LAPORAN TUGAS BAHASA INGGRIS TEKNIK

TRANSLATE AND THEORY OF INDUSTRY

DisusunOleh : RudiniMulya 41610010035

JURUSAN TEKNIK INDUSTRI FAKULTAS TEKNOLOGI INDUSTRI JAKARTA - BARAT TAHUN 2010/2011

Antenatal Service Policies Antenatal Care Policy and Management For village midwives in the Municipality of Banda Aceh

Abstract Antenatal Care Policy and Management For Village Midwife In anda Aceh Municipality Wahyu Zulfansyah1, Mubasysyir Hasanbasri2, Cahya Purnama3 Background: In order to obtain qualified human resources, early prevention is needed even before born. Optimal antenatal care will affect on woman who deliver healthy and qualified baby. In Banda Aceh municipality, the first and fourth visit coverage of pregnant mother and delivery process that was assisted by health care provider is still beyond the target. Objective: This research was aimed to find out antenatal policy and management for village midwife in Banda Aceh municipality. Method: This was a descriptive research that used case study design. Qualitative method was used to find out problem and obstacle in antenatal service by village midwife. Case study approach was used to investigate the contemporary phenomenon in the real life context whenever the border between phenomenon and the context was not clearly understood, the utilization of multi source and multi proof could be used for organizational and management studies. The data was collected by using interview, observation and document utilization. Result: The coverage of antenatal service in Banda Aceh municipality this time still beyond the target which was stated by Ministry of Health Republic of Indonesia. The conducted effort to achieve the coverage target was by improving human resources through training, monitoring and evaluation, continuous supervision, giving incentive for village midwife, antenatal care socialization and the providence of facility and infrastructure in collaboration with cadre in the village.

Conclusion: Support was needed from every stakeholder in order to support the implementation of antenatal care. Keyword: antenatal care, village midwife. 1 District Health Office of Aceh Besar 2 Health Service Management, Gadjah Mada University 3 District Health Office of Sleman
1. Background

Condition of health development in Nanggroe Aceh Darussalam years 2005 was a very favorable development conditions when than 30 years of previous health and development is the first year after a natural disaster earthquake / tsunami and post-signing of MOU between GAM and the peace GoI will, in the previous year For the year the NAD is areas that are highly prone to security. Almost all sectors can said to be extremely difficult to develop due to an atmosphere of security is not conducive so that does not support the pembangunan1. It is also felt in the health sector, many construction of facilities and infrastructure can not be done and supervised well. Placement of midwives in villages also have problems sufficient means remembering can not do the work entirely due to the conflict between GAM and GoI that vulnerable to security threats, so it is very disturbing the performance of health services. Maternal and child health programs is one of the priorities The main health development in Indonesia. this program responsible for health services for pregnant women, maternal, neonatal and infant. One program of Maternal Health and Child Health (MCH) is a lower incidence of death and illness in among mothers, and to accelerate the decline in death rates Mother and Son is to improve service quality and maintain the continuity of maternal and perinatal health services in level of basic services and referral services primer2. Reproductive health is an important issue because it is very affect the public welfare. In situations of life normal course (without any conflicts and disasters) reproductive health is an issue that is relatively vulnerable to neglect, especially in post-conflict and disaster situation Aceh province today. Women and children are the group vulnerable who need special attention. History has proved that almost

every affected country, women and children find it harder complex due to their specific needs such as reproductive mensturasi, pregnancy, breastfeeding and parenting anak3. One indicator to assess the health of the Figures Maternal Mortality and Infant Mortality. Decrease in mortality mother still feels very slow, the problem of maternal mortality was first discussed by international forum in Nairobi, Kenya in October 1987. As a follow-up, on 29 June 1988 in Indonesia was held workshop Welfare mothers involving 17 sectors and stakeholders to support the efforts of the Safe Motherhood. In lokarya the president of RI has provided instructions to suppress the maternal mortality rate (MMR) 50% of AKI 1986 (450/100.000 live births) to the birth 225/100.000 alive at the end of 2000. The activity was initiated by the department of health, BKKBN and the Office of State Minister in cooperation with POGI4 UPW. Maternal mortality rates for the Province of Nanggroe Aceh Darussalam 2005 was 354/100.000 live births, while in National was 307/100.000. Antenatal care coverage monitored through a new visit pregnant women in 2005 to K1 NAD is 83.12% while the coverage of K4 2005 was 71.92% 1. Maternal and child health situation in the Municipality of Banda Aceh: 1) coverage of the visit of pregnant women is still lacking, 2) detection of high risk mothers pregnancy by skilled health is low, 4) supervision and feedback by skilled obstetric care have not gone well, 5) training of midwives in villages are still very lacking so that K1 and K4 are still below the national target and the target Province of Nanggroe Aceh Darussalam. Efforts to reduce mortality and maternal morbidity demands a close relationship between the various levels health care system that starts from the level of service basic health centers (primary) includes the prevention, detection Early complications of pregnancy, safe and clean delivery and referral into a more baik2 facilities. Method This type of research is a descriptive case study design. Qualitative methods used to determine the problems and barriers barriers to antenatal care by a midwife in the village. Case study approach is used to investigate the phenomenon of contemporary in the context of real life, when the boundary between phenomenon in the context does not appear explicitly, the

