Wijayanti, Erna Eka and dr. Muljo Hadi Sungkono, SpOG (K). and Dr. dr. Retty Ratnawati, M.Sc. (2018) Hubungan Antara Asuhan Berkesinambungan Dengan Kejadian Unmet Need pada pasangan Usia Subur di Wilayah Kecamatan Palang Kabupaten Tuban. Magister thesis, Universitas Brawijaya.
Abstract
Salah satu masalah program Keluarga Berencana adalah masih tingginya angka unmet need. Dampak dari masalah ini adalah terjadinya kehamilan yang tidak diinginkan. Indikator program Keluarga Berencana tahun 2017 untuk persentase kebutuhan ber-KB yang tidak memenuhi (unmet need) sebanyak 7,03% sedangkan capaian 15, 50%. Di kabupaten Tuban presentase unmet need masih mencapai 12, 66%. Di Palang unmet need paling tinggi yaitu 18,78%. Asuhan berkesinambungan yang meliputi kontinuitas manajemen, kontinuitas informasi dan kontinuitas relasi memberi asuhan yang koheren pada seluruh siklus hidup perempuan diharapkan dapat menjadi salah satu cara penanganan unmet need di kecamatan Palang. Penelitian ini adalah penelitian observasional analitik. Desain penelitian dengan pendekatan cross sectional. Dilaksanakan di 19 desa wilayah kecamatan Palang di dua puskesmas yaitu puskesmas Palang dan puskesmas Sumurgung. Teknik pengambilan sampel dengan random sampling. Jumlah sampel 114 unmet need dan 114 Pasangan yang menggunakan KB jadi total sampel adalah 228 Pasangan Usia Subur yang memenuhi kriteria inklusi. Dilaksanakan bulan Maret- April 2018. Data dikumpulkan dengan pengisian kuisioner, dengan kunjungan ke rumah responden. Analisis data dengan analisis univariat, bivariat dan multivariate. Alat analisis bivariat dengan uji chi- square dan multivariate menggunakan uji multipel logistic regression. Dari hasil penelitian ditemukan karakteristik responen bahwa dari umur menunjukkan rentang umur responden antara 20-35 tahun 58,30% dimana artinya responden pada masa ideal untuk memiliki anak lagi. Pendidikan responden sebagian besar SD-SMP 55,3% termasuk pendidikan rendah. Pekerjaan suami kebanyakan petani dan nelayan yaitu 41,67%, pekerjaan istri paling banyak adalah ibu rumah tangga 59,65%. Semua responden adalah muslim. Rata-rata kontinuitas manajemen 75,54, kontinuitas informasi 88,6 sedangkan kontinuitas relasi 92,32. Diskripsi kejadian unmet need didapatkan 117 responden kebanyakan tidak ingin memiliki anak lagi, 126 tidak melakukan KB tradisional, dan 166 tidak yakin kalau tidak hamil selama tidak KB. 51, 75% mengikuti Kb suntik, sisanya menggunakan alat kontrasepsi lainnya. Hasil analisis bivariat ada hubungan signifikan antara kontinuitas manajemen dengan kejadian unmet need yaitu 35,54 p=0,000 (< 0,05) nilai relative ratio sebesar 5,64, artinya kontinuitas manajemen yang baik akan memiliki peluang 5,64 kali. Ada hubungan signifikan antara kontinuitas informasi dengan kejadian unmet need 38,36 p=0,000 (< 0,05) nilai relative ratio sebesar 6,40, artinya kontinuitas informasi yang baik akan memiliki peluang 6,4 kali. Ada hubungan signifikan kontinuitas relasi dengan kejadian unmet need 14,78 p=0,000 (< 0,05) nilai relative ratio 2,97, artinya kontinuitas relasi yang baik memiliki peluang 2,97 kali. Model multipel logistic regression yang dihasilkan memenuhi kriteria model fit.kontinuitas manajemen memiliki koefisien regresi-1,427 artinya berpengaruh terhadap unmet need, semakin baik kontinuitas manajemen maka kejadian unmet need berkurang. Nilai OR 0,240. Kontinuitas informasi koefisien regresinya -1,536 artinya semakin baik kontinuitas informasi maka kejadian unmet need kan berkurang, nilai OR 0,215. Kontinuitas relasi memiliki koefisien regresi -0,352 artinya tidak ada pengaruh kontinuitas relasi dengan unmet need , nilai OR 0,704. Dari ketiga variabel asuhan berkesinambungan yaitu kontinuitas manajemen, kontinuitas informasi dan kontinuitas relasi, yang tidak berpengaruh signifikan hanya kontinuitas relasi sedangkan kontinuitas informasi memiliki pengaruh yang paling kuat. Peran bidan dan nakes dalam program KB dapat meningkatkan Pasangan Usia Subur untuk menggunakan KB melalui pendekatan, keterjalinan yang baik dengan kunjungan rumah atau menyediakan waktu yang cukup untuk memberi pelayanan, melibatkan berbagai unsur dan kegiatan di masyarakat setempat seperti posyandu, pengajian, serta informasi, konseling yang baik dan mudah dimengerti serta ketersediaan alat kontrasepsi dan keterjangkauan biaya. Kemudahan prosedur dalam pelayanan dan asuhan yang koheren serta berkelanjutan akan mempermudah masyarakat dalam mendapatkan asuhan yang diinginkan. Dalam memberikan asuhan yang berkesinambungan bidan atau tenaga kesehatan lainnya harus memperhatikan karakteristik dari masyarakat, melibatkan tokoh masyarakat, tokoh agama agar mudah diterima dan hasilnya sesuai yang diharapkan. Meningkatkan frekuensi penyuluhan ke PUS dan sekolah-sekolah tentang kesehatan reproduksi. Dilakukan penelitian dengan bekerjasama pihak terkait dan lebih luas wilayahnya serta variabel yang lebih banyak agar didapatkan permasalahan yang menyebabkan tingginya unmet need sehingga permasalahan unmet need bisa diatasi.
