Evaluation on the Implementation of Ten Steps to Successful Breast Feeding by Midwives at Doctor Ramelan Naval Hospital Surabaya

Abstract

Penerapan 10  langkah menuju keberhasilan menyusui (LMKM) merupakan upaya pemerintah untuk meningkatkan program  ASI eksklusif. Di lingkungan   RSAL dr. Ramelan Surabaya sudah tertempel  tentang 10 LMKM namun belum ada kebijakan khusus tentang ASI eksklusif sehingga  bidan masih memberikan  susu formula (PASI) pada bayi baru lahir rawat gabung . Secara umum penelitian ini bertujuan untuk mengevaluasi pelaksanaan 10 langkah menuju keberhasilan menyusi (LMKM) oleh bidan di RSAL dr. Ramelan Surabaya
    Metode penelitian yang digunakan adalah kualitatif yang disajikan secara  deskriptif eksploratif. Informan utama adalah 7 bidan pelaksana di poli hamil, kamar bersalin dan ruang rawat gabung, sedangkan  3 bidan kepala ruangan dan 1 bidan supervisor, serta 3 pasien sebagai informan triangulasi. Pengumpulan data dilakukan melalui wawancara mendalam dan studi dokumentasi Analisis data hasil wawancara dengan menggunakan metode interactive model melalui beberapa tahapan seperti: data collection,  dan data reduction,  data display Conclusion drawing
Hasil penelitian menunjukkan bahwa pelaksanaan 10 LMKM belum terlaksana dengan baik antara lain : belum semua bidan memberikan penjelasan tentang manfaat dan tehnik menyusui yang benar, bidan masih memberikan susu formula pada bayi rawat gabung, belum terbentuk kelompok pendukung ASI (KP-ASI). Hal tersebut disebabkan masih sebagian kecil bidan yang sudah mengikuti pelatihan manajemen laktasi, sehingga motivasi diri kurang
Perlu adanya kebijakan tertulis tentang pemberian ASI Eksklusif, serta diharapkan semua bidan dapat mengikuti pelatihan manajemen laktasi sehingga pelaksanaan 10 langkah menuju keberhaslan menyusui (LMKM) lebih optimal, dan perlu juga adanya kebijakan yang tegas tentang keberadaan susu formula

Establishment of the 10 steps to be success in breastfeeding (LMKM) was a government effort to improve exclusive breastfeeding program. Ten LMKM information had been displayed in dr. Ramelan navy hospital (RSAL) Surabaya; however, there was no special policy regarding exclusive breastfeeding. Therefore, midwives were still giving formula milk (PASI) to infants in the integrated care room. In general, the objective of this study was to evaluate the implementation of 10 steps to be success in breastfeeding (LMKM) by midwives in RSAL dr. Ramelan Surabaya.  
This was a qualitative study with descriptive explorative approach. Main informants were 7 midwives in the pregnancy policlinic, delivery room, and integrated care room. Triangulation informants were 3 midwives as chief of the room, one supervisor midwives, and 3 patients. Data were collected through in-depth interview and documentation study. Interactive model was applied in the data analysis. Steps on the interactive model included data collection, data reduction, data display, and conclusion drawing.
Results of the study showed that ten LMKM had not been implemented properly. Not all midwives explained correctly breastfeeding benefits and breastfeeding technique; midwives still gave formula milk to infants in the integrated care room; breastfeeding support group (KP-ASI) had not been formed yet. Only a small portion of midwives who had attended lactation management training; and it caused an insufficient self-motivation among midwives.  
Written policy regarding exclusive breastfeeding is needed. All midwives are expected to attend in lactation management training; it will optimize the implementation of 10 LMKM. Strong policy regarding the existence of formula milk is needed.