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"Program Kesehatan Ibu dan Anak (KIA) dan gizi merupakan bagian dari upaya kesehatan wajib puskesmas. Salah satu keterpaduan program KIA dan gizi adalah pelayanan Ante Natal Care (ANC), dimana pemberian tablet Fe kepada ibu hamil minimal 90 tablet selama kehamilan termasuk di dalam pelayanan ANC tersebut. Pada tahun 2010-2011 terlihat adanya kesenjangan cakupan K1 dan K4 dengan cakupan Fe1 dan Fe3 di Puskesmas Perawatan Pagatan. Tujuan dari penelitian ini untuk mengetahui gambaran keterpaduan program KIA dan gizi dalam pelaksanaan distribusi tablet Fe pada ibu hamil di Puskesmas Perawatan Pagatan Kabupaten Tanah Bumbu tahun 2012. Penelitian ini merupakan penelitian kualitatif dengan tehnik wawancara mendalam menggunakan data primer dan sekunder. Informan penelitian sebanyak 6 orang yaitu kepala puskesmas, tenaga pelaksana gizi, bidan koordinator, dan 3 orang bidan di desa. Hasil penelitian menunjukkan bahwa keterpaduan program KIA dan gizi belum berjalan optimal sehingga perlu lebih meningkatkan penyelenggaraan kegiatan puskesmas dengan azas keterpaduan untuk mengatasi keterbatasan sumber daya dan di perolehnya hasil yang optimal.

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Nutrient and Child and Maternal Health (MCH) is an part of effort of compulsory health of Public Health Center. One of integrated program of MCH and nutrient is Antenatal Care (ANC), by giving Fe tablet to expectant minimum 90 tablets during gestation is one of ANC service. In 2010-2011 there was a gap in scope of K1 and K4 related to Fe1 and Fe3 in Public Health Center Treatment Pagatan. Purpose of this study is to find out description of integrated program of KIA and nutrient in implementing of distribution of Fe tablet to expectant in Public Health Center Treatment Pagatan Tanah Bambu Regency 2012.

This study is qualitative study by in-depth interview technic using primary and secondary data. Informant is 6 people including Head of Public Health Center, nutrient staff, coordinator section, and 3 midwifes in village. Study result shows that integrated program of KIA and nutrient had not worked optimally yet so it needs to develop Public Health Center activity by integrated basis to overcome limitation of resources and to reach optimal result. "

"Persalinan oleh tenaga kesehatan merupakan faktor penting dalam upaya menurunkan angka kematian ibu. Persalinan oleh tenaga kesehatan di wilayah kerja puskesmas Cibungbulang sebesar 76,8% masih di bawah target Kabupaten Bogor yaitu 87,5%. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan pemilihan penolong persalinan di wilayah kerja Puskesmas Cibungbulang Kabupaten Bogor Jawa Barat tahun 2012. Penelitian ini adalah penelitian deskriptif dengan desain penelitian yang digunakan adalah cross sectional. Variabel yang diteliti sebagai variabel dependen yaitu penolong persalinan sedangkan variabel independen adalah umur, paritas, pendidikan ibu, pengetahuan, sikap ibu, pemeriksaan kehamilan, keikutsertaan kelas ibu hamil, biaya, jarak/akses ke fasilitas pelayanan kesehatan, dukungan suami. Data pada penelitian ini menggunakan data primer dan data sekunder. Pengambilan sampel dengan cara simple random sampling yaitu berdasarkan daftar nama ibu bersalin dari register kohort ibu. Pengumpulan data dengan cara menggunakan kuesioner yang diberikan pada ibu yang bersalin pada bulan Januari sampai Desember 2011 yang terpilih sebagai sampel. Analisis data menggunakan uji univariat dan bivariat dengan uji chi square. Hasil penelitian menunjukkan bahwa 71% persalinan ditolong oleh tenaga kesehatan dan 29% ditolong oleh bukan tenaga kesehatan. Hasil analisis data bivariat menunjukkan variabel yang secara statistik berhubungan dengan pemilihan penolong persalinan adalah pengetahuan, sikap ibu, keikutsertaan kelas ibu hamil dan dukungan suami.

