukan evaluasi ulang mengenai kedudukan bidan yang berpraktik mandiri di sistem BPJS. Selain itu diperlukan program penyegaran untuk praktik mandiri bidan setiap tahun dan pemantauan serta evaluasi yang dilakukan oleh instansi terkait. Diperlukan pula penelitian lanjutan dengan jumlah sampel yang lebih banyak, dimana penelitian ini menggabungkan karakteristik bidan serta karakteristik pasien pada kasus-kasus rujukan. Namun faktor perancu dan faktor eksternal yang dapat mempengaruhi proses analisis perlu diidentifikasi terlebih dahulu, agar dapat dilakukan analisis yang menyeluruh.

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Background: Maternal mortality is still a major problem in Indonesia, where bleeding, infection, and preeclampsia/eclampsia are the commonest causes. A good referral system is one of the supporters in the management of obstetric cases so the complications can be avoided. Currently there is BPJS, where referrals start from primary to tertiary care. Self-employed midwives are not included in the BPJS system, only as a BPJS network if there is no delivery facility in primary care. It is still not clearly defined the position of midwife at the referral system for emergency cases. So there are still many self-employed midwives that directly refer the obstetric cases and cases that manifest into complication to tertiary care, which is RSCM. Characteristics of the midwife turned out to have an effect on the decision of a midwife in referring. This research collects information about the reasons for referring a case through a description of the characteristics of midwives who directly refer the complicated cases to RSCM. Objective: To identify characteristics of self-employed midwives and its relation to complicative cases referred directly to RSCM. Method: This study used descriptive design with analytic case control on self-employed midwife who referred directly the obstetric cases and/or cases that have manifested into further complication in January 2016 until July 2017. Data of self-employed midwife, obstetric cases, and cases manifested into complications that meet inclusion criteria, were recorded. Then characteristic of referral midwife namely: age, education, training that had been performed during their practice, duration of practice, number of patients that had been handled during the work period, as well as distance and travel time of referring process, were analyzed.Results: There were 82 self-employed midwives referring 29 cases of preeclampsia (35.3%), 40 cases of premature rupture of membranes (48.8%), and 13 cases of bleeding (15.9%). 28 cases were manifest into complicated cases (34.1%). The entire midwife referred those cases due to inadequate facilities. There was statistically significant correlation between duration of practice and number of complicated cases referred directly to RSCM, with p=0.001 (OR 7.036 CI95% 2,543-19,472). There was also a significant correlation between the number of patients with direct referral of complicated cases to RSCM, where p=0.001 (OR 6,032 and CI95% 2,220-16,391). There were no statistically significant correlations between age, education, training that had been performed during practice, as well as the distance and travel time of referring process, with complicated cases that directly referred to RSCM.Conclusions: All self-employed midwives were referring the obstetric cases due to inadequate facilities and they referred directly to RSCM so that patients can be handled immediately. Characteristics that affect self-employed midwife to directly send complicative cases including duration of practice and number of patients that ever handled during their work period. So it is necessary to reevaluate the position of self-employed midwife in BPJS system. In addition, a refresher course is required for them every year and the need of monitoring and evaluation conducted by the relevant agencies. Further research is needed, with a larger number of samples, which combine the characteristics of midwives and the characteristics of patients in referral cases. However, confounding factors and external factors that may affect the analysis process need to be identified first, in order to be able to do a thorough analysis."

"The direction of health development and social welfare according to the Outline of State Guideline 1999-2004 is to improve the human resource quality and to develop conducive environtment using health pradigm approach , that give priorities in improving health status, prevention, treatment, recovery, and rehabilitation since the beginning of human conception until old age. Furthermore, the directions is also increase and maintain the quality of institution and health service through sustainable empowerment of human resource and facilities and health inlrastmcture, including the availability of medicines affordable by the people. It is also increase the quality of population through controlling of birth, reduce mortality rate, and to improve the quality of family planning program.This study is intended to obtain description regarding performance of Midwife in villages as a contracted manpower -that currently are working in Regency of Padang Pariaman during their contract-extended period. The research is intended to examine what factors related to their performance, and what factors is the most closely related to the perfonnance. It was conducted by using cross-sectional study design that study the relationship of dependent variable with related &Cl0l'$ Gndependent variable) by observing the status of independent variable and dependent variable simultaneously (cross sectionally). The population of this research is the whole midwives in villages as contracted workers that are in extended-contract status, which are 92 respondents.Processing and analysis of data was done using univariate, bivariate and multivariate methods. The univariate analysis is done with descriptive analysis to see the perfomiance and description of each individual variable. The bivariate analysis was using Chi-Square ies! to sec the relationship of independent variable with dependent variable, and multivariate analysis is done by using binary multiple logistic regression test to see the relationship of independent variable together with dependent variable.The results of bivariate analysis indicates that 9 of the independent variables analyzed, it tumed out that there are three variables that has signihcant relationship (p < 0,05) with the perfomiance _of midwives in villages as contracted workers during extension period, namely knowledge, level tenure, and work load. The result of the multivariate analysis indicates that 2 variables as predictor of performance namely tenure and marriage status.Recommendation to the midwives in villages as temporary workers for the extension worlc it is necessary to recommend the tenure and marriage status of the midwives should be carefully considered in the placement of the midwives."

