PENDAMPINGAN MENINGKATKAN MUTU MANAJEMEN PAUD BINAAN

The research aimed to find out whether the quality of PAUD management assistance could improve. Research-based service was carried out at RA Perwanida 3 and PAUD Kaisah. This study used the Participatory Action Research (PAR) model of the Kemmis, S. & McTaggart , R. Research methodology which was carried out in a series through online material delivery assistance and direct mentoring to each PAUD unit. The implementation of the activity is carried out in 5 steps, namely diagnosis, making an action plan, taking action, evaluating and reflecting. Data analysis using data analysis quantitative data analysis and qualitative data analysis. Quantitative data analysis was obtained from the description of the value of document completeness, pre and post mentoring. While the qualitative data analysis was obtained from field notes, documentation notes and interview notes using four parts, namely data reduction, display data and conclusion data. The results of the dedication research with assistance to improve the quality of the assisted PAUD management, the average document data obtained from each of the assisted institutions has increased by 37%, which is based on 30 assessment indicators, 26 indicators have been successfully fulfilled by each of the assisted PAUD institutions so that initially the average file completeness was 49% after being given assistance to 86%.

Optimalisasi Kemitraan Dukun dengan Bidan di Wilayah Kerja Puskesmas Mamba Kabupaten Manggarai Timur Provinsi Nusa Tenggara Timur

ABSTRAK Kepercayaan masyarakat Manggarai Timur terhadap dukun sebagai penolong persalinan masih cukup tinggi. Program kemitraan dukun dengan bidan merupakan salah satu cara untuk mencegah terjadinya pertolongan persalinan oleh dukun. Program ini sebagai salah satu strategi untuk meningkatkan cakupan pertolongan persalinan oleh tenaga kesehatan. Kegiatan ini dilakukan untuk meningkatkan program kemitraan dukun dengan bidan di Wilayah Kerja Puskesmas Mamba Kabupaten Manggarai Timur, sehingga cakupan pertolongan persalinan oleh dukun tidak terjadi lagi. Kegiatan ini diikuti oleh kepala puskesmas, dukun, dan bidan setempat. Motode yang digunakan adalah melalui edukasi dengan penyajian materi menggunakan metode ceramah, diskusi, tanya jawab serta pembagian leaflet dan lembar balik kepada peserta. Semua peserta yang ikut dalam kegiatan ini sangat antusias dan aktif dan mampu memahami materi yang disampaikan. Peserta bersama bidan dan pemerintah setempat berkomitmen untuk bekerja sama dalam meningkatkan program kemitraan dukun dan bidan ini. Diharapkan, dengan kegiatan ini cakupan pertolongan persalinan oleh dukun tidak terjadi lagi. Kata Kunci: Kemitraan, Dukun, Bidan, Persalinan ABSTRACT The trust of the East Manggarai community towards traditional healers as birth attendants is still quite high. The shaman's partnership program with the midwife is one way to prevent birth assistance by shamans. This program is one of the strategies to increase the coverage of delivery assistance by health workers. This activity was carried out to improve the traditional healer's partnership program with midwives in the Mamba Health Center Work Area, East Manggarai Regency so that the coverage of delivery assistance by traditional birth attendants would no longer occur. This activity was attended by the head of the health center, traditional healers, local midwives, and pregnant women. The method used is through education by presenting the material using lecture, discussion, question and answer methods, and distributing leaflets and flipcharts to participants. All participants who took part in this activity were very enthusiastic and active and were able to understand the material presented. Participants together with midwives and the local government are committed to working together in improving this partnership program between traditional healers and midwives. It is hoped that with this activity the coverage of delivery assistance by traditional birth attendants will not occur again. Keywords: Partnership, traditional healers, midwives, childbirth

The RELATIONSHIP OF PREGNAN WOMEN’S CHARACTERISTICS TO THEIR PERCEPTION OF THE MCH BOOK, BENDA KEREP UB-VILLAGE, ARGASUNYA VILLAGE, CIREBON CITY

