Factors Related to the Work Performance of Midwives in the IUD Contraception Service in Primary Healthcare Centers of Surabaya City

The decrease of IUD active family planning participants' coverage in Surabaya in the last three years, from 12.27% to 6.1%, became a special attention for Surabaya district health office. The decrease was caused by inadequate work performance of midwives in implementing IUD contraception service in the primary healthcare centers in Surabaya area. Objective of the study was to analyze factors related to the work performance of midwives in the IUD contraception service in the primary healthcare centers of Surabaya city area. This was an analytical- observational study using cross sectional approach. Study population was all midwives in the primary healthcare centers in Surabaya city who provide family planning service, and who had attended in CTU training (362 midwives). Study subjects were 78 respondents, and they were selected using proportional stratified random sampling method. Data collection was conducted through structured interview and observation. Multiple linear regression tests were applied in the data analysis. Results of the study showed that work performance of midwives in the IUD contraception service in Surabaya city area was in a good category (55.1%). Midwives' knowledge on IUD contraception service specifically on screening and counseling before insertion was insufficient (82.1%). Motivation of midwives was good (55.1%). Midwives attitude regarding IUD contraception service was not supportive (51.3%). Perception of midwives towards head of primary healthcare center leadership was good (52.6%). Midwives perception on remuneration they received was good (53.8%). Facilities to support IUD contraception service were available (53.8%).Motivation, attitude, and perception on the leadership were associated with midwives' work performance. However, knowledge, perception of remuneration, and facilities were not associated with midwives' work performance in the IUD contraception service. Motivation and perception on the leadership, in common, were associated with midwives' work performance in the IUD contraception service.Suggestions for district health office was to perform supervision directly and periodically, to evaluate and monitor the implementation of program in every primary healthcare center, and to provide permission for midwives who want to take further study

Analysis on Policy Implementation of Exclusive Breastfeeding for Working Women in South Kalimantan Province

Coverage of exclusive breastfeeding in the South Kalimantan province was still low (51.18%); itwas lower than the national target (80%).The number of working mothers in this province wasrelatively high and it was increasing in the last several years. Policies concerning breastfeedingduring working time in the work place, such as decrees, government regulations, and commonregulation from three ministers had been established. However, a number of institutions had notobeyed the policies. Objective of the study was to explain the implementation of exclusive breastfeeding for working mothers in South Kalimantan Province.This was a qualitative study. Data collection was done through in-depth interview and observation.Study respondents/subjects were a head of women empowerment section of the women empowermentand child protection institution (BPPPA), a head of human resource section of the labor andtransmigration department, and a head of nutrition section of South Kalimantan province healthoffice. Those respondents were considered as main informants. Triangulation informants were leadersof government institutions and leaders of companies. Content analysis method was applied in thedata analysis.Results of the study showed that a number of institutions had not provided lactation room in the workplace. No communication was done among BPPPA, Disnakertrans, and province health office. Workinggroup from those three institutions had not been established. Only one of three private institutions hadreceived information regarding the policies. No funding was allocated, human resource and specificfacilities to implement policies were not provided. All executors supported the policies. Specific districtgovernment regulations concerning exclusive breastfeeding had not been established.In conclusion, implementation of exclusive breastfeeding policy for working mothers in SouthKalimantan province was not done properly. It was caused by no specific local governmentregulations concerning exclusive breastfeeding

Factors Related to the Work Performance of Private Midwives in Using the “Poedji Rochjati” Scores for Early Detection of High Risk Pregnancy in Gresik Regency

Poedji Rochjati score was a method used in East Java province to detect high risk pregnancy. Private practice midwives (BPS), surprisingly, did not optimally detect high risk pregnancy using ‘Poedji Rochjati' score; they only used the score when there was a certain indication. Objective of this study was to identify factors affecting work performance of BPS in utilizing ‘Poedji Rochjati' score to detect pregnancy risk. This was an observational analytical study with cross sectional approach. Data were collected using questionnaire. Study population was BPS in Gresik district, and 90 of them were selected as study subjects. Chi square was applied in the bivariate analysis, and multiple logistic regressions were applied in the multivariate analysis. Results of the study showed that 56.67% of BPS had good work performance in utilizing ‘Poedji Rochjati' score. Variables related to work performance were knowledge (p= 0.04), attitude (p= 0.001), motivation (p < 0.001), perception on IBI supervision (p= 0.003). Workload was not significantly associated with work performance (p= 0.443). Attitude and motivation together were associated with work performance. District health office and IBI are suggested to improve the quality of supervision and guidance to BPS in utilizing ‘Poedji Rochjati' score; to give routine refreshing to improve knowledge, attitude, and motivation of BPS in conducting proper detection of high risk pregnancy

