Antenatal, Place of Birth and Post-natal Related to Breastfeeding Practice among Women in Peri-urban Area, Semarang

Background: Key health issues for women of reproductive age include problems concerning sexuality and reproduction. Sexuality is not merely about sex, but about the right of women to make choices and decisions related to sexual behaviour and practices, relationships, breastfeeding, contraception and abortion. This paper will examines the various health facilities, the services and treatments which are available, in particular those which influence breastfeeding practices. Methods: A combination of qualitative and quantitative data collection methods were used in this research. In the quantitative method, a questionnaire survey was conducted following preliminary analysis of the data collected through focus group discussions (FGDs). The methods employed for qualitative data collection included focus group discussions, informal and in-depth interviews and participant observation. The sample group in the peri-urban area included pregnant women, mothers with babies less than 2 years old, a few husbands and a small number of women of reproductive age. Results: This research found that there were many factors influencing the choice of birth place such as location, costs and the quality of the services provided by nurses, doctors, etc. The women in this area still preferred the services of the dukun bayi for the postnatal treatment. Conclusion: The place where the mother delivers the baby influences their motivation to breastfeed. Although the respondents mentioned that breastfeeding is a good practice for feeding baby, however, they lack of knowledge about breastfeeding. This condition is closely related to poor counselling about breastfeeding

Evaluasi Manajemen Program Perawatan Metode Kangguru (PMK) untuk Perawatan Bayi Berat Lahir Rendah (BBLR) di RSUD Gunung Jati Cirebon

