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"Trends of cesarean section trend in Indonesia (2007-2012) have doubled the risk of long-term and short-term health problems. This study was aimed to determine relation between antenatal care provider and cesarean section. This quantitative study used cross-sectional design with a total sample of 5,143 women aged 15-49 years who gave birth to the last child through cesarean section or not as in urban areas selected in samples of 2012 Indonesia Demographic and Health Survey. Logistic regression multivariate analysis was used to determine relation between antenatal care provider and section cesarean, which was controlled by maternal age, antenatal care facility, parity, and place of birth. Results showed that antenatal care at obstetrician was 6.6 times higher, while antenatal care at obstetrician and midwife was 2.1 times higher for cesarean section compared to women who had antenatal care at midwife after controlled by maternal age, antenatal care facility, parity, and place of birth. There is interaction between socioeconomic status and obstetrician for a cesarean section. Regulation on cesarean section by health authority, as well as protective and preventive labor applied towards on the high economic class community may reduce unnecessary cesarean section. Trends of cesarean section trend in Indonesia (2007-2012) have doubled the risk of long-term and short-term health problems. This study was aimed to determine relation between antenatal care provider and cesarean section. This quantitative study used cross-sectional design with a total sample of 5,143 women aged 15-49 years who gave birth to the last child through cesarean section or not as in urban areas selected in samples of 2012 Indonesia Demographic and Health Survey. Logistic regression multivariate analysis was used to determine relation between antenatal care provider and section cesarean, which was controlled by maternal age, antenatal care facility, parity, and place of birth. Results showed that antenatal care at obstetrician was 6.6 times higher, while antenatal care at obstetrician and midwife was 2.1 times higher for cesarean section compared to women who had antenatal care at midwife after controlled by maternal age, antenatal care facility, parity, and place of birth. There is interaction between socioeconomic status and obstetrician for a cesarean section. Regulation on cesarean section by health authority, as well as protective and preventive labor applied towards on the high economic class community may reduce unnecessary cesarean section."

"ABSTRAKPetugas pemberi pelayanan kesehatan adalah suatu kelompok yang seharusnya menyadari bahwa dirinya termasuk kelompok risiko tinggi tertular AIDS/HIV. Untuk itu petugas kesehatan harus tahu cara pencegahannya. Mengetahui tingkat pengetahuan, sikap dan perilaku pemberi pelayanan kesehatan adalah penting untuk mengetahui tindakan yang harus dilakukan oleh pihak managemen dalam melindungi tenaga kerjanya.Tujuan penelitian ini adalah untuk mengetahui tingkat pengetahuan, sikap dan perilaku petugas kesehatan mengenai penyakit AIDS, baik etiologi, cara penularan dan usaha/tindakan pencegahannya.Dilakukan survei tentang hal tersebut terhadap pemberi pelayanan kesehatan di Rumah Sakit Cipto Mangunkusumo pads bulan November 1993 sampai bulan Januari 1994. Pengumpulan data dilakukan dengan wawancara dan mengisi kuesiner yang telah dikembangkan secara khusus untuk itu, dan juga dilakukan pengamatan terhadap dokter, dokter gigi, perawat, petugas laboratorium, pekarya dan petugas di kamar jenazah.Responden terdiri dari 40 (14%) dokter, 156 (51%) perawat/bidan, 16 (5.5%) petugas laboratorium dan 30.5% pekarya dan petugas kamar jenazah.Unit pelayanan yang diamati adalah OK Bedah, Unit Rawat Jalan, Instalasi Gawat darurat, Bagian Bedah Mulut, Unit Rawat Inap, Unit Kamar Jenazah dan Patologi Klinik.Pengetahuan responden terhadap etiologi (host, agent dan environment) HIV, cara deteksi, cara penularan, pencegahan dan akibat AIDS menunjukkan tingkat baik pada 65.1% responden. Kelompok pekarya yang sebagian besar menjadi tenaga kebersihan dan petugas kamar jenazah dan mempunyai risiko tinggi terpapar HIV karena pekerjaannya, merupakan kelompok yang paling rendah tingkat pengetahuannya.Namun, meskipun hampir seluruh responden mengetahui bahwa AIDS/HIV adalah penyakit menular dan dapat mengakibatan kematian, sikap setuju dan bersedia melakukan tindakan perawatan pada penderita dengan HIV positip dan kesediaan melakukan tindakan pencegahan ditemukan baik pada 72.4% responden.Perilaku yang sudah pernah dilakukan oleh responden menunjukkan tingkat baik pada 46.38% saja. Pernah tertusuk jarum dialami oleh 1 dari 4 responden, demikian juga pernah tidaknya tersobek sarung tangan sewaktu melakukan tindakan pada penderita. Pemakaian alat pelindung seperti sarung tangan, apron dan masker juga hanya ditemukan pada sekitar 1 diantara 3 petugas kesehatan.Hubungan antara pengetahuan tentang AIDS dan perilaku terhadap tindakan pencegahan tertular AIDS terbukti ada hubungan yang bermakna. Demikian juga terdapat hubungan bermakna antara sikap dan perilaku yang baik.Faktor pemungkin (enabling factors) yaitu ketersedian sarana kerja dinyatakan kurang memadai menurut responden dan hasil pengamatan, demikian juga faktor penguat (reinforcing factors) antara lain anjuran/petunjuk atasan tentang cara pencegahan HIV masih kurang.Meskipun menurut responden sumber informasi tentang AIDS sudah banyak sumber dan sangat beragam, namun disarankan masih perlu disebarkan informasi terutama untuk cara/tindakan praktis pencegahan agar tidak tertular HIV khususnya bagi petugas kesehatan terutama kelompok pekarya dan perawat.

