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The maternal mortality rate in Indonesia is still high and still far from the established target of SDG's, which is 305 compared to 102 maternal deaths per 100,000 live births. Adequate pregnancy screening services are needed to reduce maternal mortality. This study aims to determine the quality of antenatal care (ANC) services at public health centers (midwives competence and support facilities and service infrastructure). Data collection was conducted in 212 health centers and the sample size is 224 midwives in the health centers. Midwives were observed at the time of antenatal care. The observed ANC components were 5T, 7T, and 9T. In addition, it was observed also the availability of facilities, infrastructure, and medicines related to ANC in health centers. The midwives who performed the ANC correctly and well for the 9T, 7T, and 5T components were 18.8%, 23.2%, and 31.7%. Only 20.4% of health center have all equipment, medicines, and supporting media of ANC 9T service. Only one-fifth of midwives perform complete and correct ANC services for the 9T service components. Midwife knowledge in doing ANC 9T is better for those who have profession less than 20 years old and hold at least diploma degree midwifery. Keywords : Antenatal Care, Midwives, Health Center Abstrak Angka kematian ibu di Indonesia masih tinggi dan masih jauh dari target SDG’s yang telah ditetapkan, yaitu 305 dibandingkan dengan 102 kematian ibu per 100.000 kelahiran hidup. Pelayanan pemeriksaan kehamilan yang adekuat sangat dibutuhkan untuk menurunkan angka kematian ibu. Penelitian ini bertujuan mengetahui kualitas pelayanan pemeriksaan kehamilan atau antenatal care (ANC) di puskesmas (kompetensi bidan serta dukungan sarana dan prasarana pelayanan). Pengumpulan data dilakukan di 212 puskesmas dengan jumlah sampel 224 orang bidan. Bidan diamati pada saat melakukan pelayanan ANC. Komponen ANC yang diamati adalah 5T, 7T, dan 9T. Selain itu diamati juga ketersediaan sarana, prasarana, dan obat-obatan terkait dengan ANC di puskesmas. Bidan yang melakukan ANC dengan benar dan baik untuk komponen 9T, 7T, dan 5T secara berturut – turut adalah 18,8%, 23,2%, dan 31,7%. Hanya 20,4% puskesmas telah memiliki seluruh peralatan, obat, dan media penunjang pelayanan ANC 9T. Hanya seperlima bidan melakukan pelayanan ANC secara lengkap dan benar untuk komponen pelayanan 9T. Pengetahuan bidan dalam melakukan ANC 9T lebih baik pada mereka yang menjalani profesinya kurang dari 20 tahun dan berpendidikan minimal D3 kebidanan. Kata kunci : ANC, Bidan, Puskesmas

ABSTRAK     Kinerja  seorang  perawat  dapat dilihat   dari   mutu   asuhan   keperawatan   yang diberikan  kepada  pasien,  karena  pada  dasarnya yang dijadikan acuan dalam menilai kualitas pelayanan  keperawatan  adalah  dengan menggunakan standar praktik keperawatan. Tujuan penelitian untuk mengatahui pengaruh stres kerja, lingkungan kerja, motivasi, loyalitas dan kepemimpinan terhadap kinerja perawat di era covid19 perawat di  Rumah Sakit dr. Minthohardjo Jakarta Tahun 2020. Jenis penelitian ini adalah penelitian kuantitatif. Desain penelitian yang digunakan adalah cross-sectional. Sampel dalam penelitian ini menggunakan purposive sampling adalah sebanyak 103 responden. Berdasarkan hasil penelitian menunjukan ada pengaruh stres kerja (Pvalue 0.028 OR =< α (0.05), lingkungan kerja (Pvalue<= 0.005; OR  = 3.086), motivasi  (Pvalue<= 0.05; OR = 4.643), loyalitas (Pvalue<= 0.05; OR= 3.247), dan kepemimpinan (Pvalue<= 0.05; OR = 3.38) terhadap    perawat di Rumah Sakit dr Minthohardjo Jakarta Tahun 2020.Disarankan bagi Rumah Sakit dapat mengontrol kinerja pelayanan perawat agar terciptanya hubungan yang baik antara perawat dengan pasien serta meningkatkan kinerja untuk tujuan pelayanan kesehatan rumah sakit yang lebih baik serta melakukan tindakan inpeksi kerja kepada perawat dalam melakukan tindakan keperawatan.  