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2013 ABSTRAK Eva Susanthi Evaluasi Manajemen Program Perawatan Metode Kangguru (PMK) untuk Perawatan Bayi Berat Lahir Rendah (BBLR) di RSUD Gunung Jati Cirebon xviii + 139 halaman + 71 tabel + 14 lampiran Persentase kejadian Bayi Berat Lahir Rendah (BBLR) di Kota Cirebon pada tahun 2011 sebesar 36,9% atau 208 BBLR per 5636 LH dan pada tahun 2012 sebesar 37,79% atau 208 kasus dari 5504 LH. Perawatan BBLR dengan Perawatan Metode Kangguru (PMK) sudah mulai diterapkan di Rumah Sakit Umum Daerah (RSUD) Gunung Jati Cirebon sejak tahun 2011. Hasil studi pendahuluan didapatkan ada keterbatasan SDM terlatih, anggaran dan sarana prasarana, perencanaan program PMK tidak dibuat serta belum adanya koordinasi dengan stakeholder. Tujuan penelitian ini untuk menganalisis pelaksanaan manajemen program PMK di RSUD Gunung Jati dilihat dari aspek input, proses, output dan lingkungan. Metode penelitian ini yaitu kualitatif melalui wawancara mendalam dan observasi langsung. Informan utama terdiri dari 5 orang yaitu Direktur RSUD Gunung Jati Cirebon, Kepala Ruang Perinatologi dan 3 orang petugas terlatih PMK di Ruang Perinatologi. Informan triangulasi 20 orang terdiri dari 9 orang dari pihak rumah sakit, 6 orang dari pihak stakeholder dan 5 orang dari ibu/keluarga BBLR. Data dianalisis menggunakan metode content analysis. Hasil penelitian menunjukkan bahwa pelaksanaan program PMK di RSUD Gunung Jati belum optimal, dimana variabel input masih kurang yaitu SDM terlatih PMK masih kurang, anggaran hanya ada pada awal program, sarana dan prasarana sangat terbatas, SOP belum disesuaikan dengan kondisi rumah sakit, hal ini dikarenakan jajaran manajerial belum membuat analisis kebutuhan dan belum menguasai bagaimana melakukan analisis masalah. Variabel proses didapatkan perencanaan, pengorganisasian belum dilaksanakan karena jajaran manajerial belum menguasai manajemen sehingga berpengaruh pada pelaksanaan program PMK yang hanya dilaksanakan kurang dari dua jam menjelang pasien dipulangkan sehingga pasien tidak begitu paham bagaimana PMK dilanjutkan dirumah, hal ini dikarenakan SDM terlatih sangat terbatas dengan beban kerja yang tidak sedikit. Variabel output tidak menggambarkan keberhasilan program PMK karena rumah sakit tidak membuat perencanaan standar output. Variabel lingkungan yaitu stakeholders berjalan sendiri-sendiri, jejaring pelaksanaan program PMK belum terkoordinir dengan baik. Disarankan agar RSUD Gunung Jati membekali jajaran manajerial di RSUD Gunung Jati mengenai analisis masalah agar dapat memenuhi keterbatasan input dan membekali jajaran manajerial mengenai manajemen program PMK, membuat output program yang ingin dicapai dan membuat jejaring kerjasama dengan stakeholders. Kata Kunci : Perawatan Metode Kangguru, Sistem, Input, Proses, Output, Lingkungan. Referensi : 32 (1978-2012) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2013 ABSTRACT Eva Susanthi Management Evaluation of Kangaroo Mother Care to Take Care of Low Birth Weight Babies at Gunung Jati Public Hospital in Cirebon xviii + 139 pages + 71 tables + 14 enclosures Percentage of Low Birth Weight Babies (LBWB) in Cirebon City was 36.9% or 208 cases from 5,636 live births in 2011 and was 37.79% or 208 cases from 5,504 live births in 2012. Kangaroo Mother Care (KMC) to take care LBWB has been implemented at Gunung Jati Public Hospital in Cirebon since 2011. The result of preliminary research revealed that number of trained workers, available funds, and means were limited, planning of KMC program was not made, and there was no coordination with stakeholders. This research aimed to analyze management implementation of KMC program at Gunung Jati Public Hospital viewed from the aspects of input, process, output, and the environment. This was qualitative research by conducting indepth interview and direct observation. Number of Informants was 5 persons consisted of the Gunung Jati Public Hospital Director, Head of Perinatology Room, and 3 trained KMC officers at the Perinatology Room. In addition, number of informants for triangulation purpose was 20 persons consisted of 9 persons from the hospital, 6 persons from stakeholders, and 5 persons from LBWB families. Data were analyzed using content analysis. The result of this research showed that the implementation of KMC program at the hospital had not been done optimally. Regarding Input variables, there were fewer trained KMC officers, allocation of fund was just available at the beginning of the program, means was limited, Standard Operating Procedure had not been adjusted with the hospital condition because hospital managers had not made analysis of necessity and they could not make problem analysis. The process variables indicated that planning and organizing had not been implemented because the managers could not manage well. This condition influenced the implementation of KMC program which had to be conducted less than two hours before patients went home. This problem was due to limited number of trained KMC officers and heavy workloads. The output variables showed that the success of the program could not be described because there was no output standard. The environment variables revealed that there was no good coordination among stakeholders. As a suggestion, the hospital director needs to improve the hospital managers’ knowledge about problem analysis as an input variable and management of KMC program as an output variable. The director also needs to determine a standard of output and improve cooperation with stakeholders. Key Words : Kangaroo Mother Care, System, Input, Process, Output, The Environment Bibliography : 32 (1978-2012

Analisis Determinan Pemanfaatan Buku KIA oleh Bidan Desa dan Ibu Hamil di Kabupaten Demak