"Kesehatan Ibu dan bayi perlu perhatian khusus dengan mendekatkan akses pelayanan berkualitas dan pemberdayaan masyarakat. Progran perencanaan persalinan dan pencegahan komplikasi (P4K) salah satu upaya menurunkan angka kematian ibu dan angka kematian bayi untuk mencapai kualitas hidup sehat. Tujuan penelitian untuk mengetahui faktor-faktor yang berhubungan dengan pelaksanaan P4K oleh Bidan di Kabupaten Donggala Provinsi Sulawesi tengah. Desain penelitian cross sectional populasi 186 bidan puskesmas sample size menggunakan estimasi proporsi diambil secara simple random sampling dengan sampel 67 bidan. Hasil analisis statistik bivariat diperoleh 62,5% lama kerja < 14 tahun berperilaku kurang terhadap pelaksanaan P4K nilai p- value 0,039 dan nilai OR 3,1, ada hubungan yang signifikan antara lama kerja dengan pelaksanaan P4K, lama kerja bidan ≥14 tahun berpeluang 3,1 kali untuk berperilaku baik terhadap pelaksanaan P4K di sarankan menyekolahkan Bidan dan lebih mengembangkan penelitian kualitatif mengenai faktor-faktor yang berhubungan dengan pelaksanaan P4K.

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Maternal In Infant need special attention with closer access to quality services and community empoverment. Program planning and prevention complications of childbirth (P4K) an effort to reduce maternal mortality and infant mortality rate to achieve a healthier quality of life. Research objectives were to determine the factors relaxed to implementation of the P4K by midwives in Donggala district area central Sulawesi Province. This research is quantitative research with cross sectional analitytic methode. With the total population 186 midwive only 67 sampel 67 of midwive as research respondents drawn using simpel random sampling technigue. Bivariat statistic analysis result that 62,5% working period < 14 year actiess to the implementation of P4K. P=value 0,039 and OR value 3,1 there is significant corelation between working period ≥ 14 year has 3,1 probability to act well to the implamentation of P4K it is suggested to educate the midwive formally and development qualitative researh, related to the factors influencing the midwive to inplemet the P4K."

"Skripsi ini bertujuan untuk mengetahui komponen kualitas kehidupan kerja/quality of work life dan hubungannya dengan kinerja bidan puskesmas dalam penatalaksanaan pertolongan persalinan di Kabupaten Bogor. Metode penelitian menggunakan desain kuantitatif dan pendekatan cross sectional pada 101 bidan puskesmas di Kabupaten Bogor. Digunakan analisis univariat dan bivariat dengan uji statistic chi-square. Hasil analisis bivariat didapat ada tiga komponen QWL yaitu : kompensasi yang seimbang, keselamatan lingkungan kerja dan pengembangan karir, masing-masing mempunyai hubungan yang signifikan dengan kinerja bidan.

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This skripsi aims to determine the components quality of work life (QWL) and its relationship with midwife performance at public health in the help childbirth in the city of Bogor. Use quantitatif research method and design of a cross sectional study in 101 midwife at public health in the city of Bogor. Use univariate analysis and bivariate analysis statistical chi-square test. Bivariate analysis results obtained there are three components of QWL are : fair compensation, working environment safety and career development, each having a meaningful relationship/significant with midwife performance."

"Tesis ini tentang faktor-faktor yang berhubungan dengan kompetensi bidan dalam tata laksana awal pre-eklampsia berat di Kabupaten Ciamis tahun 2013. Merupakan penelitian kuantitatif dengan desain potong lintang. Populasi dan sampel adalah seluruh bidan yang melayani persalinan di puskesmas di Kabupaten Ciamis, dengan cara proporsional random sampling didapat jumlah sampel minimal sebanyak 97 bidan.Hasil penelitian didapat 18,7% bidan yang kompeten dalam tata laksana awal pre-eklampsia berat, faktor-faktor yang berhubungan bermakna adalah umur, masa kerja, pelatihan, motivasi, dan supervisi. Motivasi merupakan faktor paling dominan, dengan nilai p 0,00 dan OR 13,7. Penyebab rendahnya kompetensi bidan karena tidak adanya buku pedoman, standar operasional yang baku, dan MgSO4.

