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Abstrak :
Jaminan Persalinan (Jampersal) merupakan salah satu upaya terobosan untuk memberikan kemudahan bagi masyarakat dalam hal ini ibu hamil untuk memperoleh pembiayaan persalinan, sehingga masyarakat terutama ibu hamil dapat terakses seluruhnya oleh persalinan yang aman dan sehat. Dengan Jaminan persalinan ini diharapkan AKI dan AKB dan dapat diturunkan. Indikator keberhasilan Jampersal adalah adanya peningkatan cakupan pelayanan KIA dan KB. Penelitian ini dilakukan untuk mengetahui peningkatan hasil pencapaian pelayanan KIA dan KB sebagai indikator keberhasilan Jampersal. Penelitian ini merupakan studi deskriptif terhadap data-data sekunder hasil pencapaian pelayanan KIA dan KB. Desain penelitian menggunakan pendekatan kuantitatif dengan sampel yang diambil adalah semua pelayanan KIA dan KB. Jenis penelitian ini merupakan evaluasi summatif, karena hanya melakukan penelitian terhadap data-data hasil akhir dari suatu program. Hasil analisis menunjukkan bahwa terdapat peningkatan hasil pencapaian pelayanan KIA dan KB sebelum dan sesudah adanya kebijakan Jampersal di Kecamatan Cisaat Kabupaten Sukabumi pada tahun 2010 dan 2011. Sedangkan pencapaian pelayanan Jampersal belum bisa mendongkrak terhadap hasil peningkatan pencapaian pelayanan KIA dan KB di Kecamatan Cisaat Kabupaten Sukabumi. Banyak faktor yang mempengaruhi terhadap peningkatan hasil pencapaian pelayanan KIA dan KB di Kecamatan Cisaat Kabupaten Sukabumi. ......Delivery Assurance (Jampersal) is one of the groundbreaking effort to provide convenience to the public in this case pregnant women to obtain financing labor, so that people, especially pregnant women can be accessed entirely by the delivery of safe and healthy. With this delivery guarantee is expected to MMR and IMR and can be derived. Jampersal success indicator is the presence of increasing coverage of MCH services and family planning. The research was conducted to determine the increase in the achievement of MCH and family planning as an indicator of success Jampersal. This study is a descriptive study of secondary data achievement MCH and family planning. The study design uses a quantitative approach to the samples taken are all MCH and family planning services. This type of research is the evaluation summatif, because just doing research on outcomes data from a program. The analysis showed that there was an increase in the achievement of MCH and family planning services before and after the policy in the District Cisaat Jampersal Sukabumi district in 2010 and 2011. While the achievement of service have not been able to boost Jampersal against the resulting increase in the achievement of MCH and family planning services in the District Cisaat Sukabumi district. Many factors influence the achievement of improved MCH and family planning in Sub Cisaat Sukabumi district.

Abstrak :
Masalah kesehatan maternal terutama masalah kematian ibu masih menjadi masalah prioritas Bangsa Indonesia dalam meningkatkan kualitas Sumber Daya Manusia (SDM). Angka kematian ibu yang tinggi sering dikaitkan dengan pemanfaatan layanan kesehatan ibu bersalin. Pemanfaatan pelayanan kesehatan ibu bersalin di Indonesia menunjukkan variasi antar wilayah regional, diduga berhubungan oleh faktor lingkungan dan perbedaan karakteristik dari populasi. Penelitian ini mengukur pemanfaatan pelayanan kesehatan ibu bersalin dan mempelajari besar hubungan lingkungan dan karakteristik populasi terhadap pemanfaatan pelayanan kesehatan ibu bersalin. Penelitian ini menggunakan data sekunder SDKI 2017 yang mencakup 3.586 wanita usia subur (15–49 tahun) yang pernah melahirkan dalam waktu satu tahun sebelum survei. Analisis regresi logistik multinomial digunakan untuk menguji hipotesis adanya perbedaan pemanfaatan pelayanan kesehatan ibu bersalin berdasarkan perbedaan kondisi lingkungan dan perbedaan karakteristik responden. Penelitian ini menunjukkan bahwa lingkungan dan karakteristik populasi berhubungan signifikan terhadap pemanfaatan pelayanan kesehatan ibu bersalin. Dari analisis multivariat wanita yang paling berpeluang bersalin di rumah dengan bukan tenaga kesehatan yaitu wanita dengan karakteristik suami bekerja di sektor pertanian / wirasuasta (aOR: 7,56 95% CI: 1,69-33,80), dan wanita yang paling berpeluang untuk bersalin di rumah dengan tenaga kesehatan yaitu wanita bertempat tinggal di Pulau Kalimantan (aOR: 11,43 95% CI: 6,13-21,28). Dari hasil analisis hubungan lingkungan dan karakteristik populasi pada penelitian ini disimpulkan bahwa adanya ketidakmerataan akses kesehatan maternal (inequitable access to maternal healthcare) khususnya pada pemanfaatan pelayanan kesehatan ibu bersalin di Indonesia. Untuk mewujudkan pemeratan akses kesehatan maternal perlu adanya komitmen pemerintah pusat dan daerah dengan memaksimalkan anggaran di daerah khususnya pada Pulau di luar Jawa-Bali.

