Another year over ….

Final editorial for year 2015 for Journal of Asian Midwive

Evaluasi Model Komunikasi Bidan Desa Sebagai Ujung Tombak Upaya Penurunan Angka Kematian Ibu Bersalin Di Kabupaten Sukabumi Provinsi Jawa Barat

Angka kematian ibu adalah risiko yang terkait dengan setiap kehamilan yaitu risiko obstetrik. Hal ini dihitung sebagai jumlah kematian ibu selama tahun tertentu per 100.000 kelahiran hidup pada periode yang sama. Pada Tahun 2012, Angka Kematian Ibu Ratio (MMR) di Indonesia meningkat tajam menjadi 359 kematian per 100.000 kelahiran hidup dibandingkan dengan 228 kematian per 100.000 kelahiran hidup pada tahun 2010. Provinsi Jawa Barat merupakan penyumbang terbesar MMR tinggi di Indonesia dengan 369/100.000 kelahiran hidup pada tahun 2012 dan 238/100.000 hidup kelahiran pada tahun 2010. Sukabumi merupakan salah satu kabupaten dengan MMR tertinggi di Jawa Barat dengan sebanyak 363/100.000 kelahiran hidup pada tahun 2012 dan 226/100.000 kelahiran hidup pada tahun 2010. Sementara target MDG's untuk MMR pada tahun 2015 adalah 102/100.000 kelahiran hidup. Semua program yang diarahkan pada peran bidan desa sebagai ujung tombak upaya penurunan AKI di Indonesia. Seorang bidan dituntut untuk memiliki kemampuan komunikasi yang baik aktif, dan dinamis, dan dapat diterima oleh masyarakat karena keberhasilan program dalam menurunkan AKI di Indonesia, 73% ditentukan oleh keahlian seorang bidan dalam melayani pasien. Seperti di kabupaten lain di Indonesia, setiap bidan di Kabupaten Sukabumi juga melayani persalinan dari satu atau dua desa di wilayah tersebut. AKI di Sukabumi menurun lebih dari 60% dibandingkan dengan angka tahun sebelumnya. Komunitas model komunikasi bidan di Kabupaten Sukabumi dianggap memiliki kontribusi penting terhadap prestasi tersebut

Estimasi Risiko Penyebab Kematian Neonatal Di Indonesia Tahun 2007

Background: in Indonesia, the infant mortality is still high, if comparing to other Asean countries, thah is 4.6 times higher than in Malaysia, 1.3 times higher than in Philippines, and 1,8 times higher than in Thailand. The aims of this research was to determine the association of the neonatus mortality causes and age of mothers at the time delivering and birth assitant. Methods: data analyzed were data od Basic Health Research year 2007-2008 on RKD-07. Block AV1. The total samples were 257 infants. Analyze data with univariat, bivariat, and than logistic regresi binary. Results: result showed the neonatus mortality caused is the complication of temperature regulation 39.8%; the complication of pregnant and delivering mother is 23.4%; and also the causes of respiration and cardiovascular 23.1%. In the village, the neonatus mortality age is more than, and the neonatus mortality happened to be < 24 hours after delivering. Amount of mother with risk age ( > 20 years old and ≥36 year old) is more enough. The proportion of complication of mother with risk age is 24.3%, it is more high while the mother without risk age is 16.6%. Mother with risk age when delivering have risk 1,6 times to happen temperature regulation disorder in baby. In Village, the proportion of unsave deliverying midwive more high while save delivering midwive. The delivering with non medical provider have more enough risk 1,2 times to happen complication when delivering baby, have more enough risk 1,2 times to happen respiration and cardivascular disorder in neonatus, and have more high risk 1,6 times to happen temperature regulation disorder in neonatus. Mother with unsave deliverying midwive (non medical provider) have more high risk 3,7 times to happen hypertension or eclamsia while mother thaht helping by medical provider when deliverying baby, have more enough risk 2,7 time to happen long phase of delivering (long partus) and have more enough risk 1,02 times to happen premature/rupture membrane when delivering baby. Suggestions: It is suggested that the need to intensify education to the public, especially couples of childbearing age including pregnant women, husbands and families by health workers and cadres of health that seeks to avoid pregnancy at risk for maternal age range, ie > 20 years and > 36 years, pregnant women and families should always be directed to the maternity health workers when delivering baby, so the likelihood of either risk in infants and mothers during childbirth and after childbirth can be reduced. Besides needing skills upgrading of skills of health workers especially in the promotion of the importance of antenatal care through training and periodic refreshing

