?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.relation=http%3A%2F%2Fwww.badankebijakan.kemkes.go.id%2Frepositori%2Fid%2Feprint%2F1791%2F&rft.title=The+Study+of+Roles+and+Working+Situation+of+Midwives+and+Village+Midwives+in+North+Sulawesi+Province%2C+Indonesia&rft.creator=Arifin%2C+Andryansyah&rft.subject=WQ+152-175+Childbirth.+Prenatal+Care&rft.description=The+objective+of+the+Study+of+Roles+and+Working+Situation+of+Midwives+and+Village+Midwives+in+North+Sulawesi+Province%2C+Indonesia+is+to+know+Indonesian+community+health+policy+and+working+situation+of+midwives+and+village+midwives.+++++++Specifically+is+to+know+new+community+health+policy+of+Indonesian+government+and+the+MOH%2C+to+know+midwives+and+village+midwives+working+condition+and+their+consciousness+of+their+work+and+to+know+relationship+and+information+system+among+midwives+and+village+midwives+with+community+peoples+at+Bolaang+Mongondow+District%2C+Noth+Sulawesi%2C+Indonesia.+This+study+was+conducted+at+Bolaang+Mongondow+District%2C+North+Sulawesi+Province%2C+Indonesia.++++++The+study+design+is+a+cross+sectional+study%2C+with+a+simple+random+sampling.+The+number+of+the+respondents+are+191+midwives+consist+of+%3A+24+health+center+midwives%2C+51+sub-health+center+midwives%2C+107+village%26%238217%3Bs+midwives%2C+7+hospital+midwives+and+2+district+health+office+midwives.++++++Data+was+collected+by+using+a+set+of+structure+questioner+which+consisted+characteristic+of+respondent%2C+working+condition%2C+income%2C+experience+as+birth+attendant%2C+training+and+equipment+and+drugs+availability.+There+were+4+Focus+groups+discussion+among+40+village%26%238217%3Bs+midwives+(each+group+consist+of+10+participants).+Data+collected+was+analyzed+in+frequency+distribution%2C+cross-tabulation+and+descriptively+using+SPSS+statistical+analysis.++++++Based+on+data+analysis+mentioned+above%2C+it+can+be+concluded+as+follows+%3A++++++1.+Indonesia+government+has+policy+to+place+midwive+at+village+level+to+improve+community+health.+The+main+task+of+midwive+is+to+give+maternal+and+child+health+service+health+promotion+and+strengthening+community+participation+toward+better+understanding+and+to+be+able+to+have+healthty+live%2C+beside+administrative+work.+Midwive+education+system+required+one+year+training+after+graduation+from+3+years+at+nursing+school.+Nursing+school+required+graduation+from+secondary+school.+This+education+system++of+midwife+is+different+with+education+system+in+Japan%2C+where+required+graduation+of+senior+high+school+plus+3+year+schooling+plus+3+year+schooling+and+one+year+practice+to+be+public+health+nurse.++++++2.+Most+of+the+midwives+working+at+the+village+as+temporary+government+employee+for+3+years+and+can+be+extended+when+necessary.+More+than+50+%25+midwive+has+private+practice+in+the+field+of+mother+and+child+health+and+family+planning+according+to+MOH+regulation.+The+midwive+a+average+official+working+time+is+6.9+hours+per+day%2C+and+majority+of+midwive+done+extra+work+for+about+10+hors+a+week.+The+proportion+of+time+used+per+week+for+maternal+and+child+health+(37.68%25)%2C+common+disease+exam+and+treatment+(16.55%25)+infant+health+care+(13.86%25)%2C+under+five+years+old+health+care+(12.82%25)%2C+case+referred+and+death+investigation+(8.35%25)+health+education+(6.55%25)+and+family+planning+(4.19%25).++++++3.+The+first+fifth+rank+of+priority+perceived+by+midwife+are%2C+pregnancy+examination%2C+delivery+assistant%2C+post+natal+care%2C+health+education+and+high+risk+mither+care.+There+are+some+differences+in+priority+setting+of+main+activities+among+midwive+at+health+center%2C+sub-health+center%2C+village+delivery+post+and+district+health+office.+This+defferences+may+impact+to+activity+chosen+to+be+conducted+when+a+conflict+time+occurs.