scholarly journals Analisis Faktor Determinan Permasalahan Pelayanan Kesehatan Ibu dan Anak

2011 ◽  
Vol 6 (1) ◽  
pp. 9 ◽  
Author(s):  
Zahtamal Zahtamal ◽  
Tuti Restuastuti ◽  
Fifia Chandra

Masalah kesehatan yang dihadapi Indonesia kini adalah status kesehatan masyarakat yang rendah, antara lain ditandai dengan angka kematian ibu dan bayi yang tinggi serta masih banyak indikator pelayanan kesehatan ibu dan anak (KIA) yang belum ideal. Penelitian ini bertujuan untuk mengetahuifaktor-faktor yang berhubungan dengan permasalahan pelayanan KIA. Desain penelitian yang digunakan pada penelitian ini adalah cross sectional, data faktor predisposisi dikumpulkan dari 550 orang responden yang tersebar di 4 kabupaten/kota dengan menggunakan kuesioner. Selanjutnya,data faktor determinan yang lain dikumpulkan dengan wawancara pada informan antara lain kepala dinas kesehatan kabupaten/kota dan kepala subdinas kesehatan keluarga. Hasil penelitian menunjukkan faktor predisposisi yang berhubungan dengan pelayanan KIA yaitu sikap responden, pengaruh orang yang memutuskan pemilihan pelayanan kesehatan dalam keluarga, serta pengetahuan responden terkait pelayanan KIA. Diketahui juga bahwa masih banyak kepercayaan masyarakat terkait aspek KIA yang belumsesuai dengan nilai-nilai kesehatan. Faktor pemungkin yang berhubungan dengan pelayanan KIA antara lain distribusi tenaga kesehatan masih belum merata, kualitas ketenagaan pemberi pelayanan KIA belum ideal, dan sarana pendukung pelayanan belum memadai. Faktor pendorong yang berhubungan dengan pelayanan KIA antara lain belum ada kebijakan daerah sebagai acuan, dana pendukung pelayanan belum memadai serta kuantitas kegiatan yang seharusnya dilakukan secara lintas sektoral masih banyak yang belum terealisasi dan belum optimal.Kata kunci: Kesehatan ibu dan anak, permasalahan pelayanan, pelayanan kesehatanAbstractThe current issue of health in Indonesia is the low status of public health, among others, characterized by high rates of maternal and infant mortality and many indicators of maternal and child health (MCH) services that have not been ideal yet. This study aims to determine the factors associated with problems of MCH services. This design used in this research is cross sectional. Predisposing factor data were collected from 550 respondents who were scattered in four districts using a questionnaire. Furthermore, another determinant factor data were collected by interviewing the informants, among others, chief of district health department, Head of Sub Office ofFamily Health. The results showed that the predisposing factors associated with MCH services is the attitude of the respondent, the influence of people who make decisions in family health care, respondents’ knowledge related to MCH services. Please also note that there are still many aspects of MCH related public trust that has not been in accordance with the values ofhealth. Enabling factors associated with MCH services including the distribution of health workers is still not equitable, quality of MCH service workforce has not been ideal and service support facilities have been inadequate. Reinforcing factors associated with MCH services, among others, the lack of regional policy as a benchmark, the fund has not been adequate support services, the quantity of activities that should be done across sectors is still much that has not been realized and is still not optimal.Key words: Mother and child health, service problem, health care

2012 ◽  
Vol 9 (1) ◽  
Author(s):  
Hashima E Nasreen ◽  
Margaret Leppard ◽  
Mahfuz Al Mamun ◽  
Masuma Billah ◽  
Sabuj Kanti Mistry ◽  
...  

2019 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol

Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mesele Damte Argaw ◽  
Binyam Fekadu Desta ◽  
Sualiha Abdlkader Muktar ◽  
Wondwosen Shiferaw Abera ◽  
Ismael Ali Beshir ◽  
...  

