Learning Disabilities dalam Layanan Kesehatan Ibu dan Anak: Studi Kasus di Dinas Kesehatan dengan Sumber Daya Terbatas di Indonesia

https://doi.org/10.22146/jkki.v6i2.26922

Nana Diana(1), Mubasysyir Hasanbasri(2*), Mohammad Hakimi(3)

(1) Dinas Kesehatan Kabupaten Kepahiang, Bengkulu
(2) Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada
(3) Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada
(*) Corresponding Author

Abstract


ABSTRACT

Background: The growing number of infant mortality is one of the challenging problems in distric health offi ce. One of the causes of this problem is the recurring mistakes in the system. Learning organization is a strategic step to continuously learn and determine proper solution. However, there are learning disabilities in the organization that interfere with the learning organizationin maternal and infant mortality.

Objective: This study was aimed to explore learning organizationin emergency care unit by midwifes in the perspective of organizational learning in three organization level: distric health office, community health center, and midwifes.

Method: This was a case study with multi cases design in the working area of Distric Health Offi ce of Kepahiang Region from September to October 2015. Study subjects were secretary of distric health offi ce, director of Planning division, director and officers of maternal and infant health division, coordinator of midwifes, and midwifes. Three strategic steps of conducting qualitative studies were preparing and organizing data, reducing data into themes, and presenting data.

Result: There were four learning disabilities that often occurred in organization, which were: I am my position, the enemy is out there, the illusion of taking charge and the myth of team management.

Conclusion: Learning disabilities interfered with implementation of learning organization. Improving the role of maternal and perinatal audit were strategic opportunities to optimize learning organization process.

Keywords: Learning organization, organizational learning,midwives, emergency care unit.

ABSTRAK

Latar Belakang: Kasus kematian bayi yang terus meningkat setiap tahun merupakan permasalahan yang belum mampu tertangani oleh dinas kesehatan. Ada kesalahan berulang yang terjadi, namun dinas kesehatan belum mampu mengambil pelajaran dari kesalahan tersebut. Learning organization merupakan langkah yang strategis untuk senantiasa belajar dan menentukan langkah penanganan yang tepat. Tetapi ada learning disabilities yang terjadi dalam organisasi sehingga proses learning organization dalam kasus kematian ibu dan bayi tidak mampu berjalan sebagaimana yang diharapkan.

Tujuan: Tujuan dari penelitian ini adalah mengeksplorasi bagaimana learning organization dalam layanan kegawat daruratan oleh Bidan Desa ditinjau dari Perspektif organizational learning pada tiga level organisasi yaitu Dinas Kesehatan, Puskesmas dan Bidan Desa.

Metode: Penelitian ini adalah studi kasus dengan desain multi kasus di wilayah Kerja Dinas Kesehatan Kabupaten Kepahiang mulai bulan September sampai dengan Oktober 2015, subjek penelitian adalah sekretaris dinas kesehatan, kepala seksi perencanaan, kepala seksi KIA, staff KIA, bidan koordinator dan bidan desa. Ada tiga langkah strategis dalam melakukan analisis data kualitatif: menyiapkan dan mengorganisasikan data, untuk analisis mereduksi data menjadi tema, dan menyajikan data.

Hasil: Ada empat learning disabilities yang sering terjadi dalam organisasi meliputi I am my position, the enemy is out there, the illusion of taking charge dan the mytm of team management.

Kesimpulan: Learning disabilities merupakan hambatan dalam menerapkan learning organization. Penguatan peran audit maternal dan perinatal merupakan peluang strategis untuk mengoptimalkan proses learning organization.

Kata Kunci: Learning organization, organizational learning, Bidan desa, Layanan kegawatdaruratan.

 


Keywords


Learning organization, organizational learning,midwives, emergency care unit.



References

United Nations, 2013. World Population Prospects The 2012 Revision, New York.

World Health Organization, 2013. Trends in Maternal Mortality : 1990 to 2013, Switzerland.

Walker, N., 2011. Plausible estimates of stillbirth rates. Lancet, 377(9774), pp.1292–4.

World Health Organization, 2005. Make Every Mother and Child Count, Geneva.

Souza, J.P. et al., 2013. Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study. Lancet, 381(9879), pp.1747–55.

Graham, W.J. & Varghese, B., 2012. Quality, quality, quality: gaps in the continuum of care. Lancet, 379(9811), pp.e5-6.

Koblinsky, M. et al., 2012. Maternal Morbidity and Disability and Their Consequences: Neglected Agenda in Maternal Health. 30(2), pp.124–130.

Vidyasagar D, 2002. A global view of advancing neonatal health and survival. Journal of Perinatology., p.22(7):513-515.

Renfrew, M.J. et al., 2014. Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. Lancet, 384(9948), pp.1129–45. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24965816 [Accessed November 22, 2014].

Yang, B. et al., 2004. The Construct of the Learning Organization: Dimensions, Measurement, and Validation. Human Resource Development Quarterly, 15 No 1, pp.31–35.

