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Abstrak :
Pelayanan antenatal merupakan salah satu intervensi kesehatan yang efektif untuk menurunkan angka kematian ibu. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi kualitas kerja bidan di desa dalam pelayanan antenatal di Kabupaten Tanah Datar tahun 2010 dengan melihat selisih cakupan antara K1 dan K4. Dengan desain penelitian cross sectional dan metode penelitianya kuantitatif, dilaksanakan pada bulan Februari-April 2011. Besar sampel, seluruh bidan di desa dan di pustu sebanyak 220, yang bisa digunakan datanya 170 responden dengan menggunakan kuesioner sebagai instrumen penelitian. Hasilnya ditemukan 47,6% bidan di desa memiliki kualitas kerja baik dan 52,4 % bidan di desa memiliki kualitas kerja kurang. Hasil analisis uji statistik dengan chi square menunjukkan hubungan yang bermakna dengan kualitas kerja bidan di desa dalam pelayanan antenatal adalah sekolah asal, pengalaman pelayanan ANC, lama kerja, status kepegawaian, motivasi yang diperkuat oleh kebutuhan fisiologi dan rasa aman, sedangkan yang tidak berhubungan adalah pendidikan, pengetahuan, pelatihan, status perkawinan, supervisi, kelengkapan alat, klasifikasi desa dan imbalan dengan kualitas kerja bidan di desa dalam pelayanan antenatal. Perlu diberikan pelatihan khusus bagi bidan yang akan di tempatkan di desa guna peningkatan pengetahuan dan keterampilan khususnya pelayanan natenatal dan pertolongan persalinan normal agar mempunyai bekal yang cukup untuk di turunkan dilapangan.

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Antenatal care is one of effective health interventions to reduce maternal mortality. The purpose of this study was to determine the factors that affect the quality of work in the village midwives in antenatal care in Tanah Datar to see the difference in coverage between K1 and K4. With cross-sectional study design and quantitative methods penelitianya, conducted in February-April 2011. Large samples, the whole village midwives in health centers and as many as 220, which can use the data 170 respondents using a questionnaire as a research tool. The results found 52.4% of midwives in the villages have been working less quality and 47.6% of midwives in the village has a good quality of work. The results of statistical analysis with chi square test showed a significant relationship with quality work in the village midwives in antenatal care is the school of origin, the ANC service experience, length of employment, employment status, motivation is reinforced by the physiological needs and security, while unrelated to education, knowledge, training, marital status, supervision, equipment is completed, the classification of the village and returned with the quality of work in the village midwives in antenatal care. Need to be given special training for midwives will be in place in the village in order to improve knowledge and skills in providing specialized assistance services natenatal and normal in order to have enough stock to be upgraded in the field.

Abstrak :
Berdasarkan SDKI 1997, Angka Kematian Ibu (AKI) di Indonesia masih tinggi yaitu 334 per 100.000 kelahiran hidup (target nasional: 125 per 100.000 kelahiran hidup pada tahun 2010) dan Angka Kematian Bayi (AKB) sebesar 25 per 1000 kelahiran hidup (target nasional adalah 15 per 1000 kelahiran hidup), ini menggambarkan tingkat kesejahteraan masyarakat serta arus terhadap pelayanan kesehatan masih rendah, khususnya kesehatan ibu dan anak. Untuk menurunkan AKI dan AKB telah dilakukan berbagai upaya diantaranya adalah memudahkan pelayanan kesehatan yang dapat menjangkau seluruh lapisan masyarakat dengan menempatkan bidan di desa. Penelitian ini bertujuan untuk memperoleh gambaran tentang kinerja bidan di desa dalam pelayanan kesehatan ibu dan neonatal dan faktor-faktor yang berhubungan dengan kinerja serta faktor yang paling dominan. Dengan memakai indikator K1, K4, linakes, KNI dan KN2. Kinerja baik bila cakupan K1 > 95%, K4 > 90%, Linakes 85%, KNI > 80% dan KN2 7 80%. Penelitian ini dilakukan di Kabupaten Lampung Barat dengan menggunakan rancangan penelitian Cross Sectional. Sampel penelitian adalah seluruh bidan di desa yang bertugas di Kabupaten Lampung Barat yang berjumlah 94 orang. Analisis data meliputi analisis univariat, analisis bivariat dengan uji Chi Square untuk melihat hubungan antara variabel bebas dengan variabel terikat dan analisis multivariat dengan uji regresi logistik untuk melihat faktor yang paling dominan berhubungan dengan kinerja bidan di desa Hasil penelitian menunjukkan bahwa proporsi kelompok bidan di desa yang memiliki kinerja kurang lebih besar dibandingkan bidan di desa yang memiliki kinerja baik. Hasil analisis bivariat menunjukkan bahwa variabel pengetahuan, sarana, penghasilan tambahan dan supervisi mempunyai hubungan bermakna