Hubungan Persepsi Ibu Tentang Sarana Pelayanan KIA dengan Kun- Jungan Pemeriksaan Kehamilan (K4) (Studi di Wilayah Kerja Puskesmas Tegal Barat II Kota Tegal Tahun 2006)

Background: Maternal and Child Care is one of factors to reduce Maternal Mortality Rate. This service needs sufficient supports, i.e. antenatal care guideline, health personnel, and its facilities. A pregnant mother is required to have a minimum of 4 times of Antenatal Care within her pregnancy, i.e. 3rd month, 6th month, 7th and 9th month. Compared to other health centers, Tegal Barat II Health Center recorded lower rate on Antenatal Visitors Rate or about 60%. Meanwhile, the national standard requires 90% of Antenatal Visitors Rate. This research aimed to explain the association between maternal perception on maternal and child carefacilities and antenatal care (K4).Method: This research was an explanatory research, utilizing cross sectional approach. Forty five respondents were taken from mothers who have babies less than 3 months old and visited the health centers. Questionnaires were utilized to gather the data, and the analysis wasconducted based on descriptive as well as analytic.Result: Result showed that out of 45 respondents: 53.3% had perception that antenatal guideline book was not interesting, 17.8% said that health personnel had to examine fundus height metrically, and 93.3% said that all pregnant women had to obtain Fe tablets from health center. Variables that significantly associated with antenatal care (K4) were maternal perception on antenatal care guideline (at p-value: 0.012) and maternal perception on antenatal care facilities (at p-value: 0.0001). Meanwhile, maternal perception on health personnel (at p-value: 0.161) was not associated with antenatal care. It was concluded and recommendedthat the performance of Antenatal Care Guideline and Antenatal Care Facilities must be improved.Keywords: Antenatal care, service quality

Factors Related to Work Performance of Village Midwives in Applying Informed Choice and Informed Consent in Contraception Service in North Minahasa District

Application of informed choice and informed consent constituted an effort to increasecoverage and quality of family planning (KB) service. Application of informed choice andinformed consent in North Minahasa district was not optimum. It could be seen from the factsthat coverage of active KB participants decreased in the last four years, and the number ofpeople who dropped out from using contraceptive device increased. Objective of the studywas to analyze factors related to work performance of village midwives in applying informed choice and informed consent in contraception service in North Minahasa district. This was anobservational-analytical study with cross sectional approach. Data were collected throughinterview guided by questionnaire. Study population was 100 village midwives in NorthMinahasa. Fifty respondents were selected randomly from all primary healthcare centersvillage midwives who fulfilled inclusion and exclusion criteria. Chi-square test and logisticregression were applied in the data analysis. Results of the study showed that mean ofrespondents' age was 34 years, mean of respondents' duration of work was 11 years, andmost of respondents' education was D III Kebidanan. Motivation, facilities, perception onworkload, and work performance were good. However, knowledge was still insufficientspecifically on understanding term for counseling step ‘SATUTUJU' and on the method to fillinformed consent form. Supervision was still inadequate due to no routine supervisionactivity. Factors related to work performance were motivation (ρ= 0.048), facility (ρ= 0.001),and perception on supervision (ρ= 0.001). Factor that, in common, influenced workperformance were perception on supervision (ρ= 0.001). Motivation, facility, and perceptionon supervision were related with work performance of village midwives in applying informedchoice and informed consent in the contraception service. The strongest factor affecting workperformance was perception on supervision

Factors Affecting Village Midwives Work Performance in Conducting Early Detection of High Risk Pregnancy in the Antenatal Care in South Bengkulu District

Antenatal care provided health service for pregnant women and their fetuses according to theminimum standard of 7T, and minimum of four examinations during pregnancy. These standardswere intended to assure protection to pregnant women, such as risk factors early detection,complication prevention and management. Based on the coverage of maternal and children localarea monitoring (PWS-KIA), maternal and infant mortality rates, and preliminary survey tovillage midwives, it was concluded that work performance of village midwives was stillinadequate. Objective of this study was to identify factors affecting work performance of villagemidwives in conducting early detection of high risk pregnancy in the antenatal care. This was anexplanatory research with cross sectional approach. Data were collected using structuredquestionnaire and observation. Study population was village midwives. Samples consisted of 93respondents who were selected using simple random sampling technique. Results of the studyshowed that 73.1% of village midwives\u27 age were in the range of 25-35 years old, and 37.6% ofvillage midwifes duration of work were in the range of 36-60 months. Bivariate analysis withcross tabulation and Pearson Product Moment test indicated that variables related to workperformance were knowledge (p= 0.000), motivation (p= 0.004), perception on supervision ofcoordinator midwives (p= 0.016), and perception on workload (p= 0.047). Multivariate analysisusing multivariate logistic regression test indicated common effect of knowledge and facilitiesvariables with significance value of 0.000 and r 2 = 0.394; it meant that 39.4% of workperformance variable could be explained by variation of those two variables. District healthoffice is expected to provide training, to complete facilities for village midwives before startingto work in the village; to form team or committee as a consultation place. Puskesmas is expectedto complete documentation facilities; head of puskesmas and coordinator midwives are advisedto actively doing supervision

