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"Seperti diketahui bahwa penempatan bidan di pedesaan berkaitan dengan pemerataan dan kualitas pelayanan kesehatan. Apabila aspek manajemen dari Pedoman Pembinaan Teknis Bidan di desa dilaksanakan dengan manajemen yang efektif dan efisien maka akan dapat meningkatkan produktifitas bidan di desa sesuai dengan tugas dan fungsinya.Penelitian ini menggunakan Analisis Kualitatif yaitu wawancara mendalam dan triangulasi sumber dengan pendekatan siklus pemecahan masalah. Apabila terdapat kesenjangan manajemen dalam aspek input, proses dan output maka akan dicarikan alternatif pemecahannya untuk disarankan kepada pelaksana program.Hasil temuan penelitian analisis manajemen pembinaan teknis bidan di desa tahun 1995/1996 masih belum sepenuhnya sesuai dengan buku Pedoman Pembinaan Teknis Bidan di Desa yang dikeluarkan oleh Departemen Kesehatan RI tahun 1994.Sehubungan dengan hal tersebut maka peneliti mengajukan saran kepada pelaksana program untuk perbaikan yaitu :1. Setiap kegiatan pembinaan teknis bidan di desa oleh puskesmas harus didokumentasikan agar aspek manajemen dapat menjadi bukti pendukung.2. Pemerintah perlu melakukan pendidikan dan latihan aspek manajemen untuk dokter dan bidan puskesmas.3. Pihak Dinas Kesehatan Dt II harus berupaya untuk menyediakan dana, tenaga dan sarana bagi puskesmas yang berkaitan dengan pembinaan teknis bidan sebagai konsekuensi adanya Pedoman.4. Dinas Kesehatan Dt. II harus lebih meningkatkan peranannya di dalam pembinaan bidan di desa sesuai dengan tugas dan fungsinya agar aspek pengendalian terhadap puskesmas menjadi lebih berfungsi.

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Management aspect of technical supervision of midwife in the village has to use effectively and efficiently in order to increase a midwife productivity in accordance to her function. The research uses Qualitative method; in-depth interview and triangular resource approaches.The Health Center and Health Office of Sambas Regency would get recommendations for improving the management aspect of technical supervision of midwife in the village.The result of Health Center?s technical supervision of midwife at Sambas Regency on 1995/1996 is not appropriate in accordance to Technical Supervision Manual Book from Health Department.I would like to suggest some recommendation in order to improve the Health Center's technical supervision management, as follows :1. The management will able to give some evidences if the activity of midwife technical building in health center is documented.2. The government has to hold a management training to doctors and midwives at health center.3. Chief of Health office of Sambas Regency has to prepare the fund, human resources and tools to support the activity in accordance to manual book.4. Health Office of Sambas Regency has to increase the activity in technical supervision according to its function."