dengan kinerja bidan di desa dan yang tidak mempunyai hubungan bermakna adalah umur, status perkawinan, masa kerja, dukungan pimpinan dan dukungan masyarakat. Hasil analisis multivariat menunjukkan bahwa variabel pengetahuan, penghasilan tambahan dan supervisi merupakan faktor dominan yang dapat menentukan hubungan variabel independen dengan kinerja bidan di desa. Variabel yang paling dominan berhubungan dengan kinerja bidan di desa adalah variabel pengetahuan. Setelah diketahui faktor faktor yang berhubungan dengan kinerja bidan di desa, maka dapat diformulasikan berupa saran saran sebagai berikut: Bagi Pemerintah Daerah Kabupaten Lampung Barat yaitu membuat kebijakan memberikan insentif kepada bidan di desa dan bidan PTT yang berprestasi dapat diangkat sebagai pegawai negeri sipil. Bagi Dinas Kesehatan mengadakan pelatihan fungsional dan manajemen sosial approach, merencanakan supervisi yang berkualitas, mempermudah pemberian lain praktek bidan, mengusulkan penambahan tenaga bidan di desa sesuai kebutuhan, bidan di desa yang berprestasi diusulkan sebagai bidan di desa teladan. Bagi Puskesmas memberikan pembinaan secara periodik dan intensif serta mengadakan monitor dan evaluasi. Bagi bidan sendiri mengadakan pendekatan kepada masyarakat, memanfaatkan peran aktif dukun bayi, melaksanakan kerja sama lintas sektoral dan berusaha untuk meningkatkan pengetahuan dan ketrampilannya. ......The Factors Related to Village Midwife Performance in Health Service for Maternal and Neonatal in West Lampung Regency 2002Based on the SDKI 1997, Maternal Mortality Rate (MMR) in Indonesia is still high, which is 334 per 100.000 living birth (national target: 125 per 100.000 living birth) and Infant Mortality Rate (IMR) is 25 per 1.000 living birth (national target is 15 per 1.000 living birth). These describe the level of public prosperity and access to health service is still low, especially for the health of mothers and children. To decrease the MMR and 1MR various efforts have been undertaken. One of them is to facilitate health service that could reach the public through placement of midwives in villages. The objective of this study is to get a description regarding the operation of midwives in villages concerning the health service for mothers and neonatal, and the factors which relate to the operation and the most dominant factor, using K I , K4, l inakes, KN1 and KN2 indicators. The operation is good when the scoop is 1(1 y 95%, K4 ? 90%, Linakes ? 85%, KN1 ? 80%, and KN2 ? 80%. This study is carried out in West Lampung Regency using a cross sectional study plan. The samples of the study are every villages midwives who are in duty in West lampung Regency which consist of 94 people. The analysis consist of univariat analysis, biovariat analysis with chi Square test to find out the relationship between the independent variable with the dependent variable and multivariate analysis with logistic regression test to find out the most dominant factor which is related to the operation of midwives in villages. The result of the study shows that the midwives group proportion in villages which has less operation is higher compared to midwives in villages which has good operation. The result of bivariat analysis shows that the variable of knowledge, facilities, additional income, and supervision has significant relationship with the midwives operation in villages; and variables which have no significant relationships are age, marital status, work period, support from the superior or the public. The result of multivariate analysis shows that the variables of knowledge, additional income, and supervision are the dominant factors which could determine the relationship between the independent variable with the operation of midwives in villages. The most dominant variable related to the operation of midwives in villages is knowledge. Once the factors which are related to the operation of midwives in villages have been identified, then the following suggestions could be formulated: For the District Government of West Lampung Regency is to make a policy that would give incentive for the village midwives and PTT midwives who have good track record could be raised as civilian government officers. For the Health Board is to make social approach management training and functional training, plans a good supervision, facilitate midwives working permit, proposes to increase the midwives according to the needs, village midwives who have good track records is proposed as the best midwife. For the Public Health Centers are to give education periodically and intensively and also to monitor and evaluate their progress. As for the midwives themselves are to make an approach to the public, using the active role of traditional midwives, undertake cross sector cooperation and try to improve their own knowledge.

