Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Infeksi Saluran Pernapasan Akut (ISPA) terutama pneumonia merupakan penyebab utama kesakitan dan kematian pada bayi dan anak balita di negara berkembang termasuk Indonesia. Setiap tahun dari 15 juta kematian yang diperkirakan terjadi dikalangan anak dibawah usia lima tahun (balita) kira -kira 4 juta kematian (26,6%) di sebabkan oleh penyakit ISPA terutama pneumonia. Tingginya angka kematian tersebut maka WHO dan UNICEF mengembangkan suatu strategi yang disebut Manajemen Terpadu Balita Sakit (MTBS) yang merupakan upaya kuratif sekaligus upaya promotif dan preventif. MTBS dirancang untuk memadukan pendekatan 6 penyakit utama yaitu Pneumonia, Diare, Malaria, DBD, Campak, penyakit telinga serta malnutrisi dan anemia pada balita dengan menggunakan algoritma untuk menilai dan mengklasifikasikan balita sakit, yang prinsipnya untuk memperbaiki kualitas pelayanan kesehatan pada balita sakit secara menyeluruh tidak terpisah-pisah antara satu gejala dengan gejala yang lain. Pendekatan MTBS di Kab. Donggala di mulai tahun 1999 dengan uji coba 4 puskesmas yang hasilnya dapat meningkatkan cakupan penemuan kasus penumonia dari 69% pada tahun 1998 menjadi 86% tahun 1999 dan 109,9% pada tahun 2000. Namun keberhasilan puskesmas dengan pendekatan MTBS dalam meningkatkan kesembuhan pneumonia balita belum dapat dievaluasi terutama di tingkat pelaksanaan baik terhadap masalah petugas dan pasien pada tatalaksana standar. Penelitian ini dilakukan untuk mengetahui pengaruh talakasana penumonia balita terhadap kesembuhan penderita di puskesmas MTBS Kabupaten Donggala Propinsi Sulawesi Tengah Tabun 2001. Studi ini menggunakan desain kohor prospektif yang mengevaluasi tatalaksana pengobatan kasus pneumonia di puskesmas MTBS dan membandingkan dengan puskesmas non MTBS selanjutnya melihat perkembangan penderita pada hari ke 6 pengobatan. dan mengadakan wawancara dengan menggunakan kuesioner pada ibu balita, Analisa data meliputi univariat, bivariat, dan multivariat. Hasil studi menunjukkan adanya hubungan yang bermakna antara puskesmas MTBS dan non MTBS terhadap tingkat kesembuhan p=0,002. dan hubungan yang bermakna antara tatalaksana kasus pneumonia di puskesmas MTBS berupa pemberian dosis obat dan cara pemberian obat terhadap kesembuhan masing-masing nilai p=0,000, serta penelitian ini juga menunjukkan hubungan yang bermakna antara variabel imunisasi (p=0,001), gizi (p=0,001), pendidikan (p=0,033) dan kepatuhan (p=0,000) terhadap kesembuhan penderita penumonia dan pada akhir analisa ditemukan bahwa balita yang menderita pneumonia pada puskesmas MTBS memiliki risiko untuk sembuh sebesar 2.14 kali lebih dibandingkan dengan balita pada puskesmas non MTBS. Dari hasil penelitian ini disarankan pendekatan MTBS perlu dipertimbangkan pada puskesmas -puskesmas ke Kab. Donggala yang belum melaksanakan, selain itu kegiatan program imunisasi dan perbaikan gizi perlu ditingkatkan melalui kegiatan di posyandu dan penyuluhan gizi pada ibu balita, pemanfaatan pekarangan, sementara program imunisasi selain diposyandu juga diupayakan melalui kegiatan sweeping imunisasi serta perlunya konseling bagi ibu balita di puskesmas khususnya puskesmas non MTBS.