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Asih Ariani Analisis Determinan Pemanfaatan Buku KIA oleh Bidan Desa dan Ibu Hamil di Kabupaten Demak xvi + 126 halaman + 7 tabel + 4 gambar + 5 lampiran Buku KIA sebagai sumber informasi status kehamilan harus dibaca dan dibawa ibu saat periksa kehamilan. Buku KIA bagi bidan adalah catatan pemantauan ibu hamil dan bayi/balita sehingga harus diisi lengkap. Buku KIA tidak dibaca dan dianggap sebagai buku periksa. Bidan tidak menjelaskan Buku KIA karena kesibukan pekerjaan. Bidan hanya meminta ibu membawa Buku KIA ketika berkunjung. Buku KIA tidak diisi optimal sehingga kondisi kehamilan sulit dipantau. Tujuan penelitian menjelaskan determinan pemanfaatan Buku KIA dari bidan desa dan ibu hamil di Kabupaten Demak. Merupakan penelitian deskriptif dengan metode kualitatif. Subyek penelitian 10 ibu hamil dan 10 bidan desa. Informan triangulasi Bidan Koordinator dan Kasi Kesga Dinkes. Faktor determinan meliputi pengetahuan, sikap, kepercayaan, ketersediaan Buku KIA, fasilitas penunjang dan komunikasi. Data dikumpulkan dengan wawancara mendalam dan dianalisis dengan analisis isi. Pengetahuan bidan desa tentang Buku KIA sudah baik namun belum diaplikasikan bagi peningkatan pengetahuan ibu hamil, selain untuk pencatatan dan deteksi dini faktor resiko. Ibu hamil tahu Buku KIA karena sudah mengenal dan mengetahui pentingnya Buku KIA. Bidan desa dan ibu hamil percaya bahwa Buku KIA dapat dipakai sebagai panduan informasi riwayat dan deteksi kehamilan. Jumlah Buku KIA belum memenuhi sasaran dan harus pengadaan mandiri. Komunikasi terjalin melalui interaksi langsung menggunakan Buku KIA sebagai media. Minat ibu hamil untuk rutin memeriksakan kehamilan meningkat, termasuk keikutsertaan dalam “Kelas Ibu Hamil”. Meski Buku KIA sudah dimanfaatkan untuk periksa kehamilan, namun ibu hamil belum rutin mempelajarinya sesuai isi Buku KIA. Dinas Kesehatan perlu koordinasi dengan puskesmas dan bidan desa terkait jumlah sasaran supaya Buku KIA tepat pengadaannya. Monitoring dan supervisi dilakukan secara rutin berkala. Bidan Koordinator juga perlu melakukan supervisi fasilitatif dan pendampingan teknis bagi bidan desa. Kata kunci : Pemanfaatan Buku KIA, Bidan Desa, Kehamilan Kepustakaan : 38 (1974-2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Asih Ariani Determinant Analysis of Utilising Maternal and Child Health Book by Village Midwives and Pregnant Women in Demak District xvi + 126 pages + 7 tables + 4 figures + 5 enclosures A Maternal and Child Health (MCH) book is a source of information about status of pregnancy that must be read and brought by pregnant women when visiting antenatal care services. The MCH book is utilised by midwives to monitor pregnant woman and baby/children under five years old. The MCH book was not read and was assumed as a check book. Midwives did not explain the MCH book due to busy at work. Midwives just asked mothers to bring the book when they visited them. The MCH book was not entirely filled by which pregnant condition was hard to be monitored. The aim of this study was to explain determinants of using the MCH book by village midwives and pregnant women in Demak District. This was descriptive research using a qualitative method. Research subjects consisted of 10 pregnant women and 10 village midwives. Informants for triangulation purpose involved Coordinator Midwives and Head of Family Health Section at District Health Office (DHO). Determinant factors consisted of knowledge, attitude, belief, availability of MCH books, supporting facilities, and communication. Data were collected by conducting indepth interview and analysed using content analysis. Generally, midwives’ knowledge of the MCH book was good. Notwithstanding, their knowledge had not been implemented to improve pregnant women’ knowledge. The MCH book was only utilised to record and to do early detection of risk factors. Pregnant women recognised the MCH book. They understood the importance of the MCH book. Village midwives and pregnant women believed that the MCH book could be utilised as an information guidance of history and detection of pregnancy. Number of the MCH books were not sufficient. In addition, the MCH books were provided independently. Communication was done through direct interaction using the MCH book as media. Pregnant women’ interest to routinely check their pregnancies and to participate in a pregnant women class increased. Pregnant women had not optimally learned the contents of the MCH book. DHO needs to do coordination with health centres, and midwives to precisely determine number of targets and the MCH books. Monitoring and supervising need to done regularly. Coordinator midwives need to do facilitative supervision and technical guidance for village midwives. Key Words: utilisation of MCH book; village midwife; pregnancy Bibliography: 38 (1974-2013

Antenatal, Place of Birth and Post-natal Related to Breastfeeding Practice Among Women in Peri-urban Area, Semarang