utilization multi-source and multi-proof, can be used for organizational studies and manajemen5. Data collection methods used are interviews, observation and utilization dokumen6. This research unit is a unit of Banda Municipal Health Office Aceh. The subject of this study is the Chief Medical Officer of Municipality Banda Aceh, Municipal Health Office Head of MCH Banda Aceh, the Head of Puskesmas, and village midwives. Results and Discussion Policy of the City Health Office in Banda Aceh targets antenatal care coverage is to increase the ability of midwives in villages through training, meetings with the midwife coordinator periodically, the provision of facilities, provision of incentives, promotions midwife in the village became a civil servant civil, socialization programs to the community through antenatal care means of mass media, monitoring, done by Tiered at the City Health Office through the Head of Maternal Health and Children to a midwife in the clinic coordinator who performed scheduled and implemented for all midwives in villages. To accelerate the achievement of targets in the search for targets mothers pregnant, the midwife in the village working with the people who are volunteered to help and carry out post Yandu. Usually The society has received training in running duties such as cadres. Table 1. Coverage of K1 and K4 in the Municipality of Banda Aceh. COVERAGE INDICATORS SERVICE 2004 2005 2006 TARGET K1 75.68 67.7% 86.2% 95% K4 68.17 67.31% 77% 95% Antenatal care coverage for the Municipality of Banda Aceh to K1 2004, amounting to 75.68 percent and 68.17 percent K4nya, for K1nya 2005, 67.7 percent and 67.31 percent for the year K4nya 2006 K1nya K4nya 86.2 percent and was 77 percent and labor by health workers at 69.8 percent, the lowest Jaya is a new health center with K1 and K4 31 percent 19 percent while the highest 97.2 percent Puskesmas Meuraxa K1 and K4 91.3 percent. Achieving this target is actually less than that set by the government by 95 percent is due to them midwives do not live in the village because of the unavailability of places midwives lived in the village provided by local governments and villagers, not like a village health clinic as a residence,

unavailability of vehicles for transportation as well as the difficulty good transport facilities and road vehicles to the public midwives working in village locations. To overcome the problem of confidence in the midwife in the village, performed the delivery of information and outreach to the community, that the midwife in the village have gone through the level of midwifery education and has capable and competent in carrying out his duties as midwives. Shame on prenatal care is one factors that influence the coverage of antenatal care in the City Banda Aceh. Community embarrassed to check themselves, especially during her first pregnancy. Providing additional aid for maternal nutrition pregnancy is the main attraction in service visits Antenatal and can increase the mother's visit. In the implementation of antenatal care services at the level of midwives in villages are supervised and receive guidance conducted by a midwives are on call centers as a midwife coordinator appointed by the head of clinic, as a supervisor is a senior midwife in health centers. The task is to deal with the problem of coordination midwife or constraints that occur on the midwife in the village in the field, including monitoring the occurrence of hild and maternal mortality, midwives coordination report problems problems experienced by midwives in the village and progress on issues that directly to the Head tanganinya Community Health Center, supervising the implementation is done once a month. If problems faced by midwives in the village can not be resolved at primary care level, then it would be completed level Department of Health Midwife in the village midwife activity reports each month and submitted coordination to the midwife when the midwife in the village of conduct duties to the clinic. Midwives coordinating a recapitulation for the monthly statement signed by the manager of KIA and submitted to the Head of the Head of Public Health Center Maternal Health and Child on the 15th of each month at the time of monthly meeting MCH clinic manager at the health department. All issues concerning the report will be discussed at the time meeting. Implementation of supervision is also performed at the time midwife in the village of performing their duties at the health center, regular meetings monthly at the health center was visited by a midwife and coordination to the services provided by village midwives. Jurim the Yandu present in the implementation of the post may also help monitoring the performance of midwives.

