Analysis of Antenatal Care Quality in Cases of Referred Pregnant Women in Emergency Rooms Based on MCH Book Records

Abstract

Objective: To determine the quality of antenatal care received by pregnant women, and perceptions of pregnant women and antenatal care providers regarding antenatal care. Method: A quantitative and qualitative study of cases of referred pregnant women in the Emergency Room (ER) of Dr. Cipto Mangunkusumo Hospital (RSCM) from 2017–2018 was conducted. Quantitative data was obtained by assessing the overall completeness of filling in the Maternal Child Health (MCH) book used to report the antenatal care received by the subjects. The completeness of antenatal care in the health facility was obtained using a checklist. Qualitative data was obtained by interviewing pregnant women and antenatal care providers in health facilities. Result: There were 1.442 cases of referred pregnant women in RSCM’s ER for the year 2017–2018, of whom 820 possessed and could show their MCH Book. Pregnancy in adolescence below 20 years (9.1%) and pregnancy after age 35 (19.5%) were reported. Most pregnant women were well educated (74.3%), referred from hospital or clinic (57.6%), received antenatal care in a public health center (38.7%), were in labor (32%), and were in the third trimester of pregnancy (92%). All subjects presented an incomplete MCH book. Almost half had inadequate antenatal frequency (46%). The completeness of antenatal care components in health care was 90–100%. Qualitatively, the perceptions of mothers and antenatal care providers regarding quality of antenatal care, was inadequate. Conclusion: The quality of antenatal care in the case of referred pregnant women at the RSCM’s ER based on MCH Book records did not meet the required standard. Keywords: antenatal care quality, MCH book Abstrak Tujuan: Menentukan kualitas asuhan antenatal pada kasus rujukan ibu hamil di IGD RSCM yang memiliki buku KIA, dan persepsi ibu hamil yang memiliki buku KIA dan tenaga kesehatan pemberi layanan kesehatan tentang asuhan antenatal. Metode: Dilakukan studi kuantitatif dan kualitatif pada kasus rujukan ibu hamil di IGD RSCM yang memiliki buku KIA tahun 2017-2018. Pengambilan data kuantitatif dilakukan dengan telaah kelengkapan pengisian buku KIA secara umum, Kelengkapan komponen asuhan antenatal di fasilitas layanan kesehatan (fasyankes) asal asuhan antenatal didapatkan dari survei menggunakan daftar tilik. Pengambilan data kualitatif dilakukan dengan wawancara mengenai persepsi ibu hamil dan tenaga kesehatan pemberi pelayanan asuhan antenatal di fasyankes asal asuhan antenatal Hasil: Terdapat 1.442 kasus rujukan ibu hamil di IGD RSCM selama tahun 2017- 2018, 820 di antaranya memiliki dan dapat menunjukkan buku KIA. Terdapat subjek dengan usia kehamilan remaja dibawah 20 tahun (9,1%) dan usia diatas 35 tahun (19,5%). Sebagian besar ibu hamil yang dirujuk cukup berpendidikan (74,3%), dirujuk oleh RS atau klinik (57,6%) dan mendapat asuhan antenatal di puskesmas (38.7%), dalam status persalinan inpartu (32%), dengan usia kehamilan trimester III (92%). Semua subjek (100%) dinyatakan tidak lengkap dalam pengisian halaman di buku KIA. Hampir setengah subjek mempunyai jumlah kunjungan antenatal yang tidak ideal (46%). Kelengkapan komponen asuhan antenatal di fasyankes asal asuhan antenatal berkisar 90-100%. Secara kualitatif, didapatkan persepsi ibu hamil dan tenaga kesehatan pemberi asuhan antenatal, terhadap kualitas asuhan antenatal masih kurang tepat. Kesimpulan: Kualitas asuhan antenatal pada kasus rujukan ibu hamil di IGD RSCM berdasar rekam Buku KIA belum memenuhi standar. Kata kunci: buku KIA , kualitas asuhan antenatal.