Beberapa Faktor yang Mempengaruhi Kepatuhan Bidan Desa dalam Pemberian Konseling KB Postpartum pada Ibu Pasca Persalinan di Kabupaten Semarang Tahun 2014

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2014 ABSTRAK Nugraheni Kusumawati Beberapa Faktor yang Mempengaruhi Kepatuhan Bidan Desa dalam Pemberian Konseling KB Postpartum pada Ibu Pasca Persalinan di Kabupaten Semarang Tahun 2014 xvii + 139 halaman + 37 tabel + 3 gambar + lampiran Kepatuhan bidan desa dalam pemberian konseling KB postpartum di Kabupaten Semarang masih sangat rendah. Jumlah PUS yang tidak ikut KB masih cukup banyak, yaitu 19.729 orang dan keikutsertaan KB baru pada PUS mengalami penurunan sebanyak 4.034 orang, sehingga belum bisa mencapai target KB yang diharapkan. Tujuan penelitian ini untuk menguji faktor-faktor apakah yang mempengaruhi kepatuhan bidan desa dalam pemberian konseling KB postpartum pada ibu pascapersalinan di Kabupaten Semarang. Metode penelitian observasional dengan metode survey dan pendekatan cross sectional. Instrumen penelitian menggunakan kuesioner dan check-list pada 70 bidan desa yang dipilih dengan Stratified Random Sampling. Analisis bivariat menggunakan uji chi square dan analisis multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan kepatuhan bidan desa dalam pemberian konseling KB postpartum pada ibu pasca persalinan masih rendah (54,3%). Karakteristik bidan desa: 77% berumur antara 18-40 tahun, pendidikan terakhir bidan desa 100% D III kebidanan, dan 66% masa kerja lebih dari lima tahun. Sebagian besar bidan desa berpengetahuan baik tentang KB postpartum (82,9%), memiliki motivasi rendah (51,4%), bersikap positif (62,9%), supervisi bidan koordinator masih kurang baik (54,3%), bidan desa masih kurang terampil dalam pemberian konseling KB postpartum (60%), dan sarana yang dimiliki bidan desa sudah lengkap (65,7%). Ada hubungan antara motivasi (p=0,0001), supervisi (p=0,005), dan keterampilan (p=0,021) dengan kepatuhan bidan desa dalam pemberian konseling KB postpartum. Tidak ada hubungan antara pengetahuan (p=1,000), sikap (p=0,491), dan sarana (p=0,812) dengan kepatuhan bidan desa dalam pemberian konseling KB postpartum. Variabel yang berpengaruh secara bersama-sama terhadap kepatuhan bidan desa dalam pemberian konseling KB postpartum adalah motivasi (ExpB=8,534), supervisi(ExpB=5,587), dan keterampilan (ExpB=3,382). Disarankan Dinas Kesehatan dan Puskesmas untuk lebih meningkatkan motivasi, supervisi, dan keterampilan bidan desa dalam pemberian konseling KB postpartum pada ibu pasca persalinan. Kata kunci : Faktor yang Mempengaruhi Bidan Desa, Konseling KB Postpartum Kepustakaan : 63 (1997 – 2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2014 ABSTRACT Nugraheni Kusumawati Some Factors influencing the Obedience of Village Midwife in Providing Counselling of Postpartum Family Planning to Mothers after Childbirth in Semarang District in 2014 xvii + 139 pages + 37 tables + 3 figures + enclosures The obedience of village midwives in providing counselling of postpartum family planning in Semarang District was still low. Number of couples of childbearing age who did not follow family planning program was very large, namely 19,729 persons. In addition, new family planning acceptors among those couples decreased about 4,034 persons. Therefore, it had not achieved a target yet. This study aimed to analyze factors influencing the obedience of village midwives in providing counselling of postpartum family planning in Semarang District. This was observational research with survey method and cross-sectional approach. Research instrument used questionnaires and check-lists interviewed to 70 village midwives selected using Stratified Random Sampling. Furthermore, data were analyzed using bivariate analysis (Chi-Square test) and multivariate analysis (Logistic Regression test). The result of this research showed that most of the research participants had lack of obedience (54.3%). In addition, most of them had age ranging from 18 to 40 years old (77%), graduated from DIII Midwifery (100%), and had working period more than five years (66%). Furthermore, most of the respondents had good knowledge about postpartum family planning (82.9%), low motivation (51.4%), positive attitude (62.9%), lack of supervision by coordinator midwives (54.3%), lack of skill in providing postpartum family planning (60%), and complete means (65.7%). The variables of motivation (p=0.0001), supervision (p=0.005), and skill (p=0.021) had significant relationship with the obedience of village midwives in providing counselling of postpartum family planning. On the other hand, the variables of knowledge (p=1.000), attitude (p=0.491), and means (p=0.812) were not significant. Furthermore, the factors of motivation (Exp(B)=8.534), supervision (Exp(B)=5.587), and skill (Exp(B)=3.382) jointly significantly influenced the obedience of village midwives. As suggestions, District Health Office and health centers need to improve motivation, supervision, and skills of village midwives in providing counselling of postpartum family planning among mothers after childbirth. Key Words : Factors Influencing Village Midwife, Counselling of Postpartum Family Planning Bibliography : 63 (1997-2013

