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"ABSTRAKKepatuhan bidan menerapkan standar pelayanan antenatal menentukankualitas pelayanan. Tingkat kepatuhan bidan dalam menerapkan standarpelayanan antenatal berdasarkan survey awal adalah rendah (58,3%) di KotaPadangsidimpuan membuat penelitian ini menjadi penting.Tujuan penelitian ini adalah untuk membuktikan adanya kepatuhan bidandalam menerapkan standar pelayanan antenatal di KotaPadangsidimpuan.Disamping itu juga untuk membuktikan adanya hubunganmotivasi, supervisi, pelatihan dan beban kerjadengan kepatuhan bidanmenerapkan standar pelayanan antenatal.Penelitian ini menggunakan desain potong lintang dengan pendekatankuantitatif dan jumlah sampel 112 dari total populasi 222 orang bidan praktekswasta. Data diperoleh dengan pengisian kuesioner pada bidan dan pengamatanlangsung terhadap bidan praktek, yang dilaksanakan pada akhir bulan februarisampai dengan Meitahun 2012.Hasil penelitian menunjukkan bahwa sebagian besar bidan patuhmenerapkan standar pelayanan antenatal (58,9%). Terdapat empat variabel yangmemiliki hubungan bermakna dengan kepatuhan bidan menerapkan standarpelayanan antenatalyaitumotivasi, supervisi, pelatihandan beban kerja.Disarankan kepada Dinas Kesehatan Kota Padangsidimpuan untukmenciptakan kebijakan tentang sistem reward & punishment yang sesuaikondisidaerah Kota Padangsidimpuan, wajib uji kompetensi dan menandatanganisurat komitmen patuh menerapkan standar dalam memberikan pelayanan sebagaisyarat penerbitan surat izin praktek bidan (SIPB), melakukan perbaikan carapendekatan supervisi agar supervisor dapat memenuhi tugasnya sebagaifasilitator, komunikator dan motivator serta pentingnya memperbesar peluangmengikuti seminar-seminar dan pelatihan berkaitan kompetensi bagi bidan. Untukpermasalahan beban kerja, dinas kesehatan melalui kepala puskesmas dapatmengkaji ulang pembagian tugas seorang bidan baik dipuskesmas maupun ditempat prakteknya dan melakukan rotasi penempatan bidan agar tidak terjaditugas rangkap dan kejenuhan kerja.

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ABSTRACTThe midwife to apply compliance standard antenatal care. Low levels of

compliance with antenatal care midwives applying standards based on the initial

survey (58.3%) in the City Padangsidimpuan makes this study important.

The purpose of this study was to obtain a picture of the level of

compliance with antenatal midwife to implement standards in the City

Padangsidimpuan, what are the factors that influence adherence midwives, and

how these factors apply to the compliance standards of antenatal care midwives.

This study uses a cross-sectional design with quantitative approaches and

the number of samples of the total population of 222 112 midwives in private

practice. Data obtained by filling out the questionnaire on direct observation of

midwives and midwifery practice, which was held in late February to May 2012.

The results showed that of the majority of midwives dutifully applying

standard antenatal care (58.9%). Of the five variables studied then there are four

variables that have a meaningful relationship with midwives compliance with

antenatal care standards that apply motivation, supervision, training and workload.

Noting the results of these studies, it can be recommended to the Health

Department to make improvements Padangsidimpuan supervisory approach to

supervision in accordance with the guidelines for reporting health departments,

creating a system of reward and punishment to the midwife adapted to local

conditions Padangsidimpuan and the importance to improve training opportunities

related to improving the competence midwifery in the midwife. In addition,

establishing policies that take care of every midwife SIPB must follow the

competency test and be willing to sign a letter of adherence to implement

standards in providing services as a condition of issuing a license to practice

midwifery (SIPB). To workload issues, the health department through the chief

centers may review the job description of a good midwife dipuskesmas and in his

practice and to rotate the placement of midwives in order to avoid duplicate work

and job burnout."

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

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