Background: Key health issues for women of reproductive age include problems concerning sexuality and reproduction. Sexuality is not merely about sex, but about the right of women to make choices and decisions related to sexual behaviour and practices, relationships, breastfeeding, contraception and abortion. This paper will examines the various health facilities, the services and treatments which are available, in particular those which influence breastfeeding practices.Methods: A combination of qualitative and quantitative data collection methods were used in this research. In the quantitative method, a questionnaire survey was conducted following preliminary analysis of the data collected through focus group discussions (FGDs). The methods employed for qualitative data collection included focus group discussions, informal and in-depth interviews and participant observation. The sample group in the peri-urban area included pregnant women, mothers with babies less than 2years old, a few husbands and a small number of women of reproductive age.Results: This research found that there were many factors influencing the choice of birth place such as location, costs and the quality of the services provided by nurses, doctors, etc. The women in this area still preferred the services of the dukun bayi for the postnatal treatment.Conclusion: The place where the mother delivers the baby influences their motivation to breastfeed. Although the respondents mentioned that breastfeeding is a good practice for feeding baby, however, they lack of knowledge about breastfeeding. This condition is closely related to poor counselling about breastfeeding

Faktor-Faktor yang Berhubungan dengan Kinerja dan Dasolin pada Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) di Kabupaten Sumenep Tahun 2014

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2016 ABSTRAK Fitriah Faktor-Faktor yang Berhubungan dengan Kinerja dan Dasolin pada Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) di Kabupaten Sumenep Tahun 2014 xvii+ 163 Halaman + 35 tabel + 3 Gambar + 12 Lampiran Salah satu upaya untuk menurunkan AKI (Angka Kematian Ibu) dengan melaksanakan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dalam wujud kegiatan tabulin dan dasolin yang difasilitasi bidan desa. Tujuan dari penelitian ini adalah untuk menganalisis faktor – faktor yang berhubungan dengan kinerja bidan desa sebagai fasilitator dalam kegiatan dasolin dan tabulin pada program P4K di Kabupaten Sumenep Tahun 2014. Jenis penelitian ini adalah analitik observasional dengan design cross sectional.Variabel bebas(umur, status perkawinan, pendidikan, pengetahuan, pengalaman, motivasi dan supervisi), variabel terikat (kinerja bidan desa). Jumlah sampel 90bidan desa yang berada di 30 puskesmas. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner terstruktur yang telah diuji validitas dan reliabilitas. Analisis bivariat dengan uji chi-square dan analisis multivariat dengan uji regresi logistik. Hasil penelitian ini menunjukkan bahwa responden memiliki kinerja kurang (30%), umur muda (31,1%), status perkawinan tidak menikah (24,4%), pendidikan kurang (42,2%), pengetahuan kurang (35,6%) pengalaman kurang (77,8%), motivasi kurang (26,7%), supervisi kurang (24,4%) pada pengelolaan kegiatan tabulin dan dasolin diwilayah kerjanya. Ada hubungan positif antara pengetahuan ( p = 0,019)dan supervisi (p = 0,037) terhadap kinerja bidan desa sebagai fasilitator dalam pelaksanaan kegiatan tabulin dan dasolin pada program P4K.Ada pengaruh bersama – sama antara pengetahuan (p=0,07) dan Supervisi ( p= 0,013) terhadap kinerja bidan desa sebagai fasilitator dalam pelaksanaan kegiatan tabulin dan dasolin pada program P4K. Disarankan kepada Dinas kesehatan beserta pihak puskesmas dan IBI untuk mengadakan pelatihan dan workshop atau sosialisasi kepada bidan desa mengenai program P4K khususnya kegiatan dasolin dan tabulin. Kata kunci : Kinerja, Bidan Desa, Kegiatan Tabulin dan Dasolin, Kabupaten Sumenep. Kepustakaan : 55 (1993-2012) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2016 ABSTRACT Fitriah Factors Relating to Performance and Social Fund for Delivery on a Delivery Planning and Complication Prevention Program (P4K) in District of Sumenep in 2014 xvii + 163 pages + 35 tables + 3 figures + 12 appendices One of the efforts to decrease maternal mortality rate (MMR) was an implementation of a delivery planning and complication prevention program (P4K) in activities of delivery mother’s saving and social fund for delivery conducted by village midwives. The aim of this study was to analyse factors relating to performance of a village midwife as a facilitator in the activities of delivery mother’s saving and social fund for delivery on the P4K in District of Sumenep in 2014. This was an analytic-observational study using a cross-sectional approach. Independent variables consisted of age, marital status, education, knowledge, experience, motivation, and supervision and a dependent variable was performance of village midwives. Number of samples were 90 village midwives working at 30 health centres. Data collection used a structured questionnaire that had been performed tests of validity and reliability. Furthermore, data were analysed using methods of bivariate (Chi-Square test) and multivariate (Logistic Regression test). The results of this research showed that respondents had low performance (30%), young age (31.1%), not married (24.4%), low education (42.2%), low knowledge (35.6%), low experience (77.8%), low motivation (26.7%), and low supervision (24.4%) in managing the activities of delivery mother’s saving and social fund for delivery at their work areas. Variables of knowledge (p=0.019) and supervision (p=0.037) statistically significantly related to the performance of village midwives. These two variables jointly influenced the performance of village midwives with p values= 0.07 and 0.013 respectively. District Health Office, Health Centre, and Indonesian Midwives Association need to conduct training, workshop, or socialisation to village midwives regarding the P4K particularly the activities of delivery mother’s saving and social fund for delivery. Keywords : Performance, Village Midwife, Activities of Delivery Mother’s Saving And Social Fund For Delivery, District Of Sumenep Bibliography: 55 (1993-2012