---

Effect of Pneumonia under fives Manner to recovery patient level in Health Center with MTBS strategy approach in Donggala District of Central Sulawesi Province in 2001Acute Respiratory Infection (ARI) especially pneumonia represents main causes of Mortality and morbidity under fives in the developing country including Indonesia. Every year from 15 million under five deaths that be contribute 4 million death (26,6%) caused by Acute Respiratory Infection (ARI) especially Pneumonia. The rising of that death number so WHO and UNICEF develop a new strategy named Integrated Management of Childhoods Illness (IMCI), which represent curative expedient also, promotive expedient and preventive. IMCI designed to meet of 5 main disease among under five such as Pneumonia, Diarrhea, Dengue , Malaria, Measles, and Malnutrition using algorithm to estimate and classified the sick child, which the principle to revise the quality of medical services to the sick child with entirely way, not separated between one symptoms to another. Strategy approach of IMCI in Donggala district starting on 1999 with testing in 4 health centers, the result can increase the Pneumonia coverage from 69% on 1998 to 86% on 1999 and 109,9% on 2000. In spite of the successful of Strategy approach of IMCI in health center in increasing the children Pneumonia under five recoveries can not evaluated yet, especially on accomplishment level even to the officer problem and patient on standard manner. This study performed to know the effect of Pneumonia under five manners to the recovery patient level in health center with strategy approach of IMCI in Donggala district of Central Sulawesi Province on 2001. This study using Kohor prospective analytic design. Which evaluate and compare implementation of Standard case Management Of ARI (Pneumonia) between HC with IMCI approach and HC without that approach which looking the development of illness until sixth days therapy using questioner to perform deep interview the mother. The data analysis included univariat, bivariat, and multivariat. Study result showed there are significance relation between IMCI health center and non IMCI HC the recovery level of Pneumonia p = 0.002, and significance relation between manner of Standard Case Management of pneumonia in IMCI health center in shape of doses of medicine and the way of give the medicine to the each recoveries with each score p = 0,000, along with this study shows the meaningful relation between Immunization status (p = 0,001), Nutrition status (p = 0,001), Education status (p = 0.003) and Compliance rate (p = 0,000) to the recovery of pneumonia and at the end of the analysis found that under fives children which suffer pneumonia in IMCI health center have risk to recovery than about 2.14 times compared with the child in non IMCI health center. The result of this study suggested that strategy approach of IMCI considered in every health center in Donggala district which not performed will be implementation of IMCI approach, beside that immunization program activity and increasing nutrition status improvement through the activity in Posyandu (Integrated Health Post) and promotion of nutrition espionage to the mother, home garden using, mean while immunization program beside in posyandu also striven through immunization sweeping activity, also need of Health counseling for the mother in health center especially non-IMCI Health Center.

Abstrak :
ABSTRAK
Di Indonesia angka kematian bayi (AKB) cukup tinggi bahkan paling tinggi di Asia Tenggara. Angka kematian bayi merupakan salah satu indikator yang penting untuk menilai tingkat kesejahteraan suatu bangsa.

Kematian bayi neonatal (0-30 hari) di Indonesia memberikan proporsi terbesar dibanding dengan proporsi segmen kematian bayi lain dalam angka kematian bayi 0-1 tahun. Secara nasional proporsinya ± 40% (Depkes RI, 1991). Di Kabupaten lndramayu 1990 proporsi kematian bayi neonatal itu ± 47% dari kematian bayi 0-1 tahun.

Salah satu kemungkinan penyebab yang berhubungan dengan kematian neonatal adalah anemia ibu hamil.

Masalah anemia pada ibu hamil sudah menjadi masalah nasional dan prevalensi anemia ibu hamil di Indonesia antara 50 - 70% (SKRT,I992).

Penelitian ini bertujuan ingin mendapatkan gambaran tentang seberapa besar hubungan anemia ibu hamil dengan kematian bayi neonatal di Kecamatan Sliyeg dan Gabus Wotan, Kabupaten Indramayu, Jawa Barat.

Penelitian ini dilakukan dengan disain kohort retrospektif dengan data sekunder yang diambil dari data hasil penelitian Study Prospektif KB-Kes oleh PUSKA III di Kecamatan Sliyeg dan Gabus Wotan, Kabupaten lndramayu, Jawa Barat tahun 1991-1992.