Supervision is also performed by Kapala Health Center with direct monitoring down to the field Facilities and infrastructure prepared by the Public Health Service, which place gradually through funds provided by local government, central government or private assistance. Not all facilities are available with sufficient, especially for polindes facilities. Lack of service facilities polindes, usually midwife in the village to find alternative means of service locations in facilities that are common in the village. Department of Health to procure polindes gradually, required cooperation with the community village to be able to provide land for the establishment of village health clinic locations Not all midwives in the villages have a midwife kits, this issue, sebahagian level health center would be completed by procurement of health centers with funds available in the clinic. Sebahagian midwife in the village who have not received the equipment for support services will provide antenatal care with bought using personal funds, Perceived insufficient availability of iron tablets by all midwives in village, Tetanus Toxoid vaccines are available with sufficient, only need to taken at the health center at the time of the post Yandu because in polindes not available storage space, Skills of midwives is one of the factors that support in achieving coverage of midwifery services. With training A good will can improve skills and knowledge midwife in the village midwife in the village making it possible to improve the quality of work the novice midwife needs to be improved skills because of too many centers of education of midwives not accompanied by a sufficient and adequate practice. Paksanaan training for midwives in the villages was carried out in stages because the funds are very limited To overcome the limitations of training opportunities for midwives in the village, subdistrict Puskesmas Head Meuraxa made a breakthrough by transferring knowledge gained by midwives who participated in training to midwives in villages other midwives in the villages through meetings conducted at the clinic. This meeting is not limited in obstetrics course Midwives in villages in the Municipality of Banda Aceh, in addition to a salary and allowances at certain moments they get holiday allowance. Public Health Service also gives awards

midwives in the form of an example and see to it that the midwife be appointed as Civil Servants. Thus midwife in the village should be able to improve services. salaries and incentives paid from the Public Health Service, salary paid every month and the incentive is paid once every four months. To midwives in rural health centers Lampoh Power, Head of Puskesmas provide benefits that come from funds Askeskin paid twice a year. An important factor to improve performance is the provision of compensation. Providing compensation there are 2 kinds of direct and indirect compensation. Direct compensation is salary, bonuses and incentives. Compensation Indirect promotion of such award or pangkat7 increase. The presence of midwives in villages in the city of Banda Aceh are expected to expand the range of services that already exist at once can increase the coverage of MCH program through increased examination of quality maternal health, relief childbirth, early detection of pregnancy and service improvement factor neonatal. Human resources (HR) is the main asset of an organization, both business and nonprofit organizations, because a success and sustainability of the organization's future be affected by human resources dimilikinya7. Health authorities monitoring the implementation of the program maternal and child health in steps from head office to Sub Division Head of MCH to the midwife at the health centers of coordination for midwives in the village carried out in a scheduled each month and do Feed back from the Chief Medical Officer of Health Center and cross check from midwife to midwife in the village coordinator. Supervision of MCH program performing well when done follow-up improvements in MCH services through intensification MCH movement and mobilization of resources necessary to increase the range and quality of service KIA8. From the observations made in both the health department or health centers in terms of monitoring the activities directly or technical guidance, supervision can not find documents to a health clinic and the midwife in the village. Not all centers performed regular monitoring and scheduled, monitoring is more to study the monthly reports. Accurate data is in need of monitoring activities and evaluasi9. KIA program activity data from the village midwife to the health center and from the

clinic to the Office of the material to perform monitoring and supervision of program activities. results summary reports can be used to determine the rawan8 clinic. These deficiencies can cause the program can not implemented optimally. Effective supervision by the head of the health center or midwife supervisor in the city of Banda Aceh to develop and deliver assurance that the activities carried out by midwives in the villages do not deviant and to support midwives in villages in carry out the task. Supervision undertaken not to seek error midwives but also to reward midwife in the village. Person's supervisor will not succeed in his job if he does not show the value of leadership, both in dealing with subordinates, train employees and kerjasama10 building. Advocacy and stakeholder commitment and pelaksan, leadership, fostering and monitoring activities to be key in service implementation. Readiness of the institution in terms of preparation, implementation, evaluation at an early stage requires guidance and continuous monitoring to better ensure availability of quality health services for masyarakat11. Assignment of village midwives routinely for two to three days in cause the service to the community health center village need to be reduced. The low ability in manage the tasks assigned will have an impact on dissatisfaction. The reason being unable to manage time well so the time for the patient berkurang12. To motivate pregnant women to want to check her pregnancy to health workers, midwives in villages do with visiting the houses. Motivation is closely linked to success person, organization or community in achieving Goal13 conclusion The results of this study found that antenatal care coverage in the Municipality of Banda Aceh is still below target established by the Ministry of Health. For 2006 K1nya achieving 86.2 percent, 67.31 percent and help K4 delivery by health personnel by 69.8 percent. To maintain continuity and quality of service to reach the target Expected approach is needed in the village midwife to mother maternal. Policy pursued Municipal Health Office in Banda Aceh by improving human resources through training, monitoring and evaluation are done regularly, giving incentives for midwives in the village and conducted the importance of socialization prenatal care and deliveries by trained personnel kesehatah and provision of infrastructure services and maternal health children.