Evaluasi Kinerja Sistem Informasi Manajemen Farmasi Di RS Roemani Muhammadiyah Dengan Metode Hot Fit Model

Evaluasi kinerja Sistem Informasi Manajemen Farmasi (SIMF) di RS Roemani harus dilakukan karena kebijakan pengoperasian sistem farmasi belum sepenuhnya dilaksanakan, manajer keuangan masih sulit untuk memprediksi pengeluaran biaya untuk pembelian stok obat, informasi jumlah obat yang terekap pada sistem informasi farmasi tidak sama dengan jumlah obat yang ada di gudang, dan kualitas petugas farmasi juga masih rendah. Model analisis HOT- Fit menempatkan komponen penting dalam sistem informasi yakni manusia (Human), organisasi (Organization), dan teknologi (Technology). Tujuan yang ingin dicapai adalah mengetahui kinerja sistem informasi farmasi di RS Roemani Muhammadiyah ditinjau dari persepsi pengguna dengan menggunakan indikator HOT Fit Model. Jenis penelitian ini adalah penelitian deskriptif dengan pendekatan kuantitatif. Populasi dalam penelitian ini adalah semua petugas yang terlibat dalam SIM farmasi berjumlah 40 orang. Instrumen penelitian dalam bentuk kuesioner, lembar observasi dan pedoman wawancara. Data yang diperoleh dianalisis dengan analisis statistik diskriptif yang dilanjutkan dengan pengkatagorian baik (e”maen/median) dan kurang baik (<mean/median) dengan menggunakan normalitas data. Dari hasil observasi yang dilakukan pada penelitian ini, diperoleh prosentase dari total skor jawaban responden pada masing-masing aspek, pada kinerja SIM farmasi dikatagorikan baik (75%). Kinerja SIM farmasi dikatagorikan kurang baik (55%) dari aspek human, kurang baik (57,5%) dari aspek organization dan baik (55%) dari aspek technology. Penelitian ini menghasilkan simpulan Kinerja SIM farmasi dikatagorikan baik karena sudah dapat memenuhi kebutuhan dari aspek ketepatan waktu penerimaan informasi dan kelengkapan informasinya, dan dari aspek kualitas informasi bisa dikatakan bahwa sistem informasi farmasi sudah memenuhi kriteria kelengkapan dan relevansinya tetapi belum dapat memenuhi keakuratan informasinya seperti halnya pada data jumlah obat yang terekap pada sistem belum sama seperti data jumlah obat yang ada di gudang. Dari aspek kecepatan waktu penyediaan informasinya belum terpenuhi karena pada saat dilihat pada sistem data yang ada tidak akurat dan harus menunggu akhir bulan setelah penyamaan data obat dengan perhitungan manual baru dapat dilihat data obat yang akurat. Kinerja SIM farmasi itu dikatagorikan baik hanya dari aspek technology sedangkan dari aspek human dan organization dikatagorikan kurang baik seperti halnya belum adanya program pelatihan tentang sistem informasi pada petugas farmasi, tidak adanya SPO pada petugas farmasi dan petugas SIM yang menyebabkan keterlambatan pembetulan jika terjadi masalah pada sistem, tidak adanya masterplan sistem informasi farmasi dan tidak adanya supervisi pada bagian farmasi oleh kepala farmasi. Dari hal tersebutlah yang menyebabkan belum terpenuhinya kebutuhan keakuratan dan kecepatan penyediaan informasi. Saran yang diajukan adalah untuk menguji rekomendasi (SPO petugas farmasi, SPO petugas SIM, jadwal kegiatan pelatihan, dan masterplan SI farmasi) yang diberikan untuk melihat efek penggunaan SIM farmasi yang lebih baik dan supervisi oleh kepala farmasi secara berkala untuk melakukan pengawasan terhadap petugas farmasi berkaitan dengan pelaksanaan SPOnya.Performance evaluation of Pharmacy Management Information System (PMIS) at Roemani Hospital was done because a policy of pharmacy system operation had not been fully implemented, a finance manager was difficult to predict expenditures to buy stock of medicines, information about amount of medicine on the pharmacy information system was different from amount of medicine which was available in repository, and quality of pharmacist was still low. Analysis model of HOT - Fit put important components on information system namely Human, Organization, and Technology. This research aimed to find out about performance of pharmacy information system at Muhammadiyah Roemani Hospital viewed from users' perceptions using indicators of Hot Fit Model. This was descriptive research using quantitative approach. Population was all officers (40 persons) who were involved in PMIS. Research instruments consisted of a questionnaire, an observation sheet, and guidance interview. Furthermore, data were analyzed using descriptive statistics continued by categorizing to be good (e”mean/median) and bad (<mean/median) using data normality. The result of observation revealed that overall; viewed from total score of all aspects, mostly respondents had good performance of PMIS (75%). In addition, viewed from the aspects of human and organization, most of them had bad performances (55%) and (57.5%) respectively. In contrast, viewed from the aspect of technology, most of them had good performance (55%). As a conclusion, the performance of PMIS had been categorized as good. It had fulfilled the aspects of timeliness of receiving information and completion of the information. In addition, the aspects of information quality had fulfilled criteria of completeness and relevance but have not fulfilled accuracy of information. The aspect of technology was categorized as good performance whereas performances of the other aspects, namely human and organization were not good. These factors caused inaccuracy and quickness of providing information. As a suggestion, further pieces of follow- up research need to be conducted to examine recommendation (SOP of a pharmacist, SOP of a MIS officer, a training schedule, and master plan of pharmacy IS) which is provided to identify effects of a PMIS use. In addition, supervision by head of pharmacy needs to be done to monitor performance of pharmacist related to the implementation of SOP

