Childbirth performed in health care facilities has been proven to reduce the risk of maternal death. Childbirth in health care facilities at Lamunti Health Center in 2017 is still low at 16.8%. This study aims to know the determinants and reasons for the use of childbirth in health care facilities by maternity in the working area of Lamunti Health Center 2017. The research method uses quantitative and qualitative combined methods. Bivariate analysis showed three related factors namely health insurance ownership, antenatal care and obstetric complications. Multivariate analysis showed two related factors, namely antenatal care and obstetric complications. Obstetric complications are the most dominant factor associated with the use of childbirth in health care facilities. The qualitative results found that there were still many people who did not yet have a BPJS card, the standard of antenatal care in the village was less than 10 T, the existence of obstetric complications was the reason for the mother giving birth in a health care facility. Commitments / policies are needed to support childbirth in health care facility; integrated ANC training; community empowerment (implementation of childbirth planning programs and prevention of complications; classes of pregnant women; alert villages and PIS-PK).
This thesis discusses about the responsibility of the hospital in providing health services facilities for its medical personnel. The focus of this study discusses BPJS health insurance for workers, then the regulations related to the implementation of health service facilities in hospitals, and the hospital's obligations to fulfill that responsibility, especially for its medical personnel. The discussion was carried out through a literature study and a study at the RSUP Persahabatan in East Jakarta. This research is a normative juridical research with qualitative method. The results of the study concluded that at RSUP Persahabatan, the right to health services can be broadly divided into 2, i.e., illness and accident caused by work or illness and accident that is not the result of work. If it is not caused by work, then they can use BPJS Kesehatan and adhere to a vertical tiered referral system which was adopted by BPJS Kesehatan. As a result, it creates a condition that are not optimal for its’ medical personnel. The results of this study suggest that the government should make an implementing regulations that could regulate type A hospitals, such as RSUP Persahabatan, so that they can make first tier health services for their workers.