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"Salah satu upaya menurunkan angka kesakitan dan kematian ibu adalah melalui pemberian pelayanan yang berkualitas. Cakupan pertolongan persalinan yang di tolong oleh tenaga kesehatan di Kabupaten Agam dari tahun 2008 sampai tahun 2010 masih rendah dan cendrung turun. Sejak bulan April tahun 2011 di Kabupaten Agam sudah diterapkan Jampersal, hal ini mendorong peneliti untuk mengetahui bagaimana cakupan pertolongan persalinan oleh bidan di desa pada bulan Juli-Desember 2011 sejak diterapkannya Jampersal.Penelitian ini dilakukan bulan April-Mei tahun 2012. Sampel pada penelitian ini adalah seluruh bidan desa yang berada di dua belas puskesmas yang berjumlah 102 orang. Jenis penelitian cross sectional dengan analisis menggunakan chi square. Untuk melihat perbandingan cakupan tahun 2010 dan tahun 2011. Perbandingan tersebut 2,5 kali, dengan p. value Mc.Nemar = 0.008 (OR 2.322) bermakna secara statistic. Selain itu dianalisa juga perbedaan rata-rata cakupan sebelum Jampersal (Juli-Desember 2010) dan setelah diterapkannya Jampersal (Juli-Desember 2011) yang dihitung dengan paired t-test, hasil analisis menunjukkan p value = 0,003 secara statistik bermakna, jadi terbukti terjadi penurunan cakupan persalinan oleh bidan di desa sejak diterapkannya Jampersal, disarankan kepada Dinas Kesehatan agar melakukan supervisi melalui pendekatan secara individu kepada bidan karena semakin setuju bidan dengan Jampersal semakin kecil penurunan cakupan persalinannya.

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An act that can be done to reduce maternal morbidity and mortality is through provision of healthcare services. In Agam Residency, the number of baby delivery that helped by health care worker between 2008 until 2010 was low and tended to fall. Jampersal had been implemented in Agam Regency since April 2011. This had encouraged researcher to know how the coverage of baby delivery with village?s midwife was on July-December 2011 after Jampersal implementation.

This research was conducted on april-may 2012. The samples were all village?s midwifes in 12 Public Health Center, there were 102 peoples. This was a cross sectional study with chi square analysis to compare between 2010 and 2012 coverage. The comparison was 2,5 times with p value Mc.Nemar = 0.008 (OR 2.322) and this was statistically significant. It was also being analyzed the coverage mean difference between before and after jampersal implementation (Juli-December 2010 and Juli-December 2011) by paired t-test. The result showed that p value = 0,003 and it was statistically significant, so it was being proved that the coverage of baby delivery with village?s midwife help was declined after jampersal implementation. The suggestion for Health Department is by supervising an individual approach to the midwife because the agreements of midwife to Jampersal will reduce the decline in coverage of baby delivery with help."

"Kebijakan program Jampersal bertujuan untuk meningkatkan akses ibu hamil melakukan persalinan di fasilitas kesehatan sehingga diharapkan dapat menurunkan angka kematian ibu dan angka kematian bayi dalam upaya mempercepat pencapaian target MDG’s. Di Kabupaten Mukomuko dari tahun 2010 hingga 2012, jumlah kematian ibu dan bayi terus meningkat, jumlah persalinan di fasilitas kesehatan lebih rendah dibandingkan jumlah persalinan di non fasilitas kesehatan pada tahun 2012. Penelitian ini bertujuan untuk melihat gambaran implementasi kebijakan program Jampersal di Kabupaten Mukomuko Provinsi Bengkulu tahun 2012. Desain penelitian ini adalah kualitatif dengan menggunakan metode analisis isi (content analysis), wawancara mendalam pada informan dan studi literature serta pendekatan masalah secara deskriptif analisis. Hasil penelitian menunjukkan bahwa implementasi kebijakan program Jampersal di Kabupaten Mukomuko telah dilaksanakan sesuai dengan petunjuk teknis Jampersal yang dikeluarkan oleh Kementerian Kesehatan. Yang menjadi kendala dalam implementasi kebijakan ini adalah rendahnya tarif yang menyebabkan sangat sedikitnya BPS yang terlibat. Keterbatasan fasilitas kesehatan serta sulitnya akses ke fasilitas kesehatan menyebabkan rendahnya jumlah persalinan di fasilitas kesehatan.

