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"ABSTRACTA cross-sectional study was carried out to investigate qualitatively the current breastfeeding behavior of mothers having the first baby about six months of age and the current behavior regarding breastfeeding of health professionals working in several health care facilities (HCF) in Jakarta. The samples of mothers and health professionals were selected from HCF representing two different socioeconomic strata (middle-high and middle-low group). The result of this study shows that mother's breastfeeding behavior (the time of breastfeeding initiation, frequency and duration of breastfeeding) was in favor for the mothers of the middle-low group. Better practice concerning the time of breastfeeding initiation was also found among the health professionals of the middle-low group. Giving prelatic feed in the HCF was still common especially in the middle-high HCF. The duration of exclusive breastfeeding practice was still inadequate among mothers regardless socioeconomic status, which was also revealed in the health professional's knowledge. This study suggests that mother's motivation regarding breastfeeding should be encouraged continuously through various channels. All health professionals should be well informed and well motivated to promote breastfeeding particularly regarding the time of breastfeeding initiation, giving prelatic feed in the health care facility and the recommended time of giving supplementary feeding."

"Latar Belakang. Program 10 Langkah Menuju Keberhasilan Menyusui yang merupakan panduan dalam menjalankan Rumah Sakit Sayang Bayi. Banyak studi menunjukkan program ini dapat membantu keberhasilan proses menyusui dan meningkatkan angka cakupan pemberian ASI eksklusif. Dalam menjalankan program ini dibutuhkan tenaga kesehatan, manajemen dan semua pihak agar bisa terlaksana. Kualitas tenaga kesehatan yang melayani juga perlu diperhatikan serta kelengkapan prosedur standar pelayanan. Sarana dan prasarana yang mendukung juga dibutuhkan bagi keberlangsungan program. Sosialisasi dari kegiatan ini juga diperlukan dalam proses pelaksanaan program. RSIA Kemang Medical Care telah menjalankan langkah-langkah tersebut yang diharapkan dapat membantu keberhasilan menyusui bagi pasiennya. Metode. Penelitian ini menggunakan pendekatan kualitatif yang bertujuan untuk mendapatkan gambaran masukan, proses dan keluaran dalam program 10 Langkah Menuju Keberhasilan Menyusui. Pengumpulan data dilakukan dengan melakukan wawancara mendalam dan Focus Group Discussion dengan manajemen, tenaga kesehatan serta pasien dan informan ahli dan juga observasi dengan total 16 narasumber. Juga dilakukan survei kepada pasien RSIA Kemang Medical Care yang melahirkan di awal tahun 2013 sebanyak 100 orang dari 184 data yang ada. Penelitian dilakukan sejak 15 Oktober 2013 sampai 6 Desember 2013 dan berlangsung di RSIA Kemang Medical Care. Hasil. Hasil analisa menunjukkan bahwa RSIA Kemang Medical Care telah menjalankan 10 Langkah Menuju Keberhasilan Menyusui dengan baik dari berbagai temuan yang ada. Hasil survei menunjukkan angka ASI eksklusif pasien di awal tahun 2013 adalah sebesar 88%.

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Background. 10 steps to successful sreastfeeding program is a guide to implement a Baby-Friendly Hospital initatives. Many studies have shown that BFHI can help improve the process of breastfeeding and exclusive breastfeeding rate coverage. In carrying out the program required health personnel, management and all parties to be involved in the implementation. The quality of health personnel who serve also need to be considered as well as the whole standard service procedures. Facilities that support is also needed for the sustainability of the program. Socialization of this activity is also required in the process of implementing the program. RSIA Kemang Medical Care has been running these steps and is expected to help the succesful rates of breastfeeding for the patients.

Method. The design study is a qualitative approach that aims to get an overview of input, process and output in the 10 Steps to Successful Breastfeeding program. Data was collected through in-depth interviews and focus group discussions with the management, health care workers and patients and expert informants and also observations with 16 resource persons. A survey is also conducted to 100 out of 184 of RSIA Kemang Medical Care patients who gave birth in early 2013. The study was conducted from October 15, 2013 until December 6, 2013 and took place in RSIA Kemang Medical Care.

