Di Indonesia angka kematian ibu secara Nasional berdasarkan Survey Demografi Kesehatan Indonesia (SKDI) tahun 1995 adalah 390 per 100.000 kelahiran hidup, yang merupakan angka tertinggi di antara negara-negara ASEAN (Dep. Kes. RI 1998).Berbagai upaya untuk menurunkan angka kematian ibu dan bayi telah banyak dilakukan, salah satu diantaranya adalah peningkatan upaya pelayanan kesehatan dengan jalan mengikutsertakan oraganisasi/sektor terkait serta lembaga swadaya masyarakat dalam menunjang kesejahteraan ibu dan anak.Disamping itu, pemerintah telah menyebarkan bidan ke desa untuk membantu akselerasi penurunan angka kematian ibu dan bayi serta memperluas jangkauan pelayanan yang telah ada sekaligus meningkatkan cakupan program kesehatan ibu dan anak (KIA).Penelitian bertujuan untuk memperoleh gambaran kinerja bidan di desa dalam pelayanan antenatal (ANC) dan faktor-faktor yang berhubungan dengan kinerja bidan desa. Kinerja bidan di desa diukur dengan hasil cakupan K4. Kinerja baik bila cakupan K4 > 80% dan kinerja kurang bila cakupan K4 < 80%.Penelitian ini dilakukan di Kabupaten Agam dengan menggunakan rancangan penelitian Cross Sectional. Sampel penelitian adalah bidan di desa yang bertugas di Kabupaten Agam dan pengambilan sampel dilakukan dengan cara sistematik random sampling sebanyak 100 orang,Hasil penelitian menunjukkan 78% kinerja bidan di desa di Kabupaten Agam masih kurang dan 22% dengan kinerja baik. Penelitian menunjukkan bahwa kinerja bidan di desa di Kabupaten Agam masih kurang.Faktor-faktor berikut ini, umur, status perkawinan, penghasilan, supervise Dinas Kesehatan Kabupaten dan kondisi kerja (gedung), mempunyai hubungan yang bermakna terhadap kinerja bidan di desa. Sedangkan faktor jumlah anak, pelatihan, masa kerja, rasa aman, dan perlengkapan kerja tidak mempunyai hubungan yang bermakna dengan kinerja bidan di desa.Penelitian ini menyarankan agar :1. Pemerintah daerah menyediakan biaya operasional untuk pelatihan daiam rangka meningkatkan profesionalisme bidan di desa sehingga cakupan K4 meningkat.2. Bagi Dinas Kesehatan Kabupaten Agam :a. Melakukan upaya dalam bentuk penegasan kepada Kepala Puskesmas tentang tugas dan wewenang bidan di desa agar cakupan K4 meningkat.b. Meningkatkan profesionalisme bidan di desa melalui kegiatan : -Pertemuan sekali tiga bulan di tingkat Kabupaten.-Pertemuan bulanan di Puskesmas.-Pemberdayaan belajar melalui Kalakarya dan Gugus Kendali Mutu. -Memberikan pelayanan prima kepada ibu hamil.

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Analysis on Factors Which are Related to the Performance Villages Mid Wives in Antenatal Care Services (ANC) In Agam District, West Sumatera, October - December 2000Based on Indonesian Demographic Survey (1995), the Maternal Mortality Rate (MMR), in Indonesia were 390 per 100,000 life birth, which is the highest number of the ASEAN countries (Indonesian Department of Health, 1998).There are some programs to decrease number of Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR). One of the programs is to increase of health services by following the relevant sector and non government organization. Also the government has been already spread the village mid wives to decrease Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) number and to widening the health services.The purpose of this research is to know how the performance of the village mid wives in the Antenatal Care services and some related factors. The performance of the village mid wives is measures by four times health services visits. Good performance can be measures if the four times health services visits is 80% or more. Bad performance can be measures if the four times health services visits is less 80%.The research had already done in Agam district, West Sumatera Province by using Cross Sectional Random Sample. The sample of this research is village mid wives which were working in Agam district and by using Systematic Random Sampling method for 100 villages mid wives.The result of the research showed that 78% performance of the villages mid wives in Agam district still bad and 22% are good.There are some factors related to this performance such as age, marital status, salary, upper level health offices, supervision and working facilities. The unrelated factors to this performance are number of children, working duration, training, the mid wives feels of secure and nurse working kit.This research suggested that:1. For District Government, is to provide the operational costs for trainings in order to increase the professionalism of mid wives at villages to increase K4.2. For Agam District Health Department:a. Stressing the Head of Health Center about job and responsibility of mid wives at villages to increase K4.b. Increasing mid wife professionalism, through activities such as:-Once in three months meeting at District Level.-Monthly meeting at the Health Center.-Empowerment through Kalakarya learning and Total Quality Management. -Give prime quality services to pregnant mother.