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ABSTRAK
Hasil Survei Demografi Kesehatan Indonesia (SDKI) tahun 2012 menunjukkan terjadi peningkatan Angka Kematian Ibu (AKI) sebesar 57 %. Berdasarkan Data Laporan Kesehatan Ibu Propinsi Sumatera Utara tahun 2012-2013, Kabupaten Labuhanbatu Utara menempati urutan ke-2 tertinggi dalam hal jumlah kematian ibu.
Jenis penelitian ini adalah observasional analitik dengan rancangan studi kasus kontrol, yang bertujuan untuk mengetahui faktor-faktor yang mempengaruhi kematian ibu di Kabupaten Labuhanbatu Utara. Populasi kasus adalah seluruh kematian ibu selama tahun 2012-2013, berjumlah 40 orang. Populasi kontrol adalah ibu pasca persalinan yang hidup yang pernah mengalami komplikasi obstetri. Sampel diambil dengan total sampling. Matching kontrol dilakukan terhadap umur, tempat tinggal, dan komplikasi obstetri. Perbandingan kasus dan kontrol 1:1. Analisis data dilakukan secara univariat, bivariat dan multivariat.
Berdasarkan analisis bivariat, faktor non medik meliputi keputusan merujuk (p=0,027 OR=4,333; 95%CI:1,271-14,777) dan faktor pelayanan kesehatan meliputi akses (p<0,001 OR=7,071; 95%CI:2,519-19,850), penanganan adekuat (p<0,001 OR=9,444; 95% CI:3,212-27,767), dan tenaga pemeriksa kesehatan (p=0,039 OR=3,051; 95%CI:1,032-9,022) berhubungan dan merupakan faktor risiko kematiaan ibu. Berdasarkan analisis multivariat, penanganan adekuat (p=0,006 OR=5,368; 95%CI:1,604-17,963) adalah variabel yang paling berpengaruh, dengan nilai probabilitas sebesar 49,08%, dan nilai PAR=73,19%..
Disarankan peningkatan kompetensi bagi tenaga kesehatan yang menangani pelayanan obstetri melalui pelatihan-pelatihan, pendekatan akses baik dari pemerintah melalui peningkatan kembali fungsi ambulance puskesmas dan pemberdayaan masyarakat, dan melakukan penyuluhan kepada masyarakat.
Kata Kunci : Kematian Ibu, Faktor Risiko, Kabupaten Labuhanbatu Utara
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ABSTRACT
According to the result of Indonesia Health Demography Survey (SDKI) conducted in 2012, the Maternal Mortality Rate increased for 57%. Based on the data of the Report of Maternal Health, Province of Sumatera Utara 2012-2013, Labuhanbatu Utara District ranked second in terms of the highest Maternal Mortality Rate .
The purpose of this analytical observational study with a case-control study design was to find out the factors influencing maternal mortality in Labuhanbatu Utara District. The population for case group was all of the 40 maternal mortalities during the period of 2012 – 2013. The population for control group was all of the post-partum mothers who were still alive but had experienced obstetric complications during the period of 2012 – 2013. The samples for this study were selected through total sampling technique. Matching control was done to age, residence, and obstetric complications. The case-control ratio was 1 : 1. The data obtained were analyzed through univariate, bivariate and multivariate analysis.
The result of bivariate analysis showed that the non-medical factor included the decision to refer (p = 0.027 OR = 4.333; 95% CI: 1.271 – 14.777), and the health service factors included access (p < 0.000 OR = 7.071; 95% CI: 2.519 – 19.850), adequate handling (p < 0.000 OR = 9.444; 95% CI: 3.212 – 27.767), and health inspectors (p = 0.039 OR = 3.051; 95% CI: 1.032 – 9.022). These factors were realated to and became the risk factors of maternal mortality. The result of multivariate analysis showed that the inadequate handlin (p = 0.006 OR = 5.368; 95% CI: 1.604 – 17.963 was the most influencing variable with the value of Probability of 49.08% and PAR = 73.19%. .
It is suggested that the competency of health workers handling obstetric complications be improved through trainings, the access approach by the government be improved through the improvement of the function of the ambulance belongs to the Puskesmas (Community Health Center) and the implementation of community empowerment and the provision of extension for the community at large.
Keywords: Maternal Mortality, Risk Factor, Labuhanbatu Utara District
