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

‘Since It’s a Pleasure to Save Somebody’s Life, I Do This’

Health development efforts to decrease maternal and neonatal morbidity and mortality in South Asia have included a role for trained and/or traditional birth attendants since the late 20th century. Birth attendants are typically older women, who assist not only during birth but who also can provide counsel during pregnancy and lactation. Based on an ethnographic case study, focused on a jhuggi-jhopri (squatter) settlement in New Delhi, this chapter differentiates between two types of birth attendants. Traditional birth attendants are women who have learned their skills and knowledge, typically from elder women relatives, through apprenticeship. Their tools of practice include herbal knowledge as well as ‘modern’ medical kits they may have received through health education efforts (for example, scissors to cut the umbilical cord). In contrast, trained birth attendants are older women who were recruited through local health organizations (both governmental and non-governmental) and trained by biomedical practitioners to provide frontline care. This chapter examines both traditional and trained birth attendants’ perspectives on assisting local mothers, examining how local mothers view traditional versus trained birth attendants and, in turn, how this may affect their birth experiences

Family Planning as A Determining Factor in Preference to Traditional Birth Attendants (TBAs) Among Somali Community in Dadaab Refugee Camps, Kenya

Statement of Problem: Family planning is a determining factor in the maternal health care choices for Somali pregnant mothers in Dadaab Refugee camps. Research has revealed that during delivery, the Somali mothers prefer the services of Traditional Birth Attendants (TBAs) to those of midwives in hospitals. The preference for TBAs is borne of the belief that when women deliver in hospitals, they could be subjected to family planning against their will. The contention is that Islam and socio-cultural practices of the Somali community do not advocate family planning. The purpose of this paper is to discuss Islam’s position on family planning in order to explain the response of the Somalis of Dadaab refugee camps on family planning. Methodology & Theoretical orientation: The paper is derived from a qualitative study that involved snowball sampling, in-depth interviews and focus group discussions (FGDs). These methods brought out family planning as a determining factor in the mother’s choice of TBAs as opposed to hospital midwives in Dadaab Refugee camps. Findings: Any discourse on Islam and family planning offers two perspectives: proponents of family planning and opponents of family planning. Both perspectives use the texts of the Qur’an and Hadith (traditions) and different interpretations to justify and support their respective positions and opinions. Through primary and secondary sources, the paper interrogates both perspectives of family planning in Islam. Conclusion & Significance: It is concluded that the Somalis’ belief on family planning is informed by the two perspectives of family planning, but the opponents’ perspective holds sway. This determines the preference for TBAs for fear that mothers who deliver in hospitals could be subjected to family planning contraceptives. Recommendation: there is need to educate the community further on Islamic teachings on family planning; and more sensitization conducted on the benefits of child spacing.

HEALTH CARE PROVIDERS’ VIEWS CONCERNING KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN TAJIKISTAN: A QUALITATIVE STUDY

Introduction: This study seeks to explore health care providers’ perspectives of the traditional birth attendants’ knowledge and practices. Methods: This qualitative study was conducted in 2018 with 16 health care professionals working at various levels of maternal health care system in two purposefully selected research settings, Khorog town and Dushanbe, which have different social, economic and ethnic backgrounds. Semi-structured face-to-face interviews were conducted to gather the data. Duration of interviews ranged from 30-60 min. NVivo software for qualitative research was used to analyse the results. Results: This study has shown that health care workers have extremely negative views of the knowledge and practices of traditional birth attendants. They highlight the lack of adequate knowledge of traditional birth attendants on biomedical aspects of birth, poor skills in infections control and lack of use of clean delivery practices. They also claim that the traditional birth attendants’ practices also lead to different complications while they are woefully unprepared to recognize obstetric complications during birth. Conclusion: The study recommends providing a skilled birth attendant in every area. It also recommends avoiding a homogeneous approach to address maternal health issues in diverse countries of the Global South and reviewing maternal health care policies and programs to provide the most marginalized groups of women with skilled birth services to improve their maternal health and further decrease maternal mortality in Tajikistan.

