Implementation of Minimum Antenatal Care Service Standards in North Lampung Regency

Authors

  • Lisa Suarni Nursing Department, Poltekkes Kemenkes Tanjung Karang, Bandar Lampung, Indonesia
  • Kodri Kodri Nursing Department, Poltekkes Kemenkes Tanjung Karang, Bandar Lampung, Indonesia
  • Warjidin Aliyanto Midwifery Department, Poltekkes Kemenkes Tanjung Karang, Bandar Lampung, Indonesia
  • Hasti Primadila Nursing Department, Poltekkes Kemenkes Tanjung Karang, Bandar Lampung, Indonesia
  • Fajar Desma Wahyudi Nursing Department, Poltekkes Kemenkes Tanjung Karang, Bandar Lampung, Indonesia

DOI:

https://doi.org/10.26630/jk.v15i1.4440

Keywords:

Antenatal Care; Maternal Mortality Rate; Minimum Service Standards (MSS).

Abstract

Maternal Mortality Rate (MMR) in North Lampung is high. Coverage of antenatal care visits in 2021 (88.7%) has yet to reach the target (100%), even though the number of midwives and integrated health post (Posyandu) services increases every year. The Minimum Service Standard report also indicates that the budget for maternal care services is around 17% of the total budget allocation. This study aims to provide an overview of the implementation of the 10 Antenatal Care (ANC) services in North Lampung. The research design employs a quantitative method with a documentation study using Maternal and Child Health (MCH) books and questionnaires to measure midwives' knowledge in North Lampung. The sample size was determined using the open-source calculator SSPropor (OpenEpi, version 3), resulting in 595 collected samples for this study. Data were analyzed using univariate and bivariate analyses. None (0%) of the pregnant women received all 10 ANC services. Almost all pregnant women (>90%) received blood pressure examinations, counseling, and referral services. Meanwhile, the ANC service received least frequently (<50%) was the provision of Iron and Folic Acid (IFA) tablets. There is a significant difference in the mean coverage based on the three clusters, and there is a weak relationship between Midwives' Knowledge and the implementation of 10 ANC services. Recommendations: There is a need for programs to comprehensively improve knowledge about ANC standards among health workers and volunteers. Discipline in recording needs to be enhanced. Further qualitative studies are required to gain a broader perspective.

References

Adriana, N., Wulandari, L. P. L., & Duarsa, D. P. (2014). Akses Pelayanan Kesehatan Berhubungan dengan Pemanfaatan Fasilitas Persalinan yang Memadai di PHCs Kawangu, Kabupaten Sumba Timur. Public Health and Preventive Medicine Archive, 2(2), 135–139. https://doi.org/10.15562/phpma.v2i2.140

Anastasi, E., Borchert, M., Campbell, O. M. R., Sondorp, E., Kaducu, F., Hill, O., Okeng, D., Odong, V. N., & Lange, I. L. (2015). Losing women along the path to safe motherhood: why is there such a gap between women’s use of antenatal care and skilled birth attendance? A mixed methods study in northern Uganda. BMC Pregnancy and Childbirth, 15(1), 287. https://doi.org/10.1186/s12884-015-0695-9

Arifin, A. (2017). Studi Evaluasi Pengembangan Buku MCH di Propinsi Jawa Tengah. Project Report. Pusat Penelitian dan Pengembangan Pelayanan dan Teknologi Kesehatan.

Ashworth, D. C., Maule, S. P., Stewart, F., Nathan, H. L., Shennan, A. H., & Chappell, L. C. (2020). Setting and techniques for monitoring blood pressure during pregnancy. Cochrane Database of Systematic Reviews, 2020(8). https://doi.org/10.1002/14651858.CD012739.pub2

Bakhtiar, R., Muladi, Y., Tamaya, A., Utari, A., Yuliana, R., & Ariyanti, W. (2021). Hubungan Pengetahuan Dan Kepatuhan Ibu Hamil Anemia Dalam Mengkonsumsi Tablet Tambah Darah di Wilayah Kerja PHCs Lempake Kota Samarinda. J. Ked. Mulawarman, 8(3).

Bello, N. A., Woolley, J. J., Cleary, K. L., Falzon, L., Alpert, B. S., Oparil, S., Cutter, G., Wapner, R., Muntner, P., Tita, A. T., & Shimbo, D. (2018). Accuracy of Blood Pressure Measurement Devices in Pregnancy. Hypertension, 71(2), 326–335. https://doi.org/10.1161/HYPERTENSIONAHA.117.10295

Carl I. Fertman, Diane De Muth, & Allensworth. (2017). Health promotion programs : from theory to practice (D. D. A. Carl I. Fertman, Ed.). Jossey Bass.

