Faktor Ketidakpuasan Ibu Hamil dalam Pelayanan Asuhan Kehamilan

Dwie Ayu, Sulistyaningsih Sulistyaningsih
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Pelayanan asuhan kehamilan sebagai strategi untuk menurunkan angka kematian ibu. Salah satu masalah penting yang terus dihadapi adalah kurangnya kualitas baik pelayanan antenatal sehingga mempengaruhi kepuasan klien. Kepuasan merupakan indikator mutu pelayanan. Kepuasan ibu hamil penting untuk perbaikan lebih lanjut dari kualitas perawatan antenatal terfokus dan untuk memberikan pelayanan kesehatan yang beragam bagi wanita hamil. Tujuan dari systematic literature review ini adalah untuk menyimpulkan dan memeriksa literature yang berhubungan kepuasan ibu hamil terhadap kualitas pelayanan dalam asuhan kehamilan dan untuk mengetahui penyebab ketidakpuasan dalam pelayanan asuhan kehamilan. Studi apprasial menggunaan program Critical Appraisal Skills Program (CASP) dan metode sintesis menggunakan modifikasi PICO dengan sumber data didapatkan dari PubMed dan ProQuest terdapat 734 artikel yang di review. Kriteria inklusi adalah (1) Ibu hamil; (2) Pelayanan dalam Asuhan kehamilan; (3) Kepuasan ibu hamil; (4) Teks lengkap; (5) Artikel yang diterbitkan dari 2013 hingga 2018; dan (6) jurnal internasional. Terdapat 5 artikel yang memenuhi kriteria inklusi. Kepuasan ibu hamil terhadap kualitas pelayanan asuhan kehamilan di fasilitas kesehatan dipengaruhi oleh layanan klinik, aksesibilitas  klinik dan interaksi dokter. Penyebab ketidakpuasan ibu hamil dalam pelayanan asuhan kehamilan diantaranya lamanya waktu menunggu, fasilitas kesehatan dan komunikasi interpersonal. Dari hasil 4 artikel yang diulas didapatkan faktor utama yang menyebabkan ketidakpuasan dalam pelayanan asuhan kehamilan adalah lamanya waktu menunggu. Perlu pelayanan ANC dengan pendekatan HTA (health technology assasment) untuk mempercepat pelayanan administrasi dan observasi awal pada ibu hamil dengan mengintegrasikan teknologi RFID (Radio Frequency identification) dan WSN (wireless sensor network).


Pregnancy care services as a strategy to reduce maternal mortality. One important problem that continues to increase is the good quality of antenatal services that affects client satisfaction. Satisfaction is an indicator of service quality. Pregnancy satisfaction is important for further improvement of the quality of focused antenatal care and to provide comprehensive health services for pregnant women. The purpose of this,  systematic literature review is to conclude and examine the literature relating to the satisfaction of pregnant women with the quality of care in care Appraisal studies using the Critical Appraisal Skills Program (CASP) and synthesis methods using PICO with data sources obtained from PubMed and ProQuest containing 734 articles as reviewed. Inclusion criteria are (1) Pregnant women; (2) Services in Pregnancy Care; (3) Satisfaction of pregnant women; (4) Full text; (5) Articles published from 2013 to 2018; and (6) international journals. There are 5 articles that meet the inclusion criteria. Satisfaction of pregnant women towards the quality of pregnancy care services in health facilities as assessed by clinical services, clinic accessibility and physician interaction. The cause of dissatisfied pregnant women in pregnant care services is waiting for the length of waiting time, health facilities and interpersonal communication. From the results of 4 articles worthy of review about the main factors that cause dissatisfaction in care services Need ANC assistance by discussing HTA (health technology assessment) to improve administrative services and early monitoring of pregnant women by integrating RFID technology (Radio Frequency Identification) and WSN (network wireless sensor).


