Evaluasi Input dan Proses Pelaksanaan Pengawasan Fasilitatif oleh Bidan Koordinator terkait Program Kesehatan Ibu dan Anak di Kabupaten Lumajang

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Diana Noor Fatmawati Evaluasi Input dan Proses Pelaksanaan Pengawasan Fasilitatif oleh Bidan Koordinator terkait Program Kesehatan Ibu dan Anak di Kabupaten Lumajang xvi + 131 halaman + 3 tabel + 5 gambar + 20 lampiran Kasus kematian ibu dan bayi di Kabupaten Lumajang pada lima tahun terakhir menunjukkan kecenderungan peningkatan. Hal tersebut salah satunya dapat disebabkan karena lemahnya pengawasan fasilitatif program KIA oleh bidan koordinator sehingga permasalahan yang melatar belakangi belum terpantau akibatnya usaha perbaikan belum maksimal. Tujuan penelitian ini menganalisis input dan proses pelaksanaan pengawasan fasilitatif oleh bidan koordinator terkait program kesehatan ibu dan anak di kabupaten lumajang. Jenis penelitian adalah observasional dengan metode kualitatif. Informan utama adalah bidan koordinator Puskesmas 4 orang. Informan triangulasi bidan desa 8 orang, kepala Puskesmas 4 orang dan 1 orang kabid Kesga. Data dikumpulkan dengan wawancara mendalam. Pengolahan dan analisis data menggunakan analisis isi. Hasil penelitian menunjukkan bahwa pelaksanaan manajemen fasilitatif program KIA belum berjalan dengan baik. Beberapa masalah pada aspek input: bidan koordinator belum dilatih, keterbatasan dan keterlambatan pencairan dana, buku pedoman tidak dibagi ke bidan desa. Masalah pada proses: urutan prioritas sasaran belum sesuai ketentuan, pembahasan orientasi kegiatan pengawasan dan pengisian daftar tilik tidak rutin, daftar tilik diisi bidan koordinator. Penilaian prosedur keterampilan klinis bagi bidan desa sulit dilaksanakan karena tidak selalu ada pasien, wawancara prosedur dan peragaan keterampilan klinis jarang dilaksanakan. Masalah pada pengorganisasian belum ada SK tim maupun pembagian tugas, Masalah pada monitoring dan evaluasi yaitu masih ada Puskesmas yang belum menyerahkan laporan kegiatan ke Dinas Disarankan kepada Dinas Kesehatan untuk melakukan refreshing kegiatan pengawasan fasilitatif, melakukan pendampingan, melakukan monitoring dan evaluasi secara rutin. Bagi puskesmas disarankan untuk menerbitan SK kegiatan dan pembagian tupoksi, meningkatkan keterampilan petugas pelaksana pengawasan, mengadakan simulasi kasus untuk meningkatkan keterampilan. Kata Kunci : Pengawasan Fasilitatif, Program KIA Pustaka : 54 (1993-2015) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Diana Noor Fatmawati Evaluation of Input and Process of Implementing the Facilitative Monitoring by Coordinator Midwives relating to the Program of Maternal and Child Health in District of Lumajang xvi + 131 pages + 3 tables + 5 figures + 20 enclosures Maternal and infant mortality cases in District of Lumajang in the past five years were prone to increase. These problems were due to weaknesses in conducting the facilitative monitoring of a maternal and child health program by coordinator midwives. The aim of this study was to analyse input and process of implementing the facilitative monitoring by coordinator midwives relating to the maternal and child program in District of Lumajang. This was an observational study using qualitative approach. Main informants consisted of four coordinator midwives working at health centres. Meanwhile, informants for triangulation purpose consisted of eight village midwives, four heads of health centres, and a head of family health department. Data were collected by conducting indepth interview. Furthermore, data were analysed using content analysis. The results of this study showed that the facilitative monitoring had not been well implemented. Some problems occurred in input aspects were: coordinator midwives were untrained; disbursement of funds was limited and late; and a guidance book was not provided to a village midwife. Some problems happened in process aspects were: sequence of target priorities was not in accordance with a standard; discussing activity orientation for monitoring and filling a checklist was irregular; and coordinator midwives filled checklist. Procedure assessment of clinical skills for village midwives was difficult to implement because there was no sufficient number of patients. In addition, procedures of interview and practically clinical skills were rarely conducted. In organising aspects, there was no decree for either a team or job descriptions. In aspects of monitoring and evaluating, some health centres had not reported their activities to District Health Office (DHO). DHO needs to refresh activities of facilitative monitoring, to supervise, to monitor, and to evaluate regularly. Health centres need to release decrees for activities and job descriptions, to improve skills of monitoring officers, to conduct case simulation to improve skills. Key Words : Facilitative Monitoring, Program of Maternal and Child Health Bibliography : 54 (1993-2015

