Faktor-Faktor Yang Berhubungan dengan Perilak Pemberian ASI Eksklusif Pada Bayi Usia 6-24 Bulan di Wilayah Kerja Puskesmas Sanggaran Agung Kabupaten Kerinci Provinsi Jambi

ABSTRACT: FACTORS RELATED TO EXCLUSIVE BREASTING BEHAVIOR IN INFANTS AGED 6-24 MONTHS IN THE WORK AREA OF SANGGARAN AGUNG PUSKESMAS, KEINCI REGENCY, JAMBI PROVINCE Introduction: The problem of exclusive breastfeeding in infants is caused by a lack of mother's knowledge, mother's attitude towards exclusive breastfeeding, busy working mothers, and low maternal education. In Indonesia, the exclusive breastfeeding coverage target is 80%, according to the 2013 Riskesdas report, the milk adequacy rate of 30.2% is still below the target.Objective: To determine the factors associated with exclusive breastfeeding behavior in infants aged 6-24 months in the Sanggaran Agung Community Health Center Work Area in 2020.Methods: This type of research is quantitative with a cross-sectional design. This research was conducted on August 2-10, 2020, with the population being all mothers with children under five in the Sanggaran Agung Health Center Work Area as many as 65 people, and samples were taken using the Total Population technique. Data was collected through a questionnaire sheet. Data were analyzed by univariate and bivariate with Chy Square test.Results: The results showed the frequency distribution of exclusive breastfeeding behavior (not giving exclusive breastfeeding 46.2%, exclusive breastfeeding 53.8%), knowledge factor (not good 41.5%, good 58.5%), place of delivery (non-health facilities) 30.8%, health facilities 69.2%), birth attendants (non-health workers 27.7%, health workers 72.3%), support from health workers (less supportive 44.6%, supported 55, 4%) and family support (less supportive 35.4%, supportive 64.6%).Conclusion: Based on the results of the study, it can be concluded that there is a relationship between knowledge of mothers, birthing places, birth attendants, support for health workers and family support with exclusive breastfeeding behavior for infants aged 6-24 months in the Sanggaran Agung Public Health Center, Kerinci Regency, Jambi Province in 2020. Support from health centers and related stakeholders to increase mother's knowledge about exclusive breastfeeding and provide support to mothers to be able to give exclusive breastfeeding to their babies. Keywords: Knowledge, place of delivery, birth attendant, support for health workers, family support, exclusive breastfeeding behavior INTISARI: FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PERILAK PEMBERIAN ASI EKSKLUSIF PADA BAYI USIA 6-24 BULAN DI WILAYAH KERJA PUSKESMAS SANGGARAN AGUNG KABUPATEN KERINCI PROVINSI JAMBI Pendahuluan: Permasalah ASI eklusif pada bayi adalah karena pengetahuan ibu yang kurang, sikap ibu terhadap pemberian ASI eklusif, ibu sibuk kerja, pendidikan ibu yang rendah. Di Indonesia target cakupan ASI ekslusif adalah 80%, menurut laporan Riskesdas 2013, angka kecukupan ASI sebanyak 30,2% masih dibawah target.Tujuan: Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan perilaku pemberian ASI Eksklusif pada bayi Usia 6-24 Bulan Di Wilayah Kerja Puskesmas Sanggaran Agung Tahun 2020.Metode: Jenis penelitian ini adalah kuantitatif dengan desain Cross Sectional, Penelitian ini telah dilaksanakan pada tanggal 2-10 Agustus 2020, dengan populasi adalah semua ibu yang memiliki baduta di Wilayah Kerja Puskesmas Sanggaran Agung sebanyak 65 orang dan sampel diambil dengan teknik Total Populasi. Pengumpulan data dilakukan melalui lembar kuesioner. Data dianalisa secara univariat dan bivariat dengan Uji Chy Square.Hasil: Hasil penelitian didapatkan distribusi frekuensi Perilaku pemberian ASI Ekslusif (Tidak ASI Ekslusif 46,2%, ASI Ekslusif 53,8%), faktor pengetahuan (kurang baik 41,5%, Baik 58,5%), tempat persalinan (Non fasilitas kesehatan 30,8%, Fasilitas kesehatan 69,2%), penolong persalinan (non tenaga kesehatan 27,7%, tenaga kesehatan 72,3%), dukungan petugas kesehatan (kurang mendukung 44,6%, mendukung 55,4%) dan dukungan keluarga (kurang mendukung 35,4%, mendukung 64,6%).Kesimpulan: Berdasarkan hasil penelitian maka dapat disimpulkan bahwa Ada hubungan pengetahuan ibu, tempat persalinan, penolong persalinan, dukungan tenaga kesehatan dan dukungan keluarga dengan perilaku pemberian ASI eksklusif pada bayi usia 6-24 bulan di Wilayah Kerja Puskesmas Sanggaran Agung Tahun Kabupaten Kerinci Provinsi Jambi 2020. Dukungan dari pihak puskesmas dan stakeholder terkait untuk dapat meningkatkan pengetahuan ibu tentang ASI Ekslusif serta memberikan dukungan bagi ibu untuk dapat memberikan ASI Ekslusif untuk bayinya. Kata Kunci : Pengetahuan, tempat persalinan, penolong persalinan, dukungan tenaga kesehatan, dukungan keluarga, Perilaku Pemberian ASI Ekslusif