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Deliveries by health personnel is an important factor in efforts to reduce maternal mortality. Deliveries by health personnel in the work area by 76.8% Cibungbulang health centers are still below the target of 87.5% Bogor regency.

The purpose of this study was to determine the factors associated with the selection of delivery helper in the work area Cibungbulang Health Center Bogor West Java in 2012. The study was a descriptive study with a design study is a cross sectional. Variables examined as the dependent variable is the labor helpers while independent variables are age, parity, maternal education, knowledge, mother's attitude, prenatal care, maternal-class participation, cost, distance/access to health care facilities and husband support. The data in this study using primary data and secondary data.

Sampling by simple random sampling is based on a list of names from register cohort maternal mother. Data collection by using a questionnaire given to mothers who birth in January to December 2011 was selected as the sample. Analysis of data using univariate and bivariate test with chi square test.

The results showed that 71% of births attended by skilled health and 29% are not helped by medical personnel. The results of the bivariate data analysis showed a statistically significant variables associated with the selection of auxiliary labor is knowledge, mother's attitude, maternal-class participation and husband support."

"Penelitian ini dilakukan untuk mengetahui gambaran dan faktor-faktor yang berhubungan dengan kinerja bidan di desa dalam pelaksanaan program Jaminan Persalinan di Kabupaten Lampung Barat Tahun 2012. Penelitian ini merupakan studi kuantitatif dengan desain cross sectional. Obyek penelitian adalah bidan di desa yang ada di Kabupaten Lampung Barat dengan jumlah sampel 137 (Total Sampling). Hasil penelitian menunjukkan bahwa sebagian besar (70.8%) bidan di desa di Kabupaten Lampung Barat yang mempunyai kinerja kurang dalam pelaksanaan program Jampersal. Dari hasil analisis bivariat menunjukkan bahwa hasil yang berhubungan secara signifikan dengan kinerja bidan di desa dalam pelaksanaan program Jaminan Persalinan adalah variabel individu (pengetahuan dan pelatihan), variabel organisasi (supervisi dan kepemimpinan) dan variabel psikologi (sikap dan motivasi), jadi disarankan kepada Dinas Kesehatan dan Puskesmas agar lebih mengintensifkan proses supervisi yang sudah ada terhadap bidan di desa.

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This research was carried out to know about description and factors related to midwife village performance in Labour Assurance program implementation in West Lampung regency 2012. This research is a quantitative study with cross sectional design. The objects of this research are midwives village occupied in West Lampung Regency with 137 total samples. Research result shows that most of midwives village in West Lampung Regency have less performance in labour assurance program implementation.

From the result of bivariate analysis, shows that the result related significantly to midwives performance in village labour assurance program implementation is individual variable (knowledge and training), organization variable (supervision and leadership) and psychology variable (attitude and motivation). Therefore , it is suggested to Health Department and Public Health Center in order to more intensify existed supervision process to midwives in villages."

"ABSTRAKKeterlambatan pengambilan keputusan saat persalinan dengan komplikasiobstetri berdampak kematian ibu dan neonatal. Penelitian memahami pengambilankeputusan rujukan. Informan utama ibu dengan komplikasi obstetri saatpersalinan. Studi kasus kualitatif, purposive samplingHasil penelitian, keputusan diambil secara terpaksa. Ibu menerima rujukanhampir seluruhnya belum memahami masalah, alternatif paraji dan orang pintar.Ibu menolak rujukan belum memahami masalah, alternatif dan penanganan paraji.Persepsi kualitas pelayanan kesehatan sulit dijangkau. Proses rujukan terdapatkendala biaya, kemandirian keluarga kurang, dukungan sosial tidak tepat dandukungan bidan belum maksimal serta persepsi penanganan komplikasi obstetricukup baik.Saran : peningkatan kinerja tim, komunikasi efektif, kualitas ANC, amanatpersalinan, kemitraan paraji?bidan. Koordinasi pemetaan ibu hamil risiko tinggi,pengembangan pelayanan rujukan.