English Abstract
The problems of Family Planning Program was the high number of unmet need. The problem results in unexpected pregnancy. Based on the indicator of 2017 Family Planning Program for unmet need of contraceptives was 7.03% and the achievement was 15.50%. In Tuban regency, the percentage of unmet need was 12.66%. In Palang, the highest need was 18.78%. Continuous care covering management continuity, information continuity and relation continuity in giving coherence care for all female life cycle might be a way to handle unmet need in Palang subdistrict. The study was an analytical observational study. Cross sectional design was choosen as study approach. It was conducted in 19 willages of Palang subdistrict concentrated in two community health centers in Palang and Sumurgung. Samples were taken using random sampling technique. The numbers of sample were 144 unmet need and 114 couples using contraceptives. Then the total numbers of sample were 228 meeting inclusion criteria. This study was conducted from March up to April 2018. Data was gathered using questionnaire by asking respondents to fill it at their home. Univariate, bivariate and multivariate was used to analyze data. The chi-square test was used as bivariate analysis technique and multiple logistic regression as multivariate technique. The finding of study showed that age range of respondents were 20-35 years meaning that respondents was at ideal phase to have child. Most of respondents graduated, 55.3% from Elementary School – Junior High School and it includes low level of education. The occupations of their husband was mostly farmers and fishermen, which was 41.67% and most of the wives was jobless, that was 59.65%. All respondents are Moslem. The average of management continuity was 75.54, information continuity was 88.6 and relation continuity was 92.32. For description of unmet need occurrences, from 117 respondents, most of them did not want to have more child, 126 did not use traditional contraceptives and 166 was not sure whether they will be pregnant or not when they use contraceptives. 51.75% uses injected contraceptives and the rest uses other contraceptives. The result of bivariate analysis showed that there was significant correlation between management continuity and unmet need which was 35.54 p=0,000 (<0,05) and the ratio relative value was 5.64 meaning that good management continuity will have opportunities of 38.36. There was significant correlation between information continuity with unmet need which was 38.36 p=0,000 (< 0,05) and relative ratio value was 6.40 meaning that the opportunity for good information continuity was 6.4. There was a significant correlation between relation continuity unmet need which was 14.78 p=0,000 (< 0,05) and relative ratio value was 2.97 meaning that good relation continuity would pose opportunity of 2.97. Multiple logistic Regression model fulfill the criteria of management continuity fit model with regression coefficient of -1.427 meaning that for unmet need, the better management continuity, the lower number of unmet need occurrences. The OR value was 0.240. The regression value of information continuity was -1.536 meaning that the better information continuity, the lower unmet occurrences with OR value of 0.215. Regression coefficient of relation continuity was -0.352 meaning that there was no effect of relation continuity with unmet need with OR value of 0.704. From the three variables of continuous care which was management continuity, information continuity and relation continuity, the only variable with no significant effect was relation continuity and information continuity has the strongest effect. The role of midwives and health officer in Family Planning Program might improve the number of productive age couple to use contraceptives by having good relation with them, by visiting them at their home, or providing service for them and involving them in community activities such as those in center of pre and post natal health care and recitation activities; giving them good and understandable information on contraceptives and its charges. The easiness of procedure in delivering service and coherence and continuous care will facilitate people to get care that they expect. In giving continuous care, midwives or health officer should take people’s characteristics into account and involve public figures and religious leaders to obtain better and expected result. there was also a need to improving the frequency of guidance to PUS and school concerning reproduction health. There should be another study with broader scope and more variables (service quality, the role of husband, knowledge of PUS) to explore the higher number of unmet need in order to find solution
Other obstract
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| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/263.96/WIJ/h/2018/041807699 |
| Subjects: | 300 Social sciences > 363 Other social problems and services > 363.9 Population problems > 363.96 Birth control |
| Divisions: | S2/S3 > Magister Kebidanan, Fakultas Kedokteran |
| Depositing User: | yulia Chasanah |
| Date Deposited: | 09 Sep 2022 06:28 |
| Last Modified: | 09 Sep 2022 06:29 |
| URI: | http://repository.ub.ac.id/id/eprint/194140 |
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