Analisis Hubungan Faktor Internal dan Eksternal dengan Kinerja Bidan Desa dalam Deteksi Dini dan Penanganan Ibu Hamil Kekurangan Energi Kronik (KEK) di Kabupaten Grobogan Tahun 2015

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Rosmala Kurnia Dewi Analisis Hubungan Faktor Internal dan Eksternal dengan Kinerja Bidan Desa dalam Deteksi Dini dan Penanganan Ibu Hamil Kekurangan Energi Kronik (KEK) di Kabupaten Grobogan Tahun 2015 xviii + 154 halaman + 32 tabel + 3 gambar + 14 lampiran Kejadian KEK merupakan salah satu penyebab AKI dan AKB secara tidak langsung. Jumlah AKI di Kabupaten Grobogan tahun 2011 sebanyak 26 kasus (114,03/100.000 KH), tahun 2012 meningkat menjadi 34 kasus (AKI 151,15/100.000 KH), dan tahun 2013 menurun menjadi 22 kasus (AKI 102,03/100.000 KH). Sedangkan AKB tahun 2011 sebesar 194 kasus, terjadi kenaikan pada tahun 2012 sebesar 240 dan kembali turun pada tahun 2013 sebesar 166 kasus. Salah satu penyebab AKB adalah BBLR, karena pada masa kehamilan ibu mengalami KEK. Tujuan penelitian untuk menganalisis faktor internal dan eksternal dengan kinerja bidan desa dalam deteksi dini dan penanganan ibu hamil dan penanganan KEK. Jenis penelitian adalah observasional analitik dengan pendekatan cross sectional. Cara pengambilan data dengan kuesioner terstruktur. Populasi adalah 243 bidan desa di Puskesmas Kabupaten Grobogan. Jumlah sampel adalah 71 bidan desa yang dipilih secara Stratified Random Sampling. Analisis hubungan dengan uji Chi Square dan multivariat dengan Regresi Logistik. Hasil penelitian menunjukkan bahwa umur responden 20-35 tahun (76,1%), masa kerja tergolong baru/≤ 6 tahun (53,5%) dan responden pernah melakukan penanganan KEK (81,7%). Ada hubungan antara fasilitas kesehatan (p=0,001), dukungan rekan kerja (p=0,016), dukungan masyarakat (p=0,001), dukungan pimpinan (p=0,0001) dengan kinerja bidan desa dalam deteksi dini ibu hamil KEK. Faktor yang berpengaruh secara bersama-sama terhadap kinerja adalah fasilitas kesehatan (p=0,000; Exp(B)=25,395), dukungan pimpinan (p=0,001; Exp(B)=10,278). Disarankan kepada instansi terkait (Puskesmas dan Dinas Kesehatan Kabupaten) memberikan fasilitas kesehatan yang lengkap dan memadai agar meningkatkan kinerja tenaga kesehatan dalam pelayanannya. Kata Kunci : Bidan Desa, Kinerja, Deteksi Dini dan Penanganan Ibu Hamil KEK Referensi : 53 (1990-2012) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Rosmala Kurnia Dewi Relationship Analysis of Internal and External Factors with Performance of Village Midwives in Conducting Early Detection and Handling Pregnant Women with Chronic Energy Deficiency (CED) in Grobogan District in 2015 xviii + 154 pages + 32 tables + 3 figures + 14 enclosures Chronic Energy Deficiency (CED) is one of the causes of maternal and infant mortality indirectly. Maternal Mortality Rate (MMR) in Grobogan District increased gradually during the period of 2011 – 2012 from 26 cases (114.03/100,000 live births) to 34 cases (151.15/100,000 live births), and decreased sharply to be 22 cases (102.03/100,000 live births) in 2013. Meanwhile, Infant Mortality Rate (IMR) was 194 cases in 2011, rose dramatically in 2012 to be 240 cases, and declined sharply in 2013 to be 166 cases. Low Birthweight Babies (LBWB) was one of the causes of infant mortality because pregnant women suffered from CED during their pregnancies. The aim of this study was to analyse internal and external factors with performance of village midwives in conducting early detection and handling pregnant women with CED. This was an observational-analytic study using cross-sectional approach. Data were collected using structured questionnaires. Population was 243 village midwives at health centres in Grobogan District. As many as 71 village midwives were selected randomly using a technique of stratified random sampling. Data were analysed using analyses of bivariate (chi square test) and multivariate (logistic regression test). The results of this research showed that most of the respondents aged ranging from 20-35 years old (76.1%), had working period less than or equal to 6 years (53.5%), ever handled CED (81.7%). Variables of health facilities (p=0.001), fellow worker support (p=0.016), community support (p=0.001), leader support (p=0.0001) had significant relationship with the performance of village midwives in conducting early detection of pregnant women with CED. Factors jointly influencing the performance were health facilities (p=0.000; Exp(B)=25.395), and leader support (p=0.001; Exp(B)=10.278). As suggestions, health centres and District Health Office need to provide complete health facilities to improve performance of health workers in providing services. Key Words : village midwives; performance; early detection and handling pregnant women with CED Bibliography : 53 (1990-2012