Vassalou, 2001. The learning organization in health-care services: theory and practice. European Industrial Training, 25 No. 7, pp.354– 65.

Crites, G.E. et al., 2009. Evidence in the learning organization. Health research policy and systems / BioMed Central, 7, p.4.

Brewer, G.A. & Walker, R.M., 2013. Personnal contraints in public Organizations : The Impact of Reward and Punishment on Organizational Performance. Public administration review, 73(1), pp.121–131.

Nyamtema, A.S. et al., 2010. Factors for change in maternal and perinatal audit systems in Dar es Salaam hospitals, Tanzania. BMC pregnancy and childbirth.

Filippi, V., 2004. Obstetric audit in resource-poor settings: lessons from a multi-country project auditing “near miss” obstetrical emergencies. Health Policy and Planning, 19(1), pp.57–66.

Senge, M.P., 1990. The fi fth Discipline: The Art & Practice of the Learning Organization, New York.

Heywood, P. & Choi, Y., 2010. Health system performance at the district level in Indonesia after decentralization. BMC international health and human rights, 10, p.3.

Hadley, M.B. & Tuba, M., 2011. Local problems; local solutions: an innovative approach to investigating and addressing causes of maternal deaths in Zambia’s Copperbelt. Reproductive health, 8, p.17.

Hadley, M.B. & Tuba, M., 2011. Local problems; local solutions: an innovative approach to investigating and addressing causes of maternal deaths in Zambia’s Copperbelt. Reproductive health, 8, p.17.

Leufvén, M. et al., 2015. Dimensions of Learning Organizations Questionnaire (DLOQ) in a low- resource health care setting in Nepal. Health research policy and systems, 13, p.6.

Kossarova, L., Holland, W. & Mossialos, E., 2013. “Avoidable” mortality: a measure of health system performance in the Czech Republic and Slovakia between 1971 and 2008. Health policy and planning, 28(5), pp.508–25.

Swanson, R.C. et al., 2012. Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change. Health policy and planning, 27 Suppl 4, p.iv54-61.

Swanson, R.C. et al., 2015. Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions. Globalization and health, 11, p.5.

Goh, S.C., Chan, C. & Kuziemsky, C., 2013. Teamwork, organizational learning, patient safety and job outcomes. International journal of health care quality assurance, 26(5), pp.420–32.

Farzianpour, F., Irani, A. & Foroushani, A.R., 2016. Determine the Level of Organizational Learning Capability in Teaching Hospitals in Bandar Abbas City — Iran. Health, (January), pp.24–31.

Laeeque, S.H. & Babar, S.F., 2014. Learning Organization as a Strategy to Improve Performance of Pakistani Hospitals.

Pearce, C.L., 2015. Developmental health services leadership: Integrating hierarchical and shared leadership for health services organizational learning. Health Services Management Research, 28(3–4), pp.76–82.

Ravangard, R. et al., 2014. Relationship Between Organizational Learning and Empowerment : A Case Study Among Medical Sciences Staff Employees ’. 3(2).

Nembhard, I.M. & Haven, N., 2016. HHS Public Access. 37(2), pp.154–164.

Tsai, Y., 2014. Learning organizations, internal marketing, and organizational commitment in hospitals. BMC health services research, 14, p.152.

Pantouvakis, A. & Mpogiatzidis, P., 2013. The impact of internal service quality and learning organization on clinical leaders’ job satisfaction in hospital care services. Leadership in Health Services, 26(1), pp.34–49.

Kemenkes RI, 2010. Pedoman teknis Audit Maternal dan Perinatal, Jakarta: Kemenkes RI.

Bakker, W. et al., 2011. Health workers’ perceptions of obstetric critical incident audit in Thyolo District, Malawi. Tropical medicine & international health : TM & IH, 16(10), pp.1243–50.

Patel, Z. et al., 2007. Feasibility of community neonatal death audits in rural Uttar Pradesh, India. Journal of perinatology : offi cial journal of the California Perinatal Association, 27(9), pp.556–64.

Kayiga, H. et al., 2016. Improving the quality of obstetric care for women with obstructed labour in the national referral hospital in Uganda: lessons learnt from criteria based audit. BMC pregnancy and childbirth, 16(1), p.152.

Merali, H.S. et al., 2014. Audit-identified avoidable factors in maternal and perinatal deaths in low resource settings: a systematic review. BMC pregnancy and childbirth, 14, p.280.

Kerber, K.J. et al., 2015. Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby. , 15(Suppl 2), pp.1–16.

Mgaya, A.H. et al., 2016. Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting, Tanzania. BMC pregnancy and childbirth, 16(1), p.343.

Aragón, T.J. & Garcia, B. a, 2015. Designing a learning health organization for collective impact. Journal of public health management and practice : JPHMP, 21 Suppl 1, pp.S24-33.



DOI: https://doi.org/10.22146/jkki.v6i2.26922

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