Kepatuhan kunjungan ulang pasien rujukan persalinan merupakan salah satu upaya menurun AKI. AKI di RSUP Fatmawati 100% berasal dari kasus rujukan, dan pada bulan Januari, Februari dan Maret 2004 pasien rujukan persalinan yang patuh melakukan kontrol hanya 25%. Kasus rujukan persalinan 95,7% mempunyai penyulit sehingga perlu kunjungan ulang, mengingat asuhan masa nifas sangat penting dimana perlu memberikan konseling KB sedini mungkin, bahaya kehamilan yang akan datang, serta untuk mengetahui dampak intervensi sebelumnya, maka perlu identifikasi faktor-faktor penyebabnya.Tujuan penelitian ini adalah diketahuinya gambaran kepatuhan kunjungan ulang pasien rujukan persalinan dan faktor-faktor yang mempengaruhinya di RSUP Fatmawati Jakarta tahun 2003-2004. Penelitian menggunakan desain cross sectional. Responden dalam penelitian ini, adalah ibu hamil trimester ke III yang dirujuk untuk bersalin dari tanggal 1 juni 2003 sampai dengan 31 Mei 2004, menggunakan data sekunder, pengambilan sampel secara simpel random sampling sebanyak 212 orang.Hasil penelitian ini menunjukan tingkat kepatuhan sebesar 18,9%. Penelitian ini dari 12 variabel yang diteliti yang ada hubungan bermakna adalah 5 variabel yaitu umur, paritas, jarak kelahiran, pendidikan ibu, pengalaman berobat, dengan kepatuhan kunjungan ulang. Untuk variabel pekerjaan ibu, pekerjaan kepala keluarga, penanggung biaya, jarak tempuh, riwayat persalinan yang lalu, penyulit kehamilan, dan penyakit yang diderita ibu tidak hubungan. Dalam hal ini lima dari dua betas hipotesa yang berhasil dibuktikan kebenarannya.Dan hanya 2 variabel yang secara signifikan berhubungan yaitu jarak kehamilan dan pengalaman berobat. Dimana setiap kenaikan 1 tahun jarak kelahiran berpeluang untuk melakukan kunjungan ulang sebesar 1,21 kali dengan (95% CI: 1.03-1,43) setelah dikontrol pengalaman berobat. Responden yang berpengalaman berobat berpeluang untuk patuh sebesar 6.61 kali dengan ( 95% CI:3,07-14,20) setelah dikontrol variabel jarak kelahiran responden.Dari 12 variabel independen yang dapat diintervensi untuk meningkatkan kepatuhan di rumah sakit hanya I variabel adalah pengalaman berobat dan 11 variabel Iainnya yang berasal dari iuar rumah sakitldiluar kontrol RSUP Fatmawati, intervensinya harus dilakukan dengan koordinasi lintas sektoral baik DepKes, Depag, Depdiknas, Departemen Pemberdayaan Wanita, Depdagri dan LSM.

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Factors Related To Compliance Of Revisit Among Referred Delivery Patients In Fatmawati General Hospital, Jakarta 2003-2004Revisit compliance among referred delivery patients is one of important effort to reduce Maternal Mortality Rate. In the Fatmawati General Hospital all maternal death was caused by referred delivery cases. During January, February and March 2004 the revisit compliance of the referred delivery cases was only 25%. Revisit during post partum period is absolutely important since during this time it is timely appropriate to early introduce family planning methods for preventing future problems of maternal and newborn health_ Therefore, it is quite important to identify factors related with the revisit compliance of the referred delivery patients in the hospital.

The objective of this study was to assess factors related to revisit compliance among referred delivery patients in the Fatmawati General Hospital 2003-2004. The design of the study was a cross-sectional design. Population of the study was 3'1 quarter pregnant women who were referred to the delivery room and had a referral letter. The referral took place between June 1 2003 to May 31, 2004. A total of 212 sample of the study was selected using a simple random sampling method.

Results of the study indicated that the revisit compliance of the referred delivery patients in the Fatmawati General Hospital was 18,9%. In addition, it showed that there was a significant correlation between revisit compliance of the patients with the following independent variables namely age, parity, birth space, education of mothers, and previous experience of using the hospital services. There was no significant relationship between revisit compliance with the following variables: work status of the mother, occupation of the head of household, person respoiisible for cost of care in the hospital, distance of home to hospital, obstetric history, problems of pregnancy and diseases affecting the mothers. In this study, 5 out of 12 hypotheses was accepted.

There were significant relationship between birth space and the experience of utilization of hospital services of the pregnant women. After being controlled with the previous experience of the pregnant women in using hospital service, for each year increase of birth space provides a chance of revisit compliance 1.21 times (95% confidence interval 1,03-1,43). After being control with variable of birth space, those pregnant women who had experience in using previous hospital service had a chance 6,61 times (95% confidence interval 3,07-14,20).

Out of 12 variables that are amenable to intervention only previous experience of using hospital service which could be intervened by the hospital. Some other variables such as birth space, occupation of the husband, obstetric history etc could only be intervened by inter-sectoral cooperation among different institutions. Therefore, it is strongly recommended that the improvement of women status and their empowerment should become a priority of the government and non-government intervention.