Penelitian ini menemukan bahwa bayi yang dilahirkan oleh : - Ibu hamil dengan anemia berat mempunyai resiko kematian bayi neonatal lebih tinggi 3,36 kali dibanding dengan bayi yang dilahirkan oleh ibu hamil dengan anemia ringan. Hubungan ini bermakna secara statistik dengan p=0,O2. - Ibu hamil dengan anemia berat mempunyai resiko kematian bayi neonatal lebiih tinggi 1,88 kali dibanding dengan bayi yang dilahirkan oleh ibu hamil tidak anemia.

Dari hasil analisis stratifikasi didapatkan bahwa terdapat faktor-faktor lain yang merupakan faktor resiko dan dapat mempengaruhi hubungan ibu hamil dengan anemia berat dan ibu hamil tidak anemia yaitu antara lain : jarak kelahiran, berat bayi lahir, pelayanan antenatal , umur ibu.

---

ABSTRACT
Infant mortality is still high in Indonesia and even the highest in Southeast Asia. Infant mortality rate constitute one of significance factors to find out a prosperous rank of a nation.

Proportion of neonatal mortality (0-30 days) in Indonesia is the highest among other mortality within the first year of life. The proportional is 40% at national wide (Department of Health of the Republic of Indonesia, 1991). Meanwhile, by 1990, neonatal mortality proportion at district Indramayu was 47% of the infant mortality. One factor that is contributory to neonatal mortality is anemia in pregnant mother. The anemia of pregnant mother is a national problem with prevalence between 50% - 70% (SKRT, 1992).

The objective of this research is to find out relationship between pregnant mother with anemia and neonatal death at both sub-district Sliyeg and Gabus Wetan, District of Indramayu - West Java.

This research is conducted through a cohort retrospective design with secondary data taken from the result of Study Prospective of Family Planning and Health conducted by PUSKA UI at the two sub-districts in 1991-1992.

Research findings are babies delivered by: - Pregnant mother who is suffering severe anemia has neonatal death risk about 3,36 times higher than those born by mother suffering from mild-anemia, and this correlation is statistically significant with p=0,02. - Pregnant mother who is suffering severe anemia has neonatal death risk about 1,88 times higher then those born by mother without suffering from anemia.

Other factors which are considered as other risk factors and influencing the correlation of pregnant mother with severe anemia and those without anemia and neonatal mortality are: birth distance period, weight of delivery baby, antenatal care, mothers age of delivery.;Infant mortality is still high in Indonesia and even the highest in Southeast Asia. Infant mortality rate constitute one of significance factors to find out a prosperous rank of a nation.

Proportion of neonatal mortality (0-30 days) in Indonesia is the highest among other mortality within the first year of life. The proportional is 40% at national wide (Department of Health of the Republic of Indonesia, 1991). Meanwhile, by 1990, neonatal mortality proportion at district Indramayu was 47% of the infant mortality. One factor that is contributory to neonatal mortality is anemia in pregnant mother. The anemia of pregnant mother is a national problem with prevalence between 50% - 70% (SKRT, 1992).

The objective of this research is to find out relationship between pregnant mother with anemia and neonatal death at both sub-district Sliyeg and Gabus Wetan, District of Indramayu - West Java.

This research is conducted through a cohort retrospective design with secondary data taken from the result of Study Prospective of Family Planning and Health conducted by PUSKA UI at the two sub-districts in 1991-1992.

Research findings are babies delivered by:

- Pregnant mother who is suffering severe anemia has neonatal death risk about 3,36 times higher than those born by mother suffering from mild-anemia, and this correlation is statistically significant with p=0,02.

- Pregnant mother who is suffering severe anemia has neonatal death risk about 1,88 times higher then those born by mother without suffering from anemia.

Other factors which are considered as other risk factors and influencing the correlation of pregnant mother with severe anemia and those without anemia and neonatal mortality are: birth distance period, weight of delivery baby, antenatal care, mothers age of delivery.

