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"Pembangunan Kesehatan dewasa ini masih ditandai oleh tingginya Angka Kematian Ibu (AKI) yaitu 373 per 100.000 kelahiran hidup menurut Survey Kesehatan Rumah Tangga(SKRT, 1995) dan AKI menurut Survey Demografi Kesehatan Indonesia (SDKI, 1994) adalah 390 per 100.000 kelahiran hidup. Salah satu upaya yang telah dilakukan untuk percepatan penurunan AKI adalah dengan penempatan tenaga bidan di desa. Sejalan dengan itu ditetapkan Kebijaksanaan penyebaran pembangunan Pondok Bersalin Desa (Polindes) untuk mempermudah pelayanan persalinan di desa (Departemen Kesehatan, 1995: Ristrini dan Budiarto, 2000). Kualitas layanan antenatal standar yang meliputi 5T yaitu menimbang berat badan, mengukur tinggi badan, mengukur tekanan darah, pemberian imunisasi TT, mengukur tinggi fundus uteri dan pemberian tablet besi minimal 90 tablet selama kehamilan. Agar pelayanan antenatal pada ibu hamil sesuai standar perlu didukung oleh keterampilan bidan di desa dalam melaksanakannya yaitu meliputi cara menganalisa pemeriksaan 5T dan memberikan penyuluhan yang berhubungan dengan kesehatan ibu dan anak. Sehubungan dengan hal tersebut peneliti tertarik untuk memperoleh informasi lebih jauh tentang kepatuhan bidan di desa terhadap SOP layanan antenatal di Polindes Kabupaten Muara Enim tahun 2001. Penelitian ini dilakukan dengan metode studi kualitatif sebagai upaya untuk menggali lebih jauh masalah yang timbul dalam pelaksanaan kepatuhan bidan terhadap SOP pelayanan antenatal di Kabupaten Muara Enim. Hasilnya adalah sebagian bidan desa tingkat kepatuhannya masih rendah dalam menerapkan layanan antenatal standar 5 T dengan faktor-faktor yang mempengaruhinya yaitu beban kerja terlalu besar, motivasi kurang, pelatihan klinis masih sedikit, kurangnya supervisi dari atasan langsung serta kelengkapan sarana kesehatan yang kurang memadai. Setelah diperoleh informasi ini akan disampaikan kepada pihak terkait untuk meningkatkan motivasi bidan dengan cara mengikutkan pelatihan-pelatihan yang klinis kebidanan, mengatur kembali beban kerja bidan di desa dengan petugas kesehatan lain yang bertugas didesa ,memenuhi kelengkapan sarana kesehatan ,pemberian reward dan teguran yang jelas aturannya serta pelaksanaan supervisi lebih bersifat bimbingan dengan menggunakan pedoman dan bukan bersifat menggurui, sehingga kepatuhan bidan di desa terhadap SOP layanan antenatal akan meningkat.

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Analyze Midwives' Compliance in the Village to Standard Operation Procedure Antenatal Care in Village Birth Dwelling in Regency of Muara EnimNowadays health development is still signed by high Maternal Mortality Rate (MMR), is 100.000 alive births according to Indonesia Health and Demographic Survey (IHDS), is 390 per 100.000 alive births. One of the effort has been done to accelerate the slope is with hiring midwives in the village. A long with it is determined the spread policies of Village Birth Dwelling (Polindes) development to make child birth service easily (Health Department, 1995: Ristrini and Budiarto, 2000).

The quality of Standard Antenatal Care, which covers "5 T" are to weigh, to measure body, to measure blood tension, to give tetanus toxoid immunization, to measure fundus uteri highly and to give Ferrum tablet minimum 90 tablets within pregnancy. So that the Antenatal Care of pregnant mother suitable standard it needs some support from midwives' skills in the village in its organizing which covers the way to analyze "5 T" check and to give illumination which is correlated to save motherhood.

Correlation with this matter, the researcher was interested in giving some information about midwives' compliance in the village to Standard Operation Procedure Antenatal Care in Village Birth Dwelling (Polindes) in Regency of Muara Enim in 2001.

The research was done with qualitative study method as an effort to dig the problem, which is appeared in midwives' compliance organization to Standard Operation Procedure Antenatal Care in Regency of Muara Enim. The result of some of the village of midwives' compliance level was low in practicing "5 T" Standard Antenatal Care with factors, which was influenced it self is big working burden, lack of motivation, less-midwives clinic training, lack of supervision from direct lead and lack of health means completion. After getting this information will be sent to the Health District and Health Centre to raise midwives' motivation by following midwives' clinic training which is hoped knowledge and skill will raise, so that can give qualified Antenatal Care.