in Indonesia, breast cancer is the second leading cause of death for women after cervical cancer. Based on data from the Cirebon City Health Office in 2015, the number of maternal deaths was 4/5400 live births, the number of infant deaths was 25/5455 live births, and the number of under-five deaths was 8/5378 live births. Aspects of maternal and child health can be seen from several indicators of achievement, one of which is Infant Immunization. In 2015, of 22 urban villages in the city of Cirebon, there was only one village that had not reached the target, namely in the Argasunya village. Meanwhile, the coverage of deliveries by health workers in Argasunya was 52.64% and the highest delivery assistance by traditional birth attendants in the city of cirebon was in Argasunya Village at 4.63%. The purpose of this study was to determine the relationship between characteristics and perceptions of pregnant women on the MCH Handbook. This study used a cross sectional design. The population of all pregnant women in Benda Kerep Sub-Village, Argasunya Village, Cirebon City. Sampling used total sampling. The data taken were primary data obtained through questionnaires given to 23 pregnant women. The correlation test used Chi-Square. The results of the study showed that the majority of pregnant women had a bad perception of the MCH handbook (69.56%), were aged 20-35 (87%), graduated from elementary school (78%), were with 14-27 weeks in gestation (48%), and had a plan to deliver at home (73.92%). Based on occupation, all pregnant women did not work (100%). There was no relationship between age and perception of the MCH handbook, between education and perception of the MCH handbook, between occupation and perception of the MCH handbook, and between planned place of delivery and perception of the MCH handbook.

Implementasi Penanganan Pertolongan Persalinan oleh Bidan Pada Masa Pandemi Covid-19 dan Era New Normal

Indonesia sedang dalam situasi pandemi COVID-19 dan banyak pembatasan hampir ke semua layanan rutin termasuk pelayanan kesehatan maternal dan neonatal, hal ini mempengaruhi jumlah kunjungan ibu hamil, adanya anjuran menunda pemeriksaan kehamilan dan kelas ibu hamil, serta adanya ketidaksiapan layanan dari segi tenaga dan sarana prasarana. Pada masa pandemi Covid-19, 62,7 % persalinan ditolong oleh bidan sehingga bidan diharapkan mampu memberikan pelayan yang baik sekaligus melakukan proteksi diri agar tidak tertular. Tujuan penelitian ini mengetahui implementasi penanganan pertolongan persalinan oleh bidan pada masa pandemi Covid-19 dan era new normal dilihat dari karakteristik, prosedur pertolongan persalinan, proses pertolongan persalinan dan kendala dalam pertolongan persalinan. Penelitian ini merupakan penelitian deskriptif kualitatif menggunakan analisa pendekatan studi kasus. Penentuan sample dilakukan secara purposive sampling. Informan berjumlah 5 orang bidan yang bekerja di puskesmas PONED. Pengumpulan data dengan cara wawancara mendalam. Hasil Penelitian ini didapatkan bahwa implementasi pertolongan persalinan yang dilakukan bidan dimasa pandemi Covid-19 dan era new normal sudah sesuai dengan aturan pelayanan puskesmas pada masa pandemi Covid-19. Adapun beberapa kendala yang dihadapi bidan diantaranya penggunaan APD level 3, keadaan ruang yang tidak ada sirkulasi udara dan sulitnya rumah sakit rujukan untuk ibu bersalin dengan hasil swab postif Covid-19.Kata Kunci : implementasi; persalinan; bidan; Covid-19 Implementation of Delivery Handling by Midwife During The Covid-19 Pandemic and The New Normal ABSTRACTIndonesia is currently in a COVID-19 pandemic situation and there are many restrictions on almost all routine services including maternal and neonatal health services, this affects the number of visits by pregnant women, there are recommendations for postponing pregnancy check-ups and classes for pregnant women, as well as the unpreparedness of services in terms of personnel, facilities and infrastructure. During the COVID-19 pandemic, 62.7% of deliveries were assisted by midwives so that midwives were expected to be able to provide good service and at the same time protect themselves from being infected. The purpose of this study was to determine the implementation of Delivery Handling of Childbirth by Midwives during the Covid-19 Pandemic Period and the New Normal Era seen from the characteristics, delivery assistance procedures, delivery assistance processes and obstacles in delivery assistance. This research was a descriptive qualitative research using case study approach analysis. Determination of the sample is done by purposive sampling. The informants were 5 midwives who worked at the Basic Emergency Neonatal Obstetric Service Training health center. Data collection was obtained by in-depth interviews. The results of this study found that the implementation of delivery assistance carried out by midwives during the Covid-19 pandemic and the new normal era was in accordance with the rules of health center services during the Covid-19 pandemic. There were several obstacles faced by midwives including the use of level 3 PPE (personal protective equipment), room conditions that had no air circulation and the difficulty of referral hospitals for maternity mothers with positive COVID-19 swab resultsKeywords: implementation; childbirth; midwife; Covid-19

