Tingginya angka kematian bayi dan ibu melahirkan sebagai salah satu indikator derajat kesehatan masyarakat mendorong pemerintah untuk membuat kebijakan baru yang disebut Paradigm Seha! sebagai realisasi konsep organisasi kesehaum dunia World Health Assembly (WHA) dalam rangka upaya memperbaiki kinelja dari sistem kesehatan. sejalan dengan prinsip dan nilai-nilai pada Health for All 2000, stmtegi pembangunan kesehatan menuju Indonesia sehat 2001 rncnitik beratkan upayanya terhadap profesionalisme dalam rangka meningkatkan mutu sumber daya manusia kesehatan yang berkualitas dan professional.Masalah kesehatan di Kabupaten Karawang adalah tidak tercapainya target program pelayanan kesehatan ibu hamil (cakupan ANC Kl,K4 dan cakupan persalinan olch tenaga kesehatan) mempakan indikator rendahnya kinelja bidan di desa Tujuan penclitian ini adalah untuk mengetahui hubungan variabel bebas dengan kinerja bidan di desa Kabupaten Karawang tahun 2001 serta untuk mengetahui determinan falctor variabcl independen dalam menentukan kinerja bidan di desa.Penelitian ini mcnggunakan metoda deskri1ii£_Analisis dilaksanakan dcngan rancangan ?crass sectional? Populasi penelitian adalah bidan yang ditempatkan di _desa, berjumlah 277 orang. Sampel penelitian adalah seluruh bidan di dcsa (total sampel) namun yang berhasil di data sebanyak 267 orang. Pcngumpulan data dilaksanakan mulai bulan Juni hingga Juli tahun 2001. Analisis data meliputi analisis univariat, dengan membuat disuibusi Iiequensi masing-masing vadabel, analisis bivariat dengan membuat tabel silang antara variabel bebas dengan variabel terikat, dan analisis multivariat mclalui uji rcresi logistik ganda dengan kriteria kemaknaan p<0,05, Hasil penelitian menunjukan, proporsi kelompok responden, yang memiliki kinetja lcurang lebih besar dibanding responden yang memiliki kinetja baik.Hasil analisis bivariat menunjukan bahwa variabel umur, status perkawinan, pengalaman ketja, penghasilan tambahan dan supervisi_ memiliki hubungan bcnnakna dengan kinetja bidan di desa. Bidan yang berumur <28 tahun cenderung berkinerja kurang 8,3 kali lebih besar dibanding umur 328 tahun,. Bidan yang bclum kawin cenderung berkinetja kurang 7,3 kali lebih besar dibanding yang sudah kawin, Bidan yang kurang berpengalaman cendemng berkineljia kurang 6,1 kaii Iebih besar dibanding yang berpengalaman, Bidan yang berpenghasilan tambahan rendah cendenmg berkinetja kurang 13,6 kali lebih besar dibanding yang berpenghasilan tambahan tinggi. Bidan yang mendapat supewisi kurang cendenmg berkinezja kurang 3,5 kali lebih besar dibanding yang mendapat supetvisi baik.Hasil analisis multivanat menunjulcan bahwa vaxiabel umur, penghasilan tambahan, dan supcrvisi mempakan determinan faktor yang dapat menentukan hubungan variabel bebas dengan kinetja bidan di desa setclah dikontrol variabel status pcrkawinan, pengalaman kerj; sarana dan ])I'ZS3I'3.l13., Serta pelatihan dan dukungan masyarakat.Dengan diketahuinya faklor-faktor yang berhubungan dcngan kinerja bidan di dcsa, maka dapat difommulasikan saran-satan sebagai berikut 1 Bagi pengelola program; perlu dibuat kebijakan tentang persyaratan batasan umur dan penglaman ketja dalam penempatan bidan di desa serta wajib praktek magang di rumah sakit atau puskesmas bagi bidan sebelum ditempatkan di desa. Bagi puskesmas dan dinas kesehatan; perlu pcmbinaan intensif melalui supervisi terhadap bidan yang memilfki kinerja kurang Peningkatan SDM perlu pelatihan serta pcmbetian reward dan punishrnan melalui evaluasi yang terencana, kondusif dan berkesinambungan. Bagi bidan; perlu meningkatkan sosialisasi di masyatakat serta memanfaatkan peran aktif dukun bayi melalui program kerja sama tcrpadu yang hannonis dan saiing menguntungkan. Bagi Instjtusi pendidikan; pcrlu pcngkajian ulang tentang struktur program mata ajaran kegawatdamratan kebidanan scrta sikap dan perilaku bidan di masyarakat. Bagi peneliti lain perlu penelitian yang lebih akurat dan lebih baik tentang kinetja bidan di desa.
Materral and neonatal rate is health degree indicator of a country, and it is high rate in Indonesia made government the new policy which called ? Health Paradigm ? to improve health system perfomance. Related with the princip and the value of Health For All 2000, the health development stategy to health Indonesia' 2001 considers more its Effort to professionalism in increasing the quality of the health hiunan resources which are quality and professional.The health problem in Karawarig regcncyis not gotten the target of pregiant health service program ( including ANC K1, K4 and delivery service coverage by the health ofiicers mentioning) an indicator as low service done by midwives in the village.This research objective is to End out the relationship of tice variable with midwives perfomance in village of Karawang regency 2001 and also to know independent variable factor determinant to detemaine the midwives perfomance in village.This research used descriptive method. The analysis is done with the assumption of ? cross sectional " research population is using midwives which are placed in village are 277. Research sample is all midwive in village but just 267 are successfully recorded as data. The data collection is started in june until july 2001. Data analysis including univariate, analyis by making frequency distribution of such variable, bivariate analysis by making cross table between dependent and independent variable, and making logistic regression analysis to get the odd ratio, the last is multivariate analysis by multiregression logistic test with p value (p<0,05).The research result shows, that respondence group proportion, which have less perfomance bigger comparing than the respondence which have good perfomance. Bivariat analysis result shows that age variable, marital status, job experrence, additional income and supervision have communicative relationship with the midwives performance in the village. The risk midwive less that 28 ages tend performing less 8,3 times bigger than lessequal 28 age, unmarried midwive tends performing less 7,3 times bigger than married ones, less experienced midwive tendes perfonnancing less 6,1 times bigger comparing than the experinced ones, the low additional income midwive tends performing less 13,6 times bigger than high additional income less supcrviedlmiclwivc tends performing less 3,5 times bigger than the ones got good supervision.Multivariate analysis result shows that age variable, additional income, and supervision is determinant factor which can decide lice variable relationship with midwives perfomiing in village after they are controlled by marital status variable,job experience, facility and pre facility, and then training and social support. By being known factors which correlated with midwives perfomiance in village, can be formulated suggestion as follows. For the program keepers are necessarily made policy about age limitation and job experience requimment in placing midwives in village and they are obliged to training practice in the hospital or clinic for midwives before they are placed in village, For clinic and 'health oiicers, needs intensive improvement trough supervision to midwives who have less perfonnance.Human resources improvement needs training and giving rewards and punisment trough plarmed condusive and successive evaluation, For midwives; needs social improvement in society and uses active role for tradiad bitt attendant trough, cooperative program wich is harmoning and mutual profot. For educational institution; needs referation review about structur of rnidwiveness first aids program and midwives and behavior in sociaty. For another reseorder needs reseach wich is more accurate and better about perfomiant in village. |
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