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

Analisis Stakeholder Program Usaha Kesehatan Sekolah (UKS) di Kabupaten Sragen

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2016 ABSTRAK Pramukti Dian Setianingrum Analisis Stakeholder Program Usaha Kesehatan Sekolah (UKS) di Kabupaten Sragen 97 halaman + 9 tabel + 3 gambar + 30 lampiran Implementasi Pedoman SKB 4 Kementerian tahun 2004 tentang UKS meskipun didukung SK Bupati tentang pembentukan Tim Pembina UKS sejak tahun 2013 belum dilaksanakan secara optimal hal ini dikarenakan tidak adanya koordinasi lintas sektor oleh para stakeholder. Tujuan penelitian menganalisis Stakeholder Pada Program UKS di Kabupaten Sragen. Desain penelitian kualitatif disajikan secara deskriptif eksploratif, menggunakan teknik non probability sampling dengan purposive sampling. Subjek penelitian 4 orang informan utama adalah Kasi kesejahteraan masyarakat, Kasi Upaya Kesehatan Institusi Pemberdayaan Masayarakat (UKI PM), Kasi Kesiswaan, Seni Dan Olahraga dan Kasi madrasah dan pendidikan agama islam pada sekolah Umum dan informan triangulasi terbagi dalam 2 kelompok yaitu 4 orang dari Kabid Kesra, Kabid Promkes dan kemitraan kesehatan, Kabag Kesiswaan, Seni Dan Olahraga dan Kabag Pendidikan Agama Islam pada Sekolah Umum dan 31 orang pelaksana TP UKS kecamatan dan sekolah. Data dikumpulkan dengan indepth interview, FGD, pengolahan data dengan metode analisis isi (content analysis). Hasil penelitian menunjukkan bahwa pemetaan stakeholder yang terlibat yaitu Pembuat keputusan (Decision Maker) yaitu Pemerintah Daerah (Kesra), Pelaksana kegiatan (Designer) meliputi Dinas kesehatan, Dinas Pendidikan, Kementerian Agama dan Sasaran (client) meliputi Kepala Puskesmas, Camat, Guru pelaksana pada tingkat SD/SMP/SMU, dan Guru pelaksana pada tingkat MI/MTS/MAN. Analisis peresepsi menunjukan bahwa sebagian besar stakeholder memiliki sikap yang mendukung terhadap implementasi program UKS, Pada kelompok stakeholder pengambil keputusan yaitu pemda (kesra) belum dapat memenuhi kriteria sebagai leading sector pada program UKS, sehingga berada pada kelompok Raksasa tidur (sleeping giant), dinas kesehatan memiliki posisi potensial sebagai “Penyelamat” (saviour), Dinas pendidikan sebagai provider berada pada kelompok Kawan” (friend) dan Kementerian Agama yang juga sebagai provider diposisikan sebagai “pemerhati” (acquaintance) Kata kunci : Program UKS, Analisis Stakeholder. Sikap, Power, Urgency Kepustakaan : 42 (2004-2014). Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2016 ABSTRACT Pramukti Dian Setianingrum Stakeholder Analysis of School Health Efforts (UKS) Program in District of Sragen 97 pages + 9 tables + 3 figures + 30 appendices A Joint Decree guideline of four ministries in 2014 about UKS and Regent’s Decree about a form of an UKS supervisory team in 2013 had not been optimally implemented yet. This condition was due to no coordination between inter-sectors conducted by stakeholders. The aim if this study was to analyse stakeholder on the program of UKS in District of Sragen. This was a qualitative study presented using descriptive and explorative methods. Subjects were selected using a technique of non-probability sampling (purposive sampling). Main informants consisted of four persons, namely head of community welfare section, head of institution health efforts -community empowerment section, head of student, art, and sport section, head of madrasah and Islam education at general schools. Meanwhile, informants for triangulation purpose consisted of two groups namely four heads of community welfare department, health promotion and health partnerships department, student, art, and sport department, and Islam education at general schools and 31 implementers of UKS at subdistrict and school levels. Data were collected using indepth interview, FGD and analysed using content analysis. The involved stakeholders consisted of a decision maker namely Local Government (community welfare), implementers (designers) namely health office, education office, and religion ministry. Target (clients) consisted of head of health centre, head of sub district, teachers at levels of elementary/junior/senior high schools, and teachers at levels MI/MITS/MAN. Perception analysis showed that majority of stakeholders supported the implementation of the UKS program. A decision maker had not met criteria as a leading sector at the UKS program and was included as a group of a sleeping giant. Health office potentially could be as a saviour. Education office as a provider played a role as a friend. Meanwhile, ministry of religion as a provider placed on position as an acquaintance. Keywords : UKS Program, Stakeholder Analysis, Attitude, Power, Urgency Bibliography: 42 (2004-2014