+Beside+according+to+national+policy+to+reduce+maternal+death+the+first+priority+should+be+high+risk+mother+care+and+delivery+care.+When+compared+to+the+total+time+mention+by+respondent%2C+the+time+used+per+week+for+main+actives+was+50.06%25%2C+for+administrative+work+was+32%2C47%25+and+for+monitoring+and+supervision+was+17.47%25.+It+is+indicated+that+midwive+still+spent+much+time+for+administrative.+Also+in+priority+setting+for+administrative+work%2C+monitoring+and+supervision%2C+there+are+some+differences+among+midwife+at+different+working+places.++++++4.+Majority+of+delivery+assisted+or+supervised+by+midwife%2C+but+still+there+is+about+20%25+of+delivery+assisted+by+Traditional+Birth+Attendant+alone.+About+75%25+of+TBA+had+already+been+trained%2C+and+the+rest+is+untrained.+And+almost+all+midwife+has+good+cooperation+with+TBA.++++++5.+Most+of+the+midwife+think+that+they+do+not+have+sufficient+knowledge+and+skills%2C+due+to+shortage+of+training+period+and+limited+experience.+But+most+of+them+have+self+learning+habit+and+willing+to+have+more+training%2C+particularly+in+the+field+of+emergency+care%2C+family+planning+technic+and+communication+skills+for+health+promotion.+These+skills+are+needed+for+reduce+their+problem+in+serving+and+collaboration+with+community.++++++6.+Limited+number+of+medical+equipment%2C+drug+and+transportation+facilities+still+become+the+main+problems+particularly+at+sub-health+center+and+village+delivery+post.+More+than+half+of+respondent+felt+satisfied+with+their+job%2C+while+40%25+of+them+was+not+satisfied.+The+main+reasons+is+back+to+the+limited+facilities+at+their+area%2C+lack+of+communication+or+cooperation+with+local+community+and+limited+incomes.++++++++7.+All+respondent+stated+that+support+that+has+been+given+by+JICA+is+very+helpful+and+they+recommend+to+have+regular+monitoring+or+supervision+meeting+as+well+as+expect+to+get+continue+support.++++++It+is+recommended+to+have+following+activities+in+order+to+improve+midwife+knowledge+and+skills+in+conducting+quality+of+services+and+in+strengthening+the+collaboration+with+community+%3A+++++1.+Training+in+obstetric+and+neonatal+emergency+care+that+has+been+conducted+recently+need+to+be+followed+with+sufficient+equipment+and+drugs+supply.+Communication+skills+and+tools+need+to+be+improve+too+for+strengthening+community+participation.++++++2.+MCH+handbook+can+be+used+as+a+tools+for+improving+maternal+and+child+health+promotion%2C+so+that+the+implementation+of+this+book+should+be+based+on+standard+quality+of+serve+procedure.+In+this+case+an+on+the+job+training+need+to+be+conducted+for+all+midwives.+++++3.+The+need+of+a+guidance+in+prioritizing+activity+in+the+field+when+conflicting+in+time.+Administrative+work+need+to+be+reduced+by+using+one+sheet+integrated+recording+system+for+each+target+groups.+For+instance+when+mother+and+child+cohort+card+already+introduce%2C+it+is+not+necessary+to+have+other+recording+system+at+health+service+units+++++4.+A+proper+scheme+in+placement+of+village+midwife+need+to+be+developed%2C+the+scheme+may+include%2C+pre+placement+information+to+local+community%2C+introducing+the+new+and+role+of+midwife+in+formal+meeting+at+village+level+and+guideline+of+collaboration+by+upper+level+administrator.+++++5.+To+have+experience+in+midwife+activities+which+may+impact+to+the+improvement+of++quality+serve%2C+an+exchange+of+local+midwife+with+public+health+nurse+from+Japan+or+placement+of+junior+experties+at+be+considered.&rft.publisher=Badan+Penelitian+dan+Pengembangan+Kesehatan&rft.date=1999&rft.type=Monograph&rft.type=NonPeerReviewed&rft.identifier=++Arifin%2C+Andryansyah++(1999)+The+Study+of+Roles+and+Working+Situation+of+Midwives+and+Village+Midwives+in+North+Sulawesi+Province%2C+Indonesia.++Project+Report.+Badan+Penelitian+dan+Pengembangan+Kesehatan.+++++