Asuhan Kehamilan; Kualitas Pelayanan; Kepuasan Ibu Hamil

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Adeyinka, O., Jukic, A. M., McGarvey, S. T., Muasau-Howard, B. T., Faiai, M., & Hawley, N. L. (2017). Predictors of prenatal care satisfaction among pregnant women in American Samoa. BMC Pregnancy and Childbirth, 17(1), 1–14. https://doi.org/10.1186/s12884-017-1563-6

Babalola, S. (2014). Women’s Education Level, Antenatal Visits and the Quality of Skilled Antenatal Care: A Study of Three African Countries. Journal of Health Care for the Poor and Underserved, 25(1), 161–179. https://doi.org/10.1353/hpu.2014.0049

Bahadoran, P., Fahami, F., & Mohamadirizi, S. (2014). Effect of E-learning on primigravida women′s satisfaction and awareness concerning prenatal care. Journal of Education and Health Promotion. https://doi.org/10.4103/2277-9531.127574

Butler, M. M., Sheehy, L., Kington, M. M., Walsh, M. C., Brosnan, M. C., Murphy, M., … Barry, T. (2015). Evaluating midwife-led antenatal care: Choice, experience, effectiveness, and preparation for pregnancy. Midwifery, 31(4), 418–425. https://doi.org/10.1016/j.midw.2014.12.002

Chemir, F., Alemseged, F., & Workneh, D. (2014). Satisfaction with focused antenatal care service and associated factors among pregnant women attending focused antenatal care at health centers in Jimma town, Jimma zone, South West Ethiopia; a facility based cross-sectional study triangulated with qualitative study. BMC Research Notes, 7(1), 164. https://doi.org/10.1186/1756-0500-7-164

Creanga, A. A., Gullo, S., Kuhlmann, A. K. S., Msiska, T. W., & Galavotti, C. (2017). Is quality of care a key predictor of perinatal health care utilization and patient satisfaction in Malawi? BMC Pregnancy and Childbirth, 17(1), 1–13. https://doi.org/10.1186/s12884-017-1331-7

Desalegn, D. M., Abay, S., & Taye, B. (2016). The availability and functional status of focused antenatal care laboratory services at public health facilities in Addis Ababa, Ethiopia. BMC Research Notes, 9(1), 1–8. https://doi.org/10.1186/s13104-016-2207-z

Diamond-Smith, N., Sudhinaraset, M., & Montagu, D. (2016). Clinical and perceived quality of care for maternal, neonatal and antenatal care in Kenya and Namibia: The service provision assessment. Reproductive Health, 13(1), 1–13. https://doi.org/10.1186/s12978-016-0208-y

Ejigu, T., Woldie, M., & Kifle, Y. (2013). Quality of antenatal care services at public health facilities of Bahir-Dar special zone, Northwest Ethiopia. BMC Health Services Research, 13(1), 1. https://doi.org/10.1186/1472-6963-13-443

Fleming, E., Gaines, J., Connor, K. O., & Quick, R. (2017). antenatal care and delivery services in Kenya ? Results of a qualitative inquiry, 28, 153–174.

Floris, L., Irion, O., Bonnet, J., Politis Mercier, M.-P., & de Labrusse, C. (2018). Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction. Women and Birth, 31(2), 124–133. https://doi.org/https://doi.org/10.1016/j.wombi.2017.06.021

Gamedze-Mshayisa, D. I., Kuo, S. C., Liu, C. Y., & Lu, Y. Y. (2018). Factors associated with women’s perception of and satisfaction with quality of intrapartum care practices in Swaziland. Midwifery, 57, 32–38. https://doi.org/10.1016/j.midw.2017.10.016

gladys reuben. (2015). Women’s perceptions of antenatal, delivery, and postpartum services in rural Tanzania Global Health Action Vol 8, No 1, 1, 1–9. https://doi.org/10.3402/gha.v8.28567

Hatherall, B., Morris, J., Jamal, F., Sweeney, L., Wiggins, M., Kaur, I., … Harden, A. (2016). Timing of the initiation of antenatal care: An exploratory qualitative study of women and service providers in East London. Midwifery, 36, 1–7. https://doi.org/10.1016/j.midw.2016.02.017