Abstrak :
Angaka kematian ibu di Indonesia saat ini masih tinggi, pada tahun 1997 sebesar 373 per 100.000 kelahiran hidup, padahal pemerintah dalam hal ini Depkes ingin menurunkan angka kematian ibu. Untuk menurunkan angka kematian ibu (AKI) pemerintah telah menempatkan petugas kesehatan (Bidan di desa) dan fasilitas pelayanan kesehatan sampai kedaerah terpencil untuk ikut menjaga kesehatan ibu dan bayi selama masa kehamilan, persalinana, dan masa sesudah persalinan. Tujuan penelitian ini ingin mengetahui gambaran tingkat kepatuhan. bidan di desa terhadap standar pelayanan antenatal care (ANC) di Kabupaten Karawang, serta faktor-faktor apa saja yang berhubungan dengan kepatuhan bidan di desa terhadap standar pelayanan antenatal. Rancangan penelitian adalah cross sectional (potong lintang), populasi penelitian ini bidan di desa yang ada di Kabupaten Karawang, sebanyak 277 orang dengan jumlah sampel sebanyak 162 orang. Data di analisis secara univariat. bivariat, dan multivariat dengan menggunakan regresi logistik ganda. Perangkat lunak yang dipakai ialah program komputer di laboratorium Program Studi llmu Kesehatan Masyarakat Universitas Indonesia (PS-IKM). Hasil penelitian yang didapat adalah dari 162 responden, yang patuh terhadap standar pelayanan antenatal care (ANC) sebanyak 115 responden (71,0%), dan yang tidak patuh sebanyak 47 responden (29,0%). Faktor yang memiliki hubungan dengan kepatuhan bidan di desa terhadap standar pelayanan antenatal care (ANC) adalah.umur, pengalaman kerja, pengetahuan, sedangkan perkawinan, pelatihan, supervisi dan sarana tidak memiliki hubungan bermakna. Sedangkan hasil multivariat faktor yang paling dominan berhubungan dengan kepatuhan bidan di desa pada standar pelayanan antenatal adalah status perkawinan. Mempertimbangkan hasil penelitian ini, maka disarankan kepada semua pihak yang terkait (Dinas Kesehatan, Puskesmas) perlu pembinaan khusus terhadap bidan di desa terutama bidan di desa yang memiliki tingkat pengetahuan yang kurang, sedangkan untuk bidan perlu meningkatkan pengetahuannya melalui pelatihan dan banyak membaca. ......The Factors that Related to Village Midwife Compliance on Antenatal Service Standard at Karawang District, 2002The Maternal Mortality Rate (MMR) in Indonesia is still high, it was 373 per 1000 live births, 1997, even the government, and MOH would like to reduce it. To reduce the MMR, the government has been placed Village Midwife and facility of health service up to Remote Areas to participate maintain the maternal health and infant during pregnancy, delivery, and post-natal. The objective this study is to determine the description of Village Midwife compliance rate to ANC standard at Karawang District, and also on what factors that influence to Village Midwife compliance to ANC standard. The study design used cross-sectional, the population of this study is Village-Midwife that available at Karawang District, and the number is 277 people, with the sample as 162 people. The data was analyzed by univariate, bivariate, and multivariate used logistic regression. The software is computer program at the Laboratory of the Faculty of Public Health, University of Indonesia (PS-IKM-UT). The result of this study obtained that out of 162 respondents who's having compliance to ANC standard as 115 respondents (71.0%), and was not compliance 47 respondents (29.0%). Result of bivariate prove have significant relationship to Village Midwife compliance to ANC standard are age, work experience, knowledge, while marital, training, supervision and facility is not having significant relationship. The specially vector to related wich compliance to ANC standard as married status. Considering to the result of this study, it is recommended to all related parties (Local Health Service, Health Center) need special guidance to Village Midwife, especially Village Midwife that having lower compliance, while for Midwife should increase her knowledge through training and a lot of reading.