Development of Blood Stock Decision Supporting System in the Blood Transfusion Unit of PMI Banjar District Branch, South Kalimantan, to Support Blood Stock Planning

Blood transfusion unit of Indonesian Red Cross (PMI) Banjar district branch provided service Togovernment and private hospitals and also health clinics in the district of Banjar and severalsurrounding districts/cities. Transfusion unit of PMI Banjar district branch had not utilized computerbase information system. Data input was still done by filling the forms, data was written in theregistration books, data management process was done by counting manually using calculator,Data storage was still mixed with other data, data searching required longer time (> 5 minutes),prediction/estimation had not been done in the blood requirement planning.The objective of this study was to develop blood stock decision supporting system in the bloodtransfusion unit of PMI Banjar district branch, South Kalimantan, to support blood stock planning.Development of the system was based on FAST (Framework for the Application of System Thinking)steps. This study was a qualitative research. Study variables were the ease of access, validity,completeness and appropriateness. The study object was a blood stock decision supporting systemin the transfusion unit of PMI Banjar district branch to support blood stock planning and users.The study subject was the researcher herself/himself. Study instrument used in this study was interviewguideline and observation forms. Content analysis was used to analyze the data.The result of the study found a system problem on the performance, economic, control efficiencyand service. The user needs for data input, data management process and output was known. Basicdata system design was obtained, blood requirement prediction model was available, and textmessaging (SMS) gateway model for output of blood stock information for external user wasavailable. The quality of information was improving such as improvement in the ease of obtaininginformation; the produced information was more complete, more appropriate and more accurate.Suggestions for blood transfusion unit of PMI Banjar district branch are it is better to apply thesystem and conducting socialization to the community to use SMS in order to obtain information onthe blood stock through both leaflet and printing or electronic media. It is important to develop anapplication to manage the donors via SMS alert to remind their next giving blood donation schedule,to give thank you and awards to the donors

Evaluation on the Implementation of Ten Steps to Successful Breast Feeding by Midwives at Doctor Ramelan Naval Hospital Surabaya

