Latar Belakang : Salah satu indikator persalinan bersih dan aman adalah pertolongan ditolong tenaga kesehatan di fasilitas kesehatan (faskes). Standar Pelayanan Minimal (SPM) bidang kesehatan tahun 2016 menyatakan target persalinan sesuai standar adalah 100%, sedangkan data Puskesmas tapin Utara menyebutkan persalinan di faskes sebesar 56,8% dan non faskes Sebanyak 43,2%. Dari data yang didapat disimpulkan bahwa persalinan di wilayah puskesmas Tapin Utara belum mencapai target SPM bidang kesehatan. Tujuan : Menganalisis determinan pemilihan tempat persalinan oleh ibu bersalin diwilayah puskesmas Tapin Utara.Metode : Penelitian Kuantitatif dengan pendekatan cross sectional. Pengambilan sampel dengan tekhnik total sampling sebanyak 62 ibu bersalin selama januari 2017. Analisis bivariat digunakan Uji chi square dan analisis multivariat regresi lostik bergandaHasil : Gambaran pemilihan tempat persalinan oleh ibu bersalin diwilayah puskesmas tapin utara adalah ibu bersalin di faskes (43,5%) dan non faskes (56,5%). Determinan pemilihan tempat persalinan adalah budaya (p=0,000), Pemeriksaan Kehamilan (p=0,001), pengetahuan(p=0,000), dan Biaya persalinan (p=0,001), sedang yang bukan merupakan determinan pemilihan tempat persalinan adalah pendapatan (p=0,154), akses ibu ke faskes (p=0,207) dan dukungan keluarga (p=0,439). Determinan paling dominan adalah biaya persalinan (p=0,008, OR=11,712).Simpulan : Determinan pemilihan tempat persalinan di wilayah puskesmas tapin utara adalah budaya, pemeriksaan kehamilan, pengetahuan dan biaya sedangkan yang bukan determinan adalah pendapatan, akses ke faskes dan dukungan keluarga. Determinan paling dominan adalah biaya persalinan.Kata kunci : Tempat Persalinan, Budaya, Pemeriksaan Kehamilan, Pengetahuan, Pendapatan, Biaya Persalinan, Akses ibu ke Faskes dan dukungan keluarga. Abstract:Background : Maternal mortality rate still high because delivery is not at health facilities. Information of north tapin central public health said there had been 470 delivery and while non health facilities about 43,2 % .For which figures obtained concludea that delivery in district tapin not reached target public health years 2016 who was targeted delivery service at health facilities appropriate standard 100 % service. Objective : analysis determinant factors relating to the selection of the place of birth in the puskesmas Tapin utara.Methods : Quantitative research by approach cross sectional . Sampling used total sampling about 62 delivered in january 2017 .The stastik used is chi square and regression lostik simple.Result : there are 43,5 % mother who has deivery at health care facilities, while the non health care facilities are 56.5 %. Correlation factors of cultural deals namely p = 0,000 value , the anc p = 0,001 value , p value knowledge = 0,000 , delivery fees p = 0,001 value , p income = 0,154 value , mother access to health care facilities p = 0,315 value , and support the family p = 0,411 value .Value the ordi highest of the results of the test stastik safinat logistic regression simple namely the cost factor of 11,712 childbirth.Conclusion : The result of 7 factor in some 4 factors that there are dealing with the selection namely the delivery: cultural factors , a pregnancy , knowledge , and the delivery fee .The cost factor a factor most dominant dealing with the selection the delivery Keywords : The delivery , culture , pregnancy, knowledge , income , the delivery fee , access health care, support by family