Pengetahuan, Sikap dan Praktek Bidan Praktek Swasta (BPS) dalam Pelaksanaan Inisiasi Menyusu Dini (IMD) di Kota Semarang Tahun 2012

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Hermeksi Rahayu Pengetahuan, Sikap dan Praktek Bidan Praktek Swasta (BPS) dalam Pelaksanaan Inisiasi Menyusu Dini (IMD) di Kota Semarang Tahun 2012 xiv + 67 halaman + 2 tabel + 5 lampiran Cakupan ASI Eksklusif di kota Semarang turun dari 40,07% (2006) menjadi 38,44% (2009). Sebenarnya, capaian ASI dapat ditingkatkan ketika bayi lahir dengan tatalaksana IMD. Bidan sebagai pelaku pertolongan persalinan sangat berperan dalam keberhasilan pemberian ASI Eksklusif. Penelitian ini bertujuan untuk mendapatkan gambaran tentang pengetahuan dan sikap bidan terkait IMD dengan praktek IMD di BPS kota Semarang Jenis penelitian ini kualitatif.Pengumpulan data yang dilakukan dengan menggunakan wawancara mendalam . Informan utama 4 bidan praktek swasta dan informan triangulasi ibu bersalin, IBI dan Dinas Kesehatan. Data terkumpul dan dianalisis dengan analisis isi. Penelitian menunjukkanbahwa, pelaksanaan IMD selama ini belum optimal, karena tidak semua bidan melaksanakan IMD dengan benar pada setiap pertolongan persalinan. Pengetahuan bidan tentang IMD sudah baik dan sikap bidan tentang IMD sudah mendukung, namun di dalam pelaksanaannya tidak sesuai dengan langkah – langkah IMD. IMD dilakukan hanya untuk menemukan puting ibu dengan cara mulut bayi langsung ditempelkan pada puting ibu hanya beberapa menit saja. Bidan senior yang mempunyai pengalaman kerja yang cukup lama, relatif sulit berubah, walau sudah mendapatkan pelatihan tentang APN. Selain itu, adanya kepentingan finansial, yang menjanjikan dari berbagai produk susu formula,tidak ada pembatasan pengiklanan produk susu dan tidak didukung adanya peraturan dan sanksi dari Dinas Kesehatan dan IBI selaku profesi. Sanksi hanya berupa teguran dan himbauan. Perlu dilakukan sosialisasi dan penyegaran terus menerus terkait IMD, termasuk upaya pembinaan, monitoring dan evaluasinya secara rutin. Kata kunci : Pengetahuan, sikap, praktek bidan, Inisiasi Menyusu Dini, Bidan Praktek Swasta. Referensi : 37 (1989-2009) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2012 ABSTRACT Hermeksi Rahayu Knowledge, Attitude, and Practice of Independent Practice Midwives (IPM) in Implementing Early Initiation of Breastfeeding (EIB) in Semarang City in 2012 xiv + 67 pages + 2 tables + 5 enclosures Coverage of exclusive breastfeeding in Semarang City declined from 40.07% (2006) to 38.44% (2009). It could be increased by implementing early initiation of breastfeeding (EIB). Midwives as birth attendants played an important role in the success of providing exclusive breastfeeding. The aim of this study was to identify knowledge and attitude of midwives regarding EIB associated with practice of EIB at Independent Practice Midwives (IPM) in Semarang City. This was qualitative study. Data were collected by conducting indepth interview. Main informants consisted of 4 IPM. Meanwhile, informants for triangulation purpose consisted of maternal, Indonesian Midwives Association (IMA), and City Health Office. Furthermore, data were analysed using content analysis. The results of this study showed that EIB had not been optimally implemented because not all midwives well practiced in each delivery process. Midwives had good knowledge and positive attitude to support EIB. Notwithstanding, the practices had not followed the procedures of EIB. EIB was done to find mother’s nipples using infant’s mouth for a while. Senior midwives were difficult to change their practices even though they had been trained about APN. In addition, there was any conflict of interest particularly related to money incentive from formula milk industries. There were no limitation for advertising milk products and no regulations or punishments from the Health Office and IMA. Provided punishments were only warning and appealing. As suggestions, there needs to socialise and refresh sustainably related to EIB including to supervise, monitor, and evaluate regularly. Key Words : Knowledge, Attitude, Midwife’s Practice, Early Initiation of Breastfeeding, Independent Practice Midwives Bibliography : 37 (1989-2009