Establishment of the 10 steps to be success in breastfeeding (LMKM) was a government effort toimprove exclusive breastfeeding program. Ten LMKM information had been displayed in dr. Ramelannavy hospital (RSAL) Surabaya; however, there was no special policy regarding exclusivebreastfeeding. Therefore, midwives were still giving formula milk (PASI) to infants in the integratedcare room. In general, the objective of this study was to evaluate the implementation of 10 steps tobe success in breastfeeding (LMKM) by midwives in RSAL dr. Ramelan Surabaya.This was a qualitative study with descriptive explorative approach. Main informants were 7 midwivesin the pregnancy policlinic, delivery room, and integrated care room. Triangulation informantswere 3 midwives as chief of the room, one supervisor midwives, and 3 patients. Data were collectedthrough in-depth interview and documentation study. Interactive model was applied in the data analysis. Steps on the interactive model included data collection, data reduction, data display, andconclusion drawing.Results of the study showed that ten LMKM had not been implemented properly. Not all midwivesexplained correctly breastfeeding benefits and breastfeeding technique; midwives still gave formulamilk to infants in the integrated care room; breastfeeding support group (KP-ASI) had not beenformed yet. Only a small portion of midwives who had attended lactation management training;and it caused an insufficient self-motivation among midwives.Written policy regarding exclusive breastfeeding is needed. All midwives are expected to attend inlactation management training; it will optimize the implementation of 10 LMKM. Strong policyregarding the existence of formula milk is needed

The Implementation Analysis of Community-Based Total Sanitation Program as Strategy for Improving Clean and Healthy Living Behavior by Primary Health Care Center Workers in Grobogan Regency

In Grobogan district, the occurrence of diarrhea, morbilli, framboesia, and diphtheria was relativelyhigh. The presence of these diseases was an indicator of hygienic and healthy live behavior (PHBS)of a community. Objective of community based total sanitation (STBM) was to reduce those diseases.However, the implementation of STBM program was still inadequate. Indicators of STBM programwere improper defecation, washing hand using soap, clean water management, waste management, and liquid waste management. Objective of this study was to describe the implementation of STBMprogram in Grobogan district.This was a qualitative study with phenomenon approach. Data collection was done by conductingin-depth interview to 8 main informants: health promotion and environmental health workers.Focus group discussion was conducted to triangulation informants; triangulation informantsconsisted of cadres, local religious leaders, local community leaders, and local people. Data wereanalyzed using content analysis method.Results of the study showed that the majority of workers implemented STBM program well. A thingthat was still insufficient or inadequate was monitoring. The majority of worker's knowledgeregarding the implementation of STBM program was sufficient. Not all workers had good attitudein the implementation of STBM program. The majority of workers did not know regulations inimplementing STBM program; however, cadres knew the regulation. All workers had received STBMprogram training. All heads of primary healthcare centers (puskesmas) had conducted routinesupervision. Facilities were in the form of water closet maker instruments, hand washing facility,waste management instruments, and flip charts.Suggestions for District Health Office were to improve cross program and sector collaborations inthe implementation of STBM program, to increase the role of cadres in the implementation ofSTBM program

Evaluation on Integerated Health Post Monitoring Process by Health Workers in Singkawang City Primary Healthcare Centers,West Kalimantan

Infant mortality rate (IMR) in Singkawang in 2011 was high, 9/1000 live births (absolute number ofdeath was 44). In the integrated health service post (Posyandu), basic services that would reduceIMR were nutritional program and diarrhea control. The development of posyandu in Singkawangin 2011 was not optimal, and the total number of active posyandu was 9.7% of 134 units. Cases ofunder-five children with ‘below the red line (BGM)' and with severe malnutrition found in theposyandu in 2011 were still low; it was 5.1% and 1.09% respectively from all cases in the field.Policy regarding posyandu in Singkawang was to delegate supervision activity to local midwives.Problems faced by midwives in the posyandu supervision were the implementation of supervisionfor 5 tables was not optimal, home visits were rarely conducted, cadres had difficulty in conductingeducation activities, and funding for posyandu supervision was insufficient.This was a qualitative study. Main informants were midwives supervisors, and triangulationinformants were cadres, mothers who participated in the posyandu, and coordinator of posyandu.Data collection was done by conducted in-depth interview using interview guidelines. Method ofanalysis used was content analysis.Results of the study showed that there was inappropriate implementation of coordination meeting;supervision of posyandu information system (SIP) and supervision of reporting and recording werenot properly done; this supervision was only between posyandu coordinator and cadres; it did notinclude midwives who were the supervisors of the posyandu. Young health workers who served inthe posyandu made posyandu participants uncomfortable. The participants of posyandu felt thathealth workers had insufficient experiences. There was a tribe that was reluctant to have theirchildren immunized in the posyandu. Health workers from the main puskesmas came late; no properplace for posyandu was provided; health workers who had not received training, and there was nojob description and work procedure in the supervision of posyandu.Coordination among health workers are needed specifically for posyandu coordinator and midwivesin the field during supervision, and it includes relative young health workers; an approach to keypersons are needed; time management for puskesmas workers is required to avoid they come late inthe posyandu; appropriate place for posyandu should be provided together with the community;training and formulation of policies related to posyandu supervision are required