Abstrak :
ABSTRAK Dewasa ini pembangunan kesehatan yang memasuki periode Pembangunan Jangka Panjang II masih ditandai oleh tingginya angka kematian ibu (AKE) dan angka kematian bayi (AKB). Salah satu mata rantai yang berhubungan dengan kematian ibu adalah pelayanan antenatal disamping mata rantai lain yang tidak kalah pentingnya adalah persalinan. Pelayanan antenatal di Kabupaten Cianjur masih belum sesuai dengan standar minimal pelayanan antenatal "5T ", masih ada ibu hamil yang tidak ditimbang, tidak diukur, tekanan darahnya, tinggi fundusnya, tidak diberi imunisasi TT lengkap, dan tablet tambah darah minimal 90 tablet. Penelitian ini bertujuan untuk memperoleh gambaran tentang kepatuhan bidan desa terhadap standar minimal pelayanan antenatal "5T" dan faktor-faktor yang berhubungan dengan kepatuhan bidan terhadap standar pelayanan antenatal "5T"di Kabupaten Cianjur tahun 1998, dengan menggunakan rancangan cross sectional serta analisis statistiknya menggunakan analisis chi- square. Sedangkan sampel penelitian ini adalah bidan desa yang bertugas di Dinas Kesehatan Kabupaten Cianjur dan pengambilan sampel dilakukan dengan cara simple random sampling. Dari hasil penelitian ini didapatkan bahwa kepatuhan bidan desa terhadap standar pelayanan antenatal "5T " masih rendah (32,7 %). Dan dari analisa bivariat memperlihatkan adanya hubungan antara sikap dengan kepatuhan bidan terhadap standar pelayanan antenatal " 5T " (p < 0,05). Ada hubungan antara lama bekerja dengan kepatuhan bidan terhadap standar minimal pelayanan antenatal "5T" (p < 0,05). Kesimpulan dari penelitian ini adalah kepatuhan bidan terhadap standar minimal antenatal "5T " masih rendah dan ada hubungan yang bermakna antara sikap, lama kerja dengan kepatuhan bidan terhadap standar minimal pelayanan antenatal 5T. Saran, perlu adanya peningkatan sikap bidan melalui supervisi, motivasi dan kelengkapan sarana untuk pelayanan antenatal. Daftar Pustaka : 41 (1980 - 1998).

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ABSTRACT Analysis of Village Midwife Compliance on Minimum Standard of Antenatal Care Services "5T" in District of Cianjur in 1998.Currently, the National health development which has entered the second long term development period is still marked by a high maternal mortality and infant mortality rate. One of important related chains to maternal mortality rate is the antenatal care services besides the delivery. The antenatal services in District of Cianjur has not yet corresponded to minimal standard of antenatal services "5T", there still exists pregnant women who are not weighed, whose blood pressure and fundus uteri are not measured, some of them have not received yet TT immunization and minimum of 90 ferrous tablets. The aim of this research is to obtain a description of village midwife compliance level on minimal standard of antenatal services "5T" in District of Cianjur and other factors which are related to it. A cross sectional study was used with statistical analysis using chi-square analysis. Samples of this study are midwives in Health Office in District of Cianjur. Samples are taken using simple random sampling. This research shows that compliance of village midwife on the minimum standard of antenatal services is still low (37,7 %). The bivariate analysis shows relation between the attitude and compliance of midwife on the antenatal sevices standard "5T". There is also a relation between the length of work time and midwife compliance on the antenatal services standard "5T" (p < 0,05). From this research it is concluded that compliance of the midwife on the antenatal care services standard is still low and there is a significant correlation between the attitude and the length of work with the compliance of village midwife on the antenatal care services standard "5T. Improving the attitude of village midwife through supervision, increasing motivation and providing adequate facilities for the antenatal services are needed. References : 41 (1980 - 1998)

Abstrak :
Maternal mortality in childbirth in developing countries is still high. The study describes the qualitative methods used to examine the knowledge, attitude, beliefs and behaviour related to nutrition and nutritional supplementation of pregnant women. The role of village midwives and cadres? in relation to nutrition education resulted in improving nutritional behaviour of pregnant women to some extent, but poverty and culture restricted the ability of pregnant women to access better food. The study shows that the position of pregnant woman is low within the hierarchy of both the health care system and the power structures of the broader community. Husbands, mothers-in-law, village midwives, cadres and village leaders all have more power in determining nutrition during pregnancy. However, some women tried to eat better and more nutritious food in secret, thereby subverting culture and the authority of husbands and mothers-in-law.