"Dari sudut pandang keselamatan dan kesehatan kerja kelelahan merupakan ancaman yang cukup signifikan. Kelelahah pada individu bersifat subjektif, namun pekerja belum tentu menyadari adanya kelelahan tersebut. Penelitian ini bertujuan mengetahui gambaran kelelahan dan faktor risiko yang berhubungan dengan kelelahan pada perawat di puskesmas Kabupaten Sambas tahun 2023. Penelitian ini merupakan penelitian kuantitatif dengan desain potong lintang menggunakan instumen kuesioner yang dilakukan secara daring dari Maret--Juni 2023. Total sampel 126 perawat yang bekerja di puskesmas Kabupaten Sambas. Hasil penelitian mendapatkan 30,2% perawat mengalami kelelahan. Hasil analisis bivariat faktor risiko di luar pekerjaan menunjukkan hubungan signifikan antara usia dan kelelahan (p value 0,016, OR 0.357), status pernikahan dan kelelahan ((p value 0,048, OR 0,351), kualitas tidur dan kelelahan (p value 0,005, OR 6,026). Hasil analisis bivariat faktor risiko pekerjaan menunjukkan hubungan signifikan antara stes kerja dan kelelahan (p value 0,001, OR 6,763). Hasil penelitian menyarankan perawat untuk bisa melakukan manajemen waktu dengan lebih baik dan lebih memperhatikan untuk berpola hidup sehat. Selain itu manajemen juga berperan penting dalam mengembangkan strategi dan kebijakan untuk mengurangi kelelahan di tempat kerja. Diperlukan penelitian lebih lanjut untuk menggali lebih banyak faktor risiko dan menentukan faktor risiko dominan dengan menggunakan metode penelitian berbeda.Abstrak Berbahasa Inggris: From health and safety perspective, fatigue is a significant concern. Fatigue is a subjective feeling and workers isn’t always aware of it, so it’s important for managers to recognize and prevent fatigue at the early stage. This study aimed to describe fatigue and risk factors associated with fatigue on puskesmas nurses at districk of Sambas 2023. This research is quantitative study with cross-sectional design using questionnaire which was conducted online from March to June 2023. A Total sample was 126 nurses who worked in puskesmas at districk of Sambas. The results showed that 30.2% of nurses experienced fatigue. Bivariate results of non-work related risk factors showed a significant relationship between age and fatigue (p value 0,016, OR 0.357), marital satus and fatigue (p value 0,048, OR 0,351), sleep quality and fatigue (p value 0,005, OR 6,026). Bivariate results of work related risk factors showed a significant relationship between work stress and fatigue (p value 0,001, OR 6,763). The results of this study suggest nurses to have better time management and pay more attention to a healthy lifestyle. In addition, management plays an important role for developing targeted strategies and policies to reduce fatigue in the workplace. Further research is needed to explore more risk factors and determine the dominant risk factors using different research methods."

"Tesis ini membahas rujukan kasus kegawatdaruratan Obstetri Neonatal oleh Bidan Desa ke Puskesmas mampu PONED di Kabupaten Bogor. Penelitian ini adalah penelitian kualitatif. Hasil Penelitian menyarankan bahwa setiap bidan desa harus tinggal di desa dan mendapatkan pelatihan APN dan PPGDON; puskesmas harus membuat sosialisasi dan pembinaan khusus untuk kegiatan PONED; Dinas Kesehatan harus memenuhi kebutuhan Sumber Daya Manusia (SDM) khusus untuk petugas PONED melalui mutasi dan promosi yang tepat; memenuhi kebutuhan sarana dan pembinaan terjadwal secara rutin; membuat penilaian kinerja Puskesmas mampu PONED sebagai tolak ukur keberhasilan kegiatan PONED di Kabupaten Bogor; memberikan bantuan biaya transportasi kepada masyarakat miskin yang akan dirujuk.

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The focus of this study is the referral case of an obstetric and neonatal emergency by villagel midwives to the PONED preliminary health Center in Bogor District. This research is a qualitative study. This study results come up with some suggestions. Every midwife need to stay in the rural district and get the training PPGDON and training APN; PHC should make some socialization and coaching program related to PONED activities; Health Department in Bogor must fulfill the need of PONED human resources by some mutation and promotion; in addition, the supervision facility and observation need to be scheduled regulary; some indicator of success have to be developed in order to measure the PONED performance effectively; besides, the cost of transportation also should be allocated to protect the poor."

"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."