Evaluation of Local Supplementary Feeding Program in Toddler Nutrition Recovery House (Pelita) in Kedung Banteng District, Tegal Regency

One approach taken to reduce the prevalence of stunting is by providing additional recovery food to malnourished toddlers. The Rumah Pelita supplementary food program has been running in Kedung Banteng District since 2020. In the implementation of the Rumah Pelita Program, there are still existing cases of stunting and the nutritional status of targets and there has never been an evaluation of the Rumah Pelita program. The aim of the research is to determine the evaluation of the supplementary feeding program made from local food in Kedungbanteng District, Tegal Regency in terms of input, process and output aspects. This research method is qualitative research which is descriptive and evaluative in nature. The research period is January-March 2023. The research was conducted in 5 villages in the Kedungbanteng Community Health Center area. The main informants were 1 nutrition officer and 5 village midwives, and triangulation informants were 5 Rumah Pelita cadres and 5 mothers of toddlers. Data collection used in-depth interviews, while the source triangulation method was used to validate the data. Research data analysis is data reduction, data presentation and drawing conclusions. The results of the research show that the number of cadres is still insufficient, and there are still villages that have not budgeted for equipment rental and transportation for cadres, there are deficiencies in reporting and recording and there are still toddlers who experience stunting. There needs to be integration of central and regional government policies regarding handling stunting in toddlers, so that there is a division of the budget for handling stunting. and it is recommended that health workers provide health education about stunting prevention and routinely monitor the development of toddlers.  Keyword: Stunting, Policy, Nutrition, Provision of supplementary food, Toddle

Breastfeeding and Bottle Feeding Practices: a Phenomenon Towards Infant Feeding Practices in Semarang

Background: Breastfeeding is regarded as good practice today. Women are encouraged to breastfeed and to continue breastfeeding for at least four to six months. In Indonesia, a campaign for exclusive breastfeeding was introduced more than 20 years ago. However, the Indonesian Demographic and Health Survey (IDHS) 2002 show that only 55.1 percent of babies were breastfed exclusively until four months old.Method: The purpose of this paper is to examine breastfeeding and bottle feeding practices among women in Semarang based on socio-cultural factors. The respondents for the study were, respectively, pregnant and breastfeeding women who living in Lintang village in Semarang. A qualitative data collection method was used in this research. The methods employed for qualitative data collection included focus group discussions, informal and in-depth interviews and participant observation.Results: This study found that the mothers in Lintang village stated that breastfeeding is healthy, cheap and practical. They perceived breastfeeding to be a natural process, part of a women\u27s duty and good parenting, which promotes a good relationship between mother andbaby. However, this study found that they lack a complete of understanding of the processes and nutritional issues involved in breastfeeding. This researchalso found that inconsistency in government policies to support the breast-feeding programmes, such as the poor implementation of the ‘baby friendly hospital\u27 with ‘rooming-in programmes\u27 and also the length of maternity leave for working women, have led to an increase in bottle-feeding practices in Indonesi