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AbstractDelay in decision making during delivery with obstetric complication may causematernal and neonatal death. The purpose of this study to understand decisionmaking about referrals. The main informants were mothers who had obstetriccomplication during delivery. The study is a qualitative case study with purposivesampling.The result of study showed that decisions were made by force. Almost womenwho had accepted referrals did not understand the problem, alternatives bytraditional birth attendant and traditional Healing. All women who had refusedreferral have not understood the problem yet, the alternative selecting withtraditional births attended (paraji) and management with traditional birthsattended (paraji). in referal process are found that perception about health servicequality was hard to reach, money, lack of family autonomy, incorrect socialsupport and lack of midwife support but also perception about obstetriccomplication are good enough.Recommendation For Health Office the District Cianjur, Mother and BabyFriendly of Hospital Cianjur are should : Increase team work, make effectivecommunication, ensure antenatal care quality, Do plan of delivery andparthnership traditional birth attendant-midfery, Make Coordination and mappingof high risk pregnant mothers, development of referral health service."

"Penerapan Pengembangan Manajemen Kinerja (PMK) bidan di puskesmas ini diharapkan dapat meningkatkan pengetahuan dan keterampilan bidan; kepatuhan penggunaan standar dalam melakukan pelayanan kebidanan; kemampuan manajerial pelayanan kebidanan; pelaksanaan monitoring kinerja; mutu asuhan kebidanan. Penerapan PMK ini diharapkan dapat berperan untuk tercapainya indikator Sistem Pelayanan Minimal (SPM) Kabupaten/Kota yang dilaksanakan bidan di sarana kesehatan, mengingat bidan sebagai ujung tombak pelayanan kesehatan dengan jumlah yang cukup besar (40%) dari seluruh kategori tenaga kesehatan.Dalam penerapan Pengembangan Manajemen Kinerja bidan di rumah sakit dan puskesmas diawali dengan pelatihan. Pelatihan ini ditujukan pada bidan koordinator, dengan harapan bidan koordinator dapat memberikan kiat-kiat dalam memberikan pengarahan, bimbingan, dan sekaligus menilai kinerja staf secara obyektif. Scsuai dengan Kepmenkes no. 8361Menkes/SKIVI12005, pada pelatihan tersebut ditekankan pada penguasaan lima komponen PMK yaitu standar, uraian tugas, indikator kinerja, sistem monitoring, dan Refleksi Diskusi Kasus.Penelitian ini dilakukan untuk melihat gambaran sejauh mana penerapan PMK bidan di Puskesmas dengan pendekatan sistem. Penelitian ini menggunakaii pendekatan kuantitatif dengan bidan yang telah mendapat pelatihan PMK dan telah menerapkan PMK bidan di puskesmas tempat bekerja yang berjumlah 33 orang dari lima puskesmas. Juga dilakukan pendekatan kualitatif melalui wawancara mendalam pada lima pimpinan dan bidan koordinator puskesmas yaitu di puskesmas Curup, Kampung Delima, Perumnas, Tunas Harapan, dan Sambirejo serta dilakukan telaah dokumen terhadap penerapan PMK bidan di puskesmas.Hasil penelitian antara lain: (1) Faktor masukan penerapan PMK bidan berupa uraian tugas, Standard Operational Procedure (SOP), pendidikan dan latihan, semua bidan puskesmas (100%) telah ada dan dilaksanakan dcngan baik, hanya variabel penerapan sistem penghargaan ada yang masih buruk di puskesmas (48.5%). (2) Faktor proses penerapan PMK bidan di Puskesmas berupa kegiatan pendokumentasian kegiatan dimana semua bidan (100%) telah melaksanakan dengan baik dan sesuai dengan telaah dokumen, sedangkan pemantauan dan pengendalian kegiatan umumnya sudah baik (66.7%), dan masih ada yang buruk (33.3%), pertemuan strategis umumnya juga sudah baik (72.7%) dan yang masih buruk (27.3%), kegiatan Refleksi Diskusi Kasus (RDK) umumnya sudah baik (63.6%) dan masih buruk (36.4%). (3) Faktor luaran penerapan PMK bidan di Puskesmas yaitu manajemen kinerja bidan umumnya sudah baik di puskesmas (57.6%), yang masih buruk (42.4%).Kesimpulan akhir dari penelitian ini adalah bahwa penerapan Pengembangan Manajemen Kinerja bidan di puskesmas umumnya sudah baik, hanya beberapa variabel saja penerapannya yang masih buruk dan perlu ditingkatkan lagi. O1eh karena itu, peneliti mencoba memberikan rekomendasi kepada: (1) Pemerintah Daerah untuk memberikan dukungan pelaksanaan setiap komponen program PMK bidan, menyetujui usulan program Dinas Kesehatan untuk melaksanakan pelatihan PMK kepada bidan yang belum mendapat pelatihan. (2) Kepala Dinas Kesehatan supaya melakukan tindak lanjut dari penerapan program PMK, seperti melakukan monitoring PMK setiap 3 bulan sekali, memberikan pelatihan penerapan PMK kepada bidan yang belum dilatih, dan diharapkan semua puskesmas di kabupaten Rejang Lebong dapat menerapkan PMK (3) Kepada Pimpinan Puskesmas supaya menyusun indikator kinerja bidan untuk keperluan monitoring dan penilaian kinerja, menilai kinerja bidan puskesmas minimal 1 tahun sekali dan memberikan penghargaan sebagai umpan balik.

