Factors Affecting Village Midwives Work Performance in Conducting Early Detection of High Risk Pregnancy in the Antenatal Care in South Bengkulu District

Abstract

Pelayanan antenatal adalah memberikan pelayanan kesehatan bagi ibu hamil dan janinnya sesuai standar minimal 7T serta minimal empat kali pemeriksaan selama kehamilan. Standar waktu tersebut untuk menjamin perlindungan kepada ibu hamil, berupa deteksi dini faktor risiko, pencegahan dan penanganan komplikasi. Berdasarkan cakupan Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS-KIA), angka kematian ibu dan bayi serta survei awal terhadap bidan desa disimpulkan bahwa masih rendahnya kineja bidan desa.Tujuan penelitian adalah mengetahui faktor apa saja yang mempengaruhi kinerja bidan desa dalam deteksi dini resiko tinggi ibu hamil pada pelayanan antenatal. Jenis penelitian bersifat explanatory research dengan pendekatan cross sectional. Pengumpulan data menggunakan kuesioner terstruktur dan
observasi. Populasi penelitian adalah bidan desa, dengan sampel 93 responden diambil dengan
teknik simple random sampling. Hasil penelitian menunjukkan 73,1% bidan desa pada rentang
umur 25-35 tahun dan 37,6% rentang masa kerja 36-60 bulan. Analisis bivariat dengan tabulasi
silang dan uji Pearson Product Moment menunjukkan bahwa variabel yang berhubungan dengan
kinerja yaitu pengetahuan (ρ=0,000), motivasi (ρ=0,004), persepsi supervisi bidan koordinator
(ρ=0,016), persepsi beban kerja (ρ=0,047). Analisis multivariat dengan uji regresi logistik
berganda menunjukkan adanya pengaruh bersama-sama variabel pengetahuan dan sarana
prasarana dengan nilai signifikansi 0,000 dan R2 0,394, berarti 39,4% variabel kinerja dapat
dijelaskan oleh variasi dari kedua variabel tersebut. Dinas Kesehatan Kabupaten diharapkan
memberi pelatihan, melengkapi sarana prasarana bidan desa sebelum bekerja di desa,
membentuk tim atau panitia sebagai wadah konsultasi. Puskesmas agar melengkapi sarana
pendokumentasian, kepala puskesmas dan bidan koordinator aktif mengadakan pembinaan.

Antenatal care provided health service for pregnant women and their fetuses according to the
minimum standard of 7T, and minimum of four examinations during pregnancy. These standards were intended to assure protection to pregnant women, such as risk factors early detection,complication prevention and management. Based on the coverage of maternal and children local area monitoring (PWS-KIA), maternal and infant mortality rates, and preliminary survey to village midwives, it was concluded that work performance of village midwives was still inadequate. Objective of this study was to identify factors affecting work performance of village midwives in conducting early detection of high risk pregnancy in the antenatal care. This was an explanatory research with cross sectional approach. Data were collected using structured
questionnaire and observation. Study population was village midwives. Samples consisted of 93
respondents who were selected using simple random sampling technique. Results of the study
showed that 73.1% of village midwives’ age were in the range of 25-35 years old, and 37.6% of village midwifes duration of work were in the range of 36-60 months. Bivariate analysis with
cross tabulation and Pearson Product Moment test indicated that variables related to work
performance were knowledge (p= 0.000), motivation (p= 0.004), perception on supervision of
coordinator midwives (p= 0.016), and perception on workload (p= 0.047). Multivariate analysis
using multivariate logistic regression test indicated common effect of knowledge and facilities
variables with significance value of 0.000 and r 2 = 0.394; it meant that 39.4% of work
performance variable could be explained by variation of those two variables. District health
office is expected to provide training, to complete facilities for village midwives before starting
to work in the village; to form team or committee as a consultation place. Puskesmas is expected to complete documentation facilities; head of puskesmas and coordinator midwives are advised to actively doing supervision.