Ducarme, G., Seguro, E., Chesnoy, V., Davitian, C., & Luton, D. (2012). Estimation clinique du poids fœtal et hauteur utérine dans le dépistage de l’hypotrophie fœtale à terme. Gynécologie Obstétrique & Fertilité, 40(11), 642–646. https://doi.org/10.1016/j.gyobfe.2012.09.002

Eloranta, A.-M., Gunnarsdottir, I., Thorisdottir, B., Gunnlaugsson, G., Birgisdottir, B. E., Thorsdottir, I., & Einarsdóttir, K. (2023). The combined effect of pre-pregnancy body mass index and gestational weight gain on the risk of pre-labour and intrapartum caesarean section-The ICE-MCH study. PLOS ONE, 18(1), e0280060. https://doi.org/10.1371/journal.pone.0280060

Fauvel, J.-P. (2016). Hypertensions et grossesse: aspects épidémiologiques, définition. La Presse Médicale, 45(7–8), 618–621. https://doi.org/10.1016/j.lpm.2016.05.015

Girotra, S., Malik, M., Roy, S., & Basu, S. (2023). Utilization and determinants of adequate quality antenatal care services in India: evidence from the National Family Health Survey (NFHS-5) (2019-21). BMC Pregnancy and Childbirth, 23(1), 800. https://doi.org/10.1186/s12884-023-06117-z

Harahap, M. B., Suroyo, R. B., & Safitri, M. E. (2022). Analisis Faktor Yang Memengaruhi Pemeriksaan ANC Pada Ibu Hamil Di Wilayah PHCs Alai Kota Padang Tahun 2021. MIRACLE Journal, 2(1), 138–147. https://doi.org/10.51771/mj.v2i1.246

Hikita, N., Haruna, M., Matsuzaki, M., Shiraishi, M., Takehara, K., Dagvadorj, A., Sumya, N., Bavuusuren, B., Baljinnyam, P., Ota, E., & Mori, R. (2018). Utilisation of maternal and child health handbook in Mongolia: A cross-sectional study. Health Education Journal, 77(4), 458–469. https://doi.org/10.1177/0017896917753649

Horoba, K., Wrobel, J., Jezewski, J., Kupka, T., Roj, D., & Jezewski, M. (2016). Automated detection of uterine contractions in tocography signalsComparison of algorithms. Biocybernetics and Biomedical Engineering, 36(4), 610–618. https://doi.org/10.1016/j.bbe.2016.08.005

Hutcheon, J. A., Lisonkova, S., & Joseph, K. S. (2011). Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology, 25(4), 391403. https://doi.org/10.1016/j.bpobgyn.2011.01.006

Ibikunle, H. A., Okafor, I. P., & Adejimi, A. A. (2021). Pre-natal nutrition education: Health care providers’ knowledge and quality of services in primary health care centres in Lagos, Nigeria. PLOS ONE, 16(11), e0259237. https://doi.org/10.1371/journal.pone.0259237

Japan International Cooperation Agency. (2022). Knowledge Sharing Program on Maternal and Child Health Handbook. Bogor.

Kording, F., Schoennagel, B., Lund, G., Ueberle, F., Jung, C., Adam, G., & Yamamura, J. (2015). Doppler ultrasound compared with electrocardiogram and pulse oximetry cardiac triggering: A pilot study. Magnetic Resonance in Medicine, 74(5), 1257–1265. https://doi.org/10.1002/mrm.25502

Kpewou, D. E., Poirot, E., Berger, J., Som, S. V., Laillou, A., Belayneh, S. N., & Wieringa, F. T. (2020). Maternal mid‐upper arm circumference during pregnancy and linear growth among Cambodian infants during the first months of life. Maternal & Child Nutrition, 16(S2). https://doi.org/10.1111/mcn.12951

Kupka, T., Matonia, A., Jezewski, M., Jezewski, J., Horoba, K., Wrobel, J., Czabanski, R., & Martinek, R. (2020). New Method for Beat-to-Beat Fetal Heart Rate Measurement Using Doppler Ultrasound Signal. Sensors, 20(15), 4079. https://doi.org/10.3390/s20154079

Kusumastuti, E. (2022, August 5). Anemia dalam Kehamilan. Direktorat Jenderal Pelayanan Kesehatan Kemenkes.

Lampung Provincial Health Office. (2023). Profil Kesehatan Provinsi Lampung. Lampung.

Mack, L. R., & Tomich, P. G. (2017). Gestational Diabetes. Obstetrics and Gynecology Clinics of North America, 44(2), 207–217. https://doi.org/10.1016/j.ogc.2017.02.002

Manithip, C., Edin, K., Sihavong, A., Wahlström, R., & Wessel, H. (2013). Poor quality of antenatal care services-Is lack of competence and support the reason? An observational and interview study in rural areas of Lao PDR. Midwifery, 29(3), 195-202. https://doi.org/10.1016/j.midw.2011.12.010

Mariyam, S., & Muslimah, A. E. (2018). Analisis Riwayat Tablet Tambah Darah Pada Ibu Hamil Dengan Anemia Di Indonesia ( Data Riskesdas 2018). Kebidanan, 10(2), 1-8. https://journal.unita.ac.id/index.php/bidan/article/view/404

Mikrajab Muhammad Agus, & Rachmawati Tety. (2016). Analisis Kebijakan Implementasi Antenatal Care Terpadu PHCs Di Kota Blitar. Buletin Penelitian Sistem Kesehatan, 19(1), 41–53.

