Stikes Jenderal Achmad Yani Cimahi
Factors Contributing to Workplace’s Support to Breastfeeding Employees
1
Hemi Fitriani*,
2ImamiNur Rachmawati,
3Tri Budiati
1 Nursing Science Departement. School of Health Sciences Jenderal Achmad Yani
2,3 Department of Maternity Nursing Science University Indonesia Email : [email protected]
Abstract
One of the factors contributing to the low successful rate of the national exclusive breastfeeding is the lack of workplace‘s supports to breastfeeding employees (Harnowo,2012). This research further investigates what factors enable to this low support. Employing the cross-sectional approach, this research involves 130 company managers selected through stratified random sampling technique.
Conducted in Cimahi, this research administers Chow Questionnaire (2009) in investigating manager‘s attitude toward breastfeeding. Furthermore, Pan-Asian Lactation Consultant Association (PALCA) questionnaire (2012) is administered to gauge the workplace‘s support. The findings show that the company ownership, whether it is public or private, and whether or not the company operates in health sector contribute the most. The company ownership, in this sense, the public company, is proved to demonstrate the greatest influence. The government should play a great role in supporting breastfeeding program. It is recommended that the government takes part in assisting, supervising and giving penalties to any violations in attempts to support breastfeeding in workplaces.
Key words : breastfeeding, cross sectional, employees, manager, workplace’s support
Introduction
Nutritional status of children under 5 years of age needsa crucial consideration and attention due to the higher risk of diseases and death. Result of National Basic Health Research (Riskedas) 2010 proved that the prevalence of underweightchildrenin 2010 wasin high rate around 17,9%.
However, the target of underweight prevalence by 2015 decreased to 15% (Kementerian Kesehatan Republik Indonesia, 2012). Governments hasefforted to reducethisproblem by promoting exclusive breastfeeding program. The findingshows that this program contributes to the prevention of underweight problem among children(Mediana, 2011).
National target of exclusive breastfeeding program in Indonesia is 80%, but the implementation of this programis still in low rate.Riskesdas (2010) approved that exclusive breastfeeding program on newborn infants until 5 month in Indonesia is only reached to 15,3%
(Ministry of Health of The Republic Indonesia.2012). However, this program reached to 67,3% in West Java (Department of Health of The Republic Indonesia.2011). This condition proves that Indonesian infants have higher risk of underweight problem, disease and death. Moreover, the major concern on maternal breastfeeding restriction in Indonesia isthe condition of breastfeeding employees (Weni, 2012).
Breastfeeding employees realized that workplace becomes one of the reasons they quitbreastfeeding early. Furthermore, the limited time for pumping, the limitation of exclusive breastfeeding pump tools, and the lack of private space becomethe other factorsof this discontinuedexclusive breastfeeding program(Coffman. 2011; Rejeki.2004).
The numbers of employees in Indonesia increase every year.In fact, data of The National Labor Force Survey (Sakernas) show that the rate of Indonesian female employees in 2008 was37,9% and it increased to 38,58% in 2010 (Department of Manpower and Transmigration, 2013).As breastfeeding employees grow higher, workplace can helpto reducethe problem of underweightchildrenby allocating an adequateplace and time for pumping andproviding the appropriate breastfeeding facilities. These strategies will be helpful for both breastfeeding employee and her infants.In this sense, the existence of workplace‘s law in gainingmore support to breastfeeding employees is significantly contributed to the successful of breastfeeding behavior(Chen, Wu, & Chie. 2006). In addition, the employees expect that workplace will support
and allow them to breastfeed their newborn infants by providing the private space and pumping times (Rejeki, 2004).
The finding shows that workplace which have the appropriate breastfeeding facilities are only 10,81% while the private offices providing these facilities are 11,11% (Harnowo.2012).The low numberof breastfeeding facilities at workplacewillindirectly restrict to the successfulexclusive breastfeeding program. Another study from the other contries proved that the lack ofworkplace‘s supports to this program is caused by lactation since manyworkplacesconvinced that lactation makes their employees less productive, increases outcome and wastes the times. (Stewart & Glenn, 2008;
Bai,Wunderlich, & Weinstock.2012).Eitherresearchmainly investigates about workplace‘s support to breastfeeding employees or research concerns on managers‘ attitude toward breastfeeding employees by involving company managers as the respondents have not been widely conducted in Indonesia. Therefore, the research focuses on workplace‘s support to breastfeeding employees should be conducted.
This research is conducted in Cimahi which is located in West Java. In 2007, the target of exclusive breastfeeding program in this city is56,36%, or below thespecific national target.11 Therefore, this research is being crucial to be conducted since the numbers of employees in Cimahi as a central city of industry increase every year (Development Planning Agency at Sub National Level/ BappedaCimahi.2011).
The result of this research can be used as referencesfor government in evaluating the implementation of Government Regulation of The Republic Indonesia Number 33 years 2012on the exclusive breastfeeding at workplace, particularly in Cimahi. Likewise, the data of this research are expected to bethe additional information for government‘s policy to reduce this crucial problem andit expectedlywill gain high support to this successful program in Indonesia, particularly in Cimahi.
Whereas, the successful exclusive breastfeeding program will optimally increase the number of child health and the quality of human resources.
Methods
The research belongs to quantitative by employing cross-sectional approach.The samples of this researchinvolve 130 company managers selected through stratified random sampling technique.The inclusion criteria of the sample are the company managers worked in unseasonal industry and hired the productive employees.Meanwhile, the exclusion criteria are thosewho are not willing to involve in this research.The instrument of the research is questionnaire with validity (r is calculated 0,374–0,928 > 0,3) and high reliability (reliability range is 0,612–0,932).