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The Application Of Management Performance Development o: Midwife in health center is expected improve the midwife's knowledge and skill; compliance of usage in midwifery service standard; ability of midwifery service managerial; execution of performance monitoring; midwifery care quality, while expectation of Development Of Management Performance contribute to reach a Minimum Service System indicator in the District City which is executed and midwife in health place, considering midwife as part of health service with high amount (40%) from all of health worker category.

The Application Of Management Performance Development in hospitals and health centers started with training. This Training is addressed for the coordinator midwife in health center, while the expectation of the coordinator midwife is to give suggestions in guidance, teaching, tuition, and at the same time to assess stair performance objectively. According to Kepmenkes No. 836 / Menkes / SK / VI / 2005, this training emphasized five components: standard, job description, performance indicator, monitoring system, and reflection cased discussion (RCD).

This research is done to give an assessment and to describe how far the application of Development Of Management Performance of midwife in Health Center is done. This research applying the quantitative method to midwife as respondents who work in a health center which have applied the Development Of Management Performance, they are 33 midwife from five health centers. This research is also done by a qualitative method through interview for five leaders of health center and midwife coordinator, such as Curup Health Center. Kampung Delima, Perumnas, Tunas Harapan, and Sambirejo and also analyze document for applying Development 0C Management Performance midwife in health center.

Research results include: (I) Input factor for applying Development Of Management Performance midwife, such as job description, SOP, and training and fellowship for all of Health Center midwives (100%) arc done well available with duty in Health Center, but applying of appreciation system variable is not good (48.5%). (2) Process factor for applying Development of Management Performance Midwife in Health Center such as activity of documentation where all midwives (100%) have done this matter based on document study by

Researcher, while monitoring activity generally is good (66.7%), the other is bad (33.3%), strategic meeting generally is so good (72.7%) and the other is bad (27.3%), Reflection Case Discussion (RCD) activity generally is good (63.6%) and the other is bad (36.4%). (3) Output factor for applying Development of Management Performance Midwife in Health Center that is midwife performance management generally is good in Health Center (57.6%), the other management is bad (42.4%).

The conclusion of this research is that applying development of midwife performance management in health center generally is good, there just some variables which is bad. Therefore, researcher try to give recommendation for: (I) Local Government, giving support the application of Management Performance Development of midwife in health center, approve proposal of District Health Office program to doing Development Of Management Performance training for midwife who does not get training yet. (2) Head of District Health Office: should follow-up program of Management Performance Development, such as monitoring every 3 months once, doing training of Management Performance Development For midwife who have not been [rained yet, and expected that all health center in Rejang Lebong district can applying the Management Performance Development of midwife. (3) Health Center leader, monitoring and performance assessment minimally 1 year once to assess midwife performance in Health Center and give appreciation as feed back."