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The factors contributed to midwife's competency in early management severe preeclampsia in Ciamis Regency in 2013 was presented in this thesis. The study was conducted by using quantitative method and data analysis was based on crosssectional data collected from proportional random sampling of 107 midwifes.

The results showed that 18.7% midwifes were competent in early management severe pre-eclampsia. Some factors related to midwifes competencies such as; age, working?s period, training, motivation, and supervision. It was found that motivation was the main factor in midwifes? competency with p 0.00 and OR 13.7. The results of the study also revealed that there was no standard manual book, standard operational, and MgSO4 which caused low competency among midwifes in helping patients with severe pre-eclampsia."

"Sebuah penelitian dilaksanakan di Kabupaten Aceh Tengah bertujuan untuk mengetahui bagaimana kinerja bidan khususnya dalam pertolongan persalinan dan faktor-faktor yang berhubungan dengan kinerja bidan tersebut.Metode penelitian yang digunakan adalah cross sectional. Sampel penelitian adalah bidan di desa yang bertugas di Kabupaten Aceh Tengah dan pengambilan sampel dilakukan dengan cara total populasi dengan jumlah sampel 146, yang terdiri dari bidan di desa dengan masa kerja < 5 tahun.Variabel-variabel yang diteliti meliputi variabel dependen yaitu kinerja bidan dalam pertolongan persalinan , sedangkan variabel independen adalah faktor internal yang terdiri atas lama tugas, pengalaman, sikap, status perkawinan dan faktor eksternal yang terdiri atas tempat tinggal, sosialisasi, penghargaan, umpan balik, JPS-BK, sarana.Hasil penelitian ini menunjukkan bahwa kinerja bidan dengan kategori baik sebesar 36, 2%, dan kinerja bidan dengan kategori kurang 63,8 %. Penelitian ini menyimpulkan bahwa faktor Jaring Pengaman Sosial Bidang Kesehatan (JPS-BK) dan pengalaman mempunyai hubungan yang bermakna tehadap kinerja bidan di desa.Penelitian ini menyarankan kepada pembuat kebijakan, agar terus mengupayakan rangsangan yang dapat meningkatkan kinerja bidan dengan pemberdayaan yang lebih effektif dalam rangka peningkatan pelayanan kesehatan masyarakat. Kepada Pelaksana program hendaknya berupaya meningkatkan pengalaman bidan dengan pelatihan, diskusi bahkan program magang atau kakak asuh. Selain itu mengingat pentingnya dana JPS-BK, perlu diusahakan agar dana itu tetap tersedia di masyarakat atau dicari penggantinya.

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Factors Associated With Midwife Performance at Rural For Delivery Aids at District of Central Aceh - September 1999A study was implemented at District of Central Aceh to asses the midwifes performance and find factors related to it.

The research method used is cross sectional one. The sample was the community midwife in charge at District of Central Aceh. All midwifes who worked for period less than five years, were used as samples, the number was 146.

The dependent variable was the midwifes performance in deliver us services, whereas the independent variables were internal factors comprised of job period, experience, attitude, marital status and external factors consisted of socialization, award, feedback, and JPS-BK facilities and residing.

This research found that 36,2% of midwifes had a good performance and 63,8% had a fair performance. It was found that social safety net in Health and experience were significantly correlated with then midwifes performance.

This research suggest to policy maker to consistency seek out stimulation that may increase midwifes performance by empowering in more effective framework to increase midwifes experience the program executives should give the midwifes use experience through training, discussion and learning by doing. It is advised to keep Social Safety Net in health find or its replacement."

"Di Indonesia profesi bidan masih sangat memegang peran penting.Keberadaannya menjangkau hingga pedesaan ysang terpencil Seringkali karena faktor kedekatan emosi,dan tarif yang lebih murah,bidan lebih dipilih ketimbang dokter kandungan...."

