scholarly journals Analisis Kebutuhan dan Pemanfaatan Buku Serta Pedoman Pelayanan KIA di Puskesmas: Studi Kualitatif

2020 ◽  
Vol 23 (2) ◽  
pp. 99-107
Author(s):  
Diyan Ermawan Effendi ◽  
Arief Priyo Nugroho ◽  
Suharmiati Suharmiati ◽  
Lestari Handayani

The high rate of maternal (MMR) and infant mortalities (IMR) is a detrimental health development challenge in Indonesia. The use of the Maternal and Child Health (MCH) handbook and MCH service guidelines are the government’s eff orts in reducing the MMR and IMR. However, the reduction of MMR and IMR is still slow. The fi nding of the previous study asserts the need for MCH handbook and MCH service guidelines modifi cations to be suited to the needs of users, both health workers, and expectant mothers. Therefore, this study mainly aims to analyze the needs and use of MCH handbook and service guidelines by doctors and midwives in the primary health centers. The method was qualitative needs analysis with 137 informants from 12 health centers in three regions of Indonesia. The results revealed that the needs of health workers were clustered in three signifi cant aspects; instrumental (language and book-making materials), managerial (procurement, distribution, and dissemination) and operational (ease of access to MCH handbook and service guidelines as well as the availability of SOP). The fulfi llment of these three aspects is expected to improve the MCH program’s achievement, especially in cities where the research took place and other areas with similar characteristics. Abstrak Tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi masalah dalam pembangunan kesehatan di Indonesia. Penggunaan buku Kesehatan Ibu dan Anak (KIA) serta pedoman pelayanan KIA merupakan upaya pemerintah dalam penurunan AKI dan AKB. Meskipun demikian, penurunan AKI dan AKB dinilai masih lambat. Hasil penelitian sebelumnya menunjukkan perlunya modifi kasi buku dan pedoman pelayanan KIA disesuaikan dengan kebutuhan pengguna, baik tenaga kesehatan maupun ibu hamil. Oleh sebab itu, penelitian ini bermaksud menganalisis kebutuhan dan pemanfaatan buku dan pedoman pelayanan KIA oleh dokter dan bidan di puskesmas. Metode yang digunakan adalah analisis kebutuhan kualitatif dengan 137 informan dari 12 puskesmas di tiga Kabupaten/kota di Indonesia. Hasil analisis menunjukkan kebutuhan nakes terkelompok pada tiga aspek utama, yaitu instrumental (bahasa dan bahan pembuat buku), manajerial (pengadaan, pemerataan distribusi dan sosialisasi) dan operasional (kemudahan akses pada buku dan pedoman layanan KIA dan ketersediaan SOP). Pemenuhan terhadap tiga aspek tersebut diharapkan mampu memperbaiki capaian program pelayanan KIA khususnya di wilayah tempat penelitian.

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.


Author(s):  
Aminu U. Kaoje ◽  
Sani Labaran ◽  
Aminu G. Magashi ◽  
Jessica T. Ango

Background: Primary health care facilities constitute the first point of contacts of public with healthcare and form integral part of the country’s health system.Methods: A descriptive cross sectional study was conducted among 88 primary care facilities in the State. A simple random sampling technique was used to select the facilities. Federal Ministry of Health integrated supportive supervision tool was adapted for data collection and analysis done using SPSS Version 20.0. The variables were summarised with frequency and percentage and results presented in tables.Results: Almost two-thirds (65%) of the facilities provide 24 hours service coverage for both maternal and child care services. Only 16% of the facilities had medical officers, 12.5% had required number of nurse/midwife while 27% had no single nurse/midwife. With respect to trainings, one third of the facilities had personnel trained on medium and extended lifesaving skills, 20% had a trained staff on emergency obstetrics and newborn care while 61% had no single trained personnel on integrated management of childhood illnesses. A large proportion of the facilities provide maternal services such as focused ANC and delivery but none use partograph to monitor labour. A good number of facilities were lacking basic equipment and medicine supply with about two third of facilities lacking misoprostol and magnesium sulphate, and only 15% had functional DRF.Conclusions: Health resources and the level of service provision in its current form may not lead to a significant improvement in maternal and child health in the state to guarantee universal coverage.


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

Abstract Background: The maternal, neonatal and child mortality rates in Ethiopia are among the reported highest in Africa. Despite the reported alarming mortality rates, there are proven public health interventions in place to avoid preventable maternal and child deaths. 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 Activity has been implementing LMG interventions to improve performance of primary health care entities. The LMG interventions include a six-day classroom training with an additional six to nine months of leadership project implementation, supplemented with three to four onsite coaching sessions. The purpose of this evaluation was to measure the effects of LMG interventions on maternal and child health service performances and on the overall health system strengthening measurement results of primary health care entities. Methods: The study used a cross-sectional study design with 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 estimate the average treatment effects of LMG interventions on contraceptive acceptance rates, antenatal care, skilled birth attendance, postnatal care, full immunization services, growth monitoring services, management system, work climate and capacity to respond to new challenges. 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 (SD) and 57.02 ± 13.71 (SD) 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). The average treatment effects of 3.54, 3.51, 2.64, 3.00, 1.073.34 percentage-points were observed for contraceptive acceptance rate, antenatal care, skilled birth attendance, postnatal care, full immunization, and growth monitoring services, respectively. In addition, with regards to health system strengthening measurements, we found an average treatment effect (ATE) of 12.46, 4.79 and 4.88 percentage points for strengthening management system, enhancing work climate and capacity to respond to new challenges, respectively. Conclusion: We found positive evidence of 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 a higher and statistically significant difference in management systems, work climate and readiness to face new challenges. Therefore, this study generates 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 maternal and child deaths.


Sign in / Sign up

Export Citation Format

Share Document