Hubungan Kejadian Hipertensi dengan Kadar Trigliserida pada Supir Bus di Terminal Arjosari Kota Malang

Hypertension is a health problem that is widely encountered in the community and correlates with other diseases. There are many factors that cause hypertension, one of which is abnormal triglyceride levels or hypertriglycerides. Higher levels of triglycerides will inhibit the occurrence of lipogenesis. Lipogenesis is a factor that causes hypertension from food intake, this is because food has a significant role in increasing blood pressure, especially protein and fat. This study aims to determine the relationship between triglyceride levels and hypertension. This type of research is an analytical research with the crosssectional method, statistical data analysis using correlation regression, the number of population as many as 50 respondents and the sample used as many as 21 respondents. Data collection using questionnaires, blood pressure measurements and triglyceride level checks. Blood pressure measurement is done manually and then for the examination of triglyceride levels using the GPO-PAP method is carried out in the laboratory of the Bareng Health Center using a spectrophotometer. The statistical analysis used is the correlation Pearson test. The results of the study on bus drivers with high blood pressure showed that some respondents had high triglyceride levels because they often ate fatty foods. Based on the examination that has been carried out on 21 bus driver respondents at the Arjosari Terminal, Malang City, it shows that triglyceride levels and high blood pressure have no relationship, with the test results using the Pearson correlation statistical test obtained a result of P=0.0766 0.05 with a Pearson value of P=-0.069 correlation meaning that it does not have a relationship with the degree of very weak relationship.Hipertensi merupakan masalah kesehatan yang banyak di jumpai pada masyarakat dan berkorelasi dengan penyakit lainnya. Banyak faktor terjadinya hipertensi salah satunya adalah kadar trigliserida yang tidak normal atau hipertrigliserida. Kadar trigliserida yang lebih akan menghambat terjadinya lipogenesis. Lipogenesisi adalah satu faktor penyebab hipertensi dari asupan makanan, hal ini dikarenakan makanan mempunyai peranan yang berarti dalam meningkatkan tekanan darah terutama protein dan lemak. Penelitian ini bertujuan untuk mengetahui hubungan kadar trigliserida dengan hipertensi. Jenis penelitian ini merupakan penelitian analitik dengan metode crossectional, analisis data statistik dengan menggunakan regresi korelasi, jumlah populasi sebanyak 50 responden dan sampel yang di gunakan sebanyak 21 responden. Pengumpulan data dengan menggunakan kuesioner, pengukuran tekanan darah dan pemeriksaan kadar trigliserida. Pengkuran tekanan darah di lakukan secara manual lalu untuk pemeriksaan kadar trigliserida dengan metode GPO-PAP di lakukan di laboratorium Puskesmas Bareng menggunakan alat spektrofotometer. Analisis statistik yang di gunakan adalah uji pearson korelasi. Dari hasil penelitian pada supir bus dengan tekanan darah tinggi menunjukan sebagian responden memiliki kadar trigliserida yang tinggi di karenakan sering mengonsumsi makanann yang berlemak. Berdasarkan pemeriksaan yang telah di lakukan pada 21 responden supir bus di Terminal Arjosari Kota Malang, menunjukan hasil bahwa kadar trigliserida dan tekanan darah tinggi tidak memiliki hubungan, dengan hasil uji menggunakan uji statistik korelasi pearson di dapatkan hasil P=0,0766 0,05 dengan nilai pearson korelasi P=-0,069 artinya tidak memiliki hubungan dengan derajat hubungan yang sangat lemah

Kecemasan Menyebabkan Terjadinya Kandidiasis Vulvovaginalis Pada Primigravida di BPS Widia Husada Malang