Heaman, M. I., Moffatt, M., Elliott, L., Sword, W., Helewa, M. E., Morris, H., … Cook, C. (2014). Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: A case-control study. BMC Pregnancy and Childbirth, 14(1), 1–16. https://doi.org/10.1186/1471-2393-14-227

Henshall, C., Taylor, B., Goodwin, L., Farre, A., Jones, M. E., & Kenyon, S. (2018). Improving the quality and content of midwives’ discussions with low-risk women about their options for place of birth: Co-production and evaluation of an intervention package. Midwifery, 59, 118–126. https://doi.org/10.1016/j.midw.2018.01.016

Hildingsson, I., Haines, H., Cross, M., Pallant, J. F., & Rubertsson, C. (2013). Women’s satisfaction with antenatal care: Comparing women in Sweden and Australia. Women and Birth, 26(1), e9–e14. https://doi.org/10.1016/j.wombi.2012.06.002

Hodgins, S., & D’Agostino, A. (2014). The quality-coverage gap in antenatal care: toward better measurement of effective coverage. Global Health: Science and Practice, 2(2), 173–181. https://doi.org/10.9745/GHSP-D-13-00176

Hurst, T. E., Semrau, K., Patna, M., Gawande, A., & Hirschhorn, L. R. (2015). Demand-side interventions for maternal care: Evidence of more use, not better outcomes. BMC Pregnancy and Childbirth, 15(1). https://doi.org/10.1016/0303-8467(92)90098-N

Kamil, A., & Khorshid, E. (2013). Maternal perceptions of antenatal care provision at a tertiary level hospital, Riyadh. Oman Medical Journal, 28(1), 33–35. https://doi.org/10.5001/omj.2013.07

Kisuule, I., Kaye, D. K., Najjuka, F., Ssematimba, S. K., Arinda, A., Nakitende, G., & Otim, L. (2013). Timing and reasons for coming late for the first antenatal care visit by pregnant women at Mulago hospital, Kampala Uganda. BMC Pregnancy and Childbirth, 13, 1–7. https://doi.org/10.1186/1471-2393-13-121

Koblinsky, M., Moyer, C. A., Calvert, C., Campbell, J., Campbell, O. M. R., Feigl, A. B., … Langer, A. (2016). Quality maternity care for every woman, everywhere: a call to action. The Lancet, 388(10057), 2307–2320. https://doi.org/http://dx.doi.org/10.1016/S0140-6736(16)31333-2

Liu, R., Chao, M. T., Jostad-laswell, A., & Duncan, L. G. (2017). Does CenteringPregnancy Group Prenatal Care Affect the Birth Experience of Underserved Women? A Mixed Methods Analysis. Journal of Immigrant and Minority Health, 19(2), 415–422. https://doi.org/http://dx.doi.org/10.1007/s10903-016-0371-9

Mateji, Milicevic, Djikanovic, & Vasic. (2014). Maternal satisfaction with organized perinatal care in Serbian public hospitals. BMC Pregnancy and Childbirth, 14(1). https://doi.org/10.1186/1471-2393-14-14

McDonald, S. D., Sword, W., Eryuzlu, L. E., & Biringer, A. B. (2014). A qualitative descriptive study of the group prenatal care experience: perceptions of women with low-risk pregnancies and their midwives. BMC Pregnancy and Childbirth, 14(1), 334. https://doi.org/10.1186/1471-2393-14-334

Mekonnen, M. E., Yalew, W. A., & Anteneh, Z. A. (2015). Women’s satisfaction with childbirth care in Felege Hiwot Referral Hospital, Bahir Dar city, Northwest Ethiopia, 2014: Cross sectional study Womens Health. BMC Research Notes, 8(1), 528. https://doi.org/10.1186/s13104-015-1494-0

Miltenburg, A. S., Van Der Eem, L., Nyanza, E. C., Van Pelt, S., Ndaki, P., Basinda, N., & Sundby, J. (2017). Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study. PLoS ONE, 12(12), 1–15. https://doi.org/10.1371/journal.pone.0188279