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The policy of Jampersal aims to improve access of pregnant women to deliver in health facilities that are expected to reduce maternal mortality and infant mortality rates in an effort to accelerate the achievement of the MDG's. In Mukomuko district from 2010 to 2012, the number of maternal and infant mortality continues to increase, the number of deliveries in health facilities is lower than the number of deliveries in health facilities non in 2012. This study aims to see an overview of the implementation of Jampersal policy in the Mukomuko regency Bengkulu province in 2012. This is a qualitative research design using content analysis, in-depth interviews with informants and the literature study and descriptive approach to problem analysis. The results showed that the implementation of Jampersal policy in the Mukomuko regency has been implemented in accordance with the technical instructions Jampersal issued by the Ministry of Health.Which is a constraint in the implementation of this policy is that the low rates cause BPS very least involved. Limitations of health facilities and the difficulty of access to health facilities has a low number of deliveries in health facilities."

"Kewaspadaan universal dipandang sangat strategis untuk mengendalikan infeksi HIV/AIDS di sarana pelayanan kesehatan (Depkes, 2010). Berdasarkan wawancara dan observasi penulis pada 10 bidan di Kabupaten Badung, penulis menemukan bahwa 80% bidan belum menerapkan kewaspadaan universal dengan baik. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan perilaku penerapan kewaspadaan universal pada pertolongan persalinan oleh bidan di puskesmas wilayah kerja Dinas Kesehatan Kabupaten Badung pada tahun 2012. Penelitian ini adalah penelitian kuantitatif dengan desain cross sectional, dengan sampel adalah bidan yang melaksanakan persalinan yang berjumlah 86 orang. Data dianalisis dengan uji chi square dengan tingkat kepercayaan 95% sehingga α = 5%. Hasil penelitian didapatkan proporsi responden yang berperilaku menerapkan kewaspadaan universal dengan baik pada saat pertolongan persalinan adalah sebesar 18,6%, ada hubungan antara faktor predisposisi yaitu pengetahuan (p=0,000,OR=20,40) dan sikap (p = 0,000, OR = 21,207), faktor pemungkin yaitu ketersediaan sarana prasarana (p=0,000) terhadap perilaku penerapan kewaspadaan universal. Dari penelitian ini disarankan untuk melakukan refreshing training, melengkapi fasilitas, sarana dan prasarana, dibuat kebijakan kewaspadaan universal yang disosialisasikan pada seluruh tenaga kesehatan serta selanjutnya dilaksanakan pengawasan dan pemberian sanksi yang tegas dalam penerapan kewaspadaan universal.

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Universal precautions is deemed strategic for the control of HIV / AIDS in health care facilities (MOH, 2010). Based on interviews and observations of the author on 10 midwives in Badung regency, the authors found that 80% of midwives have not implemented universal precautions as well.

This study aims to determine the factors associated with the behavior of the application of universal precautions to help labor by a midwife at the health center working area Badung Health Agency in 2012.

The study was a quantitative study with cross sectional design, the sample is a midwife who perform labor, amounting to 86 people. Data were analyzed with chi square test with 95% confidence level so that α = 5%.

The study found the proportion of respondents that is behaving properly implement universal precautions at the time of delivery assistance amounted to 18.6%, there is a relationship between predisposing factors, namely knowledge (p = 0.000, OR = 20.40) and attitude (p = 0.000, OR = 21.207), enabling factors, namely the availability of infrastructure facilities (p = 0.000) on the behavior of the application of universal precautions.

From this study it is advisable to conduct refresher training, complete amenities, facilities and infrastructure, created a policy that promoted universal precautions in all health personnel and subsequently conducted surveillance and sanctions in the strict application of universal precautions."

"Maternal mortality rate in Indonesia is still very high with a very slow reduction from year to year. Some intensive efforts to reduce maternal mortality rate have been done, one of which is deployment of village midwives. However, the deployment of midwife in the village in Tasikmalaya regency has not shown desirable results.

This research has a purpose as to find information on the result of maternal and child health service and implementation of maternal and child health program management by midwife village and to know correlation between implementation of maternal and child health program management by midwife village and its results. This research uses cross sectional method and quantitative descriptive analysis with village midwife as unit analysis. The sample in this research is village midwife who has worked minimal one year in the village.