Regulating Midwives: Foreclosing Alternatives in the Policymaking Process in West Java, Indonesia

Promotion of “skilled birth attendants” (SBAs) in global maternal health policy has prompted a range of policy responses to “traditional birth attendants” (TBAs). In Indonesia the response has been to develop a national policy of partnership between SBAs (bidan) and TBAs (dukun bayi). This policy aims to ensure the presence of an SBA at every birth yet offers a role for TBAs. In this chapter I examine the development of a district regulation on partnership, promoted within the context of decentralization policies enacted in Indonesia from 1999. The district regulation aimed to strengthen the national policy in a location in West Java where TBAs remain popular. Drawing on 10 months of fieldwork from 2012 to 2013 at a district health office and on observations of its outreach programs, I elucidate how the regulation on partnership was promoted through the policy entrepreneurship of certain key figures in the district health office. They argued that the partnership regulation was the fastest means to improve maternal health. But casting a spotlight on the relationship between SBAs and TBAs diverted attention away from other health system challenges including under-resourced medical facilities and a weak referral system. Three contexts played into this process of bringing the partnership issue to the fore: global policies promoting SBAs and sidelining TBAs; pressure to achieve the Millennium Development Goal (MDG) on maternal mortality; and the limited financial power and decision space afforded to districts under decentralization in Indonesia. In this context, the regulation offered a viable path for demonstrating commitment to improving maternal health outcomes, yet one that failed to address broader constraints in the health system that contribute to persistent high maternal mortality rates.

African traditional abdominal massage in pregnancy resulting in antepartum uterine rupture, abruptio placenta and foetal demise – a case report

The practice of abdominal massage dates to years ago and associated with foetal and maternal morbidity and mortality when undertaken by untrained traditional birth attendants in our setting. We present a 30-year old G3P2+0 with uterine rupture and intra-uterine foetal death following abdominal massage. She was resuscitated and had emergency exploratory laparotomy and repair of uterine rupture.

