Strategi Penanggulangan Anemia Pada Ibu Hamil di Wilayah Kerja Tujuh Puskesmas Kota Medan
Ellen Hartati Nasution : The Strategy Treatment of Anemia among Pregnant Women in Seven Puskesmas Working…, 2005
USU Repository © 2006
Strategi Penanggulangan Anemia Pada Ibu Hamil
di Wilayah Kerja Tujuh Puskesmas Kota Medan
Tesis
Ellen Hartati Nasution
Universitas Sumatera Utara
Sekolah Pasca Sarjana
Magister Kesehatan Masyarakat
2005
Abstrak
Program penanggulangan anemia melalui pemberian tablet besi bagi ibu hamil telah
dilaksanakan sejak tahun 1975 di Indonesia. Survey prevalensi anemia ibu hamil di delapan
kabupaten/kota di Sumatera Utara pada tahun 1997 sebesar 78,4%.. Tingginya angka ini dipengaruhi
oleh berbagai faktor.
Penelitian ini bertujuan untuk mengetahui hubungan beberapa faktor risiko; yaitu: paritas,
jarak kelahiran, status gizi, riwayat persalinan, riwayat penyakit dan pelayanan antenatal dengan
kejadian anemia ibu hamil.
Penelitian dilakukan menggunakan rancangan matching kasus kontrol dengan cara
membandingkan 130 orang ibu hamil anemia dengan 130 orang ibu hamil yang tidak anemia yang
diambil dari wilayah kerja tujuh puskesmas quality assurance di Medan. Analisa data
mempergunakan Program SPSS versi 1.5 dan regresi logistik ganda.
Hasil penelitian menunjukkan ada hubungan yang bermakna antara: paritas > 3 dengan
kejadian anemia ( OR adjusted = 3,9; 95% CI = 1,327 - 11,433; nilai p = 0,013); jarak kelahiran < 2
tahun dan > 3 tahun dengan kejadian anemia (OR adjusted =9,7; 95% CI = 4,699 - 20,400; nilai p =
0,000); status gizi yang tidak baik dengan kejadian anemia (OR adjusted = 8,7; 95% CI = 4,219 18,146; nilai p = 0,000); riwayat persalinan yang tidak baik dengan kejadian anemia (OR = 8,5; 95%
CI = 2,770 - 26,314; nilai p = 0,000); riwayat penyakit dengan kejadian anemia (OR = 2,4; 95% CI =
1,022 - 5,788; nilai p = 0,045) dan pelayanan antenatal yang tidak baik dengan kejadian anemia (OR
= 3,7; 95% CI = 1,272 -10,803; nilai p = 0,016).
Faktor risiko yang paling dominan adalah faktor jarak kelahiran < 2 tahun dan > 3 tahun
dengan OR adjusted = 9,7.
Intervensi yang dilakukan untuk mengatur jarak kelahiran dan paritas, meningkatkan
pelayanan antenatal, memperbaiki status gizi serta pengelolaan riwayat persalinan dan riwayat
penyakit adalah dengan merubah perilaku para ibu maupun petugas kesehatan melalui strategi
pendekatan penyuluhan atau Komunikasi Informasi Edukasi (KIE).
Kata kunci : Anemia, paritas, jarak kelahiran, Antenatal Care, status gizi, ibu hamil.
Ellen Hartati Nasution : The Strategy Treatment of Anemia among Pregnant Women in Seven Puskesmas Working…, 2005
USU Repository © 2006
The Strategy Treament of Anemia Among Pregnant Women
in Seven Puskesmas Working Area in Medan
Thesis
North Sumatera University
Postgraduate Program
Magister of People Health Science
By: Ellen Hartati Nasution
Abstract
The program of iron deficiency anemia treatment by supplying of iron tablets for pregnant
women has been done in Indonesia since 1975. Survey of iron deficiency anemia among pregnant
women in North Sumatera in eight districts in 1997 was 78.4%; which was higher than other
provinces in Indonesia.This high prevalence of anemia is influenced by various factors.
This research was aimed to learn the association between risk factors of parity, spacing,
nutritional status, history of labor, history of diseases and antenatal care toward anemia among
pregnant women.
This was matched case control study using 130 pregnant women with anemia and 130
comparisons pregnant women without anemia taken from seven quality assurance puskesmas
working area in Medan. Samples were drawn randomly and the data was collected through direct
interview and observation The data was analyzed applying SPSS Program Version 11.5 and the
multiple logistic regression.
The study shows that there is a significant association between : parity > 3 and anemia (OR
adjusted = 3.9; 95% CI = 1.327 - 11.433; p value = 0.013); spacing less than 2 years or over 3 years
and anemia (OR adjusted =9.7; 95% CI = 4.699 -20.400; p value = 0.000); bad nutritonal status and
anemia (OR adjusted = 8.7; 95% CI = 4.219 - 18.146; p value = 0.000); bad history of labor and
anemia (OR = 8.5; 95% CI = 2.770 - 26.314; p value = 0,000); bad history of diseases and anemia
(OR = 2.4; 95% CI = 1.022 - 5.788; p value = 0.045) and bad Antenatal Care and anemia (OR = 3.7;
95% CI = 1.272 -10.803; p value = 0.016).
The most dominant factor was spacing less than 2 years and over 3 years
(OR
adjusted 9.7).
Intervention to manage spacing, antenatal care, nutritional status, parity and history of labor
and diseases by changing behaviours of pregnant women and health worker through the strategy of
health education or Communication Information and Education.
