Analisis Mutu Pelayanan Ibu Bersalin Di Puskesmas Poned, Kabupaten Deli Serdang (Studi Kasus Di Puskesmas Talun Kenas Dan Puskesmas Hamparan Perak)
7
ABSTRAK
Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) merupakan
indikator yang lazim digunakan untuk menentukan derajat kesehatan masyarakat.
Salah satu kebijakan Departemen Kesehatan dalam akselerasi penurunan AKI dan
AKB antara lain dengan merintis pembentukan puskesmas PONED. Terdapat 21
Puskesmas PONED di Kabupaten Deli Serdang dan telah mendapat intervensi
program EMAS sejak tahun 2012, tetapi AKI masih tinggi. Di Puskesmas Talun
Kenas yang telah diintervensi EMAS dilaporkan AKI sebesar 125/100.000 kelahiran
hidup dan Puskesmas Hamparan Perak yang belum diintervensi EMAS dilaporkan
AKI sebesar 39/100.000 kelahiran hidup.
Tujuan penelitian ini adalah melakukan analisis mutu pelayanan bagi ibu bersalin
di puskesmas PONED, Kabupaten Deli Serdang. Penelitian ini dilakukan dengan
metode kualitatif melalui wawancara mendalam. Tempat penelitian yaitu Puskesmas
Talun Kenas dan Puskesmas Hamparan Perak. Informan dalam penelitian ini adalah
kepala bidang kesehatan keluarga Dinas Kesehatan Kabupaten Deli Serdang, kepala
puskesmas, bidan koordinator, petugas terlatih PONED dan masyarakat pengguna
layanan PONED di dua puskesmas tersebut.
Dari hasil penelitian didapatkan bahwa sosialisasi program PONED masih belum
dilakukan dengan baik, jumlah tenaga terlatih PONED masih kurang, kualitasnya
juga masih kurang, pelatihan PONED masih kurang. Sarana dan prasarana
pendukung PONED masih belum memadai untuk puskesmas yang belum diintervensi
oleh EMAS. Pembinaan khusus dari dinas kesehatan kabupaten mengenai
pelaksanaan PONED masih kurang. Prosedur rujukan pasien kegawatdaruratan belum
dilakukan dengan baik. Tidak adanya alokasi dana khusus untuk pelaksanaan
PONED di puskesmas. Sementara itu untuk Puskesmas Talun Kenas telah memenuhi
semua aspek mutu pelayanan sedangkan Puskesmas Hamparan Perak mutu
pelayanannya masih kurang baik.
Saran agar Dinas Kesehatan Kabupaten lebih memperhatikan pembinaan ke
puskesmas PONED yang ada di Kabupaten Deli Serdang termasuk mengadakan
pelatihan, menambah sarana dan prasarana PONED serta mengadakan evaluasi untuk
perbaikan mutu pelayanan selanjutnya. Untuk program EMAS sebaiknya
direplikasikan ke seluruh puskesmas PONED yang ada di Kabupaten Deli Serdang
sehingga tidak ada kesenjangan mutu pelayanan yang diberikan oleh semua
puskesmas PONED
Kata Kunci : Puskesmas, Pelayanan Obstetri Neonatal Emergensi Dasar,
Mutu Pelayanan
i
8
ABSTRACT
Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) is an
indicator which is commonly used to determine public health standard. One of the
policies of the Department of Health in accelerating the decrease in MMR and IMR
is, among others, by pioneered the establishment of PONED puskesmas (public
health center). There are 21 PONED Puskesmas in Deli Serdang District and 10 of
them which had been intervened by EMAS program since 2012 but MMR is still high.
Talun Kenas Puskesmas which had been intervened by EMAS program and reported
125/100.000 live births for MMR, while Hamparan Perak which had not yet
intervened by EMAS program reported 39/100.000 live births for MMR.
The objective of the research was to analyze the service quality for mothers
who give birth at PONED Puskesmas, Deli Serdang District. The research used
qualitative method by conducting in-depth interviews. It was conducted at both Talun
Kenas Puskesmas and Hamparan Perak Puskesmas. The informants were the head of
family health of the health service of Deli Serdang District, the head of puskesmas,
midwife coordinators, trained personnel of PONED, and those who used PONED
service at both puskesmas.
The result of the research showed that the socialization of PONED program
was not conducted properly, the number of trained PONED personnel was
inadequate, its quality was also inadequate, and PONED training was inadequate.
The supporting equipment and infrastructure of PONED was inadequate for
puskesmas which had not yet intervened by EMAS. Special guidance by the District
Health Office about the implementation of PONED was inadequate. The procedure of
the reference for emergency patients was not done adequately. There was no special
grant for the implementation of PONED at puskesmas. Talun Kenas Puskesmas had
had all of the quality aspects, while Hamparan Perak Puskesmas had not had quality
aspects.
It is recommended that the District Health Service pay more attention to the
development of PONED puskesmas in Deli Serdang District by conducting training,
adding equipment and infrastructure of PONED, and evaluating the next service
quality improvement. Besides that, EMAS program should be replicated to all
PONED puskesmas in Deli Serdang District so that there will be no discrepancy in
service quality given by all PONED puskesmas.