To reorganize working burden midwives in the village with other Health Officer, who are on duty in the village, to fulfill health means equipment, to give reward and clear warning and to guide supervision organization and solve the problem, too and to give a teaching guidance, so that the midwives' compliance in the village to Standard Operation Procedure Antenatal Care will be raised."

"ABSTRAKDewasa ini pembangunan kesehatan yang memasuki periode Pembangunan Jangka Panjang II masih ditandai oleh tingginya angka kematian ibu (AKE) dan angka kematian bayi (AKB).Salah satu mata rantai yang berhubungan dengan kematian ibu adalah pelayanan antenatal disamping mata rantai lain yang tidak kalah pentingnya adalah persalinan. Pelayanan antenatal di Kabupaten Cianjur masih belum sesuai dengan standar minimal pelayanan antenatal "5T ", masih ada ibu hamil yang tidak ditimbang, tidak diukur, tekanan darahnya, tinggi fundusnya, tidak diberi imunisasi TT lengkap, dan tablet tambah darah minimal 90 tablet.Penelitian ini bertujuan untuk memperoleh gambaran tentang kepatuhan bidan desa terhadap standar minimal pelayanan antenatal "5T" dan faktor-faktor yang berhubungan dengan kepatuhan bidan terhadap standar pelayanan antenatal "5T"di Kabupaten Cianjur tahun 1998, dengan menggunakan rancangan cross sectional serta analisis statistiknya menggunakan analisis chi- square. Sedangkan sampel penelitian ini adalah bidan desa yang bertugas di Dinas Kesehatan Kabupaten Cianjur dan pengambilan sampel dilakukan dengan cara simple random sampling.Dari hasil penelitian ini didapatkan bahwa kepatuhan bidan desa terhadap standar pelayanan antenatal "5T " masih rendah (32,7 %). Dan dari analisa bivariat memperlihatkan adanya hubungan antara sikap dengan kepatuhan bidan terhadap standar pelayanan antenatal " 5T " (p < 0,05). Ada hubungan antara lama bekerja dengan kepatuhan bidan terhadap standar minimal pelayanan antenatal "5T" (p < 0,05).Kesimpulan dari penelitian ini adalah kepatuhan bidan terhadap standar minimal antenatal "5T " masih rendah dan ada hubungan yang bermakna antara sikap, lama kerja dengan kepatuhan bidan terhadap standar minimal pelayanan antenatal 5T.Saran, perlu adanya peningkatan sikap bidan melalui supervisi, motivasi dan kelengkapan sarana untuk pelayanan antenatal.Daftar Pustaka : 41 (1980 - 1998).

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ABSTRACT

Analysis of Village Midwife Compliance on Minimum Standard of Antenatal Care Services "5T" in District of Cianjur in 1998.Currently, the National health development which has entered the second long term development period is still marked by a high maternal mortality and infant mortality rate.

One of important related chains to maternal mortality rate is the antenatal care services besides the delivery. The antenatal services in District of Cianjur has not yet corresponded to minimal standard of antenatal services "5T", there still exists pregnant women who are not weighed, whose blood pressure and fundus uteri are not measured, some of them have not received yet TT immunization and minimum of 90 ferrous tablets.

The aim of this research is to obtain a description of village midwife compliance level on minimal standard of antenatal services "5T" in District of Cianjur and other factors which are related to it. A cross sectional study was used with statistical analysis using chi-square analysis. Samples of this study are midwives in Health Office in District of Cianjur. Samples are taken using simple random sampling.

This research shows that compliance of village midwife on the minimum standard of antenatal services is still low (37,7 %). The bivariate analysis shows relation between the attitude and compliance of midwife on the antenatal sevices standard "5T". There is also a relation between the length of work time and midwife compliance on the antenatal services standard "5T" (p < 0,05).

From this research it is concluded that compliance of the midwife on the antenatal care services standard is still low and there is a significant correlation between the attitude and the length of work with the compliance of village midwife on the antenatal care services standard "5T.

Improving the attitude of village midwife through supervision, increasing motivation and providing adequate facilities for the antenatal services are needed.

References : 41 (1980 - 1998)"