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ABSTRACTKnowledge, Attitude and Practice of AIDS Among Health Provider On Cipto Mangunkusumo HospitalThe health provider is any one who should concern that they have high risk on expose and transmitted of AIDS/HIV. They should know how to prevent it. To be able to know the level of knowledge, attitude and practice of AIDS/HIV among them is very important to management.This survey is undertaken to know the level of knowledge, attitude and practice among health provider of AIDS especially on etiology, transmission of infection and prevention infection against AIDS/HIV and also to know the relation between those factors and other factors.This survey were done among health provider in Cipto Mangunkusumo Hospital on November 1993 until January 1994. Data gathering done by interview and self-administered questionnaire and also by observation using observation checklist. The respondents are doctor,. dentist, nurse/midwives, laboratory personnel and janitor including cadaver unit personnel.The total number of respondents is 304 covering 40 (14%) doctors and dentists, 156 (51%) nurses and midwives, 16 {5.5%) laboratory personnel and 92 (30.5%) janitor from many departments namely Surgery Operation Room Department, Accident/Emergency Department, Mouth dan Teeth Department, Out-patients Department, In-patients Department ( Unit IRNA A ) and cadaver Unit.Sixty five percents of respondents have a good degree of knowledge about etiology, detection, transmission of infection, prevention and prognosis of AIDS. The janitor group who are those work as cleaning service and cadaver personnel which have high risk on expose to HIV, is the lowest degree of knowledge about AIDS/HIV. Although, almost all respondents know that AIDS/HIV is communicable disease with has death pronosis, they have a good degree of attitude and 72.4% of them agree to curing and caring HIV positive patients and have a good willing to do the infection prevention activities.The past behavior about the prevention infection activities done by the respondents pointed that only 46.38% of all respondents have a good degree of behaviour. One person out of 4 respondent have experience of noccuring the needle stick injury and also damaging gloves during service.Using of personnel protective equipment such as gloves, masker and special cloth wear only one person out of 3 respondents.The relation between the degree of knowledge and behaviour to prevention infection activities against HIV and the relation between, between attitude and behaviour , proven that there is a significant relationship.Regarding the enabling factors such as adequate supplies of work facilities (gloves, disposible spuit, masker etc) still not enough, based on observation results and respondents opinion. The same results concerning the reinforcing factors such as guidance from management about how to prevent HIV is still neglected.However, although there are a lot of sources of information about AIDS, we recommend that information especially practice activities to prevent HIV needed to disseminate. This information concern especially for nurses and janitor or all of health provider."

