Inisiasi Menyusu Dini dan Pemberian Air Susu Ibu Eksklusif di Kecamatan Johan Pahlawan Kabupaten Aceh Barat

Abstract

Majority of midwives in Johan Pahlawan Sub-district ot West Aceh District were trained in Early Initiation in 2007, intended to increase the exclusive proportion of mother’s milk. However, the implementation of early initation is not adequate yet. This study was intended to analyze the supporting and inhibiting factors in the implementation of early initation and mother’s milk in Johan Pahlawan Sub district, West Aceh District. The study was a qualitative study, using phenomenological approach. The key informants in the study were the heads of health centre. The midwives coordinators, the rural midwives, and the integrated service centre cadres. The main informants were mothers who had six-month babies and her family members (husbands, mothers, mother-in-laws, brothers and sisters, brother/sister-inlaws, and grandmothers). The method of collecting the data were using intensive interviews and observation. The data were analyzed by using constant cooperative method. The result of study showed that the supporting factors of implementing the early initiation could be seen in the trained midwives, the geographical condition, and the active intergrated public service centre. The inhibiting factors were as follows: some of the midweves who worked at the public health centre and the hospitals did not completely attend the intergrated public service centre training, and some of the mothers were fatigue. Some supporting factors in giving the mother’s milk were, among others, the awareness of the husbands and their spouses of the exclusive mother’s milk, the willingness and the positive attitude of mothers to the exclusive mother’s milk, and the availability of health facilies. Some inhibiting factors of giving the exclusive mother’s milk were the madeueng custom, the inadequate support of the health service and health field service workers in informing the exclusive mother’s milk, the lack of mother’s knowledge on the exclusive mother’s milk, the embedded nipples, and bad position in breastfeeding It is suggested that the Johan Pahlawan health centre enhance the information of the integrated service centre and the exclusive mother’s milk, empower the integrated publik service cehtre cadres, and establish the supporting group of mother’s milk. It is also suggested that the district heald office in West Aceh District make training and refreshing programs, implement the ten-step breastfeeding at the hospital, health centre, delivery clinics, private delivery clinics, and take a firm action to the officials who neglect it.

Sebagian besar bidan di Kecamatan Johan Pahlawan Kabupaten Aceh Barat, telah dilatih dalam hal Inisiasi Menyusu Dini (IMD) pada tahun 2007, dengan tujuan untuk peningkatan cakupan ASI eksklusif. Namun pelaksanaan IMD dan pemberian ASI eksklusif pada bayi belum maksimal. Penelitian ini bertujuan untuk menganalisis faktor pendukung serta penghambat pelaksanaan IMD dan pemberian ASI eksklusif di Kecamatan Johan Pahlawan Kabupaten Aceh Barat. Jenis penelitian adalah penelitian kualitatif dengan pendekatan fenominologi. Informan dalam penelitian ini terdiri dari informan kunci yaitu: kepala puskesmas, bidan koordinator, bidan desa dan kader posyandu. Informan pokok yaitu ibu yang mempunyai bayi umur 6 bulan dan anggota keluarganya (suami, ibu, ibu mertua, kakak, kakak ipar, dan nenek). Metode pengumpulan data dengan cara wawancara mendalam dan observasi. Pengolahan dan analisis data dilakukan dengan menggunakan metode perbandingan tetap (constant comperative method). Hasil penelitian menunjukkan bahwa faktor yang mendukung pelaksanaan IMD antara lain bidan sudah terlatih, kondisi geografis dan posyandu aktif. Faktor yang menghambat yaitu bidan yang bertugas di puskesmas dan rumah sakit belum semuanya mengikuti pelatihan IMD dan ibu kelelahan. Faktor yang mendukung pemberian ASI eksklusif antara lain pengetahuan suami dan istri terhadap ASI eksklusif, keinginan dan sikap positif ibu terhadap ASI eksklusif dan ketersediaan sarana kesehatan. Faktor yang menghambat pemberian ASI eksklusif yaitu budaya madeueng, pelayanan kesehatan dan petugas kesehatan yang belum sepenuhnya mendukung ASI eksklusif, pengetahuan ibu yang kurang terhadap ASI eksklusif, puting susu yang tenggelam, dan posisi menyusui yang kurang sempurna. Disarankan kepada Puskesmas Johan Pahlawan supaya meningkatkan penyuluhan tentang IMD dan ASI eksklusif, memberdayakan kader posyandu dan membentuk kelompok pendukung ASI. Dinas Kesehatan Kabupaten Aceh Barat agar membuat progam pelatihan dan penyegaran IMD, memberlakukan kebijakan tentang sepuluh langkah menyusui di rumah sakit, puskesmas, klinik bersalin dan bidan praktek swasta, serta membuat tindakan tegas bagi petugas yang tidak mengindahkannya.