Salah satu penyebab tingginya angka kematian ibu adalah masih kurangnya cakupan persalinan yang ditolong oleh tenaga kesehatan di Indonesia. Di beberapa propinsi, termasuk propinsi Jawa Barat, angka persalinan yang ditolong oleh dukun bayi, masih tinggi. Untuk itu diperlukan adanya pendampingan bidan di desa pada persalinan yang ditolong oleh dukun bayi, dengan adanya pendampingan tersebut bidan dapat memonitor dukun bayi dan mengambil tindakan bila diperlukan. Penelitian ini dilakukan di Kecamatan Cicurug, Kabupaten Sukabumi, tepatnya di puskesmas induk yang ada di kecamatan tersebut, yaitu puskesmas Cicurug dan puskesmas Cipari.Tujuan dari penelitian ini adalah untuk mendapatkan gambaran pengetahuan, sikap, dan praktek dukun bayi dan bidan di desa dalam kegiatan pendampingan bidan di desa pada persalinan yang .ditolong oleh dukun bayi.Penelitian dilakukan dengan pendekatan kualitatif untuk memperoleh informasi yang mendalam mengenai kerjasama dalam pendampingan bidan di desa pada persalinan yang ditolong oleh dukun bayi. Metode pengumpulan data yang digunakan adalah dengan wawancara mendalam dan FGD.Informan utama pada penelitian ini adalah bidan di desa, dukun bayi terlatih, dan dukun bayi tidak terlatih sebagai obyek penelitian, sedangkan informan pendukung lainnya yaitu kepala puskesmas, bidan, koordinator, kepala seksi KIA Dinas Kabupaten Sukabumi, kepala desa, dan ibu bersalin dengan dukun bayi untuk mendukung dan melengkapi informasi mengenai kerjasama tersebut.Hasil penelitian adalah:1. Pengetahuan dukun bayi terlatih dan bidan di desa tentang kerjasama/pendampingan persalinan cukup baik, namun demikian bidan di desa tidak mendampingi setiap persalinan yang ditolong oleh dukun bayi, kecuali bila dukun bayi mengalami kesulitan. Sementara itu dukun bayi tidak terlatih tidak mengetahui adanya bentuk kerjasama dengan bidan di desa.2. Sikap dukun bayi terlatih di puskesmas Cicurug terhadap hubungan kerjasama dengan bidan di desa umumnya baik, sebaliknya, di puskesmas Cipari kurang baik. Perbedaan ini disebabkan karena di puskesmas Cicurug pernah ada pelatihan dukun dan pertemuan rutin antara bidan di desa dan dukun bayi terlatih yang tetap berlangsung sampai sekarang, tidak demikian halnya dengan puskesmas Cipari selain itu juga disebabkan oleh perbedaan karakteristik antara bidan di desa dan dukun bayi dari segi usia, pendidikan, dan asal daerah.3. Bentuk praktek kerjasama dukun bayi terlatih dan bidan di desa di puskesmas Cicurug; bidan di desa dipanggil oleh dukun bayi bila yang bersangkutan mengalami kesulitan, sedangkan di puskesmas Cipari, dukun bayi terlatih jarang memanggil bidan di desa, biasanya bila mereka mengalami kesulitan pihak keluarga yang memanggil bidan di desa. Beberapa dukun bayi terlatih baik di puskesmas Cicurug dan Cipari masih merasa kurang puas dalam hal pembagian peran kerjasama dan sistim pembayaran.Dari fakta di atas dapat disimpulkan bahwa umumnya dukun terlatih sudah mengetahui adanya kerjasama pendamping dalam pertolongan persalinan, namun demikian dalam prakteknya kerjasama tersebut baru terjadi bila dukun bayi terlatih mengalami kesulitan dalam menangani persalinan. Sementara itu dukun bayi tidak terlatih belum mengetahui adanya bentuk kerjasama tersebut.Saran: Untuk meningkatkan kerjasama antara bidan di desa dan dukun bayi, hendaknya pihak Dinkes menerbitkan kebijakan lokal spesifik yang sesuai dengan budaya setempat, dan hal ini dikoordinasikan di tingkat puskesmas untuk selanjutnya disosialisasikan ke seluruh pihak.
Qualitative Analysis of Assistance from Village midwife in Deliveries Attended by Traditional Birth Attendant at Kecamatan Cicurug, Kabupaten Sukabumi, Jawa BaratOne of the main causes of the high maternal mortality rate in Indonesia is the inadequate coverage of childbirths attended by health care providers. In some provinces including West Java, numbers of deliveries attended by traditional birth attendants (TBA) is still rated as high. For this reasons, a companion of village midwife is needed by a TBA when attending deliveries to monitor the performance of the TBAs and to take necessary actions when needed. This research was conducted at Kecamatan Cicurug, Kabupaten Sukabumi, specifically at the major community health centers, puskesmas Cicurug and puskesmas Cipari.The purpose of this research is to obtain a clear picture of the level of knowledge, attitude, and practical skills of the TBAs in the subject area in relation to the program of accompanying TBA during birth attendance.This research uses qualitative approach to collect complete information regarding cooperation between the village midwife and the TBA in deliveries attended by TBA. The data collection methods used in this research is interviews and FGD.The main targets of information collection in this research are the Village midwife, trained TBAs, and untrained TBAs as object of the research, while the supporting source of information are the midwife coordinator, the Head of KIA at the Health Service Office in Kabupaten Sukabumi, Chief of village, and the women in labor in 2000-2001 attended by TBAs to support the cooperation in information collection project.The results of the research are:1. The knowledge of the trained TBAs and village midwife regarding the form of cooperation/labor accompaniment are quite well, however the village midwife is not always present at the childbirths attended by TBA, and are present only when the problems occur. While the untrained TBAs haven't had knowledge regarding the form of cooperation/labor accompaniment by village midwife.2. The attitude of the trained TBAs and the village midwifes regarding the form of cooperation at puskesmas Cicurug is generally good, while at puskesmas Cipari is seen as not encouraging. The differences of their cooperation are due to some reasons, one of which is the puskesmas Cicurug was once organizing a training for TBAs in, addition to routine meetings, but at puskesmas Cipari such routine meetings have never been held. Aside from this fact, the difference in characteristic of TBA and village midwife such as the differences of age, education, and point of origin also become an issue.3. The usual practice conducted by the trained TBAs and village midwifes at puskesmas Cicurug in terms of cooperation/labor accompaniment is the TBAs will call the village midwife if she faces difficulties. Whereas at puskesmas Cipari, the trained TBAs seldom ask the village midwife to help. When they have problems with labors, the family of the laboring women will call the village midwife. In terms of work role division and pay system between the village midwife and the TBAs, some trained TBAs both at Puskesmas Cicurug and Puskesmas Cipari are not quite satisfied.Conclusion: The trained TBAs and the village midwifes have known about the form of cooperation/labor accompaniment, however on usual practice the TBAs will call the village midwife only if she faces difficulties. On the other hand, the untrained TBAs haven't known about the form of accompaniment by village midwifes.Suggestions: to develop work relationship between the TBAs and the village midwifes, Dinkes should make a local policy which appropriate to their culture and should be coordinate in puskesmas level and will socialize in all level. |
T 8429-Analisis kualitatif.pdf :: Unduh