Tujuan: Kecemasan pada ibu hamil dapat mengurangi kekebalan tubuh. Kecemasan yang terjadi dalam jangka panjang dapat mempengaruhi sistem kekebalan tubuh secara keseluruhan. Kondisi hamil merupakan kondisi imunosupresan. Perubahan respon imun pada kehamilan dapat mengurangi kemampuan ibu terhadap infeksi, sehingga rentan terhadap infeksi jamur C. albicans.  Tujuan penelitian ini untuk membuktikan hubungan antara tingkat kecemasan primigravida dengan terjadinya kandidiasis vulvovaginalis. Metode: Penelitian ini merupakan penelitian korelasi dengan case control (retrospektif) desain. Populasi yang digunakan adalah semua ibu hamil yang diuji dalam beberapa bulan dari Januari hingga Agustus 2014. Sampel dipilih sesuai dengan kriteria inklusi. Teknik pengambilan sampel dilakukan dengan total sampling. Hasil: Hasil uji Spearman menunjukkan p=0,00 dengan α=0,05; ada hubungan yang signifikan antara tingkat kecemasan dengan kandidiasis vulvovaginalis. Nilai korelasi r=0.507 menunjukkan kekuatan korelasi sedang, dan  arah korelasi positif. R2=0,24 menunjukkan kecemasan memiliki pengaruhsebesar 24% terhadap kejadian candidiasis vulvovaginalis. Simpulan: Kondisi kecemasan merangsang hipotalamus pituitari axis untuk  membentuk kortisol dan menurunkan s-IgA yang sehingga tubuh rentan terhadap infeksi C. albicans. Kesimpulan dari penelitian ini ada hubungan antara tingkat kecemasan pada primigravida dengan kandidiasis vulvovaginalis. Selanjutnya disarankan untuk dilakukan pengukuran kadar kortisol sebagai tanda kecemasan dan S-IgA sebagai tanda penurunan perlindungan mukosa vagina. Kata Kunci: Kecemasan, primigravida, candidiasis vulvovaginali

Pengaruh Yoga pada Ibu Inpartu Primigravida terhadap Kemajuan Persalinan Kala I Fase Aktif

The fears, anxiety, and fear both of during pregnancy, childbirth or in the face after childbirth often experienced by primigravida. Increased maternal psychological burden can cause a variety of complications that can result in the availability and quality of maternal persalianan fetus. Yoga can help mothers to overcome anxiety when faced with the birth process. This study aims to determine the progress of labor primigravida difference between the treated yoga and yoga as well as how much yoga affect the progress of labor primigravida.The research design is the design of pre experiment design with a static group comparison approach. The population was primigravida is the active phase of the first stage from April to November 2016 in BPM Nurul Aini as many as 34 people. Total sample is 17 people doing yoga and 17 people do not do yoga. The statistical test used was Wilcoxon Mann - Whitney U - Test (SPSS) and Linear Regression Test.The results of research that labor progress Kala Active Phase I primigravida given treatment yoga almost half the normal progress ie 6 hours of 8 people (47.1%) and were not given the treatment yoga accelerating progress on the 5 o'clock as many as 1 ( 5.9%). Wilcoxon Mann Whitney U Test Results in SPSS p value <0.05, it indicates that the difference between the labor progress primigravida treated yoga exercises with yoga exercises that do not. And then to know how far the influence of yoga exercises on the progress of the first stage of labor is the active phase primigravida performed linear regression test and get the value of R2 = 0.383, which means yoga exercises influence by 38.3% against the first stage of labor progress for primiravida active phase. In an effort to overcome anxiety and pain during childbirth, yoga can be disseminated to the public to be done routinely. Their yoga classes maternal health services can facilitate pregnant women to actively follow it. The participation of health workers, cadres, families and communities in the implementation of yoga classes can help implement a yoga class for pregnant women

Gambaran Kadar Hemoglobin Pada Petani Buah Jeruk Pengguna Pestisida Di Desa Karangwidoro Kecamatan Dau Kabupaten Malang: Description of Hemoglobin Levels in Citrus Fruit Farmers Using Pesticide in Karangwidoro Village, Dau District, Malang Regency

Hemoglobin is a protein that contains iron and is found in erythrocytes which functions as a carrier of oxygen from the lungs throughout the body. Hemoglobin also carries carbon dioxide back to the lungs to be exhaled out of the body. When the level of hemoglobin in the body is low, anemia is indicated. Low hemoglobin levels can be caused by the use of pesticides which are toxic chemicals and are often used by farmers to eradicate pests in the agricultural sector. Exposure to pesticides in the body causes the formation of sulfhemoglobin and methemoglobin binding which is the cause of the low amount of hemoglobin in red blood cells resulting in anemia. The purpose of this study was to describe the level of hemoglobin in citrus fruit farmers using pesticides in Karangwidoro Village, Dau District, Malang Regency. This research is a descriptive research with purposive sampling technique. The population is 76 farmers and the sample consists of 22 male farmers. Hemoglobin levels were checked using the Easy Touch Hemoglobin tool. The normal value of hemoglobin level is 13.0 g/dL-17.0 g/dL. The results showed that Hemoglobin levels in citrus fruit farmers using pesticides ranged on average 14.9 g/dL, the lowest value was 11.5 g/dL, and the highest value was 18.0 g/dL. The conclusion in this study is that almost all farmers who use pesticides have hemoglobin levels within normal limits. The suggestion for this research is to be able to add a series of complete blood profile examinations such as erythrocytes, hematocrit, leukocytes, and platelets