Private Practice Midwives Research Articles

PERBANDINGAN KEJADIAN PENINGKATAN TEKANAN DARAH PADA TRIMESTER II BERDASARKAN LAJU FILTRASI GLOMERULUS (LFG)

During normal pregnancy, glomerolus filtration rate (GFR) is increased so that the concentration of urea and creatinine decreased. With the onset of hypertension in pregnancy, renal perfusion and glomerular filtration decreases, the greater of decline showed more severe illness. This was an observational analytic study with Cohort design and performed in Obgyn Department of M. Djamil Hospital Padang, general district hospital in Batusangkar and Achmad Mukhtar, Private Practice Midwife in Batusangkar from June-December 2014. 100 samples of first trimester of pregnancy, each subject were examined ureum, creatinine, cystatin-c and glomerular filtration rate (GFR) based on CKD-EPI Cystatin and Creatinine 2012 Equation formula. Then divided into two groups, high glomerular filtration rate (GFR) high and low glomerular filtration rate (GFR) group. Each subject was evaluated blood pressure every 3 weeks and statistical analysis was done using the Independent samples test and chi square. There was significant association difference in the levels of urea, creatinine and cystatin-c between high GFR group and low GFR group (p <0.05). There was a statistically significant relationship between low GFR group of pregnant women with changes in systolic and diastolic blood pressure that persists or increases of 5-10 mmHg (p <0.05). Keywords: Preeclampsia, glomerular filtration rate (GFR), ureum, creatinine, cystatin-c, blood pressure

PERBANDINGAN KEJADIAN PENINGKATAN TEKANAN DARAH PADA TRIMESTER II BERDASARKAN LAJU FILTRASI GLOMERULUS (LFG)

During normal pregnancy, glomerolus filtration rate (GFR) is increased so that the concentration of urea and creatinine decreased. With the onset of hypertension in pregnancy, renal perfusion and glomerular filtration decreases, the greater of decline showed more severe illness. This was an observational analytic study with Cohort design and performed in Obgyn Department of M. Djamil Hospital Padang, general district hospital in Batusangkar and Achmad Mukhtar, Private Practice Midwife in Batusangkar from June-December 2014. 100 samples of first trimester of pregnancy, each subject were examined ureum, creatinine, cystatin-c and glomerular filtration rate (GFR) based on CKD-EPI Cystatin and Creatinine 2012 Equation formula. Then divided into two groups, high glomerular filtration rate (GFR) high and low glomerular filtration rate (GFR) group. Each subject was evaluated blood pressure every 3 weeks and statistical analysis was done using the Independent samples test and chi square. There was significant association difference in the levels of urea, creatinine and cystatin-c between high GFR group and low GFR group (p <0.05). There was a statistically significant relationship between low GFR group of pregnant women with changes in systolic and diastolic blood pressure that persists or increases of 5-10 mmHg (p <0.05).Keywords: Preeclampsia, glomerular filtration rate (GFR), ureum, creatinine, cystatin-c, blood pressure

HUBUNGAN PENGETAHUAN DAN MOTIVASI BIDAN PRAKTIK SWASTA TERHADAP PELAKSANAAN PIJAT BAYI DI WILAYAH PUSKESMAS KECAMATAN GADING CEMPAKA TAHUN 2011

Incidence of low birth weight in Bengkulu City has increased from 7,86% in 2009 to 11.50% in 2010. One effort to increase the stimulation of growth and development in LBW infants is infant massage.The factors that influence it are knowledge and motivation. The perpose of this study was to determine the relationship of knowledge and motivation of midwives in private practice in the implementasi of inflant massage. This study uses an observational design with a descriptive cross sectional approach, total sampling from 59 BPS. Retrievel of data using the primary data through questionnaires. Analyzed by univariate and bivariate chi squer. The results obtained that almost half of respondents did not perfort inflant massage. There was a significant association between knowledge of midwives in private practice with the implementation of inflant massage (p=0.00) and there was a significant association between the motivation of BPS with the implementasi of inflant massage (p= 0.009). the conclusion from the result of this study is there is a significant relationship between knowledge and motivation of midwives in private practice to the implementation of inflant massage.