Results. The analysis shows that RSIA Kemang Medical Care has a good implementation of the 10 Steps to Successful Breastfeeding from numerous findings. The survey has shown that exclusive breastfeeding rates are 88% from the early 2013 patients data."

"ABSTRAKLatar belakang: Pemberian ASI eksklusif oleh ibu sehat pada bayi sehat cukup bulan sesuai masa kehamilan dengan persalinan normal seharusnya tidak memiliki kendala, namun cakupan pemberian ASI eksklusif di Indonesia semakin menurun.Tujuan: Mengetahui insidens keberhasilan pemberian ASI eksklusif di RSCM dan faktor yang memengaruhinya setiap bulan selama 6 bulan.Metodologi: Studi kohort prospektif analitik pada 243 ibu sehat yang memiliki bayi sehat cukup bulan sesuai masa kehamilan, dengan persalinan normal di RSCM. Wawancara terarah dilakukan setiap bulan selama enam bulan. Analisis bivariat dan multivariat regresi logistik dilakukan pada faktor yang memiliki jumlah subyek seimbang.Hasil: Insidens ASI eksklusif, yaitu sebesar 64,8% (bulan-1); 53,7% (bulan-2); 43% (bulan-3); 30,7% (bulan-4); 23,5% (bulan-5); dan 22,3% (bulan-6). Keberhasilan ASI eksklusif dipengaruhi oleh inisiasi menyusu dini hingga bulan-2, ibu tidak berkerja/bersekolah pada bulan-3 hingga bulan-6, keyakinan ibu akan produksi ASI hingga bulan-6, dukungan suami/keluarga hingga bulan-6, perasaan tidak stres pada bulan-2 dan bulan-3 (p<0,028). Analisis multivariat menyimpulkan keyakinan ibu akan produksi ASI memengaruhi keberhasilan ASI eksklusif setiap bulan dengan resiko relatif (RR) dan 95% interval kepercayaan (IK) sebesar 14,85 dan 6,9-31,94 (bulan-1); 44,26 dan 10,16-192,75 (bulan-2); 14,62 dan 4,88-43,83 (bulan-3); 32,28 dan 4,23-246,37 (bulan-4); 19,85 dan 2,57-153,16 (bulan-5); 19,02 dan 2,47-146,31 (bulan-6). Dukungan suami/keluarga memengaruhi keberhasilan ASI eksklusif setiap bulan dengan RR dan 95%IK sebesar 4,06 dan 2,06-8,03 (bulan-1); 4,93 dan 2,5-9,73 (bulan-2); 2,35 dan 1,15-4,81 (bulan-3); 5,44 dan 2,03-14,59 (bulan-4); 6,49 dan 1,77-23,75 (bulan-5); 24,43 dan 3,20-186,42 (bulan-6). Ibu bekerja/sekolah memengaruhi keberhasilan ASI eksklusif pada bulan ketiga (RR 3,38; 95%IK 1,21-9,43) and bulan keempat (RR 6,56; 95%IK 1,39-30,99).Simpulan: Insidens ASI eksklusif di RSCM menurun setiap bulannya hingga 6 bulan. Faktor yang memengaruhi keberhasilan ASI eksklusif setiap bulan selama enam bulan bersifat multifaktorial.