"Tingginya Angka Kematian Ibu dan Angka Kematian Bayi merupakan masalah kesehatan masyarakat di Indonesia. Upaya yang dilakukan oleh pemerintah untuk mengeliminir masalah tersebut antara lain dengan memeratakan dan mendekatkan jangkauan pelayanan kesehatan kepada masyarakat agar masyarakat mempunyai akses yang tinggi terhadap pelayanan kesehatan, dalam bentuk pembangunan Puskesmas, Puskesmas Pembantu, dan penempatan Bidan di Desa. Fakta di Kabupaten Merangin terlihat masih rendahnya kinerja Bidan Desa, dari tinjauan teoritis diketahui banyak faktor yang berhubungan dengan kinerja Bidan Desa, antara lain kurangnya frekuensi dan kualitas supervisi yang dilakukan oleh Puskesmas terhadap Bidan Desa.Tujuan penelitian ini adalah untuk mengetahui hubungan antara supervisi oleh Kepala Puskesmas dan oleh Koordinator Kesehatan Ibu dan Anak (MA) Puskesmas dengan kinerja Bidan Desa di Kabupaten Merangin Propinsi Jambi, serta faktor yang berpengaruh terhadap hubungan tesebut. Untuk mencapai tujuan penelitian, desain yang digunakan adalah crossectional. Sampel penelitian semua Bidan Desa yang ada di Kabupaten Merangin yang terdiri dari 69 orang Bidan Desa.Hasil penelitian menunjukkan 37,7 % Bidan Desa dengan kinerja baik, 26,1 % yang memperoleh pembinan melalui supervisi kategori baik, 66,7 % berstatus kawin, 29,0 % berstatus pegawai negeri sipil, 89,9 % mempunyai masa kerja lebih dari tiga tahun, 68,I % bekerja di desa klasifikasi biasa, 59,4 % mendapat cukup penghasilan tambahan, 24,6 % berpengetahuan kategori baik, 66,7 % dengan sikap kategori baik, dan 63,8 % yang mempunyai motivasi baik.Terdapat hubungan yang bermakna antara supervisi oleh Puskesmas dengan kinerja Bidan Desa dan hubungan tersebut tetap bermakna setelah dikontrol dengan variabel penghasilan tambahan, pengetahuan, dan motivasi. Tidak ditemukan adanya interaksi antara supervisi dengan variabel lain di dalam hubungannya dengan kinerja, dan penghasilan tambahan ditemukan sebagai faktor dominan yang berhubungan dengan kinerja Bidan DesaDaftar bacaan : 30 (1980 - 2000).

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The Relationship between Supervision that Conducted by Public Health Center and Rural- Midwives' Performance at Merangin District, Jambi ProvinceStil in high level maternal mortality rate (MMR) and infant mortality rate (IMR) is one of the problems for community health in Indonesia. The efforts that conducted by the government to eliminate these problems, among other to generalized and make close the coverage of public health service to community in order they have obtain high access to the health service. It is in the form of public Health center establishing, sub- public health center, and placing the midwives in rural. The fact, at Merangin District showing that there was still low the midwives' performance in rural, i.e. it was lack of frequency and the quality of supervision that conducted by the public health center to those midwives in rural.The objective of this study is to determine the relationship between supervision that conducted by the public health center and the coordination of Maternal and Child Health (MCH) and the midwives' performance in rural at Merangin District, Jambi Province, and the factor that related to those relations. The study design was cross-sectional, and the samples of this study are all of midwives that available in Merangin District, with number is 69 midwives.The result of this study show that 37,7% of midwives with good performance, 26,1% who obtain guidance through supervision good category. 66,7% were married, 29,0% were civil servant. 89,9% having working experience over than three years. 68,1% work in rural, general classification. 59,4% having enough earning from side job, 24,6% having good knowledge. 66,7% with category good attitude, and 63,8% having good motivation.There was significant relationship between supervision that conducted by the public health center and the performance of midwives, and those relationships is still significant after controlled by the variable of additional salary, knowledge, and motivation.There was not found an intervention between supervision and other variable in working relationship, and additional salary that found as dominant factor that related to the performance of midwives in rural.Reference: 30 (1980-2000)."

"[ABSTRAKAngka kematian ibu tahun 2013 Kabupaten Sambas Provinsi Kalbar masih tinggi sebanyak 17 kasus. Tujuan penelitian mengetahui implementasi manajemen aktif kala III (MAKT) oleh bidan puskesmas wilayah kerja Dinas Kesesehatan Kab. Sambas. Desain penelitian cross sectionaldengan mixed method, sampel 58 menggunakan Total Sampling Hasil penelitian bidan menerapkan manajemen aktif kala III 63,8% dan yang tidak menerapkan manajemen aktif kala III 36,2%. Terdapat hubungan variabel Pengetahuan dan sikap dengan Implementasi Manajemen Aktif Kala III. Variabel sikap terhadap manajemen aktif kala III merupakan faktor paling dominan dengan (nilai p= <0,007)