Sikap Mengenai Keselamatan pada Residen dan Perawat di Rumah Sakit Pendidikan

Background: Provider attitudes about issues pertinent topatient safety may be related to errors and adverse events.Residents as the main health provider in teaching hospitalsplay an important factors for assuring patient safety.Objective: To assess the attitudes of residents towards patientsafety and compare the attituted to other health providersnurse/midwive) in the Obstetrics Gynaecology Outpatient Clinic.Methods: This was a survey conducted in a teaching hospitalat Yogyakarta. Safety Attitude Questionnare (SAQ)-A questionnairewas adapted into Indonesian setting to assess attitudesamong residents and nurses at Obstetrics Gynaecologyoutpatient clinic. All residents and health providers were invitedto participate in this survey.Results: Total of 71 respondents involved in this survey (consistedof 79% of total residents and 82% of total nurses). TheSAQ-A questionnaire which was used here had comparableinternal consistency with the previous study. In general attitudestowards patient safety were higher among nurses/midwive than residents. Significant differences revealed relatedto perception to management and stress recognition.Perception to management score was the lowest compared toother scales (19,6% residents versus 33,3% nurses withpositive attitudes). There was no differences for other scalesbut still with low attitude scores. Aspects related to informationtransfer between residents and consultant, clinic referralsystem and care in test results management were perceivedas poor by residents and nurses.Conclusion: Residents have lower attitudes towards patientsafety compare to nurses/midwive. This study shows theimportance of providing orientation among residens beforetheir training program to improve patient safety attitude.Key Words: attitude towards patient safety, safety attitudesquestionnaire, teaching hospita

Midwife Acceptability in Implementation of Labor Warranty Policy in the District Mojokerto

Background: The existence of midwive as the Jampersal main guard so important. Midwive acceptability has become Jampersal issue\u27s at district level, then the reason is enough to do a policy analysis of Jampersal.It is important to ensure successful implementation in the field, so the aim of improving access to maternal and child health services, as well as further reduction of MMR and IMR can be achieved. This study aimed to analyze the midwifes acceptability to the implementation of Jampersal in Mojokerto regency. Methods: This research is observational study. This study is also the policy analysis research on policy implementation stage.Policy research is classified as an ‘analysis of policy\u27. In-depth interviews and focus group discussions withthe data obtained from the field actors. Content analysis is done by analyzing the acceptability of thematically based midwives in Mojokerto regency to the Jampersal membership, benefit package, accountability, and the tariff. Result: Research shows that midwives most accept to the Jampersal accountability. It is perceived more easily than other health financing. For the acceptability of the benefit package and the tariff, midwives could still accept although with little objection. For Jampersal membership, most midwives still objected to the Jampersal membership models. Conclution: It needs to be disseminated to a deeper understanding of the meaning and purpose of the Jampersal philosophy. Recommendation: Socialization is also able to explain what the background of every detail measures taken, including what makes the midwife objected

The Effect of Motivation and Other Factors on Midwive Performance of Preeclampsia Management in Malang, East Java

Background: The incidence of preeclampsia, the precursor to eclampsia, varies greatly worldwide. WHO estimates the incidence of preeclampsia to be seven times higher in developing countries (2.8% of live births) than in developed countries (0.4%). Preeclampsia and eclampsia remain a major cause (31.04%) of maternal mortality in East Java. It is essential to early detect preeclampsia in order to prevent mortality. Good performance of midwives in the management of preeclampsia may reduce maternal mortality attributable to eclampsia. It is hypothesized that motivation, leadership style, working atmosphere, insentive, skill, and training, all have impact on midwives performance. This study aimed to analyze the effects of motivation and other factorson midwives performance in preeclampsia managementin Malang, East Java, using path analysis model. Subjects and Method: This was an analytic observational study with cross sectional design. The study was conducted in Community Helath Centers, Malang, East Java in September 2017. A total sample of 161 midwives were selected using total sampling technique. The endogenous variables were motivation and midwives performance. The exogenous variables were insentive, working atmosphere, leadership style, skill and training. The data were collected using a set of questionnaire and analyzed by path analysis. Results: Midwife performance were positively affected by working atmosphere (b= 0.11; SE= 0.04; p= 0.004), leadership style (b= 0.06; SE= 0.02; p= 0.004), skill (b= 0.24; SE= 0.03, p< 0.001), and motivation (b= 0.68; SE= 0.03; p< 0.001). Motivation was positively afected by insentive (b= 0.25; SE= 0.09, p= 0.006), training (b= 0.89; SE= 0.28; p= 0.001), skill (b= 0.39; SE= 0.06; p< 0.001), leadership style (b= 0.08; SE= 0.05; p= 0.110), and working atmosphere(b= 0.35; SE= 0.09; p< 0.001). Conclusion: Midwives performance are positively affected by working condition, leadership, skill, and motivation. Keywords: preeclampsia, path analysis, motivation, midwives performanc

