Monitoring terhadap Pelayanan Kesehatan Maternal di Kabupaten Cianjur khususnya Dinas Kesehatan belum berjalan sebagaimana mestinya. Masalah utama yang dihadapi adalah belum optimalnya pengolahan data yang dilakukan, belum dimanfaatkannya data Bidan di Desa dan data kematian maternal untuk keperluan analisis, termasuk belum pernah dikembangkannya analisis dengan menggunakan peta. Disamping itu berdasarkan Profil Kesehatan Kabupaten Cianjur cakupan pelayanan K1 untuk akses layanan antenatal adalah 79,8% dan K4 untuk cakupan ibu hamil lebih rendah yaitu 68,4% sedangkan cakupan persalinan oleh nakes baru 50,3% sehingga program pelayanan kesehatan maternal di Kabupaten Cianjur perlu dipantau terus menerus karena cakupan program masih belum memenuhi target yang ingin dicapai.Tujuan pengembangan Monitoring Pelayanan Kesehatan Maternal Berbasis Wilayah adalah dikembangkannya sebuah aplikasi program yang dapat mempercepat proses pemasukan, pengolahan dan penyajian data sehingga dapat membantu proses pengambilan keputusan. Selain itu, dapat pula dilakukan pemetaan untuk melihat indikator input, output dan outcome dan pelayanan kesehatan maternal berdasarkan kecamatan, sehingga diperoleh variasi per wilayah dengan perbandingan warna termasuk melakukan teknik analisis spasial terhadap indikator-indikator tersebut untuk melihat wilayah yang perlu ditingkatkan manajemen pelayanan kesehatan maternal. Dalam pengembangan sistim ini indikator utama yang digunakan adalah rasio keberadaan Bidan di Desa, cakupan pemanfaatan pelayanan kesehatan maternal (dilihat dari cakupan akses pelayanan antenatal (KI), cakupan ibu hamil (K4) dan cakupan persalinan oleh nakes) dan indikator kematian maternal absolut.Metodologi yang digunakan adalah pendekatan sistim terdiri dari analisis sistim yang dimulai dengan menetapkan masalah dalam sistim informasi yang ada, informasi peluang pengembangan, indikator dan data yang dibutuhkan. Kemudian mendesain sistim pengumpulan, pengolahan dan penyajian data, mendesain format input dan output laporan, serta perancangan program aplikasinya. Tahap selanjutnya dilakukan analisis data secara spasial dan secara statistik mengunakan uji chi-square untuk melihat hubungan antar indikator rasio keberadaan Bidan di Desa, daerah prioritas peningkatan pemanfaatan pelayanan kesehatan maternal dan kematian maternal.Dalam penelitian ini telah berhasil disusun prototipe pengembangan Sistim Monitoring Pelayanan Kesehatan Maternal Berbasis Wilayah secara komputerisasi dengan menghasilkan informasi laporan Bidan di Desa, laporan kematian, laporan dan grafik bulanan program.Berdasarkan hasil pemetaan diperoleh gambaran bahwa kecamatan di Kabupaten Cianjur yang memiliki rasio keberadaan Bidan di Desa < 1 sebesar 91,7 %, merupakan daerah prioritas I yang perlu ditingkatkan pemanfaatan pelayanan kesehatan maternalnya sebesar 45,8%. Hasil analisis spasial antara indikator rasio keberadaan Bidan di Desa, daerah prioritas dan kematian maternal dilanjutkan dengan uji bivariat untuk melihat hubungan antar indikator tersebut, diperoleh tidak ada hubungan yang bermakna (P > 0,05), kemungkinan karena data yang dimanfaatkan adalah data rutin di tingkat kabupaten.Dengan tersusunnya prototipe Sistim Monitoring Pelayanan Kesehatan Maternal Berbasis Wilayah yang telah diujicoba di laboratorium computer, sebaiknya Dinas Kesehatan Kabupaten Cianjur segera mengimplementasikan dengan jalan melengkapi perangkat lunak pendukung yaitu Arcview.Daftar Bacaan : 33 (1980 -- 2002)
The monitoring of Maternal Health Services at Kabupaten Cianjur especially at Dinas Kesehatan has not been running as well as expected. Some of the problems are because the data management has not been yet optimalized, underutilization on village midwives, and the use of maternal mortality data for analysis, including the use of regional map for analysis has not been yet developed. According to the Health Profile of Kabupaten Cianjur, the coverage of K 1 for the accessibility on antenatal services is 79.8% but the K4 coverage on pregnant mothers is lower, at 68.6%, while the coverage of delivery attended by health personnel is only 50.3%. Looking at those figures above, there is a need for monitoring on maternal health services at Kabupaten Cianjur, as the target is still beyond the expectation.The purpose of the development of regional-base monitoring system for Maternal Health Services is to develop an application program that can be use to speed the process on inputting, managing and displaying the data in order to facilitate the decision making process. Another reason is that the program will help to map the data in looking at the input, output and outcome indicators of maternal health services based on the district (kecamatan). Then, the variation between areas can be look at the difference of the color as the result of spatial analysis technique used at the program. Therefore, based on the color of the area, the priority is given to the area that needs to improve its maternal health services. In order to develop the system, the indicators used are: the ratio of midwife staying at the village; the coverage on the utilization of maternal health services - which look at the coverage of the access on antenatal services (K 1), the coverage of pregnant mothers (K4) and the coverage of delivery attended by health personnel; and the indicator of absolute maternal mortality.The method use for this study is the system approach that be composed of system analysis, system design, and spatial data analysis. The system analysis is started with the determination of problems on the existed information system, the information of the possibility for developing the system, indicators and data needed. The next step is to design the system for gathering, managing, and displaying data, including to design the report on the input and output form, and to design its application program. Then, to carry the spatial data analysis and statistical analysis using chi-square test in order to find out the relationship between the indicator of ratio of midwife staying at the village, priority area need to improve its maternal health services, and the maternal mortality.The study has accomplishes on arranging a computerized of a prototype of the development of regional-base monitoring system for Maternal Health Services that can produce the information on the report of village midwives, mortality report, monthly program report and its graphs. Based on the mapping result from the application program, it can be seen that Kabupaten Cianjur has a ratio of midwife staying at the village < 1 is 91.7%, the area that has Priority I need to improve its utilization of the maternal health services is found at 45.8%. The result from spatial analysis between indicator of ratio of midwife staying at the village, priority area and the maternal mortality, and continued by bivariat test to see the relationship between those indicators, has found that there is no significant relationship (P>0.05). This might be because the source of the data used is come from routine kabupaten data.As the prototype of the development of regional-base monitoring system for Maternal Health Services has accomplished and has been tried out at computer lab at the Faculty of Public Health, it is suggested that the Health Authority of Kabupalen Cianjur will implement the system as soon as possible by completed the system with supported software, the Arcview. |
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