Mutia, F., & Hadi, A. J. (2023). Faktor yang Berpengaruh dengan Perilaku Pemeriksaan ANC Ibu Hamil di Wilayah Kerja Puskesmas Batangtoru Kabupaten Tapanuli Selatan. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 6(9), 1887-1897.

Mutiara, E. S., Manalu, L., Klise, R. E., Aginta, S., Aini, F., & Rusmalawaty, R. (2023). Analisis Pemberian Tablet Tambah Darah pada Ibu Hamil di PHCs: Studi Literature Review. MEDIA KESEHATAN MASYARAKAT INDONESIA, 22(2), 125–135. https://doi.org/10.14710/mkmi.22.2.125-135

National Institute for Health and Care Excellence. (2019). Hypertension in pregnancy: diagnosis and management. National Institute for Health and Care Excellence (NICE).

North Lampung Health Office. (2022). Profil Kesehatan Lampung Selatan. Lampung.

Ormond, B. A., Zuckerman, S., & Lhila, A. (2000). Assessing the New Federalism, an Urban Institute Program to Assess Changing Social Policies. Washington DC. https://eric.ed.gov/?id=ED441909

Pay, A. S. D., Wiik, J., Backe, B., Jacobsson, B., Strandell, A., & Klovning, A. (2015). Symphysis-fundus height measurement to predict small-for-gestational-age status at birth: a systematic review. BMC Pregnancy and Childbirth, 15. 1-9. https://doi.org/10.1186/s12884-015-0461-z

Ministry of Health RI. (2019). Permenkes No 4 Tahun 2019 Tentang Standar Teknis Pemenuhan Mutu Pelayanan Dasar Pada Standar Pelayanan Minimal Bidang Kesehatan. Jakarta.

Qomar, U. L., Na’mah, L. U., & Yelvin, B. K. D. V. W. (2021). Hubungan Paritas, Umur Dan Usia Kehamilan Dengan Jarak Kunjungan Antenatal Care Trimester III Di Masa Pandemi Covid 19 Di PMB Brida Kitty Dinarum Vwy. Jurnal Ilmiah Kesehatan Keperawatan, 16(2).

Redaksi Mediakom. (2024). Agar Ibu dan Bayi Selamat. Jakarta: Kementerian Kesehatan Republik Indonesia. https://sehatnegeriku.kemkes.go.id/baca/blog/20240125/3944849/agar-ibu-dan-bayi-selamat/

Schiff, E., Friedman, S. A., Kao, L., & Sibai, B. M. (1995). The importance of urinary protein excretion during conservative management of severe pre-eclampsia. American Journal of Obstetrics and Gynecology, 172(1), 375. https://doi.org/10.1016/0002-9378(95)91106-5

Shivaprasad, C. (2011). Sheehan's syndrome: Newer advances. Indian Journal of Endocrinology and Metabolism, 15(7), 203. https://doi.org/10.4103/2230-8210.84869

Solnes Miltenburg, A., van der Eem, L., Nyanza, E. C., van Pelt, S., Ndaki, P., Basinda, N., & Sundby, J. (2017). Antenatal care and opportunities for quality improvement of service provision in resource-limited settings: A mixed methods study. PLOS ONE, 12(12), e0188279. https://doi.org/10.1371/journal.pone.0188279

Spasojevic, N., Vasilj, I., Hrabac, B., & Celik, D. (2015). Rural-Urban Differences in Health Care Quality Assessment. Materia Socio Medica, 27(6), 409. https://doi.org/10.5455/msm.2015.27.409-411

Supiana, N. (2021). Implementasi 10ANC dalam Pencegahan Komplikasi Kehamilan dan Persalinan di PHCs Ampenan. Jurnal Ilmu Kesehatan Dan Farmasi, 9(2), 19–24. https://doi.org/10.51673/jikf.v9i2.873

Ulfa, I. M., Suhartati, S., & Anisa, N. F. (2021). Evaluasi Pemanfaatan Buku MCH Oleh Ibu Hamil Di Kecamatan Banjarmasin Timur. Dinamika Kesehatan, Jurnal Kebidanan Dan Keperawatan,12(1), 81–96.

World Health Organization. (2024). Kematian Ibu. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.

Yang, Y.-Y., Fang, Y.-H., Wang, X., Zhang, Y., Liu, X.-J., & Yin, Z.-Z. (2018). A retrospective cohort study of risk factors and pregnancy outcomes in 14,014 Chinese pregnant women. Medicine, 97(33), e11748. https://doi.org/10.1097/MD.0000000000011748

Zile, I., Rezeberga, D., Lazdane, G., & Gavare, I. (2019). Comparison of antenatal care factors and pregnancy outcome in rural and urban context. SHS Web of Conferences (Vol. 68). EDP Sciences. https://doi.org/10.1051/shsconf/20196802007

Downloads

Published

25-04-2024