Abstrak :
Penelitian ini dimaksudkan untuk mengetahui hubungan faktor predisposisi yang dimiliki ibu hamil risiko tinggi menurut umur, pantas, jumlah anak, jarak kelahiran, pendidikan, pengetahuan, persepsi, sikap, dan faktor pendorong yaitu penghasilan keluarga. penanggung biaya, jarak ke RSUD, sarana lain, anjuran merujuk oleh Iingkungan, keluarga lain dalam satu rumah, pengalaman berobat di RSUD, serta faktor kebutuhan yang terdiri dan nwayat persalinari yang lalu, penyakit yang diderita saat itu dengan rujukan ibu hainil risiko tinggi dan Puskesmas ke RSUD Sekayu. Penelitian ini dilakukan pada 10 Puskesmas dîwilayah Kabupaten Musi Banyuasin dimana RSUD Sekayu berada, yaitu : Puskesmas Sekayu Kota, Puskesmas Lumpatin, Puskesmas Tebing Bulang, PuskesiflaS Jirak, Puskesmas Babat Toman, Cinta I(arya, Puskesmas Suka Damai, Puskesmas Nulak, Puskesmas Tanah Abang, Puskesmas Karya Maju. Penelitian ini merupakan studi potong lintang, dengan menggunakan total populasi, dengan memakai kuesioner terstruktur kemudian dilakukan pengambilan data terhadap 100 responden. Data yang diperoleh kemudian diolah secara statistik menggunakan tehnik analisis distribusi frekuensi dan Kai-Kuadrat dengan menggunakan program komputer SPSS versi 9.0. Hasil penelitian menunjukkan bahwa dari 100 responden yang dirujuk ke RSUD temyata yang datang ke RSUD sebanyak 71 responden (71 %), sedangkan faktor-faktor yang berhubungan secara bermakna adalah paritas, jarak kelahiran, pendidikan, persepsi, jarak rumah ke RSUD, riwayat persalinan yang lalu. Dari faktor-faktor yang bermakna tersebut yang paling dominan mempengaruhi adalah persepsi ibu hamil terhadap rujukan. Perlu bagi Dinas Kesehatan Kabupaten Musi Banyuasin mempertahankan keberadaan bidan didesa, meningkatkan keterjangkauan sarana rujukan dengan Ambulans desa, meningkatkan pelaksanaan JPKM, serta meningkatkan pembinaan terhadap RSUD Sekayu. Kepada RSUD Sekayu agar memberikan informasi yang selengkap-lengkapnya kepada Puskesmas secara berjenjang bahkan sampai kemasyarakat umum, serta ibu hamil khususnya, dengan meningkatkan promosi keberadaannya sampai kepada masyarakat terpencil, serta rneningkatkan persaingan dengan rumah sakit swasta yang ada. ......This research aims to know the correlation predisposing factors, which is had by pregnant mother high risk according to the age, how many times pregnancy, child number, birth spacing, education, knowledge, perseption, attitude and enabling factors are family income, cost guarantor, distance to District General Hospital, other means, referral suggestion by circumstance, other family in one house, experience in District General Hospital and need factors, which consist of the Last Child Birth History, Disease with Referral System of Pregnant Mother High Risk from Health Centre to Sekayu District General Hospital. This research was done at lO Health Centres (Puskemas) in the Regency of Musi Banyuasin, which is stated in District General Hospital are: Sekayu Kota, Lumpatan, Tebing Bulang, Jirak, Babat Toman, Cinta Karya, Suka Damai, Ngulak, Tanah Abang and Karya Maju Health Centres. This research is a Cross Sectional Study with using total population that using structured quesioner and then was done data taking of l00 respondences. The data which was taken and then was processed by statistic using Frequency Distribution Analysis Technic and Chi-Square using computer SPSS version 9.0 program. The results of research show that l00 resporidences, who were referial to District General Hospital, apparantly they came to Distnct General Hospital was 71 respondences (71%), while the factors, which were correlated with purposes were how many times pregnancy, birth distance, education, perseption, house distance to District General Hospital, Last Child Birth History. From these factors, which are predominant is the perception of pregnant mother to the Referral. It is necessary for Health District in the Regency of Musi l3anyuasin to maintain midwives? existence in the village, to raise achievement. The referral means with village ambulance, to raise Sociely Health Care Garantie (JPKM) Organization and to raise establishment to Sekayu District General Hospital. To Sekayu District General Hospital so that give some information completely to Health Centre gradually even until general society and especially to pregnant mother, to raise existence promotion until low society and to raise competition with the private hospital.