Quality of Antenatal Care Services by Midwives After Training of Integrated Antenatal Care to Pregnant Women in Province of Central Sulawesi

ABSTRAK Kematian ibu masih cukup tinggih di propinsi Sulawesi tengah. Terdapat 122 angka kematian ibu yang terdiri dari 48 kematian ibu hamil, dan 45,83% penyebab kematian karena Hiper tensi dalam kehamilan. yang seharusnya kasus ini bisa diatasi pada saat pemeriksaan kehamilan. Kegiatan peningkatan kemampuan, sikap dan keterampilan pelaksana asuhan ibu hamil (ANC) yang bermutu disebut dengan Pelatihan ANC Terpadu. Penelitian ini bertujuan Menganalisis dimensi mutu pelayanan asuhan Antenatal care oleh bidan pasca pelatihan ANC Terpadu di Propinsi Sulawesi Tengah.. Penelitian ini dilakukan dengan metode kualitatif. Pengumpulan data dilakukan dengan observasi dan wawancara mendalam pada empat belas orang informan utama yaitu bidan yang telah mengikuti pelatihan ANC terpadu di daerah terpencil dan perbatasan serta daerah yang bermasalah kesehatan yang bertugas di Puskesmas. Informan triangulasi adalah empat belas orang ibu hamil, dan enam orang Kasi KIA DKK Kabupaten, Kota dan Propinsi Sulawesi Tengah. Analisis data dilakukan dengan metode analisis isi. Hasil penelitian menunjukkan aspek masukan: asuhan Antenatal care dilakukan oleh bidan,dengan latar belakang pendidikan D III kebidanan, Pelayanan antenatal care tidak dipunggut biaya, dan alat pemeriksaan laboratorium seperti pemeriksaan HB, test protein dan glukose belum lengkap sehingga tidak dapat mendeteksi adanya komplikasi atau penyakit yang menyertai kehamilan, yang menyebabkan mutu pelayanan bidan kepada ibu hamil belum baik. Proses pembuatan perencanaan asuhan, pemeriksaan Kehamilan dilaksanakan Setiap ada kunjungan pemeriksaan Kehamilan., sesuai tahapan standar pelayanan dan pengawasan pelaksanaan Asuhan dilakukan Sebulan sekali dan yang diawasi adalah Pencapaian PWS, Kinerja bidan, Kasus kematian, Kasus rujukan.Mutu pelayanan asuhan Antenatal care oleh bidan pasca pelatihan ANC Terpadu kepada ibu hamil di Propinsi Sulawesi Tengah sudah berjalan baik. Bidan dalam memberikan pelayanan antenatal care kepada ibu hamil menghargai, menghormati, memberikan perhatian dan mendengarkan keluhan dan juga menjaga rahasia ibu hamil. Direkomendasikan kepada Kasi KIA DKK Propinsi Sulawesi Tengah untuk lebih memperhatikan dan memenuhi kelengkapan alat pemeriksaan kehamilan, khususnya alat pemeriksaan laboratorium seperti Test Protein, Glukose dan pemeriksaan HB. Kata kunci : Mutu Pelayanan asuhan Antenatal, aspek masukan, Proses, keluaran. ABSTRACT Maternal Mortality Rate in Province of Central Sulawesi was high (122/100,000 live births).Therefore, there needed to conduct a training to improve ability, attitude, and skills of midwives in providing Antenatal Care Services (ANC). This related to quality of ANC services. An integrated training of ANC had been conducted at a province level in 2012. The aim of this study was to analyse dimensions of quality of ANC services by midwives after training of integrated ANC. This was a qualitative study. Data were collected by conducting observation and indepth interview towards 14 main informants consisted of midwives working at health centres who had followed the training of integrated ANC in remote and border areas and in an area that had health problems. Meanwhile, informants for triangulation purpose consisted of 14 pregnant women and 6 heads of Maternal and Child Health (MCH) sections at District Health Office, City Health Office, and Province Health Office of Central Sulawesi. Furthermore, data were analysed using content analysis. The results of this study showed that regarding input, ANC services were provided by Midwives graduated from D III Midwifery, ANC services were free of charge, and there was lack of laboratory equipment particularly for tests of Haemoglobin, Protein, and Glucose. Planning was made when there was any visit, ANC was conducted in accordance with a service standard. The local area monitoring of MCH coverage was implemented once a month. Midwives in providing ANC services appreciated, respected, paid attention, listened complaints, and keep secrets of pregnant women. As suggestions, Heads of MCH sections at Health Offices in Province of Central Sulawesi need to provide laboratory equipment for pregnancy test particularly for tests of protein, glucose, and haemoglobin. Keywords : Quality of Antenatal Care Services, Aspects of Input, Process, and Output