The sampling method is random sampling. Independent variable consist of needed data collection, plan of action, action book, infant and mother cohort, visit to integrated post, home visit, guidance to traditional mid wife, guidance of interested person child and safe motherhood, village coordination meeting and locally region monitoring of child and safe motherhood. Whereas dependent variabel is the result of maternal and child health services. To Test of chi square showed that plan of action was correlated with the result of maternal and child health service. In general midwife village had done maternal and child health program management from planning, actuating, controlling, and evaluation. Quality of implementation of program management by midwife in the village has not been optimal, may be bacause of title guaodance and controll from the health centre or regency health departement.;Maternal mortality rate in Indonesia is still very high with a very slow reduction from year to year. Some intensive efforts to reduce maternal mortality rate have been done, one of which is deployment of village midwives. However, the deployment of midwife in the village in Tasikmalaya regency has not shown desirable results.

This research has a purpose as to find information on the result of maternal and child health service and implementation of maternal and child health program management by midwife village and to know correlation between implementation of maternal and child health program management by midwife village and its results. This research uses cross sectional method and quantitative descriptive analysis with village midwife as unit analysis. The sample in this research is village midwife who has worked minimal one year in the village.

The sampling method is random sampling. Independent variable consist of needed data collection, plan of action, action book, infant and mother cohort, visit to integrated post, home visit, guidance to traditional mid wife, guidance of interested person child and safe motherhood, village coordination meeting and locally region monitoring of child and safe motherhood. Whereas dependent variabel is the result of maternal and child health services. To Test of chi square showed that plan of action was correlated with the result of maternal and child health service. In general midwife village had done maternal and child health program management from planning, actuating, controlling, and evaluation. Quality of implementation of program management by midwife in the village has not been optimal, may be bacause of title guaodance and controll from the health centre or regency health departement."

"Indonesia masih dihantui Angka Kematian Ibu AKI yang relatif tinggi dibandingkan dengan negara-negara Region Asia Tenggara, yaitu 190 per 100.000 kelahiran hidup. AKI dapat direduksi dengan persalinan dengan perawatan yang terampil. Kementerian Kesehatan RI sejak tahun 2015 menetapkan persalinan yang aman adalah persalinan yang dilakukan oleh tenaga kesehatan nakes di fasilitas pelayanan kesehatan fasyankes. Meskipun cakupan pertolongan persalinan oleh nakes dan persalinan di fasyankes di Indonesia sudah tinggi, tetapi masih terdapat perbedaan cakupan menurut umur ibu, tingkat pendidikan ibu, status ekonomi, wilayah tempat tinggal, dan provinsi. Untuk memudahkan penghitungan ketidakmerataan kesehatan antar negara dan mengetahui daerah mana yang tertinggal, WHO mengeluarkan aplikasi bernama Health Equity Assessment Toolkit HEAT dan Health Equity Assessment Toolkit HEAT Plus, aplikasi ini mampu mengidentifikasi perbedaan dalam indikator kesehatan antar subkelompok populasi. Peneliti dapat memasukkan data sendiri ke dalam aplikasi HEAT Plus, dalam penelitian ini peneliti menggunakan data SDKI. Hasil analisis menunjukkan cakupan persalinan oleh nakes dan persalinan di fasyankes meningkat dari tahun 1994-2012. Cakupan tersebut terkonsentrasi pada ibu berumur 25-39 tahun, ibu dengan tingkat pendidikan SMP, ibu dengan kuintil kekayaan terkaya, ibu yang tinggal di daerah perkotaan, dan ibu yang tinggal di wilayah Sumatera dan Jawa. Ukuran ketidakmerataan yang mengalami penurunan tertinggi adalah Population Attributable Risk PAR dan Population Attributable Fraction PAF. Ketidakmerataan cakupan persalinan oleh nakes cenderung mengalami penurunan pada semua dimensi, sedangkan ketidakmerataan cakupan persalinan di fasyankes mengalami peningkatan pada dimensi provinsi.

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Indonesia is still haunted by a relatively high Maternal Mortality Rate MMR compared to the Southeast Asian Region countries, which is 190 per 100,000 live births. MMR can be reduced by delivery with skilled care. The Ministry of Health of Indonesia since 2015 established a safe delivery is the delivery done by Skilled Birth Attendants SBA in health service facilities. Although coverage of delivery assistance by SBA and delivery in health service facilities in Indonesia is high, but there are still coverage differences based on age, education level, economic status, residence, and province.