"Indonesia memiliki komitmen untuk menurunkan Angka Kematian Ibu menjadi 225/100.000 menjelang tahun 2000. Sebagai upaya untuk mencapai tujuan tersebut khususnya dalam meningkatkan cakupan persalinan oleh tenaga kesehatan, pemerintah telah melaksanakan program GSI sejak tahun 1996.Tujuan penelitian ini adalah untuk mengetahui keefektifan GSI dalam meningkatkan cakupan persalinan oleh tenaga kesehatan. Penelitian ini memadukan metode kuantitatif dan kualitatif.Data primer diambil dengan menggunakan kuesioner, wawancara mendalam dan observasi sementara data sekunder menggunakan laporan pelaksanaan GSI.Hasil penelitian menunjukkan bahwa variabel-variabel yang berhubungan secara statistik dengan keefektifan GSI dalam meningkatkan cakupan persalinan oleh tenaga kesehatan adalah pendidikan istri dan suami, pendapatan dan perencanaan persalinan. Ambulans dan donor darah tidak berhubungan secara statistik tetapi penting khususnya pada kasus-kasus gawat darurat. Sebagian besar ibu mengetahui bahwa lebih aman bersalin dengan pertolongan bidan tetapi kebanyakan mereka tidak mampu membayar biaya persalinan tersebut. Karena itu, Tabulin dapat menjadi sarana yang panting dan efektif untuk meningkatkan cakupan karena dapat digunakan untuk mengantipasi biaya persalinan. Sementara itu, dukungan tokoh formal dan informal juga merupakan faktor yang sangat penting walaupun secara statistik tidak berhubungan.Berdasarkan wawancara mendalam, dapat disimpulkan bahwa keberhasilan pelaksanaan program GSI sangat tergantung pada komitmen dari seluruh pihak terkait di berbagai tingkatan dan koordinasi lintas sektoral. Masalah yang paling penting adalah tidak tersedianya dana operasional GSI.Mempertimbangkan hasil penelitian maka disarankan kepada semua pihak yang terlibat dalam pelaksanaan program GSI untuk meningkatkan komitmen mereka terhadap program ini, meningkatkan koordinasi lintas sektoral, menurunkan biaya persalinan dengan tenaga kesehatan, memberikan penghargaan khusus kepada para bidan yang berhasil meningkatkan cakupan persalinan serta menyediakan dana operasional untuk pelaksanaan kegiatan GSI sehingga program ini dapat mencapai sasaran secara lebih efektif.

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Factors Related to the Effectiveness of Mother Friendly Movement (Gerakan Sayang Ibu1GS1) in Increasing the Coverage of Delivery by Health Provider (Case study in Mande, Cilaku and Facet Subdistricts, Cianjur Regency, West Java Province)Indonesia had a commitment to decrease Maternal Mortality Rate (M MR) to be 225/100000 live birth by the year 2000. In order to achieve this aim especially to enhance the coverage of delivery by health provider, our government had carried out GSI program since 1996.

The purpose of this research was to know factors related to the effectiveness of GSI to increase the coverage of delivery by health provider. This research combined qualitative and quantitative method. The primary data used questionnaires, depth interviews and observations while secondary data used the report on implementation of GSI. The data was analized by using univariate, bivariate as well as multivariate analysis.

The result of this research indicate that those variables which have relationship with the effectiveness of GSI to increase the coverage of delivery by health provider were education of husbands and wives, income and delivery planning. Ambulance and blood donor did not have relationship statistically but they were important especially in emergency cases. Most of mothers knew that it would be safer if they could deliver by the help of health provider but most of them couldn't pay the cost of delivery. Therefore, Tabulin could be an important and effective mean to increase the coverage because it could be used to anticipate the cost of delivery, Meanwhile, the support of formal as well as informal leaders were very important too, although statistically have no relationship.

Based on depth interviews, it could be concluded that the success of implementation of GSI was really depend on the commitment of all relevant sectors in every level and the coordination of cross sector. The most important problem was unavailability of operational fund of GSI.

Considering the result of this research, it was suggested to those involved in implementation of GSI to improve their commitment against this program, decrease the cost of delivery by heath provider, giving special appreciation to the midwives who could increase their coverage and provide operational fund for the implementation of GSI so that this program could achieve its target more effectively."