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ABSTRACTBackground: Exclusive breastfeeding by healthy mothers to healthy term babies with normal birth is not supposed to be a problem yet the coverage of exclusive breastfeeding in Indonesia is declining.Objective: To obtain the success rate incidence for exclusive breastfeeding and its affecting factors in every month for six monthsMethods: A prospective analytical cohort study in 243 healthy mothers with healthy term babies with normal birth at CMH. Guided interviews were conducted every month for six months. Bivariate and multivariate were performed on factors with equal subject numbers.Results: Exclusive breastfeeding incidences are 64.8% (first month); 53.7% (second month); 43% (third month); 30.7% (fourth month); 23.5% (fifth month); and 22.3% (sixth month). The multivariate analysis concluded that the mother’s belief of breastmilk production affects the exclusive breastfeeding success for every month with RR dan 95%CI: 14.85 and 6.9-31.94 (first month); 44.26 and 10.16-192.75 (second month); 14,62 and 4.88-43.83 (third month); 32,28 and 4.3-246.37 (fourth month); 19.85 and 2.57-153.16 (fifth month); 19.02 and 2.47-146.31 (sixth month). The husband/family support affects the exclusive breastfeeding success with RR and 95%CI: 4.06 and 2.06-8.03 (first month); 4.93 and 2.5-9.73 (second month); 2.35 and 1.15-4.81 (third month); 5.44 and 2.03-14.59 (fourt month); 6.49 and 1.77-23.75 (fifth month); 24.43 and 3.20-186.42 (sixth month). Non-working/studying mothers affects the exclusive breastfeeding success for the third month (RR 3.38; 95%CI 1.21-9.43) and fourt month (RR 6.56; 95%CI 1.39-30.99).Conclusions: Exclusive breastfeeding incidence in CMH declined every month up to sixth month. Factors affecting the success for each month in the six months are multifactorial."

"Upaya untuk menurunkan kematian neonatal merupakan kunci utama dalam keberhasilan penurunan kematian bayi. Meningkatkan status kesehatan bayi dengan pemberian ASI (Air Susu Ibu) secara eksklusif merupakan upaya penurunan AKB. Banyak faktor yang mempengaruhi keberhasilan pemberian ASI eksklusif, diantaranya pemahaman dan motivasi adalah faktor utama keberhasilan ibu dalam memberikan ASI eksklusif. Untuk menanamkan pemahaman pentingnya ASI eksklusif seluruh ibu setidaknya harus mendapat informasi tentang ASI eksklusif dimulai sejak masa kehamilan Dengan memperoleh konseling tentang ASI diharapkan ibu hamil akan memperoleh pengetahuan tentang manfaat ASI sehingga bila ibu memahaminya maka ia akan termotivasi untuk memberikan ASI pada bayinya Penelitian ini bertujuan untuk melihat hubungan kualitas pelayanan antenatal dan pelaksanaan ASI eksklusif setelah dikontrol oleh variabel IMD, berat bayi lahir, umur, pendidikan, pekerjaan, paritas, kontrasepsi dan dukungan suami/keluarga. Desain yang dipakai adalah Crossectional terhadap 143 ibu yang memiliki bayi umur 6-24 bulan di wilayah Kota Cirebon tahun 2013. Analisis data yang digunakan adalah uji chi square dan regresi logistik. Hasil penelitian menunjukkan bahwa 41,3% ibu memberikan ASI eksklusif/predominan. Ibu yang mendapat kualitas pelayanan antenatal baik dalam hubungannya dengan ASI eksklusif sebanyak 48,3%. Hasil analisis bivariat yang terbukti berhubungan secara bermakna adalah pekerjaan (0,004) dan IMD (0,15). Hasil analisis multivariat menjelaskan bahwa, ibu yang bekerja (OR 0,250) memiliki kemungkinan empat kali untuk melaksanakan ASI eksklusif dibandingkan ibu yang tidak bekerja dikontrol oleh variabel IMD, berat bayi lahir, umur, pendidikan, paritas, kontrasepsi dan dukungan suami/keluarga. Disarankan untuk bidan sebagai tenaga kesehatan yang terbanyak dipilih ibu untuk memberikan pertolongan kesehatan harus meningkatkan kualitas KIE terutama tentang ASI eksklusif dan IMD disamping informasi kesehatan lainnya. Bagi Dinas Kesehatan mengadakan pelatihan konselor ASI, dan setiap Puskesmas harus memiliki Pojok ASI beserta kelengkapannya serta ruang bimbingan laktasi bagi ibu hamil dan ibu menyusui.

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Efforts to reduce neonatal mortality is the main key to successfully reducing infant mortality. Improving the health status of infants with breastfeeding (breast milk) exclusively, is an efforts to reduce IMR. There are many factors that affect the success of exclusive breastfeeding, including the knowledge and motivation which were the key factors of successfully mother’s breastfeeding. To embed the knowledge about the importance of exclusive breastfeeding, mothers should be informed about exclusive breastfeeding during pregnancy by obtaining the counseling about breastfeeding. The more they understand about breastfeeding, the more motivations they will get to give exclusive breastfeeding to their babies.