DETERMINAN KULTURAL DAN STRUKTURAL DALAM KEMITRAAN BIDAN DENGAN DUKUN BAYI (BHISA/SANDO) DI KABUPATEN WAKATOBI, SULAWESI TENGGARA

Background: Births assisted by skilled health personnel in health facilities is the prevention of maternal mortality. Wakatobi District has a low coverage of birth attendance by skilled health personnel, and the community has a powerful culture in all aspects of life, including visiting traditional birth attendants known as Bhisa/Sando in caring for women from pregnant to childbirth. Objective: To identify the cultural and structural determinants that affect the partnership between Bhisa/Shando and midwives in maternal and child health services (MCH). Methods: This study used an operational research design with a qualitative approach. A total of 68 informants were involved in focus group discussions, in-depth interviews, and participatory observations. Thematic analysis was used in processing all information. Results: Cultural determinants that affect the partnership between Bhisa/Shando and midwives were hereditary traditions and a powerful belief in Bhisa/Shando's ability to take care for pregnant women, labor women, postpartum women, and newborns. Meanwhile, structural determinants included inadequate facilities and health personnel for MCH services and suboptimal supports from related parties. These results may cause the partnership between Bhisa/Shando and midwives will not be optimal. Conclusion: Cultural and structural factors have a strong influence in realizing the partnership between Bhisa/Sando and midwives. The involvement of Bhisa/Sando in MCH services conducted by midwives, adequate MCH service infrastructure, and support from community leaders, cadres, and related agencies is essential to be carried out to improve Bhisa/Sando's partnership with midwives in improving MCH services. Keywords: Bhisa/Shando, partnership of midwives and traditional birth attendants, maternal and child health Abstrak Latar belakang: Persalinan yang ditolong oleh tenaga kesehatan di fasilitas kesehatan merupakan upaya untuk mencegah kematian ibu. Kabupaten Wakatobi memiliki cakupan penolong persalinan oleh tenaga kesehatan yang rendah, dan masyarakatnya memiliki budaya yang sangat kuat dalam segala aspek kehidupan, termasuk mendatangi dukun bayi yang disebut sebagai Bhisa/Sando dalam menangani ibu hamil hingga bersalin. Tujuan: Mengidentifikasi determinan kultural dan struktural yang memengaruhi kemitraan antara Bhisa/Shando dengan bidan dalam pelayanan kesehatan ibu dan anak (KIA). Metode: Studi ini menggunakan desain riset operasional dengan pendekatan kualitatif. Total 68 informan terlibat dalam diskusi grup terarah, wawancara mendalam, dan observasi partisipasi. Analisis tematik digunakan dalam mengolah seluruh informasi. Hasil: Determinan kultural yang memengaruhi kemitraan antara Bhisa/Shando dengan bidan yaitu tradisi turun temurun dan kepercayaan yang kuat terhadap kemampuan Bhisa/Shando dalam menangani ibu hamil, ibu bersalin, ibu nifas, dan bayi baru lahir. Sedangkan determinan struktural meliputi fasilitas dan tenaga kesehatan untuk pelayanan KIA yang belum memadai serta dukungan dari pihak terkait yang belum optimal. Hal ini menyebabkan kemitraan antara Bhisa/Shando dengan bidan belum optimal. Kesimpulan: faktor kulturan dan struktural berpengaruh kuat dalam mewujudkan kemitraan antara Bhisa/Sando dengan bidan. Keterlibatan Bhisa/Sando dalam pelayanan KIA yang dilakukan bidan, infrastruktur pelayanan KIA yang memadai, dan dukungan dari tokoh masyarakat, kader, dan instansi terkait perlu dilakukan untuk meningkatkan kemitraan Bhisa/Sando dengan bidan dalam meningkatkan pelayanan KIA. Kesimpulan: Kualitas hidup ibu hamil dan ibu nifas relatif sama dengan kecenderungan lebih rendah pada kualitas hidup ibu nifas Kata kunci: Bhisa/Shando, kemitraan bidan dan dukun bayi, kesehatan ibu dan anak