Abstrak Angka kematian neonatal dan angka kematian balita di Indonesia masih tinggi. Kasus kegawatdaruratan merupakan penyebab tingginya angka kematian tersebut. Rumah sakit Pelayanan Obstetrik dan Neonatal Emergensi Komprehensif (PONEK) 24 jam merupakan rumah sakit rujukan dengan visi mempercepat penurunan angka kematian neonatus dan angka kematian balita. Penelitian ini bertujuan untuk mengetahui implementasi pelayanan neonatal emergensi pada rumah sakit PONEK 24 jam di Indonesia. Penelitian didesain dengan pendekatan mix method yaitu pembauran antara studi kuantitatif dan kualitatif. Studi kuantitatif adalah cross sectional dan studi kualitatif adalah Rapid Assesment Procedure yang dilakukan pada tahun 2014. Penelitian dilakukan di rumah sakit di Indonesia dengan kriteria rumah sakit PONEK 24 jam, telah menerima sosialisasi tentang PONEK, dipilih secara random di 7 provinsi di Indonesia masing-masing 2 rumah sakit tiap provinsi. Berdasarkan kriteria tersebut sebanyak 14 rumah sakit diobservasi dalam penelitian ini. Data kuantitatif yang dikumpulkan meliputi pelayanan klinis, manajemen, sarana dan prasarana, ketenagaan dan pendanaan. Data dikumpulkan dengan cara observasi, telaah dokumen dan wawancara. Data kualitatif yang dikumpulkan meliputi proses, hambatan, dan keberhasilan PONEK dengan cara indepth interview dengan informan kunci direktur rumah sakit, ketua komite medik dan dokter spesialis. Hasil penelitian menunjukkan bahwa sebagian besar rumah sakit telah melaksanakan pelayanan neonatal emergensi 24 jam, KMC dan aksesibilitas darah yang memadai. Pelayanan neonatal emergensi telah didukung dengan jenis tenaga profesional, komitmen direktur rumah sakit yang tinggi, MoU dengan IDI, kerjasama dengan NGO serta ruangan, sarana dan prasarana yang memadai. Keberhasilan rumah sakit PONEK 24 jam didukung oleh kesadaran masyarakat untuk memanfaatkan layanan rumahsakit. Namun di beberapa rumah sakit kurangnya tenaga terlatih, jumlah tenaga, tidak ada tim, sarana dan prasarana serta ruangan menjadi alasan rumah sakit tidak melaksanakan PONEK. Kesimpulan: beberapa rumah sakit telah melaksanakan pelayanan neonatal emergensi komprehensif 24 jam, namun masih perlu mendapat perhatian dalam hal pelatihan dan jumlah tenaga, biaya, sarana dan prasarana serta ruangan yang memadai. Kata kunci: neonatal, emergensi, rumah sakit, rujukan Abstract Neonatal under-five mortality rate in Indonesia was still high, while the emergency cases were the most of its causes. Emergency neonatal care (EmNC) hospital was a referral provider to accelerate decline in neonatal and under-five mortality. This research aimed to observe the implementation of emergency neonatal services at referal hospitals in Indonesia. This study was a cross sectional study with quantitative and qualitative design. The study was conducted in all of referal hospital in Indonesia with criterian socialized emergency neonatal care. Based on these criteria as many as 14 hospitals in 7 provinces were observed in this study. The quantitative data collected includes clinical services, management, facilities and infrastructure, manpower and funding. Data were collected by observation, document review and interview. The qualitative were collected including the process, constraints, and attainment of emergencies services by indepth interviews to directors, medical committee heads, and specialists as informants. The results show that most hospitals provided 24-hour emergency neonatal services, KMC and adequate blood accessibility. Emergency neonatal care has been supported by professionals (i.e doctor, obsgyn, anaesthetician, etc), commitment of hospital director, MoU with IDI and NGOs. The attainment of emergency neonatal care was supported by public awareness to utilize hospital services. Skilled physician, room, essensial supplies and equipment for performing certain emergency neonatal care functions were not available in several surveyed hospital. Some hospitals have implemented comprehensive emergency neonatal care, but still need number of skilled pshycisian, budget facilities, supplies and equipment. Keywords: neonatal, emergency, hospital, referal system

