[ABSTRAK
Diperkirakan 15-20% kehamilan dan persalinan akan mengalami komplikasi.Puskesmas mampu Pelayanan Obstetri Neonatal Emergensi Dasar (PONED)sebagai sarana untuk mendekatkan pelayanan terhadap ibu hamil, bersalin dannifas. Kabupaten Bogor mempunyai 40 Puskesmas dan 22 diantaranya termasukkategori Puskesmas PONED. Puskesmas mampu PONED Parung mempunyaicakupan penanganan komplikasi yang tinggi (77,7%) , sedangkan Puskesmasmampu PONED Cileungsi mempunyai cakupan penanganan komplikasikebidanan yang rendah (50,7%). Menurut teori Edwards III , implementasikebijakan berfokus pada 4 variabel yaitu : komunikasi, sumber daya, disposisi,dan struktur birokrasi.Rancangan penelitian yaitu penelitian kualitatif. Lokasipenelitian di Dinas Kesehatan Kabupaten Bogor, Puskesmas mampu PONEDParung dan Puskesmas mampu PONED Cileungsi.Hasil penelitian menunjukkan untuk variabel sumber daya, Faktor sumber dayamanusia (kompetensi yang tidak merata) menjadi faktor dominan dalampenanganan komplikasi kebidanan di Puskesmas mampu PONED. Untuk variabelkomunikasi Faktor koordinasi menjadi faktor dominan dalam penanganankomplikasi kebidanan di Puskesmas mampu PONED. Untuk variabel strukturbirokrasi didapatkan, struktur organisasi di Puskesmas mampu PONED Parungdan Cileungsi belum lengkap karena tidak melibatkan perawat dan belum adanyapemisahan strukur organisasi PONED di Puskesmas Cileungsi. Untuk variabeldisposisi diperlukan peningkatan komitmen petugas Puskesmas terutama diPuskesmas mampu PONED Cileungsi terkait dengan penanganan komplikasikebidanan di PONED.
ABSTRACT
An estimated 15-20% of pregnancies and childbirth can develop intocomplications. Basic Emergency Obstetric and Neonatal Care (BEONC) facilitiesas a means to bring services to mothers during pregnancy, labor or delivery, andpost partum period. Bogor Regency has 40 Primary Health Cares (PHCs), 22 ofthem categorized as BEONC. Parung PHC is a BEONC facility with a highcoverage in complication handling (77,7%), while Cileungsi PHC is a BEONCfacility with a low coverage in complication handling (50,7%). According to thetheory of Edwards III, policy implementation focuses on four variables, such as :communication, resources, disposition, and bureaucratic structure.The design ofthe research is a qualitative research. The location of the research in BogorDistrict?s Health Office , Parung and Cileungsi BEONC PHC .The results of the study showed that in the variables of Resources, the humanresources (uneven competence) becomes the dominant factor in complicationshandling BEONC facilities. In the communication variables, the dominant factorin BEmOC facilities complications handling is coordination. In the variables ofbureaucratic structure, the organization?s structure in both Parung and CileungsiPHC is incomplete because it does not include nurses, and in Cileungsi PHC theBEONC structure has not separated yet. In the variables of disposition, anincreased commitment of health officers in complication handling is requiredespecially in Cileungsi PHC., An estimated 15-20% of pregnancies and childbirth can develop intocomplications. Basic Emergency Obstetric and Neonatal Care (BEONC) facilitiesas a means to bring services to mothers during pregnancy, labor or delivery, andpost partum period. Bogor Regency has 40 Primary Health Cares (PHCs), 22 ofthem categorized as BEONC. Parung PHC is a BEONC facility with a highcoverage in complication handling (77,7%), while Cileungsi PHC is a BEONCfacility with a low coverage in complication handling (50,7%). According to thetheory of Edwards III, policy implementation focuses on four variables, such as :communication, resources, disposition, and bureaucratic structure.The design ofthe research is a qualitative research. The location of the research in BogorDistrict’s Health Office , Parung and Cileungsi BEONC PHC .The results of the study showed that in the variables of Resources, the humanresources (uneven competence) becomes the dominant factor in complicationshandling BEONC facilities. In the communication variables, the dominant factorin BEmOC facilities complications handling is coordination. In the variables ofbureaucratic structure, the organization’s structure in both Parung and CileungsiPHC is incomplete because it does not include nurses, and in Cileungsi PHC theBEONC structure has not separated yet. In the variables of disposition, anincreased commitment of health officers in complication handling is requiredespecially in Cileungsi PHC.] |
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