Determinant Factors on the Implementation of Stimulation Detection and Early Intervention on Growth and Development (SDIDTK) by Health Cadres in Malang City

Growth and development detection and early intervention stimulation (SDIDTK) was activities tostimulate basic skill of children 0-6 years old, hence they grew and developed optimally. Less stimulation could cause deviation in the growth and development of the children, and disorder could be permanent.Coverage of SDIDTK in Malang city in 2010 reached 56.13%, in 2011 was 69.41%, these coveragewere still below the target of 90%. Objective of this study was to analyze determinant factors of theimplementation of SDIDTK by cadres in primary healthcare centers in Malang cityThis was an observational analytical study with cross sectional approach. Independent variableswere cadre characteristics (age, education, occupation, length of period as a cadre), knowledge,attitude, facilities, community supports, midwives supports, and training. Dependent variable wasimplementation of SDIDTK. Study subjects were 81 cadres who conducted SDIDTK, and they wereselected purposively. Data were collected through interview guided by structured questionnaireand observation list. Chi square test and Fisher exact test were applied in the bivariate analysis;logistic regression method was applied in the multivariate analysis.Results of the study showed mean of respondents' age was 45.4 years, average length of period asa cadre was 10.6 years, 49.4% of respondents' level of education were high school, 88.9% ofrespondents' occupation were housewives, 50.6% of SDIDTK were good, respondents with goodknowledge were 95.1%, respondents with good attitude were 61.7%, 23.5% of facilities wereadequate, 74.1% of respondents stated that community supports were good, 88.9% of respondentsstated that midwives supports were good. No association was found between age of cadres (p=0.311), level of education (p= 0.146), occupation (p= 0.647), knowledge (p= 0.551), attitude (p=0.218), facilities (p= 0.233), community supports (p= 0.749), midwives supports (p= 0.516) andthe implementation of SDIDTK. Length of period as a cadre and training together had an associationwith the implementation of SDIDTK by cadres.Determinant factors of the implementation of SDIDTK by cadres were training and length of periodas a cadre. Improvement of the implementation of SDIDTK is required; it can be done by conductingSDIDTK training to all posyandu (health service post) cadres

Suplementasi Vitamin E dan Profil Lipid Penderita Dislipidemia: Studi pada Pegawai Rumah Sakit Profesor Dokter Margono Soekarjo Purwokerto

Vitamin E supplementation and lipid profile in patients with dislipidemia Background: The prevalence of dislipidemia in Indonesia increase lately. Vitamin E has important role in cholesterol metabolism and protecting low density lipoprotein cholesterol against oxidation. This study was to investigate the effect of vitamin E supplementation on lipid profile.Method: The study was a randomised controlled clinical trial. Subjects were the employees of Professor Doctor Margono Soekarjo hospital aged 30-50 years who suffered from dislipidemic. The supplementation groups received 400 IU vitamin E and the control group received placebo once a day for 30 days. Lipid profile was examined using vitros system chemistry analyser 250 dan 350. Nutritional intake were gathered using food recall method and processed with nutrisurvey. Analyses were conducted using T-test, Mann Whitney, Wilcoxon and Chi square tests. Result: There were no differences in total (p=0.910), LDL (p=0.457) and HDL cholesterol levels (p=0.809) as well as trigliseride level (p=0.687) between the two groups before suplementation. There were differences in total (p=0.004) and LDL (p=0.002), there were no differences in HDL cholesterol level (p=0.332) and trigliseride level (p=0.940) between the two groups after supplementation. There were differences on the changes in total cholesterol (p=0.001) and LDL cholesterol (p=0.000) and no differences on the changes in HDL cholesterol level (p=0.197) as well as trigliserida level (p=0.438). There was no difference in nutritional intake between the two groups. Conclusion: That supplementation of vitamin E 400 IU once daily for 30 days improve lipid profile