Sanitation clinic is an innovative health promotion program that is useful to tackle environmental-based diseases. Sanitation clinic activities such as counseling, home care and health interventions. This study aims to know of sanitation clinic activities at Gucialit and Gambut Public Health Center in tackling environment-based illness (PBL). Descriptive research type, using secondary data from sanitation clinic and health profi le of district health offi ce of Lumajang and Banjar 2014-2016, accompanied by indepth interview on information. Sanitation clinic activities obtained at Gucialit and Gambut Public Health Center such as counseling, home care and health intervention are going well. The internal referral system functions optimally, so patient visits at sanitation clinics increase. The existence of sanitation clinics in the Gucialit and Gambut Public Health Centers is very benefi cial in overcoming environmental-based diseases. Every Public health centers is important to carry out sanitation clinics, to support promotive services in tackling environment-based diseases. Abstrak Klinik sanitasi merupakan inovatif program promosi kesehatan yang bermanfaat untuk menanggulangi penyakit berbasis lingkungan. Kegiatan klinik sanitasi seperti konseling, kunjungan rumah (home care) dan intervensi kesehatan. Penelitian ini bertujuan untuk mengetahui kegiatan klinik sanitasi di Puskesmas Gucialit dan Puskesmas Gambut dalam menanggulangi penyakit berbasis lingkungan. Jenis penelitian deskriptif, menggunakan data sekunder laporan klinik sanitasi dan Profil Kesehatan Dinas Kesehatan Kabupaten Lumajang dan Kabupaten Banjar tahun 2014–2016, disertai indepth interview pada informan. Kegiatan klinik sanitasi yang diperoleh di Puskesmas Gucialit dan Puskesmas Gambut seperti konseling, pada tindak lanjut (home care) dan intervensi kesehatan berjalan dengan baik. Sistem rujukan internal berfungsi optimal,sehingga kunjungan pasien di klinik sanitasi meningkat. Keberadaan klinik sanitasi di Puskesmas Gucialit dan Gambut sangat bermanfaat menanggulangi penyakit berbasis lingkungan. Setiap Puskesmas penting untuk melaksanakan klinik sanitasi, untuk mendukung pelayanan promotif dalam menanggulangi penyakit berbasis lingkungan.
Introduction: The ODF (open defecation free) village to realize a healthy environment in preventing diarrheal diseases.This study aims to. Local government support is very important to accelerate the increase in the number of ODF village coverage. The purpose of this study is to find out the efforts of the regional government to realize the ODF village. This type of research is descriptive, using secondary data obtained and interviews. Research sites in Muaro Jambi, Sumedang and West Lombok Regencies, 2016. ODF villages have progressed along with increasing government support and community participation in encouraging stop open defecation free (SODF). The coverage of SODF people in 2016 in Muaro Jambi Regency was 78.07%, in Sumedang Regency 79.53%, and in West Lombok Regency 85.16%. Innovations to accelerate the realization of ODF villages include regulations, giving prizes, cooperating with NGOs and local entrepreneurs to make sanitation shops and sanitation savings and credit cooperatives, and providing punishment for people who break the agreement to stop defecating. The support of the local government by making innovative activities has accelerated the increase in the coverage of ODF villages in each district. Local government support and community participation are very important to realize the ODF village. ABSTRAK Program desa ODF (open defication free) untuk mewujudkan lingkungan sehat dalam mencegah penyakit diare. Dukungan pemerintah daerah sangat penting untuk percepatan peningkatan jumlah cakupan desa ODF. Tujuan penelitian ini adalah mengetahui upaya pemerintah daerah untuk menwujudkan desa ODF. Jenis penelitian diskriptif, menggunakan data sekunder diperoleh dan wawancara. Lokasi penelitian di Kabupaten Muaro Jambi, Sumedang dan Lombok Barat, tahun 2016. Terdapat kemajuan desa ODF seiring dengan meningkatnya dukungan pemerintah dan peran serta masyarakat menggalakkan stop buang air besar sembarangan (SBS). Cakupan masyarakat SBS tahun 2016 di Kabupaten Muaro Jambi 78,07%, di Kabupaten Sumedang 79,53%, dan di Kabupaten Lombok Barat 85,16%. Inovasi untuk percepatan mewujudkan desa ODF diantaranya menerbitkan regulasi, pemberian hadiah, kerja sama dengan LSM dan pengusaha lokal membuat toko sanitasi dan koperasi simpan pinjam sanitasi, dan memberikan sangsi bagi masyarakat yang melanggar kesepakatan stop buang air besar. Adanya dukungan pemerintah daerah dengan membuat kegiatan inovatif , telah mempercepat peningkatan cakupan desa ODF disetiap kabupaten. Dukungan pemerintah daerah dan peran serta masyarakat sangat penting untuk mewujudkan desa ODF.