Women Empowerment and Skilled Birth Attendants among Women in Rural Ghana

Background. A critical public health issue is maternal mortality. Around 810 women die per day from pregnancy and childbirth, with approximately 99 percent of these deaths recorded in low-and middle-income countries (LMICs). In sub-Saharan Africa (SSA), more than half of these mortalities are registered. The situation is remarkably similar in Ghana, with maternal mortality standing at 319 deaths per 100,000 live births in 2015. Methods. Using data from 2014 Demographic and Health Surveys, the study examined the association between women empowerment and skilled birth attendance among women in rural Ghana. Results. Women with medium decision-making ( OR = 0.75 , CI = 0.61 , 0.93), low knowledge level ( OR = 0.55 , CI = 0.40 , 0.76), high acceptance of wife beating ( OR = 0.68 , CI = 0.51 , 0.90), with less than 4 ANC visits ( OR = 0.25 , CI = 0.19 , 0.32), whose partner had higher education ( OR = 1.96 , CI = 1.05 , 3.64), and who had a big problem with the distance getting to the health facility ( OR = 0.63 , CI = 0.50 , 0.78) had a significant association with skilled birth attendants. Decision-making power, women’s knowledge level, acceptance of wife beating, antenatal care visit, partner’s education, getting medical help for self, and distance to health facility were seen to have a significant association with skilled birth attendants among women in Ghana. Conclusion. Efforts to increase the current SBA should concentrate on the empowerment of women, male involvement in maternal health problems, women’s education, and participation in the ANC. There is a need to review current policies, strategies, and services to improve maternal health conditions.

GAMBARAN TEKNIK RELAKSASI NAFAS PADA IBU BERSALIN DI PRAKTIK MANDIRI BIDAN “N” TAHUN 2021

Nyeri dalam persalinan dapat memiliki dampak yang berbahaya pada ibu dan janin yaitu hiperventilasi. Berdasarkan survey awal yang dilakukan di Praktik Mandiri Bidan N Cipaku pada bulan Januari tahun 2021, ditemukan 7 dari 10 ibu bersalin mengalami nyeri yang luar biasa dan tidak tertahankan. Tujuan penelitian ini adalah untuk mengetahui Gambaran Teknik Relaksasi Nafas Pada Ibu Bersalin di Praktik Mandiri Bidan “N” Periode April Tahun 2021. Metode penelitian ini menggunakan metode penelitian deskriptif dengan jumlah sempel sebanyak 35 orang. Pengambilan sampel yang digunakan dalam penelitian ini adalah metode total Sampling. Diketahui Lebih dari setengahnya responden melakukan teknik relaksasi nafas pada proses persalinannya secara baik sebanyak 19 orang (54,3%) dan kurang dari setengahnya responden melakukan teknik relaksasi nafas secara sedang pada proses persalinannya sebanyak 11 orang (31,4%) dan sebagian kecil responden melakukan teknik relaksasi nafas pada proses persalinannya secara kurang sebanyak 5 orang (14,3%). Lebih dari setengahnya responden melakukan teknik relaksasi nafas pada proses persalinannya secara baik.Saran: Diharapkan Tenaga kesehatan khusunya bidan sebagai penolong persalinan dapat membantu ibu bersalin dalam memenuhi kebutuhan ibu akan rasa nyaman dalam pengontrolan nyeri dan dapat meningkatkan kegiatan penyuluhan tentang teknik relaksasi nafas pada proses persalinan yang dapat membantu ibu bersalin mengurangi nyeri pada saat persalinan.Background: Pain in labor can have a dangerous impact on the mother and fetus, namely hyperventilation.4 Based on an initial survey conducted at the Independent Practice of Midwives N Cipaku in January 2021, it was found that 7 out of 10 maternity mothers experienced excruciating pain and did not experience pain. bearable.Objective: The purpose of this study was to find out the description of the Breath Relaxation Technique in Maternity in the Midwife Independent Practice "N" for the April 2021 Period. Methods: This research method used a descriptive research method with a sample of 35 people. The sampling used in this study is the total sampling method. The results: It is known that more than half of the respondents performed breath relaxation techniques during labor well as many as 19 people (54.3%) and less than half of the respondents performed moderate breathing relaxation techniques during labor as many as 11 people (31.4%) and a small proportion of respondents performed breathing relaxation techniques in the process of delivery less than 5 people (14.3%.Conclusion: More than half of the respondents performed the breath relaxation technique well in the labor process.Suggestion: It is expected that health workers, especially midwives as birth attendants, can help birth mothers in meeting the mother's need for comfort in pain control and can increase counseling activities about breath relaxation techniques in the labor process that can help mothers in labor reduce pain during labor.