To facilitate the calculation of health inequalities between countries and to know which areas are left behind, WHO issued an application called Health Equity Assessment Toolkit HEAT and Health Equity Assessment Toolkit HEAT Plus, this application is able to identify differences in health indicators among subgroups of the population. Researchers can enter their own data into HEAT Plus application, in this research the researcher use SDKI data.

The results showed that the coverage of delivery by SBA and childbirth in health service facilities increased from 1994 to 2012. The coverage was concentrated in mothers aged 25 39, mothers with secondary and above educational level, mothers with richest quintiles, mothers living in urban areas, and mothers who live in Sumatra and Java. The highest decreasing inequality size is Population Attributable Risk PAR and Population Attributable Fraction PAF. Inequality of delivery coverage by SBA tends to decrease in all dimensions, whereas the inequality of delivery coverage in health service facilities has increased in the provincial dimension."

"Puskesmas adalah organisasi kesehatan fungsional yang merupakan pusat pengembangan kesehatan masyarakat yang juga membina peran serta masyarakat disamping memberikan pelayanan secara menyeluruh dan terpadu kepada masyarakat di wilayah kerjanya dalam bentuk program pokok. Program kesehatan ibu dan anak (IQA) merupakan salah satu program pokok di puskesmas yang mendapat prioritas tinggi, mengingat kelompok ibu hamil, menyusui , bayi dan anak merupakan kelompok yang sangat rentan terhadap kesakitan dan kematian (Departemen Kesehatan, 1992). Dalam mengayomi kelompok rentan ini banyak kegiatan yang dilakukan oleh puskesmas dalam upaya menurunkan angka kesakitan dan kematian, salah satunya melalui kegiatan antenatal care (ANC) yang adekuat. ANC yang adekuat ditunjukkan dengan salah satu indikator yang terdapat dalam suatu sistem pemantauan wilayah setempat program KIA yaitu indikator K4 ibu hamil.Diduga rendahnya cakupan K4 ibu hamil ini mungkin dipengaruhi oleh somber daya yang tersedia di puskesmas, peran lintas sektor, luas wilayah kerja, status puskesmas, jumlah penduduk, rencana kerja tahunan (POA) puskesmas, rencana kerja petugas pelaksana program, pemantauan dan penilaian. Oleh karena itu peneliti ingin mengetahui bagaimana gambaran karakteristik puskesmas yang berhubungan dengan cakupan K4 ibu hamil. Penelitian ini dilakukan di Kabupaten Aceh Besar tahun 1999 dengan menggunakan pendekatan kualitatif. Pengumpulan data diperoleh melalui wawancara mendalam terhadap pimpinan puskesmas dan bidan pengelola KIA di 6 (enam) puskesmas terpilih dalam Kabupaten Aceh Besar. Selain itu informasi dari bidan di desa sebagai pengelola MA di pedesaan diperoleh melalui diskusi kelompok terarah. Dengan demikian, untuk meningkatkan validitas data peneliti telah melakukan triangulasi sumber data, triangulasi metode.Hasil penelitian menunjukkan bahwa karakteristik puskesmas ternyata mempunyai peran terhadap pencapaian cakupan K4 ibu hamil antara lain tenaga pelaksana ANC, baik jumlah maupun mutunya masih kurang, ketersediaan sarana pelayanan yang belum memadai, dukungan/peran lintas sektor belum berjalan, serta rencana kerja petugas pelaksana program puskesmas yang belum dibuat (tidak ada). Berdasarkan hasil yang didapat pada penelitian ini, maka disimpulkan bahwa puskesmas dengan karakteristik sumber daya dan dukungan lintas sektoral yang memadai mempunyai cakupan K4=60%. Berdasarkan simpulan tersebut pula, peneliti menyarankan antara lain diperlukan upaya peningkatan mutu tenaga pelaksana program melalui pelatihan teknis fungsional, pemanfaatan sumber daya yang tersedia di puskesmas secara optimal, membuat rencana kerja puskesmas secara menyeluruh serta pimpinan puskesmas harus lebih bersifat proaktif untuk mendapatkan dukungan peran lintas sektor. Sebagai alat manajerial program MA, pemantauan wilayah setempat-kesehatan ibu dan anak (PWS-KIA) hendaknya terus dapat, digunakan dalam upaya melakukan pemantauan dan evaluasi program.

