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Abstrak :
Pemanfaatan pelayanan persalinan oleh ibu-ibu merupakan upaya untuk meningkatkan kesehatan ibu yang diharapkan dapat meningkatkan persalinan yang aman dan bersih, sehingga dapat membantu menurunkan penyebab dari kesakitan dan kematian ibu. Adapun tujuan penelitian ini adalah diperolehnya informasi tentang hubungan faktor predisposisi (umur, paritas, pendidikan, pengetahuan dan sikap), faktor pendukung (pendapatan keluarga, jarak, ketersediaan pelayanan dan sumber informasi) dan faktor kebutuhan (persepsi terhadap persalinan aman dan bersih) dengan pemanfaatan pelayanan persalinan di Kecamatan Cimalaka Kabupaten Sumedang. Metode penelitian yang digunakan adalah cross sectional dengan pendekatan kuantitatif. Pengumpulan data dilakukan dengan wawancara dan pengamatan, pengolahan data dengan program komputer dan analisis dilakukan univariat, bivariat dan multivariate. Populasi , yaitu ibu-ibu yang melahirkan anak terakhir pada tahun 2002 dan pada saat pens lmpulan data masih berdomisili di wilayah Kecamatan Cimalaka Kabupaten Sumedang. Jumlah sampel 104, yaitu yang melahirkan pada bulan April dan Mei tahun 2002 diambil secara acak. Hasil analisis didapatkan, bahwa 1) komponen predisposisi ternyata umur, paritas, pendidikan ibu dan sikap tidak terbukti berhubungan dengan pemanfaatan pelayanan persalinan. Pengetahuan tentang persalinan dan penolong persalinan terbukti ada hubungan dengan pemanfaatan pelayanan persalinan. 2) Pada komponen pendukung ternyata pendapatan keluarga dan jarak terbukti ada hubungan dengan pemanfaatan pelayanan persalinan, namun ketersediaan pelayanan dan sumber informasi kesehatan tidak terbukti ada hubungan dengan pemanfaatan pelayanan persalinan. 3) Komponen kebutuhan tentang persalinan aman dan bersih tidak terbukti ada hubungan dengan pemanfaatan pelayanan persalinan. Dari variabel-variabel yang diteliti tersebut, variabel pengetahuan, pendapatan keluarga dan jarak dari tempat tinggal ibu ke penolong persalinan merupakan variabel determinan dari pemanfaatan pelayanan persalinan. Sehubungan dengan hal-hal tersebut di atas, disarankan kepada Puskesmas untuk meningkatkan pengetahuan ibu terhadap persalinan dan penolong persalinannya dengan konseling atau komunikasi yang efektif sehingga meningkatkan kualitas pelayanan persalinan oleh petugas kesehatan. Untuk Dinas Kesehatan Kabupaten Sumedang diperlukan pelatihan ketrampilan komunikasi bagi petugas Puskesmas dan penelitian lebih lanjut tentang kualitas pelayanan persalinan yang sudah diberikan petugas kesehatan dan yang diharapkan masyarakat sehingga dapat menyediakan pelayanan yang baik sesuai standar yang ada dan diharapkan dapat membantu meningkatkan pemanfaatan pelayanan persalinan. Daftar bacaan: 33 (1975 - 2001)

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Determinants of the Delivery Service Usage by Health Staff in Cimalaka Sub District, District of Sumedang Delivery services by health staff is an effort to provide clean and safe delivery to improve maternal health and decreasing maternal morbidity and mortality rate. Objective of study is to acquire information about relation between predisposition factors (age, parity, education, knowledge, and attitude), supporting factors (family income, distance, service availability, and source of information) and needs factors (perception to clean and safe delivery) with delivery service usage in Cimalaka Sub-district, district of Sumedang. This Study using cross sectional design with quantitative approach. Data collected by interview and observation, processed by computer software, and using univariate, and multivariate analysis. The population is mothers who deliver their baby before 2002 and live at Cimalaka sub-district during data collection. Total sample is 104, who deliver their baby between April and May 2002 and taken randomly. Result from the analysis are : 1) predisposition factor such as age, parity, mother's education and attitude not related with delivery service usage, except the knowledge factors. 2) supporting factors like family income and distance have relation with delivery service usage, but not with service availability and source of information factors. 3) needs related with delivery service usage. Based on those result, this study recommend the health center to improve mother?s knowledge about delivery and delivery aid by counseling and effective communication so that could improve quality of delivery service by health staff. To Health Office of District of Sumedang to carry out training the communication skill of health staff in health centre and advance research on quality of delivery service that have given by health staff. Bibliography: 33 (1975-2001)