While the national prevalence of stunting in Indonesia has decreased, the level remains high in many districts/cities and there is significant variation. This ecological study employed aggregated data from the Basic Health Research Report and the District/City Poverty Data from 2018. We investigated the determinants of stunting prevalence at the district/city level, including autocorrelation applying the spatial autoregressive (SAR) model. The analyses revealed stunting prevalence above the national average in 282 districts/cities (54.9%), i.e. ≥30% in 297 districts/cities (57.8%) and ≥40% in 91 districts/cities (17.7%). Autocorrelation was found between Sumatra, Java, Sulawesi as well as Bali, East Nusa Tenggara and West Nusa Tenggara (Bali NTT NTB). The SAR modelling revealed the following variables with significant impact on the stunting prevalence in various parts of the country: closet defecation, hand washing, at least four antenatal care visits during pregnancy, poverty, immunisation and supplementary food for children under 5 years.

Abstrak Kualitas pendidikan tenaga kesehatan yang belum merata salah satu masalah sumber daya manusia kesehatan di Indonesia. Bidan adalah tenaga kesehatan yang menempuh pendidikan kebidanan di institusi DIII kebidanan. Institusi kebidanan dituntut mampu menghasilkan bidan yang berkualitas dan kompeten sebagai pemberi layanan kesehatan ibu dan anak. Global Alliance Vaccines and Immunization (GAVI) sebagai organisasi internasional mendorong dilakukannya penelitian pendidikan DIII kebidanan di Indonesia. Penelitian bertujuan untuk mendapatkan gambaran penyelenggaraan pendidikan DIII kebidanan melalui pendekatan sistem input, proses, dan output. Penelitian menggunakan desain potong lintang dengan pendekatan kuantitatif yang dilaksanakan di 18 institusi pendidikan DIII kebidanan di 5 provinsi, yaitu Jawa Barat, Banten, Sulawesi Selatan, Papua Barat, dan Papua pada tahun 2013. Analisis menggunakan uji chi-square. Hasil penelitian menggambarkan adanya perbedaan baik pada input, proses, maupun output antar institusi pendidikan menurut wilayah maupun kepemilikan institusi. Terdapat perbedaan pengetahuan dan keterampilan mahasiswa menurut wilayah dan provinsi (p<0,05). Terdapat perbedaan pengetahuan mahasiswa di institusi pendidikan DIII kebidanan berdasarkan kepemilikan institusi. Tidak terdapat perbedaan keterampilan mahasiswa di institusi pendidikan DIII kebidanan milik pemerintah dan swasta (p=0,062). Perlu peningkatan kualitas penyelenggaraan pendidikan DIII kebidanan agar menghasilkan lulusan yang kompeten berbasis wilayah dan kepemilikan institusi pendidikan DIII kebidanan. Kata kunci: pendidikan vokasi, kebidanan, GAVI Abstract The unequality in health workers education quality is one of human resources for health’s problems in Indonesia. Ones who want to become a midwife should attend midwifery education. Diploma III (vocational) midwifery education institution as an education provider of midwifery must produce qualified and competent midwives that will perform their function as maternal and child health (MCH) care provider. The Global Alliance Vaccines and Immunization (GAVI) as an international organization that focuses on the MCH programs in Indonesia, encourages research aiming to describe implementation of Diploma III midwifery education through a system approach (input, process and output). This is a cross-sectional study with quantitative approach that was held in 18 Diploma III midwifery education institution which were spread in 5 provinces: West Java, Banten, South Sulawesi, West Papua and Papua in 2013. The analysis used were chi-square test. The results described differences either on input, process, and output among educational institutions by region and institutional ownership. There was a difference of students’ knowledge and skill by region and province (p <0,05). There was also a difference of the students’ knowledge in midwifery education institution based on institutional ownership. There were no differences in student skills between public and private educational institution (p = 0,062). It is necessary to improve the quality of DIII midwifery education in order to produce competent graduates based on the region and the ownership. Keywords : vocational education, midwifery, GAVI