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Health center is a functional health organization designed as a development center for public health, aimed to build community participation in addition to delivering comprehensive and integrated community services in its region in the form of basic health services. Maternal and child health is one of basic services in health center, with a high priority. It is to say that pregnant and lactating mothers, babies and children are high-risk groups of morbidity and mortality (MOH, 1992). In order to protect these mothers and their coming babies, mothers should adequately do antenatal care. Adequate antenatal care is pointed out by an indicator, in a local visit area monitoring system of maternal and child health program (MCH), namely K4. K4 is the fourth ANC visit with a certain criteria.By hypothesis, a low coverage of K4 of pregnant mothers maybe influenced by the available power resources of health center, participation of inter-sector, working area, health center status, public population, plan of action of health center, plan of action officer program, monitoring and evaluation. Therefore, the researcher want to know how health center characteristics influence K4 coverage of pregnant mothers. This study was conducted in Aceh Besar District in 1999 using qualitative approach. The data was collected through in depth interviews to the chief of health center and senior midwives of 6 (six) selected health centers in Aceh Besar District. While information from midwives in village was obtained through focus group discussions (FGDs). In order to get valid data, the researcher applied triangulation on data resources and data collection method. Through the method the data were rechecked not only once.The results of this study show that the health center characteristics actually have roles toward K4 coverage of pregnant mothers, ANC staff lack off in number and quality, the availability of service facility is not sufficient, the role of inter-sector is not well run yet, and the plan of action of health center program of officer is not produced. Thus it can be concluded that health centers with sufficient resources and inter-sector support have K4 coverage more than 60 %. Based on the conclusion, the author suggests some improvement effort of through a functional technique training, the available optimal utilization of resource of the health center, production and improvement of the plan of action of health center more proactive action of and the chief of health center to have inter-sector support. As managerial tools of maternal and child health program, local area monitoring-maternal and child health (LAM-MCH) should be permanently used in monitoring and evaluating the program."

"Skripsi ini membahas tentang Analisis Pemanfaatan ruang bersalin oleh ibu bersalin di Puskesmas DTP Citeureup Kabupaten Bogor Provinsi Jawa Barat. Penelitian ini adalah penelitian kuantitaif dengan desain penelitian cross sectional. Data Penelitian diperoleh dengan instrumen kuisioner. Hasil penelitian menunjukkan bahwa 34,5% responden memanfaatkan Ruang Bersalin Puskesmas sebagai tempat persalinan. Berdasarkan uji bivariat menunjukkan tidak adanya hubungan yang signifikan antara komponen predisposing, komponen enabling dan komponen need dengan pemanfaatan Ruang Bersalin.

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This thesis discusses the Utilization Analysis by mother's delivery room at the health center maternity DTP Citeureup Bogor regency of West Java Province. The Study was a quantitative study with cross sectional research design. The research data obtained by questionnaire instruments.

The results showed that 34,5% of respondents utilize health center maternity room as aplace of birth. Based on bivariate test showed no significant relationship between the components of predisposing, enabling and component parts need to use Delivery Room."

"Jaminan Persalinan (Jampersal) merupakan prioritas pembangunan kesehatan tahun 2011 untuk menurunkan AKI dan AKB di Indonesia dan mempercepat pencapaian tujuan pembangunan kesehatan dan Milenium Development Goals /MDGs. Pemanfaatan pelayanan Jampersal pada seorang ibu dapat dilihat dari cakupan antenatal, cakupan persalinan, cakupan pelayanan KB dan cakupan pelayanan bayi baru lahir. Tujuan penelitian ini untuk mengetahui pemanfaatan Jampersal berdasarkan karakteristik ibu di Puskesmas Pauh Kambar Kecamatan Nan Sabaris tahun 2012. Jenis penelitian adalah kuantitatif dengan desain cross sectional. Sampel dalam penelitian ini berjumlah 100 orang ibu yang telah mamanfaatkan program jaminan persalinan yang berada di wilayah kerja Puskesmas Pauh Kambar Kabupaten Padang Pariaman. Pengambilan sampel dilakukan dengan metode acak sederhana (simple random sampling). Hasil penelitian menunjukkan 67% responden memanfaatkan paket pelayanan jampersal sebanyak 4 pelayanan. Analisis Bivariat yang berhubungan dengan pemanfaatan program Jaminan Persalinan adalah pengetahuan dengan P. value = 0,03 (p