Latar belakang: penelitian ini didasari oleh penghapusan Kerjasama yang dilakukan oleh pemerintah Kabupaten Barito Kuala tentang berakhirnya Jamkesda tahun 2019 pada Rumah Sakit Provinsi yang menyebabkan masyarakat diwilayah kerja UPT.Puskesmas Rawat Inap Berangas yang memerlukan rujukan ke Rumah Sakit, hanya bisa dirujuk ke RSUD.Abdul Azis Marabahan untuk mendapatkan fasilitas kelas III gratis, dimana jarak tempuh lokasi penelitian dan Rumah Sakit Rujukan sekitar 48,7km.Tujuan: Untuk mengetahui bagaimana ketiadaan Jamkesda dapat meningkatkan akses dan mutu pelayanan Kesehatan terhadap seluruh masyarakat miskin dan tidak mampu agar tercapai derajat Kesehatan masyarakat yang optimal secara efektif dan efisien dengan melakukan evaluasi ketiadaan Jamkesda terhadap rujukan di UPT.Puskesmas Rawat Inap Berangas.Metode: Penelitian ini menggunakan pendekatan kualitatif dengan Teknik snowball sampling. Data dikumpulkan melalui wawancara. Untuk uji validitas dan reliabilitas menggunakan triangulasi sebagai pembanding data.Hasil: Hasil penelitian menunjukkan bahwa kebijakan Jamkesda Kab. Barito Kuala belum optimal, terutama dalam hal pelayanan rujukan dimana bagi masyarakan miskin yang tidak mendapatkan kartu KIS mereka hanya bisa bergantung pada kebijakan pemerintah kelas III gratis di RSUD. Abdul Azis, dimana jarak tempuh ke RSUD Abdul Azis ini sekitar 48,7 km dari UPT.Puskesmas Rawat Inap Berangas.Kesimpulan: Petugas Kesehatan dan pemerintah bisa memberdayakan program P4K, menggalakan Kembali Tabulin, mengarahkan warga menjadi peserta BPJS,memberikan akses yang mudah untuk ibu yang memerlukan rujukan baik itu dari segi pembiayaan maupun lokasi rujukan serta meningkatkan kualitas SDM. Kata kunci: Evaluasi, Jamkesda, Kebijakan, RujukanBackground: This research was conducted based on the decision of the Barito Kuala Regency Government to stop the Jamkesda program in 2019 at Provincial Hospital which caused referral patients at UPT Puskesmas Berangas must be referred to Abdul Azis Marabahan Hospital to have free admission for range III classified facilities. Further, the patients have to travel around 48.7 km to reach the referral hospital.Objective: To investigate the effect of the absence of Jamkesda program in improving the quality of helat public service in UPT Puskesmas Berangas.Methods: This study used a qualitative approach with a snowball sampling technique. Data were collected through interviews. To provide validity and reliability of this research, triangulation was administered by the researcher.Results: The results showed that the Jamkesda Barito Kuala district policy was not optimal, especially in referral services for the poor. Without KIS, they depend on government policy to claim free service at the RSUD. Abdul Azis, where the distance to Abdul Azis Hospital is about 48.7 km from UPT. Puskesmas Berangas.Conclusion: Health workers and the government can empower the P4K program, implement Tabulin Program, direct residents to become BPJS participants, providing accessible service for patients who need referrals help in terms of funding and relocations. The study also concludes that government should improve the quality of human resources. Keywords: Evaluation, Jamkesda, Policy, Referral
Latar Belakang : Kala I persalinan adalah saat paling melelahkan, sakit, nyeri karena kegiatan rahim yang mulai aktif, sehingga pada fase ini dibutuhkan (power) yang adekuat untuk memulai persalinan, apabila tidak dikelola dengan baik persalinan dapat menyebabkan hambatan kemajuan persalinan atau disebut partus lama. Salah satu cara alternatif nonfarmakologi mempercepat persalinan kala I yaitu dengan konsumsi buah kurma atau sari kurma karena terdapat kandungan yang membantu pengganti asupan energi selama proses persalinan dan menimbulkan kontraksi serta mengandung hormon potuchin.Tujuan: Menelaah kajian-kajian literatur tentang pengaruh pemberian kurma terhadap kemajuan persalinan kala I.Metode: Penelitian ini menggunakan literatur review yang dipilih dan menggunakan sumber data base google scholar dan kriteria yang ditetapkan peneliti.Hasil: Dari 10 literatur yang ditemukan dan direview, 9 jurnal menyatakan dalam mempercepat kemajuan persalinan kala I dapat diberikan kurma atau sari kurma untuk mempengaruhi peningkatan sensitivitas reseptor oksitosin agar menghasilkan kontraksi uterus yang lebih efektif. Kandungan karbohidrat dalam bentuk glukosa dalam kurma ketika dibawa pembuluh darah dan diedarkan keseluruh tubuh dapat membuat metabolisme miometrium menjadi baik dan asam linoleat ketika terurai