Hubungan Status Reproduksi, Status Kesehatan, Akses Pelayanan Kesehatan dengan Komplikasi Obstetri di Banda Sakti, Lhokseumawe Tahun 2005

Abstract

Di Indonesia, angka kematian ibu (AKI) masih tinggi jika dibanding sengan negara-negara ASEAN. Penyebab utama kematian ibu adalah komplikasi obs- tetri yang merupakan penyulit atau penyakit yang timbul pada waktu kehamilan, persalinan dan pasca persalinan. Di Indonesia, komplikasi obstetri (20% da- ri seluruh ibu hamil) masih sangat tinggi, sementara yang mampu ditangani hanya sekitar 10%. Berbagai faktor yang mempengaruhi komplikasi obstetri adalah status reproduksi, perilaku pencarian pelayanan kesehatan dan status kesehatan. Penelitian yang berujuan mengetahui faktor-faktor yang berhubungan dengan komplikasi obstetri ini menggunakan desain studi cross-sectional dengan sumber data primer. Sampel adalah 220 ibu yang melahirkan bayi hidup atau mati pada tahun 2005 yang ditarik secara sistematik random sampling. Hasil penelitian mendapatkan prevalensi komplikasi obstetri 46,8%, komplikasi pada waktu hamil dan persalinan merupakan yang terbanyak (12,27%) dan paling sedikit adalah komplikasi waktu hamil dan nifas masing-masing 2,27%. Model multivariat akhir mendapatkan lima variabel yang berhubungan dengan komplikasi obstetri meliputi penolong persalinan OR=4,32 (95% CI: 0,49-37,98); paritas OR=1,86 (95% CI: 0,83-4,16); sikap OR=1,66 (0,94-2,94)[ riwayat komplikasi hamil sebelumnya OR=1,79 (0,83-3,83) dan tempat persalinan OR=1,18 (95% CI: 1,01-3,26. Upaya yang perlu dilakukan untuk menurunkan kejadian komplikasi obstetri di Kecamatan Banda Sakti adalah pelatihan bidan, pengembangan PONED dan PONEK, serta memberikan pelayanan KB segera setelah bersalin kepada ibu yang memiliki paritas berisiko dan riwayat komplikasi hamil.Kata kunci: Status reproduksi, pemanfaatan pelayanan kesehatan, status kesehatan, komplikasi obstetri.The Maternal Mortality Rate (MMR). in Indonesia is still high compared to other ASEAN countries. The cause of the maternal death is obstetrical complica- tions which arise at the period of pregnancy, childbirth. The complications badly affect the maternal death. The rate of the obstetrical complications is still high in Indonesia. It is about 20% of the whole pregnant women, but the case of complications treated is still less than 10%. A variety of factors influence the occurrence of the complications. They are reproduction status, health seeking behavior service, and health status. Therefore, this study was conducted to know the factors related to the obstetrical complications. This study uses cross-sectional design. Data were collected by questionnaires. Samples are women delivering their babies alive or dead in 2005, the number of which are 220 at minimum. Before analyzing, the data were cleaned, then, categorized according to the operational definition. The data were analyzed in three steps, namely univariate, bivariate, and multivariate.The results show that of out of 46.8% of obstetrical complications incidence, the complication mostly happened (12.27%) at the pregnancy and delivery and 2.27% of it happened at pregnancy and parturition. The last analysis without interaction results in five variables related to the complications. They are delivery helper OR=4.32 (95% CI: 0.49-37.98), parity OR=1.86 (95% CI: 0.83-4.16), attitude OR=1.66 (0.94-2.94), pregnant complication history OR=1.79 (0.83-3.83). The dominant factor is place of de- livery, OR=1.18 (95% CI: 1.01-3.26). Based on the study, the incident of obstetrical complication in Banda Bakti Sub district can be decreased by training the midwives so that they have knowledge, motivation, and skill in dealing with obstetrical complications, developing PONED and PONEK, providing family plan- ning service soon after the delivery to the women who are at risk of parity and pregnant complication history, and building partnership with midwives (helping the delivery traditionally).Key words: reproductive status, health seeking behavior service, and health status with obstetric complication