"ABSTRAKNama : NoralisaProgram Studi : Ilmu Kesehatan MasyarakatJudul : Keselarasan Peran Bidan dan Dukun dalam Pandangan Suku AnakDalam SAD pada Masa Kehamilan, Persalinan, dan Nifas diKabupaten Tebo Provinsi Jambi Tahun 2018Angka kematian ibu dikalangan Suku Anak Dalam SAD sangat tinggi. Setiap tahun sejakTahun 2012 sampai Tahun 2017 terjadi satu kematian ibu. Penyebab utama adalah perdarahan daninfeksi, penyebab tidak langsung adalah faktor budaya dimana persalinan ditolong oleh dukun beranakdan tempat persalinan di pondok. Tujuan penelitian adalah untuk memotret keselarasan peran bidan dandukun dalam pandangan SAD pada masa kehamilan, persalinan, dan nifas. Metode penelitian kualitatifdengan pendekatan etnografi. Hasil penelitian diperoleh bahwa terdapat tiga aktifitas SAD pada masakehamilan, persalinan, dan nifas yaitu cara perawatan diri dan cara mencegah terjadi bahaya kehamilan,persalinan, dan nifas, pemilihan tenaga penolong, serta upacara ritual, hal dominan yang mempengaruhiaktifitas selama kehamilan ,persalinan, dan nifas adalah pengalaman yang lalu, perasaan Saat Ini, anjurandan Pantangan , pusat kekuatan pengambilan Keputusan. SAD menyatakan bahwa bidan hanya memilikiperhatian yang positif dalam memberikan pelayanan kesehatan, sedangkan dukun mampu memberikantiga unsur inti pertolongan. Bidan menyatakan Sulit berkomunikasi dan jarang melakukan interaksidengan SAD, sedangkan dukun mampu berkomunikasi dan berinteraksi baik dengan SAD. Dukunmenyatakan SAD memiliki kepatuhan terhadap tradisi dalam pemilihan penolong, sedangkan bidanmenjaga jarak dengan SAD. Menurut temenggung SAD akan memilih bidan sebagai penolong, apabiladukun tidak mampu lagi memberikan pertolongan.Kata kunci: peran bidan;peran dukun;Suku Anak Dalam SAD ;kehamilan;persalinan;nifas

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ABSTRACTName NoralisaStudy Program Public Health SciensesTitle Alignment of the Midwife and Traditional Birth Attendent TBA inview Suku Anak Dalam SAD in Pregnancy, Delivery, and Postpartumat Tebo, Jambi 2018Maternal mortality rate among Suku Anak Dalam SAD is very high. Every year from 2012to 2017 there is one maternal death. The main cause is bleeding and infection, indirect cause is a culturalfactor where labor is helped by traditional birth attendants TBA and place of birth in the lodge. Theobjective of the study was to photograph the harmony of the role of midwives and TBA in the view ofSAD during pregnancy, maternity, and childbirth. Qualitative research method with ethnographyapproach. The results showed that there were three SAD activities during pregnancy, maternity, andchildbirth, namely self care and how to prevent the occurrence of danger of pregnancy, maternity, andchildbirth, the selection of rescue workers, as well as ritual ceremonies, dominant things that affectactivities during pregnancy, maternity, and childbirth are past experiences, current feelings, suggestionsand abstinences, centers of decision making power. SAD states that midwives have only positiveattention in providing health services, whereas TBA are able to provide three core elements of relief.Midwives say Difficult to communicate and rarely interact with SAD, while TBA are able tocommunicate and interact well with SAD. TBA claim SAD has adherence to tradition in helper election,while midwife keeps distance with SAD. According to the Chief of SAD the midwife will choose as ahelper, if the TBA is unable to provide help.Keywords midwife 39 s role TBA 39 s role Suku Anak Dalam SAD pregnancy maternity childbirth"

"ABSTRAKRingkasan penelitian ini membahas tentang kelalaian bidan dan asisten apoteker yang menyebabkan kematian berdasarkan analisis putusan No. 963 K/PID.SUS/2013 Tipe penelitian ini adalah deskriptif, karena penelitian ini menjelaskan permasalahan didasarkan pada teori atau ditinjau kaitannya antara teori dan praktek. Metode penelitian yang digunakan adalah yuridis normatif, yaitu dengan mengacu pada norma hukum yang terdapat pada peraturan Perundang-Undangan dan putusan pengadilan serta norma-norma yang berlaku dan mengikat masyarakat. Penelitian ini menjabarkan tanggung jawab dan kewenangan bidan dan asisten apoteker dalam menjalankan praktek dan dalam pemberian obat serta menganalisis putusan No. 963 K/PID.SUS/2013 Tanggung jawab dan kewenangan bidan dan asisten apoteker baik dalam menjalankan praktek dan dalam pemberian obat telah diatur dengan sangat baik dan merupakan bentuk jaminan keselamatan bagi pasien serta merupakan jaminan keamanan bagi tenaga kesehatan. Baiknya regulasi tersebut juga merupakan bentuk preventif terhadap timbulnya malpraktek atau kelalaian tenaga kesehatan dalam menjalankan tanggung jawab profesinya. Hasil penelitian ini adalah bahwa putusan pengadilan sudah tepat dan sesuai dengan aturan yang berlaku.