Abstrak Pemerintah Kabupaten Tabalong Kalimantan Selatan menerapkan pelayanan kesehatan gratis di Puskesmas melalui program Jaminan Tabalong Sehat (JTS) sejak tahun 2008. Peserta JTS adalah seluruh penduduk Tabalong yang tidak memiliki asuransi atau jaminan kesehatan. Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan pemanfaatan pelayanan kesehatan di puskesmas. Penelitian ini menggunakan desain cross sectional dan wawancara mendalam. Sampel uji sebanyak 253 rumah tangga sasaran program JTS, diambil dari 405 sampel rumah tangga yang dipilih secara sistematik, dari klaster 15 desa/kelurahan di tiga wilayah puskesmas terpilih. Hasil penelitian menunjukkan bahwa pemanfaatan pelayanan kesehatan gratis di puskesmas belum optimal. Sebanyak 52% rumah tangga pernah memanfaatkan pelayanan kesehatan puskesmas dalam setahun terakhir. Faktor yang berhubungan dengan pemanfaatan pelayanan kesehatan di puskesmas adalah pengetahuan, kemauan untuk membayar/WTP, adanya penyakit tertentu, waktu tempuh, kemudahan dan biaya transportasi. Rendahnya pemanfaatan pelayanan kesehatan di puskemas yang sudah digratiskan disebabkan karena kurang optimalnya kegiatan puskesmas, kurangnya sosialisasi ke masyarakat dan sasaran masyarakat yang disubsidi kurang tepat. Kata kunci: Pemanfaatan pelayanan kesehatan, Puskesmas, Subsidi, Tabalong Abstract Government of Tabalong District have been giving free health care subsidies at public health centre (PHC) through Tabalong Health Security (Jaminan Tabalong Sehat /JTS) program since 2008. Targetting of JTS program are all of Tabalong citizens that have not covered by health insurance or other health security programs. The objective of this research was to know the factors that related with utilization of health services at PHC in Tabalong District. Approach of this research were cross sectional design and deep interview. Sampels were 253 targetting household taken form 405 household that selected by systematic random from 15 villages cluster at three selected PHC areas. The result showed that utilization of free health services subsidies were not optimize yet. Just 52% of household utilized health services at PHC in the last year. The factors that related with health services utilization at PHC are knowledge, willingness to pay (WTP), diseases avalaibility, travelling time, easiness and cost of transportation. The low rates utilization of free health care were also caused by un-optimize of PHC’s activities, lack of promotion the JTS programs, not matching of subsidies targetting. Keywords: Health services utilization, public health centre, subsidy, Tabalong

Objectives. To find stunting hotspots district or cities in Indonesia in seven major islands in Indonesia. Method. This is an ecological study that using aggregate data. We used data from The Basic Health Research Report of Indonesia 2018 and The Poverty Data and Information Report from the Central Bureau of Statistics 2018. We analyzed 514 districts or cities in Indonesia that spread out in 7 major Islands with 34 provinces. We used The Euclidean distance method to determine the neighborhood. Morans test was occupied to identify autocorrelation while Morans Scatter Plot particularly in the high high quadrant was used to identify stunting hotspot areas. Result. It was found that there is autocorrelation among districts or cities in four major islands namely Sumatera, Java, Sulawesi, and Bali Nusa Tenggara Timur Nusa Tenggara Barat. We identified 135 districts or cities as stunting hotspot areas that spread in 14 provinces in four islands. Conclusion. There is autocorrelation among districts or cities in Sumatera, Java, Sulawesi, and Bali NTT NTB which resulted in 135 districts or cities identified as stunting hotspots in four major islands in Indonesia Policy implication. Provide information to the government in prioritizing stunting prevention areas in Indonesia in term of the acceleration of stunting prevention.