Pengetahuan, Sikap dan Praktek Bidan Praktek Swasta (BPS) dalam Pelaksanaan Inisiasi Menyusu Dini (IMD) di Kota Semarang Tahun 2012

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2012 ABSTRAK Hermeksi Rahayu Pengetahuan, Sikap dan Praktek Bidan Praktek Swasta (BPS) dalam Pelaksanaan Inisiasi Menyusu Dini (IMD) di Kota Semarang Tahun 2012 xiv + 67 halaman + 2 tabel + 5 lampiran Cakupan ASI Eksklusif di kota Semarang turun dari 40,07% (2006) menjadi 38,44% (2009). Sebenarnya, capaian ASI dapat ditingkatkan ketika bayi lahir dengan tatalaksana IMD. Bidan sebagai pelaku pertolongan persalinan sangat berperan dalam keberhasilan pemberian ASI Eksklusif. Penelitian ini bertujuan untuk mendapatkan gambaran tentang pengetahuan dan sikap bidan terkait IMD dengan praktek IMD di BPS kota Semarang Jenis penelitian ini kualitatif.Pengumpulan data yang dilakukan dengan menggunakan wawancara mendalam . Informan utama 4 bidan praktek swasta dan informan triangulasi ibu bersalin, IBI dan Dinas Kesehatan. Data terkumpul dan dianalisis dengan analisis isi. Penelitian menunjukkanbahwa, pelaksanaan IMD selama ini belum optimal, karena tidak semua bidan melaksanakan IMD dengan benar pada setiap pertolongan persalinan. Pengetahuan bidan tentang IMD sudah baik dan sikap bidan tentang IMD sudah mendukung, namun di dalam pelaksanaannya tidak sesuai dengan langkah – langkah IMD. IMD dilakukan hanya untuk menemukan puting ibu dengan cara mulut bayi langsung ditempelkan pada puting ibu hanya beberapa menit saja. Bidan senior yang mempunyai pengalaman kerja yang cukup lama, relatif sulit berubah, walau sudah mendapatkan pelatihan tentang APN. Selain itu, adanya kepentingan finansial, yang menjanjikan dari berbagai produk susu formula,tidak ada pembatasan pengiklanan produk susu dan tidak didukung adanya peraturan dan sanksi dari Dinas Kesehatan dan IBI selaku profesi. Sanksi hanya berupa teguran dan himbauan. Perlu dilakukan sosialisasi dan penyegaran terus menerus terkait IMD, termasuk upaya pembinaan, monitoring dan evaluasinya secara rutin. Kata kunci : Pengetahuan, sikap, praktek bidan, Inisiasi Menyusu Dini, Bidan Praktek Swasta. Referensi : 37 (1989-2009) Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2012 ABSTRACT Hermeksi Rahayu Knowledge, Attitude, and Practice of Independent Practice Midwives (IPM) in Implementing Early Initiation of Breastfeeding (EIB) in Semarang City in 2012 xiv + 67 pages + 2 tables + 5 enclosures Coverage of exclusive breastfeeding in Semarang City declined from 40.07% (2006) to 38.44% (2009). It could be increased by implementing early initiation of breastfeeding (EIB). Midwives as birth attendants played an important role in the success of providing exclusive breastfeeding. The aim of this study was to identify knowledge and attitude of midwives regarding EIB associated with practice of EIB at Independent Practice Midwives (IPM) in Semarang City. This was qualitative study. Data were collected by conducting indepth interview. Main informants consisted of 4 IPM. Meanwhile, informants for triangulation purpose consisted of maternal, Indonesian Midwives Association (IMA), and City Health Office. Furthermore, data were analysed using content analysis. The results of this study showed that EIB had not been optimally implemented because not all midwives well practiced in each delivery process. Midwives had good knowledge and positive attitude to support EIB. Notwithstanding, the practices had not followed the procedures of EIB. EIB was done to find mother’s nipples using infant’s mouth for a while. Senior midwives were difficult to change their practices even though they had been trained about APN. In addition, there was any conflict of interest particularly related to money incentive from formula milk industries. There were no limitation for advertising milk products and no regulations or punishments from the Health Office and IMA. Provided punishments were only warning and appealing. As suggestions, there needs to socialise and refresh sustainably related to EIB including to supervise, monitor, and evaluate regularly. Key Words : Knowledge, Attitude, Midwife’s Practice, Early Initiation of Breastfeeding, Independent Practice Midwives Bibliography : 37 (1989-2009

THE EFFECT OF MULTIMEDIA ON KNOWLEDGE AND ATTITUDE OF HIGH SCHOOL STUDENTS ABOUT EXCLUSIVE BREASTFEED

Adolescent reproductive health education contributes the enhancement of knowledge, attitudes and behaviors of exclusive breastfeeding as later mothers. Multimedia is used to its improve . The aim is to knowing the effect of multimedia on knowledge and attitude of schoolgirls about exclusive breastfeeding. Quantitative research with non-randomized control group pretest-posttest design. With 104 schoolgirls respondents in Semarang district Indonesia as a control and intervention group, processed by one way repeated measures ANOVA.The results of the study showed the influence of multimedia in improving knowledge and attitude about exclusive breastfeeding. The average score of knowledge of the intervention group increased by 4,077 from pretest to posttest 2 and control group knowledge decreased 0.48 from pretest to posttest 2. The average score of attitude of the intervention group increased 5,308 from pretest to posttest 2 and control group decreased 2,519 from pretest to posttest 2.Statistically, multimedia (p = 0,000) had an effect on improving knowledge and attitudes about exclusive breastfeeding between before and after intervention. Based on the results of this study, health and education institutions are expected to develop multimedia as an effort to implement the IEC program on exclusive breastfeeding and integrate with school activities

Dapatkah Kelas Ibu Hamil Model Virtual Meningkatkan Praktik Pencegahan Risiko Tinggi Kehamilan ?

Abstract The inability of pregnant women to identify and recognize danger signs of pregnancy indicates the lack of knowledge, attitudes and perceptions of mothers about healthy pregnancies which has an impact on the low practices of prevention of high risk of pregnancy. Pregnant Women Class Program (KIH) which is held is not optimal because of the low presence of pregnant women for various reasons. The aim of study to determine the effect of the KIH-Virtual model on the practice of preventing high risk of pregnancy. This is a quasi-experimental study with case-control approach. The population is pregnant women in Semarang City. The total sample was 60 mothers for the intervention group and 61 mothers for control group. The independent variable is KIH-Virtual intervention and dependent variable is the practice of preventing high risk pregnancy (covering 7 dimensions). Data collection through interviews and observations with four times measurements (pretest, posttest 1,2,3). Partial analysis using independent-T test and Paired test. Simultaneous analysis with Linear-Mixed-Model. Statistically, there were differences in the practice of preventing high risk pregnancy between intervention groups and control at the last measurement (p<0.05). Although both groups experienced an increase in scores at each measurement stage, it was evident in the intervention group that the increase was higher for all dimensions of practice. The highest increase in the effect of interventions on communication and collaboration practices was followed by health status monitoring practices. Daily self-care practices and lifestyle practices are the dimensions with the lowest intervention effect. Virtual-KIH influences the practice of pregnant women in the prevention of high risk of pregnancy and is able to improve the practice better than conventional models that have been underway. Abstrak  Ketidakmampuan ibu hamil mengidentifikasi dan mengenali tanda bahaya kehamilan mengindikasikan rendahnya pengetahuan, sikap dan persepsi ibu tentang kehamilan sehat, yang berdampak pada rendahnya praktik pencegahan risiko tinggi kehamilan. Program Kelas Ibu Hamil (KIH) yang diselenggarakan belum optimal karena terkendala rendahnya kehadiran ibu hamil dengan berbagai alasannya. Tujuan penelitian menganalisis pengaruh model KIH Virtual terhadap praktik pencegahan risiko tinggi kehamilan. Penelitian ini merupakan penelitian quasi experimental dengan pendekatan kasus-kontrol. Populasi adalah ibu hamil di Kota Semarang. Jumlah sampel 60 ibu untuk kelompok intervensi dan 61 ibu untuk kelompok kontrol. Variabel bebas yaitu intervensi KIH Virtual dan variabel terikatnya yaitu praktik pencegahan risiko tinggi kehamilan (meliputi 7 dimensi). Pengumpulan data melalui wawancara dan observasi dengan 4 kali pengukuran (pretest, posttest-1,2,3). Analisis parsial menggunakan uji beda independen dan berpasangan. Analisis simultan dengan Linear-Mixed-Model. Secara statistik ada perbedaan praktik pencegahan risiko tinggi kehamilan antara kelompok intervensi dengan kontrol pada pengukuran terakhir (p<0,05). Meski kedua kelompok mengalami peningkatan skor pada setiap tahap pengukuran, namun terbukti pada kelompok intervensi peningkatannya lebih tinggi untuk semua dimensi praktik. Peningkatan tertinggi efek intervensi pada praktik komunikasi dan kerjasama, diikuti praktik pemantauan status kesehatan. Praktik perawatan diri sehari-hari dan praktik gaya hidup merupakan dimensi praktik dengan efek intervensi terendah. KIH Virtual memengaruhi praktik ibu hamil dalam pencegahan risiko tinggi kehamilan dan mampu meningkatkan praktik tersebut dengan lebih baik dibandingkan model konvensional yang selama ini berlangsung. &nbsp

Faktor-Faktor yang Mempengaruhi Keterampilan Bidan Desa dalam Pengisian Partograf di Kabupaten Semarang

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Ninik Christiani Faktor-Faktor yang Mempengaruhi Keterampilan Bidan Desa dalam Pengisian Partograf di Kabupaten Semarang 115 halaman + 24 tabel + 5 gambar + 10 lampiran Angka Kematian Ibu di Kabupaten Semarang tahun 2011 masih tinggi yaitu 125,66 per 100.000 kelahiran hidup. Salah satu penyebab adalah keterlambatan bidan dalam penangganan atau dalam mendeteksi penyulit persalinan yang dapat dideteksi dengan pengisian partograf dengan benar. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi keterampilan bidan desa dalam pengisian partograf di Kabupaten Semarang. Penelitian kuantitatif ini dilakukan dengan pendekatan survey cross sectional. Populasi adalah seluruh bidan desa berjumlah 312 orang. Pemilihan subjek sebanyak 76 orang dilakukan dengan Clustered Random Sampling. Variabel terikat adalah keterampilan bidan desa dalam pengisian partograf, variabel bebas adalah umur, pendidikan. masa kerja, pengetahuan, pembinaan, dan sarana. Pengambilan data melalui wawancara dengan kuesioner terstruktur. Analisis bivariat dilakukan dengan uji Chi Square, dan analisis multivariat dengan Regresi Logistik Berganda. Hasil penelitian menunjukkan bahwa rerata umur responden adalah 38,8±5 tahun, rerata masa kerja 18±5 tahun, berpendidikan D3 Kebidanan (65,8%), telah mengikuti pelatihan APN atau PPGDON (67,1%), pengetahuan baik (86,8%), pembinaan baik (57,9%), mempunyai sarana baik (59,2%), dan terampil mengisi partograf (69,7%). Hasil analisis bivariat menunjukkan bahwa umur (p=0,045), pendidikan terakhir (p=0,030), masa kerja (p=0,016), pelatihan (p=0,0001), pengetahuan (p=0,003), pembinaan (p=0,006), sarana (p=0,004) berhubungan positif dengan keterampilan bidan desa dalam pengisian partograf. Hasil analisis multivariat menunjukkan ada pengaruh secara bersama-sama antara lain pelatihan (Exp B=7,3; p=0,003), lama kerja (Exp B=3,6; p=0,060), pendidikan terakhir (Exp B=2,9; p=0,119) dan umur (Exp B=2,6; p=0,155) terhadap keterampilan bidan desa dalam pengisian partograf di Kabupaten Semarang. Disarankan kepada dinas kesehatan terutama bidang kepegawaian atau kesga untuk bekerjasama dengan jaringan pelatihan atau organisasi IBI untuk mewajibkan bidan mengikuti pelatihan terkait pengisian partograf. Kata Kunci : Keterampilan Pengisian Partograf, APN Referensi : 72 (1992-2012) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Ninik Christiani Factors influencing Skills of Village Midwives in Filling Partograph in Semarang District 115 pages + 24 tables + 5 figures + 10 enclosures Maternal Mortality Rate in Semarang District in 2011 was high, namely 125.66 per 100,000 live birth. Lateness of midwives in treating or detecting delivery obstacles was one of the causes which could be overcome by filling partograph well. The aim of this study was to investigate factors influencing skills of village midwives in filling the partograph in Semarang District. This was quantitative study using cross sectional approach. Population was all village midwives (312 persons). Number of samples were 76 persons selected using Clustered Random Sampling. Dependent variable was skills of midwives in filling the partograph. Meanwhile, independent variables consisted of age, education, working period, knowledge, supervision, and means. Data were collected by conducting interview using a structured questionnaire. Bivariate analysis (Chi-Square test) and multivariable analysis (Logistic Regression test) were used to analyse data. The results of this study showed that the respondents had a mean age of 38.8±5 years old and a mean working period of 18±5 years. Most of them graduated from D3 Midwifery (65.8%), had followed training of APN or PPGDON (67.1%), had good knowledge (86.8%), had good supervision (57.9%), had good means (59.2%), and had skills to fill the partograph (69.7%). The results of bivariate analysis, factors of age (p=0.045), educational background (p=0.030), working period (p=0.016), training (p=0.0001), knowledge (p=0.003), supervision (p=0.006), and means (p=0.004) had positive association with skills of midwives in filling the partograph. Furthermore, the result of multivariable analysis demonstrated that factors of training (Exp B=7.3; p=0.003), working period (Exp B=3.6; p=0.060), educational background (Exp B=2.9; p=0.119), and age (Exp B=2.6; p=0.155) jointly influenced skills of midwives in filling the partograph in Semarang District. As suggestions, District Health Office particularly human resource department or family health department needs to make a cooperation with training network or Indonesian Midwives Association to obligate midwives to follow training of filling the partograph. Key Words : Skills in Filling Partograph, APN Bibliography : 72 (1992-2012

Kajian Epidemiologi Kasus Kematian Neonatal Akibat Asfiksia di RSU Tugurejo Kota Semarang Tahun 2014

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2017 ABSTRAK M. Rr. Sri Puji Rahayu Kajian Epidemiologi Kasus Kematian Neonatal Akibat Asfiksia di RSU Tugurejo Kota Semarang Tahun 2014 xviii + 89 halaman + 26 tabel + 2 gambar + 3 lampiran Bayi hingga usia kurang satu bulan merupakan golongan umur yang memiliki risiko gangguan kesehatan paling tinggi, berbagai masalah kesehatan bisa muncul. Sehingga tanpa penanganan yang tepat, bisa berakibat fatal. Di RSU Tugurejo Kota Semarang, angka kematian NDR (Net Death Rate) tahun 2014 cukup tinggi yaitu sebesar 13%, padahal standar angka NDR adalah kurang dari 5%. Angka NDR yang tinggi tersebut terutama disebabkan karena angka kematian neonatal yang mencapai 90. Tujuan penelitianadalah menganalisis kasus kematian neonatal berdasar karakteristik epidemiologi (orang, tempat dan waktu) di RSU Tugurejo Kota Semarang. Penelitian ini merupakan studi kuantitatif, yang dilakukan secara deskriptif dengan pendekatan waktu retrospectif. Variable bebas meliputi karakteristik neonatal, karakteristik ibu neonatal, karakteristik tempat dan karakteristik waktu. Sedangkan variabel terikatnya adalah kematian neonatal. Populasi penelitian adalah seluruh kematian neonatal di RSU Tugurejo Semarang tahun 2014 yang berjumlah 90 neonatal dengan jumlah sampel jenuh. Kematian neonatal akibat asfiksia 90,9% (70 bayi) terjadi pada pada usia 0-7 hari, 43 (84%) berjenis kelamin laki-laki, 57 (90,5%) karena BBLR dan sebesar 60 (88,2%) panjang badan kurang dari 47 cm atau stunting. berdasarkan karakteristik ibu adalah sebesar 50 (89,3%) pada berusia 20-35 tahun, sebesar 47 (87,0 %) ibu dengan ANC < 4 kali, usia kehamilan ibu sebesar 42 (88,9%) adalah 28-37 minggu, multipara dengan 2-4 anak sebesar 49 (92,5%), pendidikan ibu SD dan SMP sebesar 62 (91,2%),mengalami komplikasi kehamilan sebesar 61 (91,0%) dan mengalami komplikasi selama persalinan sebesar 65 (91,5%). Berdasarkan karakteristik tempat yaitu sebesar 53 (86,9%) berasal dari pedesaan dan akses ke rumah sakit sebesar 40 (83,3%) kurang dari 2 jam. Berdasarkan karakteristik waktu lama dirawat sebesar 40 (88,9%) dirawat lebih dari 48 jam dan jarak anak dengan persalinan sebelumnya sebesar 47 (88,7%) merupakan multipara dengan 2-4 anak. Penyebab Kematian neonatal akibat asfiksia pada penelitian ini sebesar 78 (86,7%) dibandingkan non asfiksia sebesar 12 (13,3%). Berdasar uji bivariat didapatkan ada hubungan antara umur neonatal (P=0,04), pendidikan ibu (P=0,027), komplikasi kehamilan (P=0,037), komplikasi persalinan (P=0,08) dan jarak anak (P=0,027) dengan kematian neonatal karena asfiksi. Disarankan bahwa RSU perlu menyiapkandokter jaga on site dan regonalisasi pelayanan kebidanan dan perinatal, perlunya ketersediaan informasi baik penyuluhan maupun konseling untuk ibu-ibu mengenai bahaya yang dapat terjadi dalam kehamilan persalinan dan masa nifas, upaya untuk menghindari masalah tersebut dan cara pemecahan masalah yang ada serta program Keluarga berencana (KB). Kata kunci : karakteristik, kematian neonatal, asfiksia Kepustakaan : 41 (1995-2014) xviDiponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2017 ABSTRACT M. Rr. Sri Puji Rahayu An Epidemiological Study of Neonatal Mortality Cases due to Asphyxia at Tugurejo Public Hospital in Semarang City in 2014 xviii + 89 pages + 26 tables + 2 figures + 3 appendices Babies aged less than a month are a high-risk group to suffer from health disorders. Without a right treatment, they can be fatal. At Tugurejo Public Hospital, in 2014, Net Death Rate (NDR) was about 13% quite higherthan the standard (<5%). It was due to infant mortality rate that achieved 90. This study aimed at analysing neonatal mortality cases based on epidemiological characteristics (person, place, and time) at Tugurejo Public Hospital in Semarang City. This was a quantitative study conducted descriptively using retrospective approach. Independent variables consisted of characteristics of neonatal mothers, place, and time whereas dependent variable was neonatal mortality. Number of samples were all neonatal mortalities (90 infants as total sampling) at Tugurejo Public Hospital in Semarang in 2014. Proportion of neonatal mortalities due to asphyxia were 90.9% (70 babies) occurred on infants aged 0-7 days. Majority of babies (43 babies (84%))were male, were categorised as Low Birth Weight (57 babies (90.5%)), and had height <47 cm or stunting (60 babies (88.2%)).Majority of the mothers aged 20-35 years old (50 persons (89.3%)),visited ANC <4 times (47persons (87.0 %)), had maternal gestational age ranged from 28-37 weeks (42persons (88,9%)), were categorised as multipara with 2-4 children(49 persons (92,5%)), graduated from elementary and secondary schools (62 persons (91.2%), experienced pregnancy complications (61 persons (91,0%)), and experienced complications during delivery process(65 persons (91,5%)). Based on characteristics of a place, majority of the respondents lived in rural areas (53 persons (86.9%)) and could reach a hospital less than 2 hours (40 persons (83.3%)). Based on characteristics of treatment time, majority of the respondents were hospitalised more than 48 hours (40 persons (88.9%))and were categorised as multipara with 2-4 children (47 persons (88.7%)). Most of neonatal mortalities were due to asphyxia (78 babies (86.7%)) compared to non-asphyxia that were 12 babies (13.3%).Age of neonatal (p=0.04), mothers’ education (p=0.027), pregnancy complication (p=0.037), delivery complication ((p=0.08), and distance of childbirth (p=0.027) significantly related to neonatal mortality due to asphyxia. The hospital needs to provide a call doctor on site and regionalise perinatal and midwifery services.Information or counselling for mothers about some risks that can occur during pregnancy, delivery, and postpartum periods needs to be provided in order to prevent, to cope these problems, and to socialise a program of family planning. Keywords : Characteristics, Neonatal Mortality, Asphyxia Bibliography: 41 (1995-2014) xvi

Pemanfaatan Ekstrak Daun Sirsak (Annona muricata Linn) Terhadap Profil Lipid (Studi Pada Tikus Putih Jantan (Rattus norvegicus) Galur Wistar Yang Diberi Diet Tinggi Lemak Tnggi Kolesterol)

Latar Belakang : Profil lipid merupakan salah satu faktor risiko terjadinya penyakit jantung koroner. Daun sirsak merupakan tanaman obat tradisional yang mengandung berbagai senyawa metabolik yang berperan terhadap perbaikan profil lipid. Tujuan :Mengetahui efek ekstrak daun sirsak terhadap profil lipid ( kadar kolesterol total, kolesterol LDL, kolesterol HDL dan trigliserida). Metoda : Studi eksperimen dengan rancangan penelitian randomized pre-posttest with control group design pada 28 tikus Wistar jantan yang dibagi menjadi 4 kelompok. Kelompok kontrol (K) hanya diberikan diet tinggi lemak tinggi kolesterol dan kelompok perlakuan (P1,P2,P3) diberikan diet tinggi lemak tinggi kolesterol dan ekstrak daun sirsak dengan dosis masing-masing 100,200,dan 300 mg/kgBB per hari selama 28 hari. Analisis data yang digunakan adalah uji Wilcoxon, Kruskal-Wallis dan Mann Whitney. Hasil : Rerata kadar kolesterol total menurun signifikan pada kelompok perlakuan P1 (p=0,028) dari 60,7 mg/dl (47,6-75,3) menjadi 45,5 mg/dl (38,4-62,4). Rerata kadar kolesterol HDL meningkat signifikan pada kelompok perlakuan P2 (p=0,043) dari 26,0 mg/dl (19,7-35,3) menjadi 27,9 mg/dl (18,8-38,0). Rerata kadar kolesterol LDL dan trigliserida menurun meskipun secara statistic tidak signifikan. Simpulan : Pemberian ekstrak daun sirsak secara signifikan dapat menurunkan kadar kolesterol total dan meningkatkan kadar kolesterol HDL. Kata Kunci : Profil lipid (kolesterol total, kolesterol LDL, kolesterol HDL, dan trigliserida), diet tinggi lemak tinggi kolesterol, ekstrak daun sirsa