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ABSTRACTThe county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001;The county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001;The county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001;The county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001;The county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001;The county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001;The county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001, The county Sambas Henan Borneo west is still high the mortality rate mother in 2013 as much as 17 cases. Research purposes to know the implementation of active management of third stage by a midwife the health center the work the Department of Health District Sambas. Study design cross sectional with mixed method, a total Sampling 58 using the results of the study midwife apply management active time treaty 63,8% and not apply management active time treaty 36,2 %. There is a relationship variable knowledge and the attitude with Implementation active Management words treaty. Variable attitude toward the management active time treaty is the most dominant factor ( pvalue= < 0,001]"

"Penelitian ini didasari masih tingginya angka kematian ibu dan angka kematian bayi di Indonesia dan khususnya di Kabupaten Buton, dan telah dilakukannya pelatihan APD bagi bidan di desa di Kabupaten Buton dan belum ada gambaran dampak pelatihan APD terhadap mutu proses persalinan. Penelitian dilakukan di Kabupaten Buton bagi bidan di desa yang telah mendapat pelatihan APD dan di Kabupaten Muna bagi bidan di desa yang tidak mendapatkan pelatihan APD. Dilaksanakan pada bulan Januari hingga Mei 2001. Jenis penelitian ini adalah deskriptif analitik dengan desain penelitian Cross Sectional. Teknik pengumpulan data menggunakan instrumen observasi untuk kepatuhan bidan terhadap proses persalinan dan kuesioner untuk karakteristik dan motivasi bidan di desa.Hasil yang didapatkan adalah ada perbedaan mutu proses persalinan antara bidan di desa yang mendapat pelatihan dengan tidak mendapat pelatihan APD (p value = 0,049 a = 0,05). Ada perbedaan mutu proses persalinan antara kelompok umur lebih atau sama dengan 32 tahun dengan kurang dari 32 tahun (p value = 0,018 a = 0,05), serta ada perbedaan mutu proses persalinan antara bidan di desa dengan masa kerja lebih atau sama dengan 11 tahun dan kurang dari 11 tahun (p value = 0,012 ct = 0,05). Untuk motivasi bidan di desa antara yang pelatihan APD dan tidak pelatihan tidak ada perbedaan yang bermakna (p value = 0,388 a = 0,05).Kesimpulan dari pelatihan ini ada perbedaan yang bermakna antara pelatihau APD dan mutu proses persalinan serta ada perbedaan mutu proses persalinan berdasarkan kelompok umur dan masa kerja. Sehingga bagi penyelenggara dan pelaksana program pelatihan APD tetap dilaksanakan dengan perbaikan pada metode, materi, waktu dan fasilitator pelatihan, juga diperlukan dukungan pelatihan lain yaitu pelatihan komunikasi.Bagi Dinas Kesehatan Propinsi Sulawesi Tenggara perlu memikirkan untuk pemerataan pelatihan APD bagi bidan di desa di Kabupaten-kabupaten lain di Propinsi Sulawesi Tenggara.

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Analysis Training Impact of Basic Upbringing Childbirth toward Childbirth Process Quality by Midwife in Town of Buton Regency in 2001This research was still based on the high rate of Mother Death and the Baby Death in Indonesia, especially in Buton regency. The research of Basic Upbringing childbirth for midwife which had been done in Buton regency of the impact for this research toward the child birth process quality had not give the description yet. This research was done in Buton Regency for midwife in town which got the training of Basic Upbringing Childbirth and in Muna regency for the midwife who didn't get the same training on January until May 2001. Type of this research was Descriptive analytic with construction Cross Sectional. Technique of data finding was by using instrument observation for discipline of the midwife to the childbirth Process Quality and questioner for characteristics and motivation.The result that the writer got was the differences of childbirth process quality between the midwife in town which got the training as compared to the midwife which didn't got it (P value = 0,049 a = 0,05). There are the differences of the Childbirth process quality between group of ages more than or same as 32 years old with the group less than 32 years old (P value = 0,018 a = 0,05), and the differences of childbirth process quality between the midwife in town by the time of working same or more than 11 years (P.value 0,012 0 = 0,05 ). There is no urgent differences for the motivation of midwife which got the training with the midwife which didn't get it (P value = 0,388 a = 0,05 ). Conclusion of this research is the urgent differences between training of Basic Upbringing Childbirth and the childbirth process quality and also the differences of childbirth process quality which based on group of ages and based on the time of working. So, for the committee and the organizer of this program still rearrange the method, materials, time and training facilitator. Beside that, it is important to add another kinds of training, such as communication training, completed with own evaluation of training method, the mutual standard, which was decided and can be obeyed by the midwife in town.For the health official of southeast Sulawesi have to consider the even distribution of Basic Upbringing Childbirth for midwife in town of regencies in southeast Sulawesi."