The Importance of Husband Support During Childbirth in Indonesia

The Assistance of the husband during the delivery of the wife makes the process smoother. The assistance was related to various factors, including husband support. This study aims to determine the relationship between husband support and wife delivery assistance at the Sheikh Yusuf General Hospital in Gowa Regency. The study was conducted from October-November 2019. This study used a cross-sectional approach the population is all husbands who came to bring their wives in the period of October-November amounted to 385 people. The research sample was obtained by simple random sampling totaling 134 people. Data analysis was performed using SPSS with a chi-square test where the significance value was p <0.05. The results showed that the respondents in this study were mostly aged 18-24 years as many as 39.6%, the last level of education was Senior High School as much as 51.5% and working as entrepreneurs 38.8%. A small proportion of respondents in this study aged 39-45 years were 4 (3.0%), D3 education level was 4 (3.0%), and worked as a repairman 3 (2.2%). The study also showed that there were 81.3% of husbands supported childbirth and 18.7% did not. In addition, there were 64.9% of husbands accompanied their wives at delivery, and 35.1% did not accompany them. There is a relationship between the husband's support and delivery assistance (p = 0.008). It is expected that the husband can play an active role in assisting his wife so that it helps the smooth delivery process

Investigating the relationship between women’s experience of intimate partner violence and utilization of maternal healthcare services in India

The utilization of maternal healthcare services is a key measure to reduce the incidence of maternal mortality. This study aims to examine the relationship between women’s exposure to intimate partner violence (IPV) and the utilization of maternal healthcare services, using a large-scale nationally representative data among Indian women. Data for this study were drawn from the fourth round of the National Family Health Survey (NFHS-4), which is collected during 2015–2016. In order to analyze, we utilized 24,882 currently married women aged 15–49 years who had at least one living child in the past five years preceding the survey. Women’s experience of IPV, which is manifested in various forms of physical, emotional, and/or sexual violence perpetrated by the partner, was considered as the key explanatory variable. Adequate antenatal care (ANC) [four or more ANC visits], delivery assistance by the skilled health provider, and postnatal care (PNC) within two days of delivery were used as outcome variables for assessing the utilization of maternal healthcare services. Descriptive statistics, cross-tabulation, Pearson’s chi-square test, and bivariate and multivariate logistic regression models were used in this study. Approximately 26% of the sample women (currently married) experienced any form of IPV in the past year. Bivariate analyses show that the utilization of all three components of maternal healthcare services was lower among women who experienced physical, sexual, or emotional violence, as compared to those who did not face any violence perpetrated by the partner. Multivariate analysis indicates that women’s exposure to IPV was significantly associated with a lower likelihood of adequate ANC utilization (Adjusted Odds Ratio [OR]: 0.90, 95% CI 0.84–0.97), even after controlling for socio-demographic characteristics. However, IPV had no significant relationship with skilled delivery assistance and unexpectedly a positive association with PNC usage (Adjusted OR: 1.09, 95% CI 1.02–1.16) in the adjusted analysis. Our study suggests formulating strategies toward the prevention of husband-perpetrated violence against women and targeting women who experienced spousal violence to improve their utilization of maternal healthcare services.

Increased Cadre Motivation Conducting Childbirth Referrals through Training with the DABA Method

One of the causes of high maternal mortality is delivery assistance provided by other than health workers or traditional healers. The way to reduce the bondage relationship is to increase the motivation of cadres to refer mothers to health workers. The DABA method is a modification or development of the SALT method (support, appreciate, learn, and transfer), is a method or technique for forming something, showing that a community has the ability to respond to every challenge including childbirth assistance. The maternal mortality rate is still high, the Inter-Census Population Survey data released by the Central Statistics Agency shows that there were 359 maternal deaths per 100,000 births in 2013. The purpose of this study was to analyze the motivation of cadres by empowering the DABA method for referral for delivery assistance by health workers in Jember Regency. Motivation is the reason that underlies an action done by an individual. The method used was quasi-experimental using 2 groups. This study used the non equivalent control group, pre test post test design. The population in this study were 2220 posyandu cadres in the working area of the health centers in the Jember District. The subjects of this study were 100 posyandu cadres in Jember district in 2019 who met the criteria. The sampling technique was carried out by simple random sampling by selecting from a list of names of cadres in each health center. There was differences (p-value = 0.021) of cadre motivation between treatment and control group. The cadre motivation of intervention group was higher than the control group for referral labor. Having high motivation means having very strong reasons to achieve what he wants by doing his current job. The cadre motivation of treatment group increased significantly, this happened because cadres trained through the DABA method were invited to achieve the dreams they had built, namely to reduce maternal and infant mortality. Training using the DABA method is able to increase the motivation of cadres to make a referral to mothers to give birth at a health service place, so training with the DABA method is highly recommended to increase motivation for certain groups to achieve certain goals. Keywords: cadre motivation; DABA method; childbirth referrals