Kata kunci: Pelayanan kesehatan Ibu bersalin, Lingkungan Wilayah Tempat Tinggal, dan Karakteristik Populasi, ketidakmerataan akses kesehatan maternal. ......Maternal health problems, specially maternal mortality, are one of the most important problems that need to be addressed for the Indonesian people in order to improve the quality of their human resources. Indonesia has a high mortality rate, which is often associated with the utilization of maternal health services. Utilization of maternal health services in Indonesia shows variations between regional areas, which might be influenced by environmental factors and differences in the characteristics of the population. This study examines the relationship between environmental factors and population characteristics with the utilization of maternal health services. This study used secondary data from the 2017 IDHS which included 3,586 women of childbearing age (15–49 years) who had given birth within one year prior to the survey. Multinomial logistic regression analysis was used to test the hypothesis of whether the use of maternal health services had significant differences between different environmental conditions and different respondent characteristics. This study showed that environmental factors and population characteristics are significantly associated with the utilization of maternal health services. Based on multivariate logistic regression analysis, women who are most likely to give birth at home with non-health workers are women whose husbands work in the agricultural sector / self-employed (aOR:7.56 95% CI: 1.69-33.80), and women who are most likely to give birth at home with health workers are women who live on the island of Borneo. (aOR: 11.43 95% CI: 6,13-21,28). Based on the analysis of the relationship between environmental factors and population characteristics in this study, it was concluded that inequality of access to maternal healthcare was evident, especially the utilization of maternal health services in Indonesia. To achieve equal / equitable access to maternal health services, commitment from the central and local governments to optimize their budget especially in provinces outside Java and Bali island is absolutely needed.

Abstrak :
Persalinan oleh tenaga kesehatan merupakan salah satu faktor penting untuk mengurangi angka kematian maternal atau ibu. Persalinan yang didampingi tenaga kesehatan terampil di Indonesia masih rendah, yaitu hanya 52,4% dari ibu hamil (bumil) yang mendapatkan pelayanan kesehatan secara lengkap. Penelitian ini mencoba mencari gambaran faktor aksessibilitas yang berpengaruh terhadap pemanfaatan pelayanan kesehatan maternal. Penelitian ini menggunakan disain penelitian potong lintang, dari survey "Kinerja Pelayanan Kesehatan berdasarkan Indikator Kabupaten Tangerang Sehat 2010", Dinas Kesehatan Kabupaten Tangerang-Banten tahun 2006. Pemeriksaan kehamilan (Ante Natal Care/ANC) pada kunjungan satu kali 97,6%, dengan 85,7% memeriksakan kehamilannya ke bidan. Kunjungan pertama (K1) yang benar/murni sebesar 73,3%, dan kunjungan minimal 4 kali dan lengkap (K4) sebanyak 52,5%. Persalinan yang ditolong oleh tenaga kesehatan sebanyak 80,3%. Pemilihan tempat bersalin di pelayanan kesehatan sebesar 70,7%. Pemanfaatan pelayanan kesehatan maternal lengkap (utilisasi) adalah pemanfaatan pelayanan K4, dan melahirkan dengan didampingi petugas kesehatan yang terlatih, jika didistribusikan terhadap akses ekonomi, dapat diterangkan oleh variabel kemampuan membayar (ATP), sedangkan akses sosial diwakili oleh pengetahuan risiko kehamilan, risiko melahirkan, ANC dan keterlibatan dalam pengambilan keputusan. Faktor aksesibilitas fisik tidak ada yang dapat menerangkan terjadinya perbedaan proporsi utiliasi tersebut. Uji multilevel, membuktikan ada perbedaan random intercept dari level 1 ke level 2, dengan median odds ratio (MOR)= 2,13, berarti ada perbedaan median OR variabel independen pada level 1, terhadap level 2, di tingkat kecamatan. Perbedaan dapat dijelaskan dengan faktor suplay, yaitu rasio bidan per 10.000 penduduk, meskipun nilai IOR (0,24-4,16), melalui 1, yang berarti efek variasi kecamatan relatif lebih besar dari variabel kontekstual.

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Maternal Health Accessibility in Tangerang District Banten, 2006. Indonesia has developed many programs to reduce maternal death, which is beliefs related to access to maternal care, but still only limited pregnant women have access to health facility. This research tried to show which variables that contribute the decision to utilize the maternal health care. Using secondary data from survey "Kinerja Pelayanan Kesehatan berdasarkan Indikator Kabupaten Tangerang Sehat 2010", conducted in 2006, by the Health District Office, Kabupaten Tangerang-Banten.. Maternal health utilization was consisted of complete antenatal care (ANC) examination, and delivery attended by professional birth attendance. In term of the ante natal care (ANC), 97.6% of the respondents had at least one time ANC to the health personnel, and 85.7% to the midwife. Complete ANC and at least 4 times meet medical personnel (K4) was 52.5%. Delivery by professional health attendance was around 80.3%, and 70.7% of the delivery were obtained in the health facility. Maternal health utilization is explained by variables ATP (ability to pay) from economic accessibility, and from the social accessibility by knowledge of ANC, knowledge of risk from the pregnancy, risk of giving birth and the involvement in decision making process to choose service delivery, but there was no physical accessibility could explained the utilization difference. Multilevel analysis proved that there was a random intercept from level I to level II, with MOR=2.13. It means there was a difference in median of OR in the level I to level II. The difference can be explained by the supply factor, which is measured by midwife ratio to 10.000 population, with IOR (0.24 ? 4.16). Since the variation of IOR exceeded 1, it means the variation among the sub-district is relatively bigger than the contextual variable (midwife ratio). Still this research could explain that midwives were playing the very important role in maternal health accessibility in district level.