"Penerapan Pengembangan Manajemen Kinerja (PMK) bidan di puskesmas ini diharapkan dapat meningkatkan pengetahuan dan keterampilan bidan; kepatuhan penggunaan standar dalam melakukan pelayanan kebidanan; kemampuan manajerial pelayanan kebidanan; pelaksanaan monitoring kinerja; mutu asuhan kebidanan. Penerapan PMK ini diharapkan dapat berperan untuk tercapainya indikator Sistem Pelayanan Minimal (SPM) Kabupaten/Kota yang dilaksanakan bidan di sarana kesehatan, mengingat bidan sebagai ujung tombak pelayanan kesehatan dengan jumlah yang cukup besar (40%) dari seluruh kategori tenaga kesehatan.Dalam penerapan Pengembangan Manajemen Kinerja bidan di rumah sakit dan puskesmas diawali dengan pelatihan. Pelatihan ini ditujukan pada bidan koordinator, dengan harapan bidan koordinator dapat memberikan kiat-kiat dalam memberikan pengarahan, bimbingan, dan sekaligus menilai kinerja staf secara obyektif. Scsuai dengan Kepmenkes no. 8361Menkes/SKIVI12005, pada pelatihan tersebut ditekankan pada penguasaan lima komponen PMK yaitu standar, uraian tugas, indikator kinerja, sistem monitoring, dan Refleksi Diskusi Kasus.Penelitian ini dilakukan untuk melihat gambaran sejauh mana penerapan PMK bidan di Puskesmas dengan pendekatan sistem. Penelitian ini menggunakaii pendekatan kuantitatif dengan bidan yang telah mendapat pelatihan PMK dan telah menerapkan PMK bidan di puskesmas tempat bekerja yang berjumlah 33 orang dari lima puskesmas. Juga dilakukan pendekatan kualitatif melalui wawancara mendalam pada lima pimpinan dan bidan koordinator puskesmas yaitu di puskesmas Curup, Kampung Delima, Perumnas, Tunas Harapan, dan Sambirejo serta dilakukan telaah dokumen terhadap penerapan PMK bidan di puskesmas.Hasil penelitian antara lain: (1) Faktor masukan penerapan PMK bidan berupa uraian tugas, Standard Operational Procedure (SOP), pendidikan dan latihan, semua bidan puskesmas (100%) telah ada dan dilaksanakan dcngan baik, hanya variabel penerapan sistem penghargaan ada yang masih buruk di puskesmas (48.5%). (2) Faktor proses penerapan PMK bidan di Puskesmas berupa kegiatan pendokumentasian kegiatan dimana semua bidan (100%) telah melaksanakan dengan baik dan sesuai dengan telaah dokumen, sedangkan pemantauan dan pengendalian kegiatan umumnya sudah baik (66.7%), dan masih ada yang buruk (33.3%), pertemuan strategis umumnya juga sudah baik (72.7%) dan yang masih buruk (27.3%), kegiatan Refleksi Diskusi Kasus (RDK) umumnya sudah baik (63.6%) dan masih buruk (36.4%). (3) Faktor luaran penerapan PMK bidan di Puskesmas yaitu manajemen kinerja bidan umumnya sudah baik di puskesmas (57.6%), yang masih buruk (42.4%).Kesimpulan akhir dari penelitian ini adalah bahwa penerapan Pengembangan Manajemen Kinerja bidan di puskesmas umumnya sudah baik, hanya beberapa variabel saja penerapannya yang masih buruk dan perlu ditingkatkan lagi. O1eh karena itu, peneliti mencoba memberikan rekomendasi kepada: (1) Pemerintah Daerah untuk memberikan dukungan pelaksanaan setiap komponen program PMK bidan, menyetujui usulan program Dinas Kesehatan untuk melaksanakan pelatihan PMK kepada bidan yang belum mendapat pelatihan. (2) Kepala Dinas Kesehatan supaya melakukan tindak lanjut dari penerapan program PMK, seperti melakukan monitoring PMK setiap 3 bulan sekali, memberikan pelatihan penerapan PMK kepada bidan yang belum dilatih, dan diharapkan semua puskesmas di kabupaten Rejang Lebong dapat menerapkan PMK (3) Kepada Pimpinan Puskesmas supaya menyusun indikator kinerja bidan untuk keperluan monitoring dan penilaian kinerja, menilai kinerja bidan puskesmas minimal 1 tahun sekali dan memberikan penghargaan sebagai umpan balik.