Key words: Anemia, parity, spacing, Antenatal Care, nutritional status, pregnant women
Ellen Hartati Nasution : The Strategy Treatment of Anemia among Pregnant Women in Seven Puskesmas Working…, 2005
USU Repository © 2006
USU Repository © 2006
Strategi Penanggulangan Anemia Pada Ibu Hamil
di Wilayah Kerja Tujuh Puskesmas Kota Medan
Tesis
Ellen Hartati Nasution
Universitas Sumatera Utara
Sekolah Pasca Sarjana
Magister Kesehatan Masyarakat
2005
Abstrak
Program penanggulangan anemia melalui pemberian tablet besi bagi ibu hamil telah
dilaksanakan sejak tahun 1975 di Indonesia. Survey prevalensi anemia ibu hamil di delapan
kabupaten/kota di Sumatera Utara pada tahun 1997 sebesar 78,4%.. Tingginya angka ini dipengaruhi
oleh berbagai faktor.
Penelitian ini bertujuan untuk mengetahui hubungan beberapa faktor risiko; yaitu: paritas,
jarak kelahiran, status gizi, riwayat persalinan, riwayat penyakit dan pelayanan antenatal dengan
kejadian anemia ibu hamil.
Penelitian dilakukan menggunakan rancangan matching kasus kontrol dengan cara
membandingkan 130 orang ibu hamil anemia dengan 130 orang ibu hamil yang tidak anemia yang
diambil dari wilayah kerja tujuh puskesmas quality assurance di Medan. Analisa data
mempergunakan Program SPSS versi 1.5 dan regresi logistik ganda.
Hasil penelitian menunjukkan ada hubungan yang bermakna antara: paritas > 3 dengan
kejadian anemia ( OR adjusted = 3,9; 95% CI = 1,327 - 11,433; nilai p = 0,013); jarak kelahiran < 2
tahun dan > 3 tahun dengan kejadian anemia (OR adjusted =9,7; 95% CI = 4,699 - 20,400; nilai p =
0,000); status gizi yang tidak baik dengan kejadian anemia (OR adjusted = 8,7; 95% CI = 4,219 18,146; nilai p = 0,000); riwayat persalinan yang tidak baik dengan kejadian anemia (OR = 8,5; 95%
CI = 2,770 - 26,314; nilai p = 0,000); riwayat penyakit dengan kejadian anemia (OR = 2,4; 95% CI =
1,022 - 5,788; nilai p = 0,045) dan pelayanan antenatal yang tidak baik dengan kejadian anemia (OR
= 3,7; 95% CI = 1,272 -10,803; nilai p = 0,016).
Faktor risiko yang paling dominan adalah faktor jarak kelahiran < 2 tahun dan > 3 tahun
dengan OR adjusted = 9,7.
Intervensi yang dilakukan untuk mengatur jarak kelahiran dan paritas, meningkatkan
pelayanan antenatal, memperbaiki status gizi serta pengelolaan riwayat persalinan dan riwayat
penyakit adalah dengan merubah perilaku para ibu maupun petugas kesehatan melalui strategi
pendekatan penyuluhan atau Komunikasi Informasi Edukasi (KIE).
Kata kunci : Anemia, paritas, jarak kelahiran, Antenatal Care, status gizi, ibu hamil.
Ellen Hartati Nasution : The Strategy Treatment of Anemia among Pregnant Women in Seven Puskesmas Working…, 2005
USU Repository © 2006
The Strategy Treament of Anemia Among Pregnant Women
in Seven Puskesmas Working Area in Medan
Thesis
North Sumatera University
Postgraduate Program
Magister of People Health Science
By: Ellen Hartati Nasution
Abstract
The program of iron deficiency anemia treatment by supplying of iron tablets for pregnant
women has been done in Indonesia since 1975. Survey of iron deficiency anemia among pregnant
women in North Sumatera in eight districts in 1997 was 78.4%; which was higher than other
provinces in Indonesia.This high prevalence of anemia is influenced by various factors.
This research was aimed to learn the association between risk factors of parity, spacing,
nutritional status, history of labor, history of diseases and antenatal care toward anemia among
pregnant women.
This was matched case control study using 130 pregnant women with anemia and 130
comparisons pregnant women without anemia taken from seven quality assurance puskesmas
working area in Medan. Samples were drawn randomly and the data was collected through direct
interview and observation The data was analyzed applying SPSS Program Version 11.5 and the
multiple logistic regression.
The study shows that there is a significant association between : parity > 3 and anemia (OR
adjusted = 3.9; 95% CI = 1.327 - 11.433; p value = 0.013); spacing less than 2 years or over 3 years
and anemia (OR adjusted =9.7; 95% CI = 4.699 -20.400; p value = 0.000); bad nutritonal status and
anemia (OR adjusted = 8.7; 95% CI = 4.219 - 18.146; p value = 0.000); bad history of labor and
anemia (OR = 8.5; 95% CI = 2.770 - 26.314; p value = 0,000); bad history of diseases and anemia
(OR = 2.4; 95% CI = 1.022 - 5.788; p value = 0.045) and bad Antenatal Care and anemia (OR = 3.7;
95% CI = 1.272 -10.803; p value = 0.016).
The most dominant factor was spacing less than 2 years and over 3 years
(OR
adjusted 9.7).
Intervention to manage spacing, antenatal care, nutritional status, parity and history of labor
and diseases by changing behaviours of pregnant women and health worker through the strategy of
health education or Communication Information and Education.
Key words: Anemia, parity, spacing, Antenatal Care, nutritional status, pregnant women
Ellen Hartati Nasution : The Strategy Treatment of Anemia among Pregnant Women in Seven Puskesmas Working…, 2005
USU Repository © 2006