Association between type of birth attendants and neonatal mortality: Evidence from a National survey

Background: Although Lesotho has one of the highest childhood mortality levels in Southern Africa, there has been limited research on the link between type of birth attendant and neonatal mortality in Lesotho. This study examined the relationship between type of birth attendant and neonatal mortality while controlling for socio-demographic characteristics of mothers in LesothoMethods: The study used data from the children’s file of 2014 Lesotho Demographic and Health Survey data. Kaplan-Meier method was used to estimate neonatal mortality rate and Cox proportional hazard regression model was used to assess the association between type of birth attendant and neonatal mortality.Results: Result shows that 5.3% of all births attended to by non-SBAs resulted into neonatal mortality compared to 2.8% of those attended to by SBA. Result further shows that regardless of socio-demographic characteristics, the risks of neonatal mortality were significantly higher with non-SBAs compared to SBA in Lesotho (HR: 2.00, CI: 1.31-3.06).Conclusion: The risk of neonatal mortality is two times higher among children delivered by Non-SBA. Scale-up in access and uptake of SBA is recommended in Lesotho. Thus, Policy on scale-up access to SBA at delivery at no costs need to be put in place. Keywords: Neonatal; mortality; Lesotho.

Model for Teaching the Helping Babies Survive Course Series and Advanced Life Support in Obstetrics Workshops to Rural Skilled Birth Attendants in Uganda

Background: Uganda, like much of Sub-Saharan Africa and other underserved regions continues to face the challenge of high neonatal and maternal mortality. The Helping Babies Survive (HBS) course and the Advanced Life Support in Obstetrics (ALSO) provide hands on education to train providers in key life-saving interventions. A uterine balloon tamponade (UBT) procedure can be life-saving in the event of uterine bleeding. The purpose of this implementation research is to gain more insight into the effectiveness of a tailored down 5-day combined HBS-ALSO-UBT course. In this study, we found that a tailored down 5-day combined HBS-ALSO-UBT could be performed with significantly improved self-assessment in diagnosing and managing a wide range of peripartum conditions.Keywords: Neonatal; Perinatal Care; Maternal Morbidity.

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

Socioeconomic inequalities in access and use of skilled birth attendants during childbirth in Ghana: a decomposition analysis

Background Equitable access to skilled birth attendance during delivery is vital for reducing global maternal deaths to 70 deaths per 100, 000 to achieve the Sustainable Development Goals (SDGs) by 2030. Although several initiatives have been implemented to reduce maternal mortality in Ghana, inequalities in access to skilled birth attendance during delivery still exist among women of different socioeconomic groups. This study assesses the socioeconomic inequalities in access and use of skilled birth attendants during delivery in Ghana. Methods Research was conducted through literature reviews and document reviews, and a secondary data analysis of the 2014 Ghana Demographic and Health Survey (GDHS), a nationally representative survey. A total of 1305 women aged 15–49 years, who had a live birth the year before to the survey in the presence of a skilled birth attendant were analysed using concentration indices and curves. The indices were further decomposed to identify the major socioeconomic factors contributing most to the inequalities. Results The results found that access to skilled birth attendants was more among women from rich households showing a pro-rich utilization. The decomposition analysis revealed that household wealth index, educational level of both mother and husband/partner, area of residence and mother’s health insurance coverage were the major contributing factors to socioeconomic inequalities in accessing skilled birth attendants during child delivery among Ghanaian women. Conclusion This study confirms that a mother’s socioeconomic status is vital to reducing maternal deaths. Therefore, it is worthy to focus attention on policy interventions to reduce the observed inequalities as revealed in the study.