This study aims to look at the relationship between the quality of antenatal care and the implementation of exclusive breastfeeding after it controlled by the IMD variable, birth weight, age, education, occupation, parity, contraception and support from her husband/family. The design of this research are using Cross-sectional design to 143 mothers of infants aged 6-24 months in the city of Cirebon in 2013. To analyze the data, the researcher used chi square test and logistic regression.

The results of research shows 41.3% of mothers are giving breastfeed xclusively/predominantly. Mothers who received antenatal care quality related to exclusive breastfeeding are 48.3%. Results of the bivariate analysis are proven to be significantly related to employment (0.004) and IMD (0.15). Multivariate analysis explains that working mothers (OR 0.250) had four times the possibility to carry out exclusive breastfeeding than mothers who are not working is controlled by the IMD variable, birth weight, age, education, parity, contraception and support from her husband/family.

Recommended for midwives as the most selected health workers by mothers to provide health aid should improve the quality of KIE, especially on exclusive breastfeeding and IMD, besides other health information. The Health Department have to held a breastfeeding counselor training, and each Health Center should have a breastfeeding corner along with the equipment as well as a lactation counseling for pregnant and nursing mothers."

"Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan perilaku Tenaga Kesehatan dalam memberikan ASI eksklusif. Metode yang digunakan adalah dengan sequencial explanatory mixed methods (kuantitatif dan kualitatif) dengan desain penelitian cross sectional. Jumlah sampel penelitian ini sebanyak 85 nakes perempuan yang memiliki bayi umur 7-24 bulan di Puskesmas Kecamatan se-Jakarta Timur. Instrumen penelitian menggunakan angket yang diisi oleh responden (self administer). Analisis data menggunakan chi square dan regresi logistik ganda. Hasil penelitian memperlihatkan proporsi pemberian ASI eksklusif sebesar 54.1%. Variabel yang berhubungan dengan pemberian ASI eksklusif adalah pengetahuan, sikap, ketersediaan fasilitas, dukungan keluarga, dukungan teman kerja, dukungan nakes dengan p value < 0.05. Hasil analisis multivariat variabel umur dan pengetahuan berhubungan dengan perilaku pemberian ASI eksklusif dan faktor yang paling dominan adalah pengetahuan. Penelitian kualitatif dilakukan sebagai pendukung untuk hasil kuantitatif, jumlah sampel sebanyak 10 informan, teknik pengambilan data dengan wawancara mendalam menggunakan panduan pertanyaan semi terstruktur. Faktor penghambat dalam perilaku pemberian ASI eksklusif adalah komitmen ibu yang kurang, masalah terkait menyusui, kurang pengetahuan keluarga. Saran agar nakes diberikan pelatihan terkait menyusui untuk meningkatkan pengetahuan, kebijakan yang lebih fleksibel kepada nakes yang masih menyusui, dan melengkapi fasilitas untuk menyusui.

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This study aims to determine the factors associated with the behavior of female health workers in exclusive breastfeeding. The method that used in this study is the sequential explanatory mixed methods (quantitative and qualitative) with a cross-sectional study design. Number of samples in this study 85 female health workers who have infants aged 7-24 months in the sub-district primary health care throughout East Jakarta. This research using questionnaires filled out by the respondent (self-administer) for the instrument. This research also use chi-square and multiple logistic regression for analizing data. The results shown that the proportion of exclusive breastfeeding is 54.1%. Variables that associated with exclusive breastfeeding are knowledge, attitude, availability of facilities, family support, support co-workers, and support health workers with p value <0.05.

The result of multivariate analysis shown that behavior of exclusive breastfeeding is associated with age and knowledge and the most dominant factor is knowledge. Qualitative research is done as supported for quantitative results, total samples are 10 informants and using in-depth interviews with a semi-structured guide questions as a data collection techniques. The factor that inhibit mother for exclusive breastfeeding is lack of commitment, problems that related breastfeeding, and lack of knowledge of the family. Suggestion to health workers to be given a training that related to breastfeeding to improve knowledge, more flexible policies for health workers who are still breastfeeding, complementary facilities for breastfeeding."