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ABSTRACTThis summary will discuss about midwife and assistant pharmacist inadvertency on drug administration that had caused death based on health law Decision Number 536 PID.B.2010.PN.PDG. The type of this research is descriptive, meaning that the research will describe problems based on theory or by seeing the connection between the theory and the actual reality. The method used in this research is juridical normative, which means that the research is conducted according to the legal norm that is available in the legislation and court decision, also society rsquo s norms. This research explains midwife and pharmacist assistant rsquo s responsibilities and authorities on doing their duty and on drug administration, also gives a good analysis about court decision No. 963 K PID.SUS 2013 Both midwife and pharmacist assistant rsquo s responsibilities and authorities have been regulated so well so they become both form of safety assurance for patients, and form of security assurance for health workers. The good regulation also prevents malpractices on happening when health workers are doing their responsibilities. The result is that the court ruling is proper and is made based the rules applied."

"Salah satu upaya menunmkan angka kesakitan dan kematian ibu adalah melalui pemberian pelayanan yang berkualilas. Pelayanan yang berkualitm dapai di wujudkan dengan adanya tenaga kesehatan yang kompeten, termasuk bidan di desa. Desain Penelitian dengan cross sectional untuk mengelahui kompetensi dan kinexja bidan di desa dalam melaksanakan pelayanan asuhan parsalinan nommal di Kabupaten Bengkayang lahun 2008. Populasi adalah bidan di desa yang bertugas di polindes. Sampel pmelitian ini adalah semua bidan di desa yang bexjumlah 53 orang yang sudah meudapatkan pelatihan asuhan persalinan normal (APN). Hasil penelitian menunjukkan sebagian besar (83,2%) bidan di desa kurang kompeten mc-laksanakan suhan persalinan normal (APN). Kompetensi merupakan faktor yang bermalcna terhadap kinexja bidan di desa dalam melaksanakan asuhan persalinan nomml berdmarkan indikator cakupan persalinan dengan Oddss Ratio 31 (95% CI: 3,4 - 28l,9) dan berdasarkan persentase kasus yang di mjuk pada alpha 5% terdapat perbedaan yang signiiikan antara rata-rata persentase kasus komplikasi persalinan yang di rujuk oleh bidan di desa dengan kompetensi. Bidan yang kurang kompelen merujuk rata-rata 13 % kasus komplikwi persalinan, sedangkan bidan yang kompeten merujuk rata-rata 4 % kmus komplikasi persalinam Vayiabel lain yang bennakna dengan lcineaja adalah pengalaman kelja bidan di desa dengan Oddss Ratio 6,7 (95% CI: 1,3 - 3317). Variabel pendidikan, umur, peralatan dan bahan menunjukkan hubungan yang tidak bemiakna. Oleh karena itu kompelensi bidan di dwa perlu ditingkatlcan bukan hanya dengan pelatihan saja tetapi perlu ditindak lanjuti dengan supervisi yang teerprogram dan uji sertifikasi kompefersi oleh suatu badan yang terakreditasi.

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One of effort for decrease of morbidity and maternal mortality be giving a quality health care.That is necessary human resources of health which having competency, included midwife in the village This research to be done with cross- sectional design for knowing competency of midwife in the village on going nomially birth attendant care at Bengkayang District 2008. Population research are midwives in tlievillage which on duty at the village centre attendant Samples research are all of the midwives intthe village, there are 53 persons which got training normally birth attendant care.

The result showed most of midwifes (83,2%) have not enough competent on going normally birth attendant care. Competency is afsigniticant factor to midwife performent on going normally birth attendant indicated birth attendant target with Odds Ratio '31 (95% CI:3,4 - 28I,9) and presentation of cases refered on alpha 5 %, there is a differentiation signilicantly between mean procentace cased refered with competency. The village's midwives which not enough competent refered mean 13% cases birth attendant complication, the midwives in the village which competent refered 4 % cases birth attendant complication. Significant variable with perrofmmtee is experienee job, odds nano 6,1 (95% cr; 1,3 _ sag). Another variables are educatiorg age and equipment showed not significant. That is why competency of the midwivx in the village necessary to be increased not only with training but also a programmly supervising and competency sertilication test from accreditation organization."