Background:The maternal mortality rate (MMR) in Indonesia in 2015 was 305 per 100,000 live births. The majority of maternal deaths occur during labor and the puerperium. Increasing access to health services is not enough so that attention is more focused on the quality of services provided. This study aimed to determine the determinants of the quality of childbirth and childbirth by midwives in Kebumen Regency. Subjects and Method: This study was a cross sectional study at 25 health facilities in Kebumen, Central Java, and was conducted during September-October 2019. The study sample consisted of 200 women giving birth and childbirth selected using the proportionate stratified sampling technique. The dependent variable was the quality of childbirth and childbirth services. The independent variables were age, parity, education, occupation, family income, and type of financing. The data collection was performed using a questionnaire and the data analysis was performed using multilevel multiple linear regression with Stata 13. Results: The quality of childbirth and childbirth services increased with maternal age 34 years (b= 1.89; 95% CI= 0.48 to 3.31; p= 0.009), multiparaous (b= 2.20; 95% CI= 0.78 to 3.63; p= 0.002), and type JKN financing (b = 0.27; 95% CI= -0.94 to 1.47; p= 0.659). The quality of childbirth and childbirth services decreased with the education of high education (b= -0.87; 95% CI = -2.02 to 0.28; p= 0.139), working outside the home (b= -1.28; 95% CI= -2.64 to 0.08; p= 0.065), and family income of Rp 1,686,000 (b= -1.85; 95% CI= -3.24 to -0.47; p= 0.009). There was a contextual in-fluence of the place of delivery and postpartum on the quality of services received by mothers with ICC= 51.26%. Conclusion:The quality of childbirth and childbirth services has improved with the age of 34, multiparous, and JKN types of financing. The quality of childbirth and childbirth services declined with the education of mothers who were high school graduates, working outside the home, and family income of Rp1,686,000. There is a contextual influence of the place of delivery and postpartum on the quality of service received by the mother.

<div class="WordSection1"><p><strong>Latar Belakang</strong>: Angka Kematian Ibu (AKI) tahun 2015 mencapai 303.000 akibat komplikasi selama kehamilan dan persalinan dengan 99% kejadian berada di negara berkembang. Komplikasi kehamilan tersebut dapat dicegah memalui perawatan selama kehamilan atau <em>antenatal care </em>(ANC). Minimnya penggunaan pelayanan ANC di negara berkembang disebabkan oleh disparitas yang terjadi akibat perbedaan geografis, demografis, sosioekonomi, dan budaya. Tinjauan pustaka ini bertujuan untuk mengidentifikasi determinan penggunaan pelayanan ANC di beberapa negara berkembang.</p><p><strong>Metode</strong>: Pencarian artikel dilakukan di basis data Scopus yang terbit tahun 2015-2019 dengan lokasi penelitian di negara berbagai berkembang.</p><p><strong>Hasil</strong>: Terdapat berbagai artikel penelitian terkait faktor-faktor yang mempengaruhi penggunaan pelayanan ANC di negara berkembang. Penulis mengelompokkan menjadi dua kategori, yaitu berdasarkan karakteristik individu dan penyedia layanan ANC.</p><p><strong>Kesimpulan</strong>: Tingkat pendidikan ibu hamil merupakan faktor yang paling berpengaruh diantara faktor lainnya. Tingkat pendidikan berhubungan positif terhadap penggunaan pelayanan ANC. Sedangkan faktor dominan dari penyedia layanan yaitu adanya fasilitas pelayanan ANC. Masih sedikitnya fasilitas kesehatan dan jauhnya jarak tempuh menjadi hambatan ibu hamil untuk melakukan kunjungan.</p></div>

Background: Community Health Center is a health service facility that organizes public health efforts. Pejagoan Health Center is one of the Health Units in the Kebumen Regency area, which coincides in Pejagoan District and houses 13 villages that carry out various health service activities, one of which is medical record services. Medical Record is the activity of recording patient documents. They have 3 medical record officers with various educational backgrounds and visitor data. In 2020, 28,652 total visitors were found.Objective: The studywas aimed to find out the need for human resources at the UPTD Medical Record Unit at Pejagoan Health Center Kebumen.Methods: The study uses quantitative descriptive and uses secondary reports from related parties as well as a calculator instrument to trade time variables, besides that this study refers to the WISN.Results: There are only 3 medical record officers at the puskesmas with 1 person having medical record education. From the results of the calculation, the Pejagoan Health Center Medical Record Unit requires 6 human resources to meet the workload standards following the job descriptions.Conclusion: Pejagoan Health Center Medical Record Unit requires 6 human resources to meet the workload standards following the job descriptions.