Maternal deaths is still high in Indonesia. Nowadays, there are still many Indonesian women helped by non-health workers in labor and delivery. To get insight about mothers’ decision making in choosing the helper in labor and delivery and the factors that hamper and support it. Methods: This is a qualitative study using in-depth interview to mothers who ever had delivered a baby, the husbands, the health workers (midwifes), and shamans who help in labor and delivery. This study was done in Blambangan Village, South Lampung in the year 2008. The data was processed by grouping, making categories and chronologies, and conducting content analysis. Most of the mothers chose the shaman as the helper in labor and delivery. The factors that influence the decision were the education level; the type of job; the impact of the midwifes, shamans, transportation, mother’s health status, the complication level of the labor and delivery, and the impact of the husbands. There were three factors that influence the mothers’ decision making in choosing the helper in labor and delivery: 1) the predisposing factors, such as education level and type of job; 2) the reinforcing factors, such as the availability of the helper in labor and delivery and transportation; 3) the enabling factors such as the previous helper in labor and delivery, the role of the husbands, midwifes, and the shamans who help in labor and delivery. Suggestions: Labor and delivery counseling through midwifes, and constructing partnership between midwifes and shamans who help in labor and delivery are very important. Keywords: labor and delivery, mother, shamans who help labor and delivery, midwifes Abstrak Angka Kematian Ibu (AKI) karena kehamilan dan persalinan masih cukup tinggi di Indonesia. Saat ini masih banyak persalinan wanita Indonesia ditolong oleh tenaga non kesehatan. Tujuan penelitian ini untuk memperoleh informasi yang mendalam tentang keputusan ibu yang pernah melahirkan dalam memilih tenaga penolong persalinan dan faktor yang menghambat dan menunjang dengan pengambilan keputusan tersebut. Metode yang digunakan merupakan penelitian kualitatif melalui wawancara mendalam kepada ibu yang pernah melahirkan, suami ibu yang pernah melahirkan, petugas kesehatan (bidan), dan dukun bayi. Penelitian ini dilakukan di desa Blambangan, Lampung Selatan pada tahun 2008. Pengolahan data dilakukan dengan cara mengelompokkan, membuat kategori dan kronologisnya, serta melakukan analisis isi. Hasilnya diketahui sebagian besar ibu memilih dukun bayi sebagai tenaga penolong persalinannya. Faktor yang mempengaruhi ibu memilih tenaga penolong persalinan adalah tingkat pendidikan, jenis pekerjaan, pengaruh bidan, dukun, transportasi, masalah kesehatan ibu, faktor kesulitan persalinan, dan pengaruh suami. Kesimpulan yang diperoleh dari peneliti ini terdapat 3 faktor yang mempengaruhi ibu memilih penolong persalinan yaitu 1) faktor pemicu seperti tingkat pendidikan dan jenis pekerjaan; 2) faktor pemungkin seperti ketersediaan penolong persalinan, dan transportasi;3) faktor penguat seperti penolong persalinan sebelumnya, peran suami, bidan dan dukun bayi. Saran: Pentingnya penyuluhan persalinan melalui bidan dan membangun kemitraan antara bidan dan dukun yang saling menguntungkan. Kata kunci: Persalinan, Ibu, Dukun bayi, Bidan
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