Abstrak :
ABSTRAK Hasil survei cepat tahun 1995 di Kabupaten Tangerang, proporsi ibu bersalin ditolong oleh tenaga kesehatan sebesar 47,3 % sedangkan proporsi ibu hamil yang melaksanakan `antenatal care' sebesar 94 %. Masih rendahnya pertolongan persalinan oleh tenaga kesehatan serta belum diketahuinya faktor-faktor apa yang berhubungan dengan pemanfaatan pertolongan persalinan oleh tenaga kesehatan, telah menarik minat peneliti untuk mengetahui proporsi ibu bersalin ditolong oleh tenaga kesehatan pada tahun 1997-1998 dan hubungan antara faktor- faktor : pendidikan, pendapatan keluarga, sikap, kejadian penyakit saat hamil dan melahirkan, ketersedian fasilitas pelayanan kesehatan, jarak tempuh, ketersedian sarana transportasi, biaya pelayanan, anjuran/nasehat orang lain di lingkungannya untuk memanfaatkan pelayanan; dengan pemanfaatan pertolongan persalinan oleh tenaga kesehatan. Penelitian dilakukan dengan menganalisa data primer menggunakan metode `cross sectional'. Hasil penelitian menunjukkan bahwa, proporsi ibu bersalin yang ditolong oleh tenaga kesehatan adalah 62,5 %, dan hipotesis peneliti telah terbukti kecuali ketersedian fasilitas pelayanan kesehatan, jarak tempuh serta anjuran/nasehat orang lain di lingkungannya untuk memanfaatkan pelayanan. Berdasarkan hasil penelitian penulis menyarankan, bahwa dalam upaya meningkatkan jumlah persalinan oleh tenaga kesehatan sebaiknya : 1. Memperlakukan dukun paraji sebagai mitra kerja petugas kesehatan. 2. Memberikan pendidikan kesehatan ibu, terutama kepada ibu-ibu yang berpendidikan rendah beserta suami dan orang tuanya, juga kepada remaja puteri di sekolah-sekolah. 3. Peningkatan tarif pelayanan persalinan dan kualitas `antenatal care' di puskesmas. 4. Pemberdayaan kelompok kerja (pokja) Gerakan Sayang Thu di semua tingkatan, sehingga pokja berfungsi secara efektif terutama dalam pengumpulan dana serta pengadaan transportasi yang dibutuhkan untuk pelayanan kesehatan ibu. Daftar Pustaka : 23 (1975 - 1997)

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ABSTRACT The 1995 Rapid survey's in Tangerang district found that 94 % of all pregnant women had antenatal care, while only 47,3 % of all births were delivered by health staff (midwives and medical persons). Because of the low proportion of births were delivered by health staff and the unknown factors related, so the author was interested to find out the proportion of birth aid by health staff in 1997-1998 and the relationship of the following factors: education, family earning, attitude, incidence illness during pregnancy and childbirth, availability of health facilities, the distance to health facilities, availability of transportation to health facilities, cost of health services, advice from another people to utilize the birth aid by health staff. The study was done by using primary data, using cross sectional method. The study found that the utilization of birth aid by health staff reached 62,5 %. And, the author's hypothesis was proved except availability of health facilities, the distance to health facilities and advice from another people to utilize the birth aid by health staff. Recommendations of study are: 1. Promote partnership among health staff and traditional birth attendants. 2. Health education on family life for using to mothers with minimal education, together with their husbands and parents. The family life education could also be taught for adolescent girls at schools. 3. Increase charge for delivery services and improve quality of antenatal care at Public Health Center (Pusat Kesehatan Masyarakat). 4. Encourage community participation to provide fund and transportation for pregnant mothers who need emergency care. References : 23 (1975- 1997)

Abstrak :
ABSTRACT
This study was done in order to obtain information about current breastfeeding behavior among resident and migrant lactating mothers in Hanoi Vietnam for the general purpose of breastfeeding promotion in Vietnam. The research hypothesis is that there is a different breastfeeding behavior of resident and migrant lactating mothers. A cross-sectional study was carried out between December 1994 and March 1995. The subjects consisting of 80 lactating mothers with 9 months old baby are divided into 2 groups. Those mothers have been living for at least 15 years in Hanoi (resident mothers) and the other mothers for between 5 months to 3 years (migrant mothers). Information of breastfeeding behavior and the socioeconomic status of mothers were obtained by using open-ended questionnaire. A second questionnaire was applied to 30 health professionals in maternity clinics where the mothers delivered. One hundred percent of mothers breastfed their child, 95% of the resident and 85% of the migrant mothers were still breastfeeding at the time of the study. Almost all of the residents (95%) and 87.5% of the migrants had positive attitude towards colostrum. About 42.5% of the resident mothers and 35% of the migrant ones started breastfeeding within 6 hours after birth. The rooming-in rate was 67.5% of the resident mothers and 52.5% of the migrant ones. The rate of early initiation of breastfeeding was significantly higher in the mothers group who had rooming-in than the others. The exclusive breastfeeding rate within the first 4 months of age was 35% of the residents and 30% of the migrants. All health professionals (100%) had positive attitude towards colostrum and breastfeeding. About 86.7% of doctors and 80% of midwives knew that 'mother' should start breastfeeding within the first 30 minutes after birth. Around 86.7% of doctors and 100% of midwives said that there was no need to give other liquid before starting breastfeeding. But their practices were not according to their knowledge: They gave wrong advises to the resident mothers (8.7%)., about 38.4% of babies from the resident mothers and 60.9% of babies from migrant ones were prelacteal fed by health professionals. Additional information on breastfeeding and child feeding were still expected by mothers especially by the migrant ones (71.4%). The results of the study suggest education on breastfeeding and proper feeding practices, especial early initiation, prolonged exclusive breastfeeding, and rooming-in.