Strategi Pencegahan Kematian Ibu Pada Komunitas Suku Talang Mamak di Kabupaten Indragiri Hulu

Abstract

Kabupaten Indragiri Hulu khususnya Kecamatan Rakit Kulim masih dijumpai adanya kematian ibu dan bayi. Data kasus kematian ibu di tahun 2018 (2 kasus), 2019 (1 kasus), 2020 (1 kasus), 2021 (1 kasus), 2022 (1 kasus), dari seluruh kasus kematian ibu dimana seluruhnya riwayat pertolongan persalinan ditolong oleh dukun. Kejadian ini disebabkan oleh masih kentalnya adat dan budaya serta adanya ditemukan penduduk asli yaitu komunitas suku Talang Mamak. Tujuan penelitian ini adalah mendesain strategi pencegahan kematian ibu pada komunitas suku Talang Mamak. Penelitian ini menggunakann pendekatan kualitatif dengan desain Partisipatory Action Research (PAR). Penelitian ini dilakukan selama delapan bulan dari bulan Agustus 2023 sampai Maret 2024 di Desa Sungai Ekok Kecamatan Rakit Kulim. Proses penelitian dilakukan dengan dua siklus dengan setiap siklusnya terdiri dari tahap plan, acting, observing, reflection. Pengumpulan data dilakukan wawancara mendalam, observasi, focus group discussion (FGD), dan dokumentasi. Analisis data dimulai dari reduksi data, display data, kesimpulan. Hasil menunjukkan Determinan masalah kematian ibu dapat dilihat dari berbagai kendala : 1). kendala pada tokoh adat (rendahnya pengetahuan, faktor tradisi budaya dan pengambilan keputusan keluarga besar serta tidak adanya peran tokoh adat), 2). kendala masyarakat (rendahnya pengetahuan, faktor tradisi budaya dan pengambilan keputusan, nikah muda, minim sarana kesehatan dan jarak fasilitas kesehatan), 3) kendala tenaga kesehatan (cakupan pelayanan KIA yg masih rendah, faktor tradisi budaya dan pengambilan keputusan, tidak ada pembiayaan persalinan dan belum adanya kebijakan khusus daerah). Strategi pencegahan kematian ibu dikembangkan dengan melibatkan para tokoh adat serta kelompok perempuan dan kader dalam sosialisasi edukasi kepada masyarakat dengan melakukan kunjungan rumah. Kemudian dilanjutkan juga kunjungan ke acara adat yaitu acara Gawai dan Cuci Lantai sehingga bisa diterima oleh seluruh penduduk Talang Mamak. Dari strategi yang dihasilkan terjadi perubahan perilaku pada masyarakat khususnya WUS dimana bisa terlihat dari peningkatan dalam jumlah cakupan pelayanan kesehatan ibu di Desa Sungai Ekok Kata kunci : Pencegahan, Kematian Ibu, Talang Mamak

Indragiri Hulu Regency, particularly in Rakit Kulim District, still experiences maternal and infant mortality. Data on maternal mortality cases in 2018 (2 cases), 2019 (1 case), 2020 (1 case), 2021 (1 case), and 2022 (1 case) indicate that all maternal deaths occurred with the assistance of traditional birth attendants. This is due to the strong traditional customs and culture and the presence of indigenous people, namely the Talang Mamak community. The purpose of this study is to design a strategy for preventing maternal mortality in the Talang Mamak community. This study used a qualitative approach with a Participatory Action Research (PAR) design. This study was conducted for eight months from August 2023 to March 2024 in Sungai Ekok Village, Rakit Kulim District. The research process was carried out in two cycles, each consisting of the planning, acting, observing, and reflecting stages. Data collection was carried out through in-depth interviews, observations, focus group discussions (FGDs), and documentation. Data analysis began with data reduction, data display, and conclusions. The results show that the determinants of maternal mortality problems can be seen from various obstacles: 1). obstacles to traditional leaders (low knowledge, cultural tradition factors and decision-making in the extended family and the absence of the role of traditional leaders), 2). community obstacles (low knowledge, cultural tradition factors and decision-making, early marriage, minimal health facilities and distance to health facilities), 3) obstacles to health workers (low coverage of KIA services, cultural tradition factors and decision-making, no funding for childbirth and the absence of special regional policies). The maternal mortality prevention strategy was developed by involving traditional leaders and women's groups and cadres in educational outreach to the community by conducting home visits. Then, visits to traditional events, namely the Gawai and Floor Washing events, continued so that they could be accepted by all residents of Talang Mamak. From the resulting strategy, there was a change in behavior in the community, especially WUS, which can be seen from the increase in the number of maternal health service coverage in Sungai Ekok Village. Keywords: Prevention, Maternal Mortality, Talang Mamak