Pemberdayaan masyarakat dalam upaya peningkatan kesehatan ibu dan anak melalui pelatihan keluarga ibu hamil ts III tentang kesiapan menghadapi persalinan aman di Wilayah Puskesmas Tanjung Harjo Kabupaten Bojonegoro

Di Wilayah Puskesmas Tanjungharjo Kasus Kematian Ibu Tahun 2019 ada 1 dari Lahir hidup 458 atau AKI sebesar 218/100.000 KH dari target 102/100.000 KH, Komplikasi kehamilan tahun 2019 adalah 39,19% dan komplikasi persalinan 32,26% dari targetnya 15-20%, pada tahun 2020 komplikasi kehamilan 40.96% dan komplikasi persalinan 44,17% dan Puskesmas yang mempunyai wilayah desa kelurahan yang melaksanakan P4K Tahun 2019 sebesar 58% dari Target 100%. Mengacu kepada butir analisa permasalahan yang teridentifikasi maka ditemukan dua masalah utama yang dihadapi mitra yaitu belum maksimalnya keluarga dalam kesiapan menghadapi persalinan Aman dan belum maksimalnya pelayanan kesehatan dalam pemberian penyuluhan dan konseling mengenai persiapan persalinan pada saat antenatal care. Upaya penurunan kematian ibu diperlukan adanya pemberdayaan terhadap masyarakat, perlu dilakukan upaya peningkatan pengetahuan dan sikap keluarga dan masyarakat mengenai pentingnya memahami bahwa setiap kehamilan beresiko mengalami komplikasi yang mengancam jiwa, oleh karenanya perlu melakukan perencanaan persalinan dengan baik dan perencanaan untuk melakukan pencegahan dan pencarian pertolongan segera bila komplikasi terjadi (kesiapan transportasi, dana dan calon donor darah) dalam program KB. Berdasarkan analisis situasi dan permasalahan mitra tersebut diatas, kami melaksanakan kegiatan pengabdian kepada masyarakat berupa pemberdayaan masyarakat dalam upaya peningkatan kesehatan Ibu dan Anak melalui Pelatihan Keluarga Ibu Hamil TS III Tentang kesiapan menghadapi persalinan aman di wilayah Puskesmas Tanjung Harjo Kabupaten Bojonegoro. Pelatihan ini karena sasaran keluarga ibu hamil trimester III yaitu Suami, maka kegiatan dilaksanakan malam hari, karena suami pada siang hari bekerja, dilaksanakan selama 3 (tiga) hari bertempat di Balai Desa Tanjungharjo dengan protokol kesehatan yang ketat, diikuti 30 peserta dengan menggunakan metode ceramah, dan pemberian materi tentang kesiapan menghadapi persalinan aman dan KIE tentang kesiapan menghadapi persalinan aman. Hasil kegiatan adalah terbentuknya 30 Suami siaga dengan hasil rata-rata pengetahuan peserta pelatihan sebagian besar (85,50%) peserta pelatihan mempunyai nilai post test sangat baik dan nilai rata-rata keterampilan peserta dalam penyuluhan sangat baik (83,33%) dan terbentuk komitmen bersama dari Kepala Puskesmas TanjungHarjo, Kepala Desa Tanjungharjo, Bidan Desa Tanjungharjo dan seluruh peserta pelatihan kesiapan menghadapi persalinan Aman (100%). Hasil Survey Kepuasan peserta didapatkan 96,67% menyatakan sangat puas. Evaluasi pelaksanaan menilai Keluarga Ibu Hamil TS III (Suami) yang sudah dilatih membina 2 orang di lingkungan desa sekitarnya dari keluarga Ibu Hamil sejumlah 60 Suami dengan penyuluhan tentang kesiapan menghadapi persalinan aman dengan mengunakan leaflet, Pengisian Sticker P4K (Perencanaan Persalinan dan Pencegahan Komplikasi) dan menempel Sticker P4K di Pintu Depan Rumah. Luaran Pengabdian masyarkat adalah tersusunnya Modul tentang kesiapan menghadapi persalinan aman bagi keluarga ibu hamil, publikasi dan HKI. Keluarga Ibu Hamil disarankan untuk mengetahui kehamilan yang beresiko dengan persiapan dan perencanaan persalinan dan kesiagaan menghadapi komplikasi Obstetri dan Neonatal.

In the Tanjungharjo Health Center area, there was 1 case of maternal mortality in 2019 there were 458 live births or an MMR of 218/100,000 KH from the target of 102/100,000 KH, pregnancy complications in 2019 were 39.19% and childbirth complications 32.26% of the target 15-20 %, in 2020 pregnancy complications were 40.96% and delivery complications were 44.17% and the Puskesmas which had urban village areas that carried out P4K in 2019 was 58% of the 100% target. Referring to the problem analysis items identified, it was found that two main problems faced by partners were that the family was not maximally prepared to face safe delivery and the health services were not maximal in providing counseling and counseling regarding preparation for childbirth during antenatal care. Efforts to reduce maternal mortality require empowerment of the community, efforts need to be made to increase knowledge and attitudes of families and communities regarding the importance of understanding that every pregnancy is at risk for lifethreatening complications, therefore it is necessary to plan delivery properly and plan to prevent and seek immediate help. if complications occur (readiness of transportation, funds and prospective blood donors) in the family planning program. Based on the analysis of the situation and the problems of the partners mentioned above, we carried out community service activities in the form of community empowerment in an effort to improve maternal and child health through Family Training for Pregnant Women TS III on readiness to face safe delivery in the Tanjung Harjo Health Center, Bojonegoro Regency. This training is because the target family of pregnant women in the third trimester is husband, so the activity is carried out at night, because the husband works during the day, it is carried out for 3 (three) days at the Tanjungharjo Village Hall with strict health protocols, followed by 30 participants using the lecture method , and providing materials on readiness for safe delivery and IEC on readiness for safe delivery. The results of the activity were the formation of 30 standby husbands with the results of the average knowledge of the training participants (85.50%) that the training participants had very good post-test scores and the average value of participants' skills in counseling was very good (83.33%) and formed joint commitment from the Head of TanjungHarjo Health Center, Tanjungharjo Village Head, Tanjungharjo Village Midwife and all training participants in readiness to face safe delivery (100%). The results of the Satisfaction Survey of participants obtained 96.67% stated that they were very satisfied. The evaluation of the implementation assessed the families of pregnant women TS III (husbands) who had been trained to foster 2 people in the surrounding village environment from the families of 60 pregnant women with counseling about readiness to face safe delivery using leaflets, Filling in P4K Sticker (Delivery Planning and Complication Prevention) and stick the P4K Sticker on the front door of the house. Outcomes of Community Service are the compilation of Modules on readiness to face safe delivery for families of pregnant women, publications and HKI. Pregnant women's families are advised to find out which pregnancies are at risk by preparing and planning for delivery and being prepared for obstetric and neonatal complications.