Keywords: Puskesmas, Service in Basic Emergency of Obstetrics and Neonatal,
Service Quality
ii
ABSTRAK
Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) merupakan
indikator yang lazim digunakan untuk menentukan derajat kesehatan masyarakat.
Salah satu kebijakan Departemen Kesehatan dalam akselerasi penurunan AKI dan
AKB antara lain dengan merintis pembentukan puskesmas PONED. Terdapat 21
Puskesmas PONED di Kabupaten Deli Serdang dan telah mendapat intervensi
program EMAS sejak tahun 2012, tetapi AKI masih tinggi. Di Puskesmas Talun
Kenas yang telah diintervensi EMAS dilaporkan AKI sebesar 125/100.000 kelahiran
hidup dan Puskesmas Hamparan Perak yang belum diintervensi EMAS dilaporkan
AKI sebesar 39/100.000 kelahiran hidup.
Tujuan penelitian ini adalah melakukan analisis mutu pelayanan bagi ibu bersalin
di puskesmas PONED, Kabupaten Deli Serdang. Penelitian ini dilakukan dengan
metode kualitatif melalui wawancara mendalam. Tempat penelitian yaitu Puskesmas
Talun Kenas dan Puskesmas Hamparan Perak. Informan dalam penelitian ini adalah
kepala bidang kesehatan keluarga Dinas Kesehatan Kabupaten Deli Serdang, kepala
puskesmas, bidan koordinator, petugas terlatih PONED dan masyarakat pengguna
layanan PONED di dua puskesmas tersebut.
Dari hasil penelitian didapatkan bahwa sosialisasi program PONED masih belum
dilakukan dengan baik, jumlah tenaga terlatih PONED masih kurang, kualitasnya
juga masih kurang, pelatihan PONED masih kurang. Sarana dan prasarana
pendukung PONED masih belum memadai untuk puskesmas yang belum diintervensi
oleh EMAS. Pembinaan khusus dari dinas kesehatan kabupaten mengenai
pelaksanaan PONED masih kurang. Prosedur rujukan pasien kegawatdaruratan belum
dilakukan dengan baik. Tidak adanya alokasi dana khusus untuk pelaksanaan
PONED di puskesmas. Sementara itu untuk Puskesmas Talun Kenas telah memenuhi
semua aspek mutu pelayanan sedangkan Puskesmas Hamparan Perak mutu
pelayanannya masih kurang baik.
Saran agar Dinas Kesehatan Kabupaten lebih memperhatikan pembinaan ke
puskesmas PONED yang ada di Kabupaten Deli Serdang termasuk mengadakan
pelatihan, menambah sarana dan prasarana PONED serta mengadakan evaluasi untuk
perbaikan mutu pelayanan selanjutnya. Untuk program EMAS sebaiknya
direplikasikan ke seluruh puskesmas PONED yang ada di Kabupaten Deli Serdang
sehingga tidak ada kesenjangan mutu pelayanan yang diberikan oleh semua
puskesmas PONED
Kata Kunci : Puskesmas, Pelayanan Obstetri Neonatal Emergensi Dasar,
Mutu Pelayanan
i
8
ABSTRACT
Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) is an
indicator which is commonly used to determine public health standard. One of the
policies of the Department of Health in accelerating the decrease in MMR and IMR
is, among others, by pioneered the establishment of PONED puskesmas (public
health center). There are 21 PONED Puskesmas in Deli Serdang District and 10 of
them which had been intervened by EMAS program since 2012 but MMR is still high.
Talun Kenas Puskesmas which had been intervened by EMAS program and reported
125/100.000 live births for MMR, while Hamparan Perak which had not yet
intervened by EMAS program reported 39/100.000 live births for MMR.
The objective of the research was to analyze the service quality for mothers
who give birth at PONED Puskesmas, Deli Serdang District. The research used
qualitative method by conducting in-depth interviews. It was conducted at both Talun
Kenas Puskesmas and Hamparan Perak Puskesmas. The informants were the head of
family health of the health service of Deli Serdang District, the head of puskesmas,
midwife coordinators, trained personnel of PONED, and those who used PONED
service at both puskesmas.
The result of the research showed that the socialization of PONED program
was not conducted properly, the number of trained PONED personnel was
inadequate, its quality was also inadequate, and PONED training was inadequate.
The supporting equipment and infrastructure of PONED was inadequate for
puskesmas which had not yet intervened by EMAS. Special guidance by the District
Health Office about the implementation of PONED was inadequate. The procedure of
the reference for emergency patients was not done adequately. There was no special
grant for the implementation of PONED at puskesmas. Talun Kenas Puskesmas had
had all of the quality aspects, while Hamparan Perak Puskesmas had not had quality
aspects.
It is recommended that the District Health Service pay more attention to the
development of PONED puskesmas in Deli Serdang District by conducting training,
adding equipment and infrastructure of PONED, and evaluating the next service
quality improvement. Besides that, EMAS program should be replicated to all
PONED puskesmas in Deli Serdang District so that there will be no discrepancy in
service quality given by all PONED puskesmas.
Keywords: Puskesmas, Service in Basic Emergency of Obstetrics and Neonatal,
Service Quality
ii