Analysis on the Implementation of Delivery Assurance Programme by Village Midwives in Lumajang District

*Warih Respitowati  -  Dinas Kesehatan Kabupaten Jember, Indonesia
Martha Irene Kartasurya  -  Fakultas Kesehatan Masyarakat, Universitas Diponegoro, Semarang, Indonesia
Lucia Ratna Kartika Wulan  -  Fakultas Kesehatan Masyarakat, Universitas Diponegoro, Semarang, Indonesia
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Section: Articles
Language: EN
Statistics: 133 191
Abstract

ABSTRAK

Implementasi jaminan persalinan di Kabupaten Lumajang masih belum sesuai petunjuk teknis seperti pelaksanaan KB pasca salin. Tujuan dari penelitian ini adalah menjelaskan implementasi program jaminan persalinan oleh bidan desa di Kabupaten Lumajang. Jenis penelitian ini adalah penelitian eksplanatif. Informan utama yaitu 2 orang bidan desa dari puskesmas PONED dan non PONED dengan cakupan persalinan tertinggi dan 2 orang bidan desa dengan cakupan persalinan terendah dari masing-masing puskesmas. Informan triangulasi berjumlah 8 orang yang terdiri dari 1 orang pengelola jampersal Dinas Kesehatan, 1 orang verifikator jampersal, 2 orang kepala puskesmas dan 8 orang pasien jampersal. Data didapatkan melalui indepth interview serta menggunakan metode observasi terhadap sarana dan prasarana polindes. Analisis data penelitian ini menggunakan content analysis. Hasil penelitian menunjukkan bahwa pelaksanaan program jaminan persalinan belum sesuai dengan petunjuk teknis dalam hal KB pasca salin. Namun demikian pelayanan KIA sudah sesuai standar pelayanan minimal. Dalam hal ukuran dasar dan tujuan kebijakan belum ada aturan tambahan di tingkat Kabupaten, hanya berupa himbauan. Dana masih dirasakan kurang memadai, fasilitas tidak dipenuhi dan kompetensi sumber daya manusia belum ditingkatkan. Ada dukungan bidan pelaksana terhadap program tetapi kompetensi pelaksana masih belum ditingkatkan. Sosialisasi dilaksanakan mendadak melalui perwakilan puskesmas. Kondisi ekonomi masyarakat membuat ibu bersalin lebih mudah dirujuk dengan adanya program jampersal akan tetapi semua bidan masih merasa program ini hanya sebuah kewajiban. Pelaksanaan jaminan persalinan belum dilaksanakan secara lengkap karena belum ada kebijakan pendukung, keterbatasan sumber daya, sosialisasi belum menyeluruh dan dirasakan sebagai kewajiban yang memberatkan.

Kata kunci : Implementasi, Jaminan Persalinan, Bidan Desa.

ABSTRACT

Implementation of delivery assurance (Jampersal) program in Lumajang district was not done
according to the technical guideline; it was not done by way of the implementation of KB after delivery program was done. Objective of this study was to explain the implementation of delivery assurance program by village midwives in Lumajang district. This was an explanatory study. Main informants were two village midwives from PONED and non PONED primary healthcare centers (Puskesmas) with the highest delivery coverage, and two village
midwives from each puskesmas with the lowest delivery coverage. Triangulation informants were 12 people. Those people were one Jampersal manager from district health office, one Jampersal verification person, two heads of Puskesmas, and 8 Jampersal patients. Data were collected through in-depth interview and observation to Polindes (village polyclinic) facility. Content analysis method was applied in the data analysis. Results of the study showed that activities of delivery assurance service were conducted using minimal standard service. Delivery assurance policy was a right policy to solve health cost problems. Executors of the policy were village midwives who had competency that suited with program purposes. Target and environment supported the program implementation. Basic indicator and purpose of the policy were clear and understandable for village midwives. However, funding was not maximal, and it caused many complaints from midwives. Communication and coordination were adequate; however social condition and community economy did not completely support the implementation of post-delivery KB (family planning). Funding for Jampersal was very small for both delivery assistance and consumable materials. This condition made the implementation of program was only for fulfilling the responsibility. Recommended suggestions for Lumajang district health office are to provide regulations related to post-delivery KB, to do proper planning regarding resources requirement to support service
implementation. Monitoring on the usage of KIA (Mother and Children) book should be done by Puskesmas to minimize technical problems such as double claim due to using double KIA book.

Keywords : implementation, delivery assurance, village midwives

Keywords: implementation, delivery assurance, village midwives

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