menjadi arakidonat diubah jadi eikosanoid diubah menjadi prostaglandin perubahan ini dapat menigkatkan kematangan serviks dan memicu peningkatkan sensitivitas uterus terhadap oksitosin.Simpulan: Berdasarkan hasil dari 10 jurnal yang telah direview dapat disimpulkan bahwa 9 jurnal menyatakan ada pengaruh pemberian kurma terhadap kemajuan persalinan kala I, karena didalam kurma terdapat dua kandungan yang dapat mempengaruhi kemajuan persalinan seperti karbohidrat dalam bentuk glukosa dan asam linoleat.Kata kunci : Kurma, Kemajuan persalinan, Persalinan kala I.ABSTRACTBackground: The first stage of labor most tiring time, feel aches, pain due to the active uterine activity, so this phase adequate power needed to able start labor, ifn’t managed properly, this labor can cause obstacles progress of labor or prolonged labor. One the non-pharmacological alternative acclerate the first stage of labor consuming date palm because ingredients help substitute for energy intake during the labor process, can cause contraction and contain the hormone potuchin.Objective: To examine literature studies the effect of giving dates to the progress of the first stage of labor.Methods: This study use literature review has been selected and data base sources google scholar and criteria by the researcher.Results: The 10 literature found and reviewed, 9 journal stated accelerating progress the first stage of labor, date palm given affect the increase oxytocin receptor sensitivity to produce more effective uterine contractions. The carbohydrate content form glucosa in dates when carried the blood vessels and circulated throughout the body can make myometrial metabolism better and linoleic acid when decomposed into arachidonic acid converted eicosanoids converted prostaglandins, this can increase cervical maturity and trigger increased sensitivity uterus to oxytocin.Conclusion: The results 10 reviewed journals, it can be concluded that 9 journals state that there effect of giving dates on progress the first stage of labor, because in dates there are two ingredients that can affect the progress of labor carbohydrates the form of glucose and linoleic acid.Keywords: Date palm, First stage of labor, Progress of labor.
Background: Preeclampsia is the most common cause (32%) of maternal deaths in Indonesia. Model Piers(Pre-eclampsia Integrated Estimate Risk) can predict the outcomes / complications of pre-eclampsia andassociated with a reduction in maternal morbidity. This study aims to assess the potential modification of themodel to predict the outcome Piers mothers with preeclampsia in Type B hospitals in Indonesia. Methods:This research is a prognostic with the analytical method and quantitative approach retrospectively. This studyused the capture technique stratified random sampling to obtain the medical records of 160 people withpreeclampsia and 160 controls in hospitals Banjarmasin Ansari Saleh 2014. Identified availability ofvariables in the model along with the outer piers preeclampsia. Performed univariate, bivariate andmultivariate corresponding availability of variables the model Piers. Result: eight of the 48 variables in themodel Piers consistently found in all samples, while output available were complication preeclampsiaeclampsia and/or HELLP syndrome. The gestational age was significantly influent eclampsia for the subjectin this study (P <0.05), HELLP syndrome (P <0.05), and a combination of both (P <0.01). Predictive value ofa logistic regression model with the variables that the outer form of the syndrome HELLP or in combinationwith eclampsia is 0.811 (AUC ROC; CI 95% from 0.636 to 0.986) and 0.767 (AUC ROC; CI 95% 0.666 to0.868), while the prediction of eclampsia was not significant (P> 0.05). Conclusion: Modifications Piersmodels to predict potential outcomes of women with preeclampsia in RS type B in Indonesia if it is supportedby policies and standards that consider this model and supported a larger number of samples.
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