"Data dan informasi profil kesehatan Indonesia tahun 2016 menunjukan hanya sebesar 29,5 % bayi mendapatkan ASI Eksklusif sampai 6 bulan, rendahnya pemberian ASI Eksklusif membuat pemerintah mengeluarkan PP No 33 tahun 2012 tentang pemberian ASI Eksklusif. Tujuan penelitian ini untuk menganalisis implementasi kebijakan pemberian ASI Eksklusif di wilayah kerja puskesmas cicalengka. Penelitian menggunakan analisis kualitatif dengan metode wawancara mendalam, diskusi kelompok terarah dan studi literatur. Hasil Penelitian menemukan implementasi kebijakan pemberian ASI di puskesmas belum berjalan optimal terlihat dari cakupan pemberin ASI secara eksklusif yang masih rendah. Sosialisasi kebijakan belum dilakukan secara keseluruhan, pembagian waktu dan tugas belum jelas dan belum memiliki anggaran khusus serta peggunaan Standar Operasional Prosedur dalam menjalankan kebijakan kurang. Komunikasi merupakan faktor yang paling berpengaruh terhadap implementasi kebijakan. Belum ada dukungan dan komitmen dari seluruh pegawai dalam pelaksanaan kebijakan pemberian ASI secara Eksklusif. Saran yang diajukan adalah konsisten melakukan sosialisasi kepada pegawai maupun masyarakat, dilaksanakan supervisi dalam upaya pengawalan kebijakan, menjalankan Standar Operasional Prosedur (SOP), mengalokasikan anggaran kegiatan di tahun 2018, membuat nota kesepahaman dengan instansi lain, dan self assessment serta evaluasi program mutlak dilakukan secara kontinyu.

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Data and information on the health profile of Indonesia in 2016 showed only 29.5% of infants receive exclusive breastfeeding until 6 months, the low level of exclusive breastfeeding made the government issue a regulation on exclusive breastfeeding in PP No.33 Tahun 2012. The study aimed to analyze the policy implementation of exclusive breastfeeding at Cicalengka Public Health Center. The study used qualitative analysis with in-depth interview method, focus group discussion and literature study.

The result of this study shows that breastfeeding policy implementation in health centers is not optimal, as seen from the low coverage of exclusive breastfeeding. Socialization of the policy has not been done as a whole, the time and task division is unclear and has no special budget and the use of standard operating procedures in carrying out the policy less. Communication is the most influential factor in the implementation of the policy. There is no support and commitment from all employees in the implementation of exclusive breastfeeding policy.

The suggestion is to consistently socialize to employees and the public, carry out supervision in an effort to secure the policy, run the Standard Operating Procedure (SOP), allocate budget activities in 2018, create a memorandum of understanding with other agencies, and Self-assessment and program evaluation absolutely must do continuously."

"Exclusive breastfeeding intention is a mothers intention to provide her baby only breast milk since the infant was born until at the age of 6 months. Intention in prenatal period is the direct affirmation of exclusive breastfeeding. This study aimed to find out the most dominant factor related to exclusive breastfeeding intention among pregnant women at a mother and child hospital in South Tangerang. A cross-sectional study design was conducted primarily. The samples were 143 pregnant women on their third trimester pregnancy selected by purposive sampling. Intention was measured by the Infant Feeding Intention scale questionnaire. Meanwhile, attitude, subjective norms, and perceived behavioral control were measured by the modified Breastfeeding Attrition Prediction Tool questionnaire. Data were analyzed using the multivariate logistic regression analysis. It was 61.5% mother had strong exclusive breastfeeding intention. Perceived behavioral control dominantly influenced the exclusive breastfeeding intention (p value = 0.007 Odds Ratio 3.030 95% CI = 1.361 to 6.746). The other factors influencing intention were attitude, exposure to exclusive breastfeeding from social media, health workers support, previous breastfeeding experience and mothers occupation. A mother with high perceived behavioral control has three times more likely to have high exclusive breastfeeding intention than those having the low ones."