Mortensen, B., Lukasse, M., Diep, L. M., Lieng, M., Abu-Awad, A., Suleiman, M., & Fosse, E. (2018). Can a midwife-led continuity model improve maternal services in a low-resource setting? A non-randomised cluster intervention study in Palestine. BMJ Open, 8(3), e019568. https://doi.org/10.1136/bmjopen-2017-019568

N.N.A., K., C., C., & S., G. (2012). Quality of antenatal care in Zambia: A national assessment. BMC Pregnancy and Childbirth, 12. Retrieved from http://www.biomedcentral.com/1471-2393/12/151%5Cnhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed11&NEWS=N&AN=2013014785

Nwaeze, I. L., Enabor, O. O., Oluwasola, T. A. O., & Aimakhu, C. O. (2013). Nigeria 2017 Ibadan, 11(1), 22–28.

Okonofua, F., Ogu, R., Agholor, K., Okike, O., Abdus-Salam, R., Gana, M., … Galadanci, H. (2017). Qualitative assessment of women’s satisfaction with maternal health care in referral hospitals in Nigeria. Reproductive Health, 14(1), 1–8. https://doi.org/10.1186/s12978-017-0305-6

Onyeajam, D. J., Xirasagar, S., Khan, M. M., Hardin, J. W., & Odutolu, O. (2018). Antenatal care satisfaction in a developing country: A cross-sectional study from Nigeria. BMC Public Health, 18(1), 1–9. https://doi.org/10.1186/s12889-018-5285-0

Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., … Declercq, E. (2014). Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. The Lancet, 384(9948), 1129–1145. https://doi.org/10.1016/S0140-6736(14)60789-3

Solnes Miltenburg, A., Kiritta, R. F., Bishanga, T. B., van Roosmalen, J., & Stekelenburg, J. (2017). Assessing emergency obstetric and newborn care: Can performance indicators capture health system weaknesses? BMC Pregnancy and Childbirth, 17(1), 1–9. https://doi.org/10.1186/s12884-017-1282-z

Tafere, T. E., Afework, M. F., & Yalew, A. W. (2018). Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study. PLoS ONE, 13(2), 1–14. https://doi.org/10.1371/journal.pone.0192428

Ten Hoope-Bender, P., De Bernis, L., Campbell, J., Downe, S., Fauveau, V., Fogstad, H., … Van Lerberghe, W. (2014). Improvement of maternal and newborn health through midwifery. The Lancet, 384(9949), 1226–1235. https://doi.org/10.1016/S0140-6736(14)60930-2

Tenkorang, E. Y. (2016). Type of Health Facility and Utilization of Antenatal Care Services Among Ghanaian Women. Population Research and Policy Review, 35(5), 631–650. https://doi.org/http://dx.doi.org/10.1007/s11113-016-9406-0

van der Kooy, J., Birnie, E., Valentine, N. B., da Graaf, J. P., Denktas, S., Steegers, E. A. P., & Bonsel, G. J. (2017). Quality of perinatal care services from the user’s perspective: A Dutch study applies the World Health Organization’s responsiveness concept. BMC Pregnancy and Childbirth, 17(1), 327. https://doi.org/10.1186/s12884-017-1464-8

van Stenus, C. M. V., Boere-Boonekamp, M. M., Kerkhof, E. F. G. M., & Need, A. (2017). Client satisfaction and transfers across care levels of women with uncomplicated pregnancies at the onset of labor. Midwifery, 48, 11–17. https://doi.org/10.1016/j.midw.2017.02.007

Villadsen, S. F., Negussie, D., Gebremariam, A., Tilahun, A., Friis, H., & Rasch, V. (2015). Antenatal care strengthening for improved quality of care in Jimma, Ethiopia: An effectiveness study Health policies, systems and management. BMC Public Health, 15(1). https://doi.org/10.1186/s12889-015-1708-3

Villadsen, S. F., Tersbøl, B. P., Negussie, D., Gebremariam, A., Tilahun, A., Friis, H., & Rasch, V. (2014). Antenatal care strengthening in