Factors Related to Giving Hb0 Immunization at Batu Anam Health Center, Simalungun

More than 11 million people with Hepatitis-B in Indonesia, with a low prevalence of hepatitis B, most of the sufferers were aged 20-40 years, while in countries with a high prevalence of hepatitis B, the majority of people with hepatitis B were children.. The purpose of this study was to determine the factors associated with giving Hb0 immunization to infants. The design of research was analytical. The study population was all mothers who had babies 0-7 days in Batu Anam Community Health Center. The sample size was 60 people. The research results were obtained based on the provision of Hb0 immunization, it was known that the majority of respondents were not given the Hb0 immunization as many as 33 respondents (55.0%) and the minority of respondents were given the Hb0 immunization as many as 27 respondents (45.0%) and it could be concluded that there was a relationship between education, work, number of children, knowledge, helpers. delivery, delivery assistance and family support for Hb0 immunization in infants. It is hoped that this research can become input for health workers to improve the quality of health services and education as well as information about Hb0 immunization in infants by providing counseling. Keywords: Hb0 immunization; infants

Evidence-based implementation of normal childbirth: what are the obstacles? (qualitative study)

Evidence-based is a very effective strategy to improve the quality of midwifery services. One of the most frequently problems faced is the gap between midwifery practices that are in accordance with the procedures (based on evidence-based) with clinical care practices that occur in the clinic. The purpose of this study was to explore in-depth the obstacles to the implementation of evidence-based normal childbirth, which are the position of delivery, monitoring and documenting delivery by using partographs in the Independent Practice of Midwives of Gunungkidul District, Yogyakarta.This research was a qualitative research with a phenomenological descriptive approach. The participants of this study were midwives who had the Independent Midwife Practice (PMB) consisting of 7 informants. Participant selection in this study used a purposive sampling technique with convenience sampling and identification of obstacles used was the Consolidated Framework for Implementation Research (CFIR). Data collection used was semi-structured interviews and observations. Data analysis used was a thematic analysis.The interview and observation of delivery assistance is done at the Independent Midwife Practice Center (PMB). The position of delivery that was often used by patients was lithotomy and left slant, and the application of evidence-based monitoring and documentation using partograph was still not optimal. This was because there were several obstacles in its application, which were obstacles from patients, families, midwives, and obstacles from the organization. The impact of these obstacles was that it can reduce the quality of obstetric care in patients according to evidence-based. The evaluation of clinical practice based on evidence-based by the organization and the existence of feedback from patients to midwives are expected to improve the quality of service to patients.

The rural-urban divide in Tanzania: Residential context and socioeconomic inequalities in maternal health care utilization

Background Existing studies in Tanzania, based mostly on rural samples, have primarily focused on individual behaviors responsible for the lower utilization of maternal health care. Relatively less attention had been paid to inequalities in structural circumstances that contribute to reduced utilization of maternal health care. More importantly, scholarship concerning the impact of the rural-urban divide on socioeconomic disparities in the utilization of maternal health care is virtually nonexistent in Tanzania. Methods Drawing from the Demographic Health Survey (2015–2016) conducted in Tanzania, our study includes a total of 3,595 women aged between 15–49 years old, who had given birth in five years before the month of the interview and living in both rural and urban Tanzania. The maternal health care utilization was assessed by four variables (i.e., antenatal care, skilled delivery assistance, the before and after discharging postnatal care). The independent variables were wealth, education, residence, parity, occupation, age, and the head of the household’s sex. We used bivariate statistics and logistic regression to examine the rural-urban differences in the influence of education and wealth on maternal health care utilization. Results Significantly lower use of maternal health care in rural than urban areas demonstrated a stark rural-urban divide in Tanzania. We documented socioeconomic inequalities in maternal health care utilization in the form of lower odds of the utilization of such services among women with lower levels of education and household wealth. The educational inequalities in the utilization of skilled delivery assistance (or = 0.37, 95% CI: 0.16, 0.86; p = 0.021) and (before discharge) postnatal care (or = 0.60, 95% CI: 0.38, 0.95; p = 0.030) were significantly wider in rural than urban areas. The differences in the odds of the utilization of skilled delivery assistance between women in poorer wealth quintile and women in richer household wealth quintile were also significantly wider in rural areas than in urban areas. However, the statistically significant rural-urban divides in the impacts of socioeconomic status on antenatal care and (after discharge) postnatal care were not observed. Conclusion This study establishes the need for consideration of the rural-urban context in the formulation of policies to reduce disparities in maternal health care utilization in Tanzania.