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The Application Of Management Performance Development o: Midwife in health center is expected improve the midwife's knowledge and skill; compliance of usage in midwifery service standard; ability of midwifery service managerial; execution of performance monitoring; midwifery care quality, while expectation of Development Of Management Performance contribute to reach a Minimum Service System indicator in the District City which is executed and midwife in health place, considering midwife as part of health service with high amount (40%) from all of health worker category.

The Application Of Management Performance Development in hospitals and health centers started with training. This Training is addressed for the coordinator midwife in health center, while the expectation of the coordinator midwife is to give suggestions in guidance, teaching, tuition, and at the same time to assess stair performance objectively. According to Kepmenkes No. 836 / Menkes / SK / VI / 2005, this training emphasized five components: standard, job description, performance indicator, monitoring system, and reflection cased discussion (RCD).

This research is done to give an assessment and to describe how far the application of Development Of Management Performance of midwife in Health Center is done. This research applying the quantitative method to midwife as respondents who work in a health center which have applied the Development Of Management Performance, they are 33 midwife from five health centers. This research is also done by a qualitative method through interview for five leaders of health center and midwife coordinator, such as Curup Health Center. Kampung Delima, Perumnas, Tunas Harapan, and Sambirejo and also analyze document for applying Development 0C Management Performance midwife in health center.

Research results include: (I) Input factor for applying Development Of Management Performance midwife, such as job description, SOP, and training and fellowship for all of Health Center midwives (100%) arc done well available with duty in Health Center, but applying of appreciation system variable is not good (48.5%). (2) Process factor for applying Development of Management Performance Midwife in Health Center such as activity of documentation where all midwives (100%) have done this matter based on document study by

Researcher, while monitoring activity generally is good (66.7%), the other is bad (33.3%), strategic meeting generally is so good (72.7%) and the other is bad (27.3%), Reflection Case Discussion (RCD) activity generally is good (63.6%) and the other is bad (36.4%). (3) Output factor for applying Development of Management Performance Midwife in Health Center that is midwife performance management generally is good in Health Center (57.6%), the other management is bad (42.4%).

The conclusion of this research is that applying development of midwife performance management in health center generally is good, there just some variables which is bad. Therefore, researcher try to give recommendation for: (I) Local Government, giving support the application of Management Performance Development of midwife in health center, approve proposal of District Health Office program to doing Development Of Management Performance training for midwife who does not get training yet. (2) Head of District Health Office: should follow-up program of Management Performance Development, such as monitoring every 3 months once, doing training of Management Performance Development For midwife who have not been [rained yet, and expected that all health center in Rejang Lebong district can applying the Management Performance Development of midwife. (3) Health Center leader, monitoring and performance assessment minimally 1 year once to assess midwife performance in Health Center and give appreciation as feed back."