Pada masa pandemi COVID-19 Kementerian Kesehatan telah mengeluarkan pedoman pelayanan persalinan sebagai acuan pelaksanaan protokol kesehatan untuk mencegah penularan COVID-19 di ruang bersalin. Pemerintah juga mengeluarkan kebijakan agar ibu hamil yang terdeteksi COVID-19 dirujuk untuk bersalin di rumah sakit sebab wanita hamil dengan infeksi COVID-19 cenderung memiliki morbiditas yang tinggi. Namun pada tahun 2021, terdapat 620 ibu hamil terkonfirmasi COVID-19 di seluruh Puskesmas wilayah Jakarta Selatan dimana lebih dari setengah jumlah pasien yang dilayani tersebut (67,3%) tidak menunjukkan gejala dan sebanyak 14,7% pasien ini akhirnya bersalin di Puskesmas. Oleh karena itu Puskesmas di wilayah Jakarta Selatan harus dapat menerapkan protokol kesehatan pada seluruh aspek pelayanan sehingga ibu bersalin tetap mendapatkan hasil layanan yang berkualitas dan aman serta transmisi COVID-19 dapat dicegah untuk melindungi pasien dan tenaga kesehatan di Puskesmas. Tujuan penelitian ini adalah mendapatkan informasi mendalam mengenai kesesuaian implementasi aspek struktur, proses, output dan outcome serta kendala dan interaksi antar aspek diatas dalam pelayanan persalinan di Puskesmas wilayah Jakarta Selatan pada masa pandemi COVID-19 tahun 2021. Penelitian ini merupakan studi kualitatif dengan melakukan observasi lapangan, tinjauan literatur serta wawancara mendalam pada tiga rumah bersalin Puskesmas yaitu Puskesmas Kecamatan Jagakarsa, Kebayoran Baru dan Setiabudi. Informan dipilih secara purposive sesuai asas kecukupan dan kesesuaian. Hasil penelitian ini menunjukkan bahwa pada masa pandemi COVID-19, Puskesmas melakukan penyesuaian pada aspek struktur rumah bersalin berupa penyesuaian aturan, penambahan kompetensi bidan dan penyesuaian sarana prasarana untuk memastikan pelayanan persalinan dapat dilaksanakan sesuai standar dan regulasi terbaru yang berlaku sehingga berdampak terhadap aspek proses berupa penyesuaian prosedur-prosedur pelayanan persalinan di Puskesmas. Penyesuaian aspek stuktur dan proses ini berdampak terhadap jenis pelayanan yang diberikan di Puskesmas dimana Puskesmas melakukan pelayanan persalinan terhadap pasien dengan dan tanpa infeksi COVID-19. Jumlah pasien rumah bersalin terkonfirmasi COVID-19 di Puskesmas bervariasi antara 8,8% hingga 15,3% dari total pasien yang dilayani di Puskesmas. Pelayanan pasien yang terdeteksi COVID-19 berupa rujukan ke rumah sakit sehingga persalinan di Puskesmas bersifat penanganan darurat. Selama tahun 2021 lebih dari 50% bidan pelaksana rumah bersalin pernah terinfeksi COVID-19 namun tidak dalam waktu yang bersamaan sehingga pelayanan di rumah bersalin tetap berjalan.
During the pandemic of COVID-19, the Ministry of Health has issued guidelines for delivery services as a reference for implementing health protocols to prevent transmission of COVID-19 in the delivery room. The government has also issued a policy so that pregnant women who are detected with COVID-19 are referred to give birth in hospitals because pregnant women with COVID-19 infection tend to have high morbidity. But in 2021, there were 620 pregnant women with confirmed COVID-19 in all Puskesmas in the South Jakarta area where more than half of the patients served (67.3%) were asymptomatic and as many as 14.7% of these patients finally gave birth at the Puskesmas. Therefore, Puskesmas in the South Jakarta area must be able to implement health protocols in all aspects of service so that patients still get quality and safe service results and the transmission of COVID-19 can be prevented to protect patients and health workers at the Puskesmas. The purpose of this study was to obtain in-depth information regarding the suitability of the implementation of the structural, process, output and outcome aspects as well as the constraints and interactions between the above aspects in delivery services at the South Jakarta Health Center during the COVID-19 pandemic in 2021. This research is a qualitative study by conducting observations, literature reviews and in-depth interviews at three delivery room of the Puskesmas (Puskesmas Kecamatan Jagakarsa, Kebayoran Baru and Setiabudi). Informants were selected purposively according to the principles of adequacy and suitability. The results of this study indicate that during the COVID-19 pandemic, the Puskesmas made adjustments to aspects of the maternity room structure in of adjusting rules, adding midwife competencies and adjusting infrastructure to ensure delivery services could be carried out according to the latest applicable standards and regulations so as to have an impact on process aspects in the adjustment of delivery service procedures at the Puskesmas. These adjustments has an impact on the type of service provided at the Puskesmas where the Puskesmas provides delivery services to patients with and without COVID-19 infection. The number of maternity patients with confirmed COVID-19 at the Puskesmas varied from 8.8% to 15.3% of the total patients served at the Puskesmas. Patients detected by COVID-19 are referrals to hospitals so that deliveries at the Puskesmas are emergency treatment. During 2021, more than 50% of midwives had been infected with COVID-19 but not at the same time so that services at the maternity home continued. |
T-Rahmadhini.pdf :: Unduh