KEMATIAN IBU SEBELUM DAN SELAMA PELAYANAN JAMINAN PERSALINAN (JAMPERSAL) DI RSUD DR. MOEWARDI SURAKARTA TAHUN 2009 - 2013

Abstract

KEMATIAN IBU SEBELUM DAN SELAMA PELAYANAN JAMINAN PERSALINAN (JAMPERSAL) DI RSUD DR. MOEWARDI SURAKARTA TAHUN 2009 - 2013

Rustam Sunaryo¹, Mohammad Hakimi², Agung Suhadi³

ABSTRACT

Background: Maternal mortality rate in Indonesia is considered to be one of the highest among South East Asia Countries. One of the main reason is access for health services cost, which leads to massive numbers of birth outside health facility. Some programs are initiated to address these issues in order to achieve Millenium Development Goals (MDG’s) with maternal mortality target of 102/100.000 live births on 2015. Jaminan Persalinan “JAMPERSAL” is one of government policy to reduce cost barrier.

Objectives: To analyze the effect of Jampersal on reducing maternal mortality rate in Moewardi General Hospital, Surakarta.

Methods: This was an observational Analysis with cross sectional design. Data were collected from all maternal mortality cases at Moewardi General Hospital from 1 ^st of January 2009 until 31^stDecember 2013. Maternal mortality rate before and during Jampersal was taken into account for statistical analysis using Chi square Test.

Results: Total number of births were significantly increasing, for about 3.5 times. Maternal mortality percentage was decreasing significantly during Jampersal, from 1.45% to 0.53% (p=0.000). The most frequent etiology of maternal death was preeclampsia/eclampsia (53.33% - 72.40%). For this cause, Jampersal also had a potential role on lowering case fatality rate from 5.95% to 3.64% (p=0.025, p<0.05)

Conclusions: Jampersal has significantly reduce maternal mortality rate but on the other side increase number of birth in me hospital. The policy would be considerd as supportive for achieving MDG’s.

Keywords: Jampersal, Maternal Mortality, cause of death

ABSTRAK

Latar belakang: Angka kematian ibu di Indonesia masih menduduki tempat tertinggi di antara negara Asia Tenggara. Salah satu penyebabnya adalah biaya persalinan sehingga sebagian ibu melahirkan tidak di fasilitas kesehatan. Beberapa program dilakukan untuk mengatasi masalah ini agar dapat mencapai target Millenium Development Goals (MDG’s) dengan AKI 102/100.000 lahir hidup di 2015. Jaminan Persalinan “JAMPERSAL” merupakan salah satu kebijakan pemerintah untuk mengurangi hambatan biaya

Tujuan: Mengananlisis pengaruh Jampersal untuk menurunkan kematian ibu di RS Moewardi, Surakarta.

Metode: Penelitian ini merupakan penelitian observasional dengan desain cross sectional. Data dikumpulkan dari semua kasus kematian ibu di RS Moewardi dari 1 Januari 2009 hingga 31 Desember 2013. Kematian ibu sebelum dan setelah dilaksanakannya Jampersal dihitung dan dianalisis dengan Chi square Test.

Hasil: Jumlah total persalinan meningkat signifikan, sekitar 3,5 kali. Persentase kematian ibu menurun signifikan selama program Jampersal dilaksanakan, yaitu 1.45% hingga 0.53% (p=0.000). Penyebab kematian tersering adalah preeklampsia/eklampsia (53.33% - 72.40%). Jampersal menurunkan angka fatalitas kasus preeklamsia secara signifikan dari 5.95% menjadi 3.64% (p=0.025, p<0.05)

Kesimpulan: Jampersal dapat menurunkan kematian ibu di rumah sakit secara signifikan tetapi di sisi lain meningkatkan jumlah persalinan. Kebijakan ini dianggap dapat mendukung tercapainya target MDGs.

Kata kunci: Jampersal, Maternal Mortality, cause of death

1 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UNS

2 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM

3 RSUD Wonosobo