Contribution Factors on Early Initiation of Breastfeeding

One of the causes of high Infant Mortality Rate is the low coverage of exclusive breastfeeding. One of the supporting factors to exclusive breastfeeding is implementation of Early Initiation of Breastfeeding (EIB). Mother's knowledge and understanding about the EIB, as well as the role of birth attendants, especially midwives can be strongly support it's the EIB. The purpose of this research was to determine the relationship between mother's knowledge, mother's attitudes and midwife role with the implementation of Early Initiation of Breastfeeding (EIB). The research was an observational analytic research employed cross sectional design. The subjects were maternity mothers who inpatient at Pulang Pisau Hospital in Central Kalimantan Province, Indonesia. The results showed that there were significant relationships between mother's knowledge, attitudes and midwife role with the Implementation of Early Initiation of Breastfeeding (EIB). Attitude was the most influenced variable to the EIB

Health Services And Its Utilization Related To Exclusive Breastfeeding And Early Breastfeeding Initiation Program In West Java Province

Despite the essential benefit of early initiation of breastfeeding and exclusive breast feeding during the first six months, the practice was still low. Health services and personnel play important role have not optimal yet in breast feeding. The aim of this study was to review the provision of health services and its utilization related to early breastfeeding initiation and exclusive breastfeeding practices in West Java province. This study was an analysis of the Indonesian Health Facility Survey (Rifaskes) 2011 and the Basic Health Survey (Riskesdas) 2010. It analyzed 45 public hospitals and 997 primary health centers in West Java Province from HFS and 285 infants (0-6 months) in West Java province from Riskesdas. It supplemented with qualitative data that obtained from in-depth interviews with the representatives from central government, Provincial Health Office, District Health Office (DHO), public health centers and hospitals in Bandung city and Bogor district, West Java. This study revealed that a number of gaps related to breastfeeding services in PHC and hospitals were still found. One of the influential factors that hindering the breastfeeding services in health services was the absence of local policy regarding early initiation of breastfeeding and exclusive breastfeeding practices in West Java Province. The limitation of human resources, facilities and specific budget were also become the obstacles in the implementation of the breastfeeding program. This study implied that most of community already utilized the maternal and childs heath care. This study indicated the importance of health services and support from health professionals for successful of breastfeeding. Thus the strong commitment of health personnels as well as the policy makers was really needed.Keywords : early initiation of breastfeeding; exclusive breastfeeding; health facilities; utilizationAbstrakMeskipun manfaat esensial dari inisiasi menyusu dini dan ASI eksklusif selama enam bulan pertama sudah banyak diketahui, namun prakteknya masih rendah. Pelayanan kesehatan dan tenaga kesehatan memegang peranan penting dalam peningkatan praktek menyusui namun belum optimal. Studi ini bertujuan untuk meninjau penyediaan layanan kesehatan dan pemanfaatannya terkait dengan inisiasi menyusui dini dan pemberian ASI eksklusif di provinsi Jawa Barat. Penelitian ini merupakan analisis dari Riset Fasilitas Kesehatan (Rifaskes) 2011 dan Survei Kesehatan Dasar (Riskesdas) 2010. Sampel dalam analisa ini adalah 45 rumah sakit umum pemerintah dan 997 Puskesmas dari data Rifaskes dan 285 bayi (0-6 bulan) di Provinsi Jawa Barat dari data Riskesdas. Analisis ini dilengkapi dengan data kualitatif yang diperoleh dari wawancara mendalam dengan pemerintah pusat, Dinas Kesehatan Propinsi dan Kabupaten/Kota (Dinkes), puskesmas dan rumah sakit di kota Bandung dan Kabupaten Bogor, Jawa Barat. Penelitian ini mengungkapkan bahwa sejumlah kesenjangan yang berkaitan dengan pelayanan inisiasi menyusu dini dan asi eksklusif di Puskesmas dan rumah sakit pemerintah masih ditemukan. Salah satu faktor berpengaruh yang menghambat pelayanan dan program ASI eksklusif dan inisiasi menyusu dini adalah tidak adanya kebijakan lokal mengenai inisiasi dini menyusui dan pemberian ASI eksklusif di Provinsi Jawa Barat. Keterbatasan sumber daya manusia, fasilitas dan anggaran khusus juga menjadi hambatan dalam pelaksanaan program ini. Penelitian menyirat kan bahwa sebagian besar masyarakat sudah memanfaatkan perawatan kesehatan ibu dan anak. Dengan pentingnya pelayanan kesehatan dan dukungan dari para profesional kesehatan untuk keberhasilan menyusui, komitmen yang kuat dari tenaga kesehatan serta pembuat kebijakan benar-benar diperlukan.Kata kunci: Inisiasi Menyusu Dini, Asi Eksklusif, Fasilitas Kesehatan, Pemanfaata