Analysis on Work Performance Difference between Trained and Untrained Midwives in Neonatal Case Integrated Management in Kudus District

Abstract

Latar Belakang : Tahun 2010 didapatkan AKB sebesar 24/1.000 kelahiran hidup dan AKN 15/1.000 kelahiran hidup. Upaya pelaksanaan penanganan bayi muda dimulai dengan memberikan pelatihan MTBM kepada para bidan desa. Karena sangat penting pelatihan MTBM bagi peningkatan kinerja bidan dalam melaksanakan kunjungan neonatal sesuai pedoman MTBM. Angka kematian bayi di Kabupaten Kudus pada tahun 2009 adalah 5,88/1000 kelahiran hidup, dari jumlah tersebut 80,2% kasus kematian terjadi pada periode neonatal. Tahun 2010 angka kematian bayi sebesar 6,39/1000 kelahiran hidup, dari jumlah tersebut 87,6% kasus kematian terjadi pada periode neonatal. Pada tahun 2011 angka kematian bayi sebesar 6,71/1000 kelahiran hidup, dari jumlah tersebut 78,43% terjadi pada periode neonatal. Tujuan penulisan adalah untuk menganalisis perbedaan kinerja bidan desa yang sudah dilatih dan belum dilatih tentang manajemen terpadu bayi muda dalam penatalaksanaan kunjungan neonatal di Kabupaten Kudus tahun 2011.
Metode : Jenis penelitian survey dengan pendekatan cross sectional. Subyek penelitian adalah bidan desa yang sudah dilatih MTBM dan yang belum dilatih MTBM masing-masing sebanyak 35 orang. Data dikumpulkan dengan wawancara. Data yang telah terkumpul dianalisis dengan uji independent samples test.
Hasil penelitian : Ada perbedaan kinerja bidan yang sudah dan belum dilatih manajemen terpadu bayi muda (MTBM) dalam penatalaksanaan kunjungan neonatal di Kabupaten Kudus tahun 2011 (p : 0,047) dengan selisih mean = 5,97. Dari aspek kualitas ada perbedaan kinerja bidan desa yang sudah dilatih dan belum dilatih (p:0,000) dengan selisin mean = 8,12. Dari aspek kuantitas (p : 892), ketepatan waktu/timeliness (p : 0,728), efektifitas sumberdaya/cost effectiveness (p:0,981), pengawasan/ kebutuhan akan supervisi (p:0,324), dan hubungan interpersonal (p:0,680).
Simpulan : Ada perbedaan kinerja bidan desa yang sudah dan belum dilatih MTBM di Kabupaten Kudus tahun 2011. Bentuk pola pelatihan perlu diubah dari penyampaian materi, evaluasi dan praktik langsung dalam pelatihan sehingga pelatihan mampu meningkatkan semua kriteria evaluasi kinerja bidan desa dalam kunjungan neonatal.

Background: Infant mortality rate (AKB) in 2010 was 24/1000 live-births, and neonates mortality rate was 15/1000 live-births. Implementation of neonatal management was started by giving training on neonatal integrated management (MTBM) to village midwives. This MTBM was important to improve work performance of midwives in the implementation of neonatal visit according to MTBM guideline. Infant mortality rates in Kudus district in 2009 was 5.88/1000 live-births, and 80.2% of infant deaths occurred in the neonatal period. Infant mortality rates in 2010 was 6.39/1000 live-births, and 87.6% of infant deaths occurred in the neonatal period. Infant mortality rates in 2011 was 6.71/1000 live-births, and 78.43% of infant deaths occurred in the neonatal period. Objective of this study was to analyze the difference between trained and untrained village midwives on neonatal integrated management in the management of neonatal visit in Kudus district, 2011.
Method: This was a study using survey method and cross sectional approach. Study subjects were trained and untrained village midwives on MTBM. Each group of midwives consisted of 35 midwives. Data were collected through interview. Independent samples t-test was applied in the data analysis.
Results: There was a work performance difference between trained and untrained midwives on MTBM in the management of neonatal   visit in Kudus district in 2011 (p: 0.047) with a mean difference of 5.97. Quality aspect: there was a work performance difference between trained and untrained village midwives on MTBM (p: 0.000) with a mean difference of 8.12. Quantity aspect (p: 0.892), timeliness (p: 0.728), cost effectiveness (p: 0.981), supervision (p: 0.324), and interpersonal relationship (p: 0.680).                  
Conclusion: There was a work performance difference between trained and untrained village midwives on MTBM in Kudus district in 2011. Modification for training pattern such as teaching method, evaluation, and field practice is needed. Therefore, the training will increase the points of all evaluation criteria for work performance of village midwives in conducting neonatal visit.