Furthermore, the technique of data analysis are divided intofrequency distribution for univariate data, chi square formulafor bivariate and predictive logistic regression formula for multivariate data. The research is conducted by holding three principles of ethical research include beneficence, respect for human dignity danjuctice which resulted in informed consent from respondents.In addition, this research has successfully passed the ethical test by its related committee in Faculty of Nursing Science at University of Indonesia.
Stikes Jenderal Achmad Yani Cimahi Result
Table 1 The result of logistic regression analysis using backward method
Government law and regulations among exclusive breastfeeding program at workplace has not been conducted appropriately.In this case, government that should play the great role as the initiator, facilitator and motivator of 1.000 Days of Life Movement (HPK) to increase the percentage of overweight children (Menkokesra, 2013) is not able to give the optimal efforts in gaining many supports to breastfeeding employees. This inability of central government indirectly restricts the successful program of breastfeeding employees. Moreover, both public and private company still gain low support to this program.
Furthermore, government is not able to determine the penalties to workplace which defense Governmental Regulation Number 33 of 2012 about breastfeeding program at workplace. The major concerns of breaking right by the company managers toward the reproductive employees, such as the right of breastfeeding progarm at work is the inexistence of penalities toward law enforcement against this violation (Effendi, 2013; Bintoro, Ardhanariwari dan Permana, 2013). Moreover, this inexistence gives many opportunities for company to defense the rights of the employees. In fact, the company will freely to disallow and defense the law and regulation for breastfeeding employees resulting in law negligence and low workplace‘s supports to exclusive breastfeeding program.
Hojnacki (2010), reveals that the company focused on both health and non-health sectors contribute to workplace‘s supports to breastfeeding employees. However, the companies focused on health sectors have 4,314 times of opportunities in supporting breastfeeding employees than non- health sectors. Winardi (2004) stated that people‘s behaviors are basically oriented to their goals (Silaniherlina, 2012). It means that the company on health sectors is oriented to public health services. Government Law Number 33 of 2009 article 48 verse 1 stated that heath care contributes to the implementation of health efforts by government. Furthermore, exclusive breastfeeding program is aimed to reduce the problem of underweightchildren and the company focused on health sectors is contributing the most to this program. This sector implements the specific programs of the government‘s policy for improving children‘s nutrition in Indonesia. One of the programs is promoting exclusive breastfeeding program (Coordinating Ministry for People Welfare of the
Stikes Jenderal Achmad Yani Cimahi
Data shows that all of respondents‘ characteristics include middle-aged employees, marriage, children, high educational background, upper company manager, good knowledge and attitude still gain low workplace‘s support to breastfeeding employees. It proved by Kurt Lewin theory (1970) which states behavior is the balanced condition of driving forces and restrining forces (Silaniherlina, 2012). Furthermore, the factors contributing the most to workplace‘s supports to breastfeeding employees are female middle-aged company managers who got married and have children. Many of them are upper managers who were graduated from high educational background, so they have good knowledge and attitude toward exclusive breastfeeding program at work. Mean while, workplace has not yet supported breastfeeding employees since both of the contributed factors and retraining factors of the companyare not stabilized.
The research found that there are the other retrain factors exist in contributing workplace‘s supports to breastfeeding employees. These factors include the perception and value of the organization (Rahmani, 2012). In this case, workplace gives a negative perception of lactation program for breastfeeding employees. As it stated by vice of General Secretary of Indonesian Young Entrepreneurs Association (Apindo), Frangky (2011); Government Draft Regulation (RPP) oriented to exclusive breastfeeding causes the implication of high cost economics, disruption on business and low industrial competitiveness(Hukum online, 2011). All of these perceptions prevent to gain more workplace‘s supports to breastfeeding employees.
In this sense, workplace should realize that the actual advantage of lactation program is decreasing employees‘ absences because of sick children. Furthermore, it decreases the turn-over rate of female employees resulted in reducing the cost training of new employees (Fall, 2006). In this case, educational program play the role to change a negative into a positive perception. Thus, it indirectly reduces the restricted factors and changes the company managers‘ knowledge andattitude toward breastfeeding employees.
Another retrain factors is workplace‘s values. Workplace oriented to high financial and achievement targets will decide to disallow exclusive breastfeeding program since this program will restrict to company‘s objectives.As a result, this negative value belongs to the second reasons of low workplace‘s supports to breastfeeding employees.
Verschoor stated that the characteristics of organizations‘ must hold the valuable vision, mission and values as their basic guidelines (Susanto, 2006). In this case, the crucial values are prioritizing the most important public interest than individual or group. Workplace which holds these principles will prioritize to consider the benefit of lactation program beside concern on its negative effect. In fact, this program produces the high income as well as the high quality of the company.
These condition are resulted bythree maint points include providing exclusive breastfeeding program and its facilities, helping government to improve the percentage of overweight children and increasing the quality of human resources.
Furthermore, government plays the great role to change the perspective of company managers in making straight vision concerning on health issues. Therefore, they can reach the target of exclusive breastfeeding program at workplace. Indonesian Law Number 36 of 2009 article 18 on health stated that government shall be responsible for empowering and encouraging active participation of the people in any form of health efforts (Ministry of Health of Republic Indonesia, 2009).
In addition, another factor of low workplace‘s supports to breastfeeding employees is low of supervision and inexistence of the penalties for law negligence toward exclusive breastfeeding program at workplace (SPMSTRANAS, 2013). Moreover, underweight children problem has not clearly been solved since the existence of penalties for WHO Code violation about Breast Feeding already promoted in 2012.
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