Abstract Background Leadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing the work climate, and creating responsive health systems. Hence, the Ethiopian Ministry of Health with the support of the USAID Transform: Primary Health Care project has been implementing LMG interventions to improve performances of primary healthcare entities. The purpose of this evaluation was to compare maternal and child health service performances and overall health system strengthening measurement results of primary health care entities by LMG intervention exposed groups. Methods The study used a cross-sectional study design with a propensity matched score analysis, and was conducted from August 28, 2017, to September 30, 2018, in Amhara, Oromia, Tigray, and Southern Nations, Nationalities, and Peoples’ (SNNP) regions. Data collection took place through interviewer and self-administered questionnaires among 227 LMG intervention exposed and 227 non-exposed health workers. Propensity score matched analysis was used to balance comparison groups with respect to measured covariates. Results The mean overall maternal and child health key performance indicator score with standard deviation (± SD) for the LMG intervention exposed group was 63.86 ± 13.16 and 57.02 ± 13.71 for the non-exposed group. The overall health system strengthening score for the LMG intervention exposed group (mean rank = 269.31) and non-exposed group (mean rank = 158.69) had statistically significant differences (U = 10.145, z = − 11.175, p = 0.001). In comparison with its counterpart, the LMG exposed group had higher average performances in 3.54, 3.51, 2.64, 3.00, 1.07, and 3.34 percentage-points for contraceptive acceptance rate, antenatal care, skilled birth attendance, postnatal care, full immunization, and growth monitoring services, respectively. Conclusion There were evidences on the positive effects of the LMG intervention on increased maternal and child health services performances at primary healthcare entities. Moreover, health facilities with LMG intervention exposed health workers had higher and statistically significant differences in management systems, work climates, and readiness to face new challenges. Therefore, this study generated evidence for integrating LMG interventions to improve the performance of primary healthcare entities and maternal and child service uptake of community members, which contributes to the reduction of maternal and child deaths.


2016 ◽  
Vol 22 (2) ◽  
pp. 77 ◽  
Author(s):  
Leesa Hooker ◽  
Angela Taft ◽  
Rhonda Small

Women suffer significant morbidity following childbirth and there is a lack of focussed, primary maternal health care to support them. Victorian Maternal and Child Health (MCH) nurses are ideally suited to provide additional care for women when caring for the family with a new baby. With additional training and support, MCH nurses could better fill this health demand and practice gap. This discussion paper reviews what we know about maternal morbidity, current postnatal services for women and the maternal healthcare gap, and makes recommendations for enhancing MCH nursing practice to address this deficit.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Chanvo Daca ◽  
Miguel San Sebastian ◽  
Carlos Arnaldo ◽  
Barbara Schumann

Abstract Background Reproductive and child health interventions are essential to improving population health in Africa. In Mozambique, although some progress on reproductive and child health has been made, knowledge of social inequalities in health and health care is lacking. Objective To investigate socio-economic and demographic inequalities in reproductive and child preventive health care as a way to monitor progress towards universal health coverage. Methods A cross-sectional study was conducted, using data collected from the 2015 Immunization, AIDS and Malaria Indicators Survey (IMASIDA) in Mozambique. The sample included 6946 women aged 15 to 49 years. Outcomes variables were the use of insecticide treated nets (ITN) for children under 5 years, full child immunization and modern contraception use, while independent variables included age, marital status, place of residence, region, education, occupation, and household wealth index. Prevalence ratios (PR) with 95% confidence intervals (95% CI) were calculated by log binomial regression to assess the relationship between the socio-economic and demographic characteristics and the three outcomes of interest. Results The percentage of mothers with at least one child under 5 years that did not use ITN was 51.01, 46.25% of women had children aged 1 to 4 years who were not fully immunized, and 74.28% of women were not using modern contraceptives. Non-educated mothers (PR = 1.33; 95% CI: 1.16–1.51) and those living in the Southern region (PR = 1.36; 95% CI: 1.17–1.59) had higher risk of not using ITN, while the poorest quintile (PR = 1.34; 95% CI: 1.04–1.71) was more likely to have children who were not fully immunized. Similarly, non-educated women (PR = 1.17; 95% CI: 1.10–1.25), non-working women (PR = 1.09; 95% CI: 1.04–1.16), and those in the poorest quintile (PR = 1.13; 95% CI: 1.04–1.24) had a higher risk of not using modern contraceptives. Conclusion Our study showed a low rate of ITN utilization, immunization coverage of children, and modern contraceptive use among women of reproductive age. Several socio-economic and demographics factors (region, education, occupation, and wealth) were associated with these preventive measures. We recommend an equity-oriented resource allocation across regions, knowledge dissemination on the importance of ITN and contraceptives use, and an expansion of immunization services to reach socio-economically disadvantaged families in order to achieve universal health coverage in Mozambique.


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