Completeness of facilities and infrastructure in the Municipality of Banda Aceh in achieving coverage of antenatal felt very lacking. Service health do not yet have a conducive space in data processing, not all villages have a village health clinic, polindes that there is as yet qualified and not all midwives in the villages have a midwife kit impact on the quality and coverage is low. To increase coverage of antenatal care in the village midwife working with posyandu cadres targeting pregnant women by conducting home visits, the importance of socialization antenatal health, motivate pregnant women to check their pregnancy regularly at least four times during her pregnancy. Government provide incentives in the form of salaries and awards in the form of exemplary midwives, village midwives and lifted into civil servants. Not all midwives in the village became an employee country, and the incentives provided felt very lacking. Implementation of supervision conducted by the clinic of a midwife in the village to improve coverage in its feel very weak, midwives supervisors do not have good decision letter from the department or clinic, lack of operational funds and the absence of pen dokumentasian, absence of a regular schedule and only incidental make ineffective supervision. Training acquired in the village midwife in supporting the achievement antenatal care: the care of normal deliveries, monitoring the region local training daruratan kegawat obstetric and family planning. Not all midwives in villages received training as a refreshment and add skills in performing their duties suggestion Antenatal care needs to be improved in pelaksanaannnya Municipality of Banda Aceh in order to achieve targets established by the Department of Health and antenatal may support related programs that already exist in the Office Health such as nutrition, prevention of infectious diseases, especially tetanus and Child Health Program, and the necessary support and community participation in the implementation of service programs Master of Health Services Policy and Management 11 health health and the presence of village midwives for midwives in the villages can endure and survive to live in the village. The need for increased management support from the Department of Health towards improving the quality of antenatal care by a midwife in the village and support the provision of facilities

and infrastructure are not yet available, provision of promotional materials such as printed materials, implementation monitoring and evaluation and supervision, and regularly scheduled mengupayaan and special incentives for village midwives that reach the target coverage of antenatal care. Required careful planning and cooperation from the Government Areas to the Society and NGOs to can provide the facilities and infrastructure to be used as a place of community health services, especially Maternal and Child Health as well as a viable means of Adequacy Other supporting such a referral when it is in a state transport emergency. Socialization needs to be done to the whole society will the importance of socialization during pregnancy and health reproduction, especially of childbearing age because it can improve the quality of future generations through the mass media and meetings menasah rural communities and implementing programs in the villages (PKK, LKMD, etc.) and propose to the mayor to provide formation for the midwife in the village as a civil servant. Propose appropriate incentives for midwives in villages and provides an opportunity to be able to continue their education. Head of the clinic to improve guidance and direction to midwives on a regular basis about the performance of village midwives. Required supervisory training for supervisors so that midwives have a standard supervision are the same for all health centers and village midwives and enhance the role of midwives as a midwife in charge of coordination Head of Puskesmas assist in solving problems arise in the village. And formed a Municipal Management Team (distric Management) consisting of all midwife supervisors in the region Banda Aceh Municipality of work which has the task malakukan guidance and supervision of the practice of antenatal care in order to ensure quality and uniformity of supervision and oversight midwives in villages in the implementation and provision of services operational funds for the supervision of midwives supervisor.

The need for training-training to improve knowledge and skills of midwives to support the implementation good antenatal care technical training for village

midwives management training for midwives and supervisors and the Chief Community Health Center. Bibliography
1.

Provincial Health Office of Nanggroe Aceh Darussalam., 2006. Department of Health., 1991. Guidelines for Antenatal Services in Nurhayati, E., 2005. Refugees and the Fulfillment of Health

profile Nanggroe Aceh Darussalam Province Health in 2006.

2.

the Work Area Health Center. Jakarta.

3.

Reproduction Post-Tsunami. Satellite Seminar Paper AnniversaryFK-UGM to 59. Yogyakarta

4.

Department of Health Working with UNFPA., 2001. Guidelines for Yin, Robert.K., 2004. Case Studies, Design and Methods, PT King Moleong, J.L., 2004. Basics of Qualitative Research, Publisher Handoko, T.H., 2001. Personnel and Resource Management Department of Health., 2002. Area Monitoring Guidelines Local

Basic Midwifery Services.

5.

Grafindo Persada, Jakarta.

6.

Teens Rosdakarya, Bandung.

7.

Humans. BPFE. Yogyakarta

8.

Maternal and Child Health (PWS-KIA). Jakarta