INISIASI MENYUSU DINI (IMD) MEMPERCEPAT PENGELUARAN ASI

Early initiation of breastfeeding is a process of letting the baby breastfeed their own immediately after birth so that it benefits both mother and baby, physically and psychologically. It can safe 22% of neonatal deaths, prevent hipotermi and enhance ties of affection. In the city of Bengkulu implementation of the early initiation of breastfeeding not yet have an impact on exclusive breastfeeding in 2009 (59.1%). The purpose of this study to know the implementation of early initiation of breastfeeding in private practice midwives in the city of Bengkulu.This study design with qualitative methods through an explorative approach to dig more deeply about the situation of implementation of the early initiation of breastfeeding on the midwives who in private practice in the city of Bengkulu. Informants of this study amounted to 12 persons elected by purpose sampling. Data were collected through in-depth interviews and direct observation analyzed by phase: transcripts, coding, and conclusions based on pre-determined category.The results showed all the informants were well versed in the early initiation of breastfeeding, but its implementation has not been done in the most especially when the patients feel tired or lack motivation and family do not support this implementation so that postponed and not taken immediately. Furthermore, this implementation did not result in exclusive breastfeeding because the patient feels there is no milk coming out so it is not important for mothers to keep breastfeeding. The attitude of midwives in the implementation of the early initiation of breastfeeding is quite good and supports the implementation of the early initiation of breastfeeding, especially with seeing the benefits. To improve the implementation of the early initiation of breastfeeding needs to be done counseling since pregnant women and prepare it so that mothers will understand its benefits and to continually feeding that can accelerate spending and prevent breast milk feeding other than breast milk during the month / exclusive

Abortion in Hauts-de-France: When to expect the first appointment?

According to the French National Authority for Health ("Haute Autorité de santé"), the first appointment for an abortion should take place within five days of the request. Whether this deadline is met or not in the Hauts-de-France region is not known. The aim of this study was to measure the time needed to get a first appointment for an abortion in Hauts-de-France. We conducted a telephone survey of health facilities, family planning and registered practitioners practicing abortions in the Hauts-de-France region, to determine the next appointment available for a woman requesting an abortion. The calls took place between April 10 and 14, 2017. The time needed to get a first appointment (means±standard deviations) was calculated for the region, the departments, the districts and the health facilities and practitioners. We contacted 93 health facilities and practitioners and 70 were included in the study. The time needed to get a first appointment for an abortion in Hauts-de-France was measured at 5.25±5.20 days: 6.32±4.72 days for health facilities, 3.84±5.11 days for gynecologists, 5.22±5.88 days for general practitioners and 0.67±0.58 days for private-practice midwives. Fifty-six percent of health facilities and practitioners gave the appointment within five days. Between the districts, the average time varied from 1 to 15.5 days. The average time needed to get a first appointment for an abortion in Hauts-de-France was near the 5-day deadline recommended by the French National Authority for Health. The training of private practice midwives and general practitioners may be the first step in shortening it in some districts where access to health care is limited.

PENGARUH KARAKTERISTIK HIS DENGAN LAMA PERSALINAN KALA II DI BPS SAHABAT PEREMPUAN GUNUNG ANYAR SURABAYA

influence contraction of uterus characteristics with length of second period in BPS Sahabat Perempuan Gunung Anyar Surabaya. Contraction of uterus is the major physiological force during the delivery process of second period. Based on the results of preliminary studies, there is still mother who get pathological second period of childbirth. Intention of this research is to identity influence contraction of uterus characteristics with length of second period. Design this research use analytic with cohort method. The population is all of the mother who have the interpretation of labor on June 14 until July 9 and delivery at private practice midwife Sahabat Perempuan Gunung Anyar Surabaya, which amounts 30 respondents. Big of sample 28 respondents, were teken with probability sampling techniques, that is simple random sampling. Processing by editing, coding and tabulating. Variable independent is contraction of uterus characteristics and variable dependent is length of second period. Result of this research with test of chie-squares with significance level α = 0,05. Most respondents with contraction of uterus characteristics normally is (53,3 % ) only a small proportion who get pathological second period of childbirth (18,75 %). From got by statistical test result of ρ = 0,025 and ρ < α of meaning H1 accepted, it means there is correlation between contraction of uterus characteristics with length of second period at private practice midwife Sahabat Perempuan Gunung Anyar Surabaya. It can see from Odds Ratio (OR) is getting 7,8 (95 % CI : 1,47 – 41,21). Its means contraction of uterus characteristics more effective for length of second period. This research conclusion that there more mother delivering have contraction of uterus characteristics normally, so more big chance mother delivering for felt with length of second period. Adviced to pregnant women to trying the contraction of uterus with pregnancy gymnastic, it can train the muscle strength of the stomach, hips, and other supporting muscle that are not rigid and well coordinated, so the contraction of uterus become normally.

Mother-baby follow-up at home and the welcome of the baby in the family

Upon discharge from the maternity hospital, the newborn is welcomed not only in a home but also within a family. The postnatal follow-up over the first few weeks can take several forms: a programme to support the return home, hospital at home service or follow-up by a private practice midwife or professionals from the mother and infant welfare protection service. The aim is to meet the needs of the baby, favour the establishment of the parent-baby bond and to support the construction of parenthood.

ANALISIS MOTIVASI BIDAN DALAM MERUJUK PASIEN UNTUK DILAKUKAN TINDAKAN SECTIO CAESAREA DI PPK II BPJS DI WILAYAH KECAMATAN MAKASAR JAKARTA TIMUR TAHUN 2014

This thesis aimed to get a picture of the motivations of midwife in referring patients for caesarean section at PPK II BPJS in Makasar Subdistrict of East Jakarta in 2014. This research was carried out because there was a tendency that doctors had cooperation with midwives, so that caesarean section had to be performed at a specific place. The study was a descriptive study with case study design, using in-depth interviews. The informants of the study were : midwives who refered to PPK II BPJS in the Makasar Subdistrict, Head of Public Relation of PPK II, BPJS doctors, patients of private practice midwives (BPS). This study examined factors contributing the motivation of midwives in referring patients for caesarean section at PPK II BPJS based on three factors: environmental conditions, partnerships and benefits.Short distance between the hospital and private practice midwives could facilitate referral patients. Midwives had more confidence about the safety of their patients when referring to PPK II that had complete facilities. BPJS’policy also affected referral patterns for caesarean section at PPK II because the midwives who not become PPK I, they could not refer patients to PPK II directly. Some of midwives only refered to the obstetricians and gynecologists at PPK II that already had existed cooperation with the midwives. Midwives informants reported that they only refered patients with medical indications and not based on or motivated by financial rewards from the reffered. If the referring process was rewarded, then it was just a bonus and not the main goal.In addition, the informants said that the socialization of BPJS program was not adequate in the community. It was expected the provision of services at the BPJS hospital had hospital accreditation certificate. This study suggested that hospital not give rewards to the midwives for refering patients for caesarean section at PPK II. It was also advisable to midwifery professional association to have clear rules and regulation on the referring process and associated financial rewards.

Analysis of Partnership of Private Practice Midwife in The National Health Insurance Program in District Bungo Jambi Province

On January 1, 2014, the government began to implement the National Health Insurance (NHI) program to realize social welfare for the whole community. Midwifery and neonatal care in the NHI program involves Puskesmas/family doctors and Private Practice Midwife (PPM) as its network. PPM participation in the NHI program in Bungo District was still lacking, only 12 (54.5%) PPM have cooperated with family doctors from 22 existing PPM. This study aimed to get an overview of PPM participation in the NHI program in Bungo District, Jambi Province. The study used qualitative research approach with Rapid Assessment Prosedur design, purposive sampling, and conducted in-depth interview to 10 PPM, Head of Health Office, MPKP BPJS Health Manager, and Chairman of Bungo Regency Section of Indonesian Midwife Organization (IMO). The study was conducted from January to July 2017. The study found that the knowledge, perceptions and attitude towards NHI program were good, but the perceived toward the claim and predetermined tariff procedures were not so good. PPM motivated to join the NHI program as many patients had become NHI participants. Support from the Government, NHI, and IMO were low, either in the form of socialization, or policies. Therefore, the study suggest an improvement in claims procedures, tariffs, and an increase of socialization from government, NHI and IMO on NHI program related to obstetric and neonatal care.

SWOT Analysis of the Midwife's Role in Controlling HIV/AIDS in Denpasar: Assessment of Barriers and Achievements

The epidemic of Human Immunodeficiency Virus (HIV)/Acquired Immuno Deficiency Syndrome (AIDS) in Indonesia has entered the stage of the concentrated epidemic. We need to assess factors that are associated to the efforts to prevent transmission of HIV/AIDS from mother to baby by midwives in the public health centers and in the private practices in City of Denpasar using SWOT analysis. This research was a qualitative study by involving eight midwives coordinator and staffs in the public health center in the City of Denpasar, ten private practice midwives and two head of health care centers. Data were collected using in-depth interview guidance and observation sheets, and the study was conducted from June to September 2015. Data were analyzed using content analysis. The policy of the officer about screening and early detecting from the central level to the district was a major strength should be in point of view of midwives. The main weakness was the lack of awareness of the private practices of midwives to support the success of voluntary counseling and testing (VCT) and provider-initiated testing and counseling (PITC) programs and the cost of laboratory test before having an antiretroviral therapy was expensive. Midwives showed a big responsibility to prevent transmission of HIV to the fetus through early screening.

Being a private practice midwife: How to negotiate the boundaries, be safe, care for women safely, meet all the requirements and importantly, how to be true to yourself as a woman and midwife

Being a private practice midwife: How to negotiate the boundaries, be safe, care for women safely, meet all the requirements and importantly, how to be true to yourself as a woman and midwife

POLA PEMAKAIAN KONTRASEPSI DAN PEMANFAATAN KARTU BADAN PENYELENGARA JAMINAN SOSIAL (BPJS) KESEHATAN DALAM PELAYANAN KELUARGA BERENCANA DI INDONESIA

Background: By 2019, the government requires all Indonesian citizens to become Jaminan Kesehatan Nasional (JKN) participants through Badan Penyelenggara Jaminan Sosial kesehatan (BPJS - health) and is entitled to health insurance benefits including family planning services. Objective: In order to describe the family planning services, contraceptive usage pattern, and BPJS health card utilization for family planning services in JKN era. Methods : This study used secondary data analysis from the results of the Intercensal Population Survey (SUPAS) in 2015. The sample is 189,652 ever married women, aged 10-54 years in all provinces in Indonesia, and have received family planning services both before and during JKN. The analysis used chi-square test. Result: One year after the introduction of the JKN program, the proportion of contraceptive use including the Long-term Contraceptive Method (LTCM) fell significantly compared to before JKN, whereas injections and pills remained high. Family planning services at Puskesmas increased sharply, while hospital and government service both went down and services by doctors and private practice midwives remained high. Utilization of BPJS health card for family planning services is still low. The use of BPJS Health card for family planning services has a significant relationship to the use of LTCM. Conclusion: Non contraceptive use of LTCM is still high. Utilization of BPJS health card for family planning services is still low, whereas the use of BPJS health card has almost four chance to encourage the use of KB MKJP.

Analisis Implementasi Sosialisasi Pemberian Asi Eksklusif Oleh Bidan Praktek Swasta (BPS) Di Kabupaten Bengkulu Selatan

Profile of South Bengkulu district health office 2008 – 2009 did not include data on exclusive breastfeeding coverage. Private practice midwives (BPS) did not have standard operating procedure (SOP) in providing obstetric service. One of midwives duties was to provide exclusive breastfeeding socialization to pregnant women, childbearing mothers and community. The objective of this study was to analyze the implementation of exclusive breastfeeding socialization by BPS in South Bengkulu district. This study applied qualitative method and using in-depth interview as data collection technique. The main informant was 3 private practice midwives in the city area and 2 private practice midwives in the rural area. Triangulation was done to 5 head of puskesmas, chief of nutritional unit and head of Indonesian Midwifery Association (IBI). Focus group discussion was conducted to 3 mothers and 3 people in the community (family member of the patient) in each selected BPS. Results of the study showed that implementation of exclusive breastfeeding socialization variable was still limited to individual education and no education materials were provided. There was no communication among head of puskesmas, head of district health office and head of IBI towards BPS. BPS facilities were still insufficient to support the success of exclusive breastfeeding. Disposition had not supported exclusive breastfeeding coverage improvement. In the bureaucracy structure variable, there was no reporting format from BPS to puskesmas on exclusive breastfeeding socialization implementation in South Bengkulu district. It was suggested to district health office to formulate regulation policy in the form of decree regarding exclusive breastfeeding and to forbid collaboration between BPS and infant formula companies. Head of puskesmas had to do supervision and monitoring to BPS. Private practice midwives were expected to improve the frequency of exclusive breastfeeding socialization and to avoid collaboration with infant formula companies.

Faktor � Faktor yang Mempengaruhi Keikutsertaan Bidan Praktik Mandiri pada Program Jaminan Kesehatan Nasional di Kota Palangka Raya

Efforts to reduce maternal and infant mortality through various programs including the National Health Insurance program. Midwives play an important role in reducing MMR and IMR, because the midwife is a health worker at the forefront and deal directly with the public, to provide continuous service and complete. This study aims to determine the factors that affect the participation of Independent Midwife Practice On the National Health Insurance Program in the city of Palangkaraya. The approach used in this study was an observational analytic and cross-sectional design. The population in this study are all midwives private practice located in the city of Palangkaraya in 2016. The samples included 105 midwives in private practice. Univariate analysis performed by the frequency distribution for bivariate analysis, age, education, length of practice, knowledge, communication, motivation, cooperation procedure, process claims, the administration process and tariff services using chi-square (x2) and the relationships among several variables were analyzed with multiple logistic regression , The result showed that the factors of education (p = 0.002), duration of practice (p = 0.003), procedure of cooperation (p = 0.000), the process claim (p = 0.042), and administrative processes (p = 0.001) showed a significant effect on the participation of midwives practice of independent Reviewed JKN program. Multiple logistic regression analysis showed that factors of education (OR = 72.23; 95% CI = 2.38 to 218.76), p <0.05, Lama practices (OR = 79.94; 95% CI = 5.22 - 122.45, p <0.05), communications (OR = 97.98; 95% CI = 3.10 to 309.40, p <0.05) and administrative procedures (OR = 56.25; 95% CI = 4.21 to 750.77, p <0.05) simultaneously have a significant influence on the program with the participation of midwives private practices JKN. Conclusion The research results are the effect of education, length of practice, communication, cooperation procedure, process claims, and administrative processes with midwives private practices participation in the program JKN

Relationship of Knowledge and Attitude among Midwives with the Implementation of Early Initiation of Breastfeeding in Badung Regency

Background and purpose: Infant Mortality Rate (IMR) in Bali and also in Indonesia is still high while the proportion of exclusive breastfeeding fully for six months is still very low. One effort to improve exclusive breastfeeding is the early initiation of breastfeeding (EIB) i.e. breastfeeding to infants shortly after birth. This study was conducted to determine the implementation of EIB by midwives and the factors that influence it.Methods: The study design was cross-sectional survey among 61 private practice midwives as respondents in Badung Regency. The respondents were all private practice midwives in three regencies purposively selected from six districts in Badung Regency. The data were collected through questionnaires filled out by midwives and analyzed by bivariate with chi-square test and multivariate using poisson regression method.Results: The IMD was implemented by 62.3% of the respondents. In the group of midwives having >4 patients per month significantly implemented the IMD more compared with those having ?4 patients per month i.e. 83.3% and 57.1% respectively (p=0.008). The implementation of IMD had a significant difference among midwives with higher knowledge i.e. 84.6% and 45.7% respectively (p=0.002), midwives having positive attitude were 79.1% vs. 22.2% (p=<0.001) and those having received supervision, namely 77.5% vs. 33.3% (p=0.001). Multivariate analysis showed that factors associated with implementation of IMD was knowledge with APR=1.5 (95%CI: 1.04-2.1) and attitude with APR=2.7 (95%CI: 1.1-6.3).Conclusion: Knowledge and attitude had a significant relationship to the implementation of IMD by midwives.

Does Australia's Health Policy Environment Create Unintended Outcomes for Birthing Women?

Does Australia's Health Policy Environment Create Unintended Outcomes for Birthing Women?

Analisis Pengelolaan Sampah Medis Pelayanan Kesehatan Praktik Bidan Swasta di Kota Banjarbaru

The development of health services is inseparable teething problems in the medical waste management, as well as in private practice midwives in the city Banjarbaru. The purpose of the research to know how the system of management, characteristics and analyze large generation of medical waste management methods, and analyze the influence and relationship education level, knowledge and attitudes of medical waste management system of midwives to practice in the city Banjarbaru. This study is a survey with sample size of the study 84 people . Data were analyzed to compare with No. Kepmenkes . 1204/Menkes/SK/X / 2004 and other relevant literature.The result is a system of medical waste management both in private practice midwives only 45.2% with the characteristics of infectious waste generation is (52.74%), pathological waste (39.59%), sharp waste (3,58%), and pharmaceutical waste (4,10%), large generation average 74.92 kg / day. The level of education and attitude influence in medical waste management system of private practice midwives, variables that are related to education level (p = 0.002) and attitude (p = 0.01), while the level of knowledge was not associated (p = 0.380).

Analisis Peran Manajerial Pengurus Ikatan Bidan Indonesia (IBI) dalam Pelaksanaan Program Peningkatan Pemberian Asi (PPASI) di Wilayah Kota Pontianak

Breastfeeding improvement (PPASI) program was an effort to increase the coverage of exclusive breastfeeding. Successfulness of the exclusive breastfeeding required support from midwives. Indonesian Midwifery Association (IBI), as a midwives professional organization, had declared to implement PPASI program step by step and continually by all IBI board members. Although IBI boards at Pontianak branch had conducted several seminar activities regarding breastfeeding and lactation management training for IBI members but private practice midwives were still giving formula milk to the newborns. Based on that problem, this study was conducted with the objective to explain managerial role of IBI boards in implementing PPASI program in the area of Pontianak city. This was a qualitative study using phenomenology approach. Study informants were IBI branch and sub branch board members in the area of Pontianak city. Data were collected by in-depth interview and analyzed using content analysis method. Results of the study showed the roles of IBI boards as leader in implementing PPASI program in the motivational activities. IBI boards reminded IBI members to do lactation management in every informal small group social gathering (arisan). Evaluation of lactation management was conducted by IBI boards because they were on duty as midwives coordinators at Puskesmas and as room chiefs in hospitals. Guidance to the members was conducted by the boards through ‘arisan’ and there was no rewards given to members who had implemented lactation management. The role of boards as information resource was done by conducting lactation seminars for IBI members and in collaboration with district health office to implement lactation management training. There was no special standard for lactation management and socialization was only given to the members who wanted to apply for private practice midwives (BPS) permit. In term of IBI board role as policy makers, the board had not made planning for PPASI program. Planning and organizing were only done for seminar activities about breastfeeding. No written regulation issued by IBI board and no sanction was assigned to the members in implementing PPASI program. Based on the study results, it was suggested to IBI board to formulate evaluation format and to give rewards to IBI members in order to motivate them to implement lactation management, to make specific standard operating procedure for lactation management and to make understandable and details regulations regarding PPASI program implementation, to assign sanction to members who broke the rules.

Rethinking women's access to continuity of midwife care

Introduction: Maternity services in Australia remain highly medicalised. Women continue to report that care is fragmented and not tailored to their needs or within the context of their families. The health system gives scant attention to promoting health or building healthy communities. There is overwhelming evidence for providing women with continuity of care by a known midwife, yet few women have access to this model of care and it is disproportionately offered in the public sector. Private practice midwives with access agreements to hospitals offer safe and satisfying care for women and their families. For example, the first two years of practice data for My Midwives, Toowoomba showed that outcomes for women and newborns compared favourably with national perinatal data for each National Core Maternity Indicator. Concurrently, the number of admissions for childbirth in private hospitals under private obstetricians is falling and health funds cite the growing cost of maternity care as a key reasons for seeking a premium rise in April. The health system is failing to gain momentum in reorienting the model of maternity service delivery to align with the evidence. It is timely to examine the opportunity affordedwith the 2010maternity service reforms, including access to Medicare, from a health service perspective. Aim: To discuss the benefits to health services of facilitating access agreements for private practice midwives, including a cost analysis, and offer strategies for midwives and maternity service managers to bring about changes to models of care.

The Mismatch Between Postpartum Services and Women's Needs: Supermom Versus Lying‐In

The Mismatch Between Postpartum Services and Women's Needs: Supermom Versus Lying‐In