scholarly journals MODEL SOSIO EKOLOGI PERILAKU KESEHATAN DAN PENDEKATAN CONTINUUM OF CARE UNTUK MENURUNKAN ANGKA KEMATIAN IBU

2017 ◽  
Vol 12 (1) ◽  
pp. 129 ◽  
Author(s):  
Sri Sumarmi

Maternal mortality rate is the important health indicator which is used as a component of Nation Development Index or quality of life index in all countries in the world. It is the most sensitive indicator among other health indicators to assess health status or quality of life in a country. Recently, Indonesiafaces an inconvenience situation when a surprise increasing of maternal mortality rate was launched by national health survey, reflected an un-successful effort to achieve Millenium Development Goals (MDGs) target 2015 or the Sustainable Development Goals (SDGs). Reducing maternal mortality ratein Indonesia is a big challenge, because maternal mortality is a multi-causes problem. Furthermore, various factors may play a role as the root causes that could not be addressed only through health interventions, but should involve multi-sectoral approach. Base on thus issues, this paper will discuss appropriate strategies to reduce maternal mortality in Indonesia by combining concept of socio ecological model of health behavior and continuum of care approach.Keywords: Maternal Mortality Rate, Socio Ecological Model, continuum of care

Author(s):  
Arif Nurhidajat ◽  
Dyah Kusumawati

Maternal Mortality Rate (MMR) is a sensitive indicator that shows the health quality of a country and gets special attention from the United Nations (UN) so that it is placed as one of the targets in the Millennium Development Goals (MDGs). This study tries to look at the effectiveness of efforts to reduce MMR in Indonesia with a focus on research on the analysis of AKI targeting in Indonesia, the effectiveness of the RAN PPAKI program, and the adequacy of budget allocations for efforts to reduce MMR. Furthermore, by using a qualitative analysis approach that adopts the Miles and Huberman (1984) model, results are obtained that the target targets for decreasing the MMR have been quite realistic even though in the determination there are differences in the calculation methods between national targets and the MDGs. In terms of the program plan and its implementation, it was found that the implementation of the RAN PPAKI program was not optimal and effective due to several factors, including: 1) determining the output and efforts to reduce MMR in the form of top down from the Ministry of Health, which paid little attention to needs and characteristics each region; 2) the synchronization and coordination between the activities of reducing MMR financed from the APBN and APBD are not optimal; 3) cross-sectoral coordination that is still very weak and not optimal; and 4) there has been no in-depth evaluation of the impact or relevance of RAN PPAKI's output / activity and budget on the achievement of the reduction in MMR. In addition, the analysis results related to the variable budget allocation for the reduction of MMR, namely the budget to support the implementation of the 2013-2015 RAN PPAKI has been sufficient but the problem is the lack of flexibility in its use, given the allocation of the budget by the center and regions less able to adjust to the needs based on the characteristics in the area. Keywords: Effectiveness, Maternal Mortality Rate, Reduction JEL Classification: H51, I18   Abstrak Angka Kematian Ibu (AKI) merupakan indikator sensitif yang menunjukan kualitas kesehatan suatu Negara dan mendapat perhatian khusus dari Perserikatan Bangsa Bangsa (PBB) sehingga ditempatkan sebagai salah satu target dalam Tujuan Pembangunan Millennium atau Millenium Development Goals (MDGs). Kajian ini mencoba melihat efektivitas upaya penurunan AKI di Indonesia dengan fokus penelitian pada analisis penetapan target AKI di Indonesia, efektivitas program RAN PPAKI, dan kecukupan alokasi anggaran untuk upaya penurunan AKI. Selanjutnya, dengan menggunakan pendekatan analisis kualitatif yang mengadopsi model Miles dan Huberman (1984), diperoleh hasil bahwa target sasaran penurunan AKI yang ditetapkan sudah cukup realistis meskipun dalam penetapannya terdapat perbedaan metode perhitungan antara target nasional dan MDGs. Dari sisi rencana program dan pelaksanaannya diperoleh hasil telitian bahwa pelaksanaan program RAN PPAKI belum optimal dan efektif yang disebabkan oleh beberapa faktor, antara lain: 1) penentuan output dan aktifitas upaya penurunan AKI lebih bersifat top down dari Kemenkes, di mana kurang memperhatikan kebutuhan dan karakteristik masing-masing daerah; 2) sinkronisasi dan koordinasi antara kegiatan penurunan AKI yang dibiayai dari APBN dan APBD belum optimal; 3) koordinasi lintas sektor yang masih sangat lemah dan belum optimal; dan 4) belum adanya evaluasi mendalam terhadap dampak atau relevansi output/aktivitas dan anggaran RAN PPAKI terhadap capaian penurunan AKI. Di samping itu, juga diperoleh hasil analisis terkait dengan variabel alokasi anggaran untuk penurunan AKI, yaitu anggaran untuk mendukung pelaksanaan RAN PPAKI 2013-2015 telah cukup memadai namun yang menjadi masalah adalah kurang adanya fleksibilitas dalam penggunaannya, mengingat peruntukkan anggaran telah ditetapkan oleh pusat dan daerah kurang dapat menyesuaikan dengan kebutuhan berdasarkan karakteristik yang ada di daerah.


2019 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Sri Mumpuni Yuniarsih ◽  
Anik Indriono ◽  
Siwi Sri Widhowati

Background: Maternal Mortality Rate (MMR) in Indonesia is still one of the highest in Southeast Asia (ASEAN). World Health Organization (WHO) as the international organization is targeting a decrease in the (MMR) as one of the targets in the achievement of the Millennium Development Goals (MDGs). However, based on the evaluation of part-time Development Plan 2010-2014, the target of reducing maternal mortality rate in Indonesia is still very difficult to achieve. One of the government's efforts to accelerate the decline of maternal mortality rate is a mother class program. Objective: This study aimed to analyze the achievement of the indicators of maternal health program in comparison with the class of pregnant women who do not attend pregnant women class. Methods: This research was a quantitative research with cross sectional design that compared the achievement of the nine indicators of the health of pregnant women in the two groups of pregnant women. The variable in this study was a comparison of weight gain, blood pressure, upper arm circumference (MUAC), high fundus, fetal heart rate (FHR), the consumption of iron tablets, hemoglobin levels, antenatal visits, and knowledge about healthy pregnancies. The number of samples in this study were 209 respondents which were divided into groups of 86 respondents in a class of pregnant women and 123 respondents in the non-class group of pregnant women. Chi square and t test was used to analyze the comparison of maternal health indicators achievement advance of two groups of respondents. Results and Discussion: The results showed that there were significant difference in knowledge about a healthy pregnancy, the consumption of iron tablet and number of antenatal visits. Pregnant women who attended classes had a better knowledge, more Fe tablet consumption and ANC visit. While indicators of weight gain, MUAC, TFU and DJJ of all respondents were within the normal range according to gestational age when the data retrieval. The other indicators such as hemoglobin level, systolic and diastolic blood pressure did not reveal any significant differences between the two groups of respondents. Keywords: Mother class program; maternal health indicators


2017 ◽  
Vol 5 (3) ◽  
pp. 28-35
Author(s):  
Ike Johan Prihatini ◽  
Sri Achadi Nugraheni ◽  
Sutopo Patria Jati

Maternal and child health was a priority of health program in Indonesia. Maternal Mortality Rate in Semarang was ranked second highest in Central Java. The highest proportion of maternal deaths occurred during puerperium. That’s indicates, there was a problem in a process of maternal health services during puerperium period in health facilities. This study was conducted to examine constraints on health systems that limit range of interventions or health services that were important for postpartum, bottlenecks related to postpartum services in Public Health Center (PHC), especially infrastructure, human resources, access to PHC, post partum visits (KF1 and KF3), as well as quality of post partum services on risk reduction of maternal mortality. This case study used a qualitative approach. Data collection through interviews to five midwives as main informants, 5 midwives coordinator and 5 heads of PHC as informant triangulation. Data analsyis used content analysis method, then assigned priority bottleneck through MCUA (Multiple Criteria Utility Assessment) techniques. WHO's scale-up BNA plan to analyze bottleneck causes. Results showed, there was a bottleneck on childbirth services in PHC. The causes of bottleneck risk reduction efforts of maternal mortality incidence in puerperium period has never been analyzed workload of health personnel in PHC, lack of monitoring and evaluation of an availability infrastructure facilities in PHC, there has not been regular training, especially on delivery until puerperium services, and PHC has not received more detailed and operational information about puerperium so their maternal knowledge about puerperium has not increased much and couldn’t raise mother's awareness to do so. Semarang Public Health Office (Dinas Kesehatan Kota Semarang) needs to conduct periodic monitoring and evaluation implementation of postpartum services and improve quality of childbirth services in PHC.Keywords: Bottleneck analysis, health services, post partum, Primary Health Care, Puskesmas, Maternal Mortality Rate


Author(s):  
Lea Ingne Reffita ◽  
Senditya Indah Mayasari ◽  
Ummi Halfida ◽  
Wili Sinarti ◽  
Yaumil Fitriyah ◽  
...  

Indonesia's Health Profile in 2019 in general, there was a decrease in maternal mortality during the period 1991-2015 from 390 to 305 per 100,000 live births, if it is associated with the 2015 Millennium Development Goals (MDGs), namely reducing the maternal mortality rate (MMR) to 102/100,000 live births. the maternal mortality rate did not reach the MDGs target. Physiological efforts are made to prevent prolonged labor, such as pelvic rocking exercise using the birthing ball technique. This is also a method that really helps respond to pain in an active way and reduces the length of the first stage of labor in the active phase. This study aims to determine the effectiveness of the implementation of pelvic rocking with a birthing ball on the progress of labor in primiparous women in 2020. This study uses Systematic Literature Reviews (SLR), which is a synthesis of systematic, clear, comprehensive literature studies, by identifying, analyzing , evaluating through the collection of existing data with an explicit search method and involving a critical review process in the selection of studies. In 6 journals, all journals perform pelvic rocking exercise techniques using the birthing ball technique when the mother enters the first stage of the active phase. The conclusion in this study is that all journals reviewed by researchers can be ascertained that all of these journals get the same results, namely stating that using the Pelvic Rocking Exercise technique with the help of a birthing ball can make delivery times for mothers go faster


2021 ◽  
Vol 7 (1) ◽  
pp. 19-23
Author(s):  
Khairani

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are health indicators of a country. Data of the 2012 Demographic Health Survey of Indonesia (DHSI) indicates that the maternal mortality rate increased by 359 deaths per 100,000 live births. Such rate was higher than the data of 2015DHSI, i.e. 228 deaths per 100,000 live births. The 2012 DHSI indicates IMR of 32 deaths  ​​per 1,000 live births, slightly lower than the 2007 DHSI indicating 34 deaths per 1,000 live births. One of the efforts to reduce MMR and IMR is through the Delivery Planning and Complication Prevention Program (PCPP). Midwives’ motivation about PCPP belonged to the category of moderate motivation (79.4%). The implementation of PCPP sticker program was mostly as planned (74.6%). There was a correlation between midwives’ motivation about PCPP and the implementation of PCPP sticker for pregnant women in the Imelda Hospital in 2020 with p-value = 0.013


Author(s):  
Yuhemy Zurizah Yuhemy Zurizah

  ABSTRACT Maternal Mortality Rate is a barometer of mother health service in a country. At this time maternal mortality rate in Indonesia is still very high. Indonesia Demography Survey on 2007, maternal mortality rate is about 28 per 100.000 of live births. The direct cause of maternal mortality in Indonesia as well as in the other country is hemorraghe (25%), sepsis (15%), eklampsia (12%), abstructed labor (8%). World Health Organization (WHO), 35-37% of pregnant women in developing coutries get anemy. Causing factor’s of anemy on pregnant women is age of pregnant, parity, economi socio, job, education, and nutritional status. Purpose of this research is to know the associated factors with incidence of anemy on pregnant women at the Health Center Talang Ratu Palembang in 2014. This research use analytic survey method with “cross sectional” approach. Population in this research is all of preganant women in medical treatment at Talang Ratu Palembang in 2014. Sample taking in this research with non random samplingmethod and accidental sampling technic. Analysis with univariatly and bivariatlywith Chi Square Statistic test with significant level α 0,05. The result of this research show that from 35 respondent there is (48,6%) respondent with anemy, high–risk age (28,6%), high parity (60,0%) and low economi socio (37,1%). This result show that there is significant relationship between age with incidence of anemy on pregnant women at the health center Talang Ratu Palembang in 2014 with p value0,027, there is significant relationship between parity with incidence of anemy on pregnant women at the health center Talang Ratu Palemabang in 2014 with p value0,023, and there is significant relationship between economi socio with incidence of anemy on pregnant women at the health center Talang Ratu Palembang in 2014 with p value0,026. Of the result, the author hope that health service worker at Talang Ratu health center can improve health service to pregnant women and often giving information about anemy on pregnant and nutritional for pregnant women during pregnancy.     ABSTRAK Angka Kematian Ibu (AKI) merupakan barometer pelayanan kesehatan ibu di suatu negara. Pada saat ini angka kematian ibu di Indonesia masih sangat tinggi. Menurut Survey Demografi dan Kesehatan Indonesia (SDKI) tahun 2007, angka kematian kematian ibu adalah 28 per 100.000 kelahiran hidup. Penyebab langsung kematian ibu di Indonesia seperti halnya Negara lain adalah perdarahan (25%), sepsis (15%), eklampsi (12%), partus lama (8%). Menurut World Health Organization (WHO), 35-37% ibu hamil di negara berkembang dan 18% di negara  maju mengalami anemia. Faktor penyebab terjadinya anemia pada ibu hamil secara tidak langsung adalah umur ibu, paritas, sosial ekonomi, pekerjaan, pendidikan, jarak kehamilan, dan status gizi.Tujuan penelitian ini adalah untuk mengetahui faktor - faktor apa saja yang berhubungan dengan kejadian anemia pada ibu hamil di Puskesmas Talang Ratu Palembang Tahun 2014. Penelitian ini menggunakan metode survey analitikdengan pendekatan cross sectional. Populasi dalam penelitian ini adalah seluruh ibu hamil yang berobat di Puskesmas Talang Ratu Palembang Tahun 2014. Pengambilan sampel pada penelitian ini dengan metode non random sampling dengan teknik Accidental sampling. Analisis dilakukan secara univariat dan bivariat. Dengan uji statistik chi square tingkat kemaknaan α 0,05. Hasil penelitian menunjukkan dari 35 responden terdapat (48,6%) responden yang anemia, umur yang beresiko  tinggi (28,6%), paritas tinggi (60,0%), dan sosial ekonomi rendah (37,1%). Hasil penelitian ini menunjukkan ada hubungan yang bermakna antara umur dengan kejadian anemia pada ibu hamil di Puskesmas Talang Ratu Palembang Tahun 2014 dengan  p value0,027,  ada hubungan bermakna antara paritas dengan kejadian anemia pada ibu hamil di Puskesmas Talang Ratu Palembang Tahun 2014 dengan p value0,023 dan ada hubungan yang bermakna antara sosial ekonomi dengan kejadian anemia pada ibu hamil di Puskesmas Talang Ratu Palembang Tahun 2014 dengan p value0,026. Dari hasil penelitian ini penulis berharap petugas kesehatan di Puskesmas Talang Ratu Palembang meningkatkan pelayanan kesehatan pada ibu hamil dan lebih sering melaksanakan penyuluhan anemia pada kehamilan dan nutrisi yang baik bagi ibu hamil.    


2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Tri Nurhudi Sasono

Abstract : Indicator of the health welfare through Sustanable Development Goals (SDGs) is to reduce the incidence of HIV-AIDS, decrease the rate of the epidemic and maintain the quality of life of people living with HIV-AIDS (PLWHA). Trend cases of HIV-AIDS is the most recent spread among people, especially housewives. In Malang until 2015 found 278 Housewife of 409 cases of AIDS. The prevalence of HIV-AIDS in Malang Regency is ranked second after Surabaya city in East Java. For the importance of public participation and citizen care AIDS Cahaya Care Turen take responsibility for the condition. Determination Rule Goverment number 2 2015 year on the Participation of the community response to HIV-AIDS in Malang as a legal rule. Concerned Citizens activities AIDS (WPA). WPA Cahaya Care Turen is increases HIV risk and quality of life PLWHA. The purpose of this study was to determine the role of Citizens AIDS Cahaya Care Quality of Care Turen against people living with HIV in Puskesmas Turen Malang. The study design using a quasi-experimental, with purposive sampling using a sampling technique. Total number of research subjects 23. Based on test results obtained with the Wilcoxon p value <0.005, which means that there is a significant difference before and after PLWHA joining participated in the WPA Cahaya Care Turen. The conclusion of this study is WPA activities involving people living with HIV and at risk groups can optimize compliance with antiretroviral drugs that have an impact on improving the quality of life of PLHIV. Suggestions in this research is done WPA Program activities are structured and ongoing cross-sector in order to improve the quality of life and empower PLWHA.Keywords : WPA Cahaya Care Turen, Quality of life, PLWHA Abstrak : Salah satu indikator kesejahteraan kesehatan melalui Sustanable Development Goals (SDGs) adalah menekan angka kejadian HIV-AIDS, menurunkan laju epidemik dan mempertahankan kualitas hidup Orang dengan HIV-AIDS (ODHA). Trend kasus HIV-AIDS terkini terbanyak adalah menjangkit dikalangan masyarakat khususnya pada ibu rumah tangga. Kabupaten Malang sampai dengan tahun 2015 ditemukan 278 Ibu Rumah Tangga dari 409 kasus AIDS. Prevalensi HIV-AIDS di Kabupaten Malang ini merupakan peringkat kedua di Jawa Timur setelah Kota Surabaya. Untuk itu pentingnya peran serta masyarakat dan warga peduli AIDS Cahaya Care Turen ikut bertanggung jawab terhadap kondisi tersebut. Penetapan Peraturan Bupati Malang no.2 th.2015 tentang Peran serta masyarakat penanggulangan HIV-AIDS di Kabupaten Malang diharapkan dapat mengurangi risiko penularan HIV dan meningkatkan kualitas hidup ODHA. Tujuan dari penelitian ini adalah untuk mengetahui Peran Warga Peduli AIDS Cahaya Care Turen terhadap Kualitas ODHA Di Wilayah Kerja Puskesmas Turen Kabupaten Malang. Desain penelitian menggunakan quasi eksperimen, dengan teknik sampling menggunakan purposive sampling. Jumlah subyek penelitian sejumlah 23. Berdasarkan hasil uji dengan Wilcoxon didapatkan nilai p value < 0.005 yang berarti bahwa terdapat perbedaan bermakna sebelum dan sesudah ODHA bergabung mengikuti kegiatan WPA Cahaya Care Turen. Kesimpulan dalam penelitian ini adalah kegiatan WPA dengan melibatkan ODHA dan kelompok beresiko dapat mengoptimalkan kepatuhan obat ART sehingga berdampak terhadap peningkatan kualitas hidup ODHA. Saran dalam penelitian ini adalah dilakukannya Program kegiatan WPA yang terstruktur dan berkesinambungan lintas sektor guna meningkatkan kualitas hidup dan memberdayakan ODHA.     Kata kunci : WPA Cahaya Care Turen, kualitas hidup, ODHA


2021 ◽  
pp. 030802262110394
Author(s):  
Brightlin N Dhas ◽  
Petra Wagman ◽  
Firas A Marji ◽  
Carita Håkansson ◽  
Ricardo Carrasco

Introduction Occupational balance (OB) is related to many health indicators, including quality of life. The Occupational Balance Questionnaire (OBQ11) was developed to measure OB, and to date, no Arabic translations of the questionnaire exist. The aim of the study was to describe the translation process of OBQ11 to Arabic and to evaluate its content validity, internal consistency, construct validity, and convergent validity. Methods OBQ11 was translated to Arabic (OBQ11-A) following standard guidelines. Content validity feedback was obtained from ten Arabic-speaking occupational therapists and in a cognitive debriefing with seven volunteers. In addition, OBQ11-A and the Family Quality of Life Survey-2006 were administered to 67 Arabic-speaking participants from a larger study about OB among parents. Results High level of agreement was found on the content of OBQ11-A from the occupational therapists. Cognitive debriefing interviews indicated that OBQ11-A was easy to understand. Cronbach’s alpha for the total OBQ11-A score was 0.864 indicating good internal consistency. Exploratory factor analysis showed acceptable factor loadings for all items. The total scores showed positive statistically significant associations with Family Quality of Life Scores ( r = 0.561, p < 0.001). Conclusions OBQ11-A may prove useful for assessing OB in Arabic-speaking populations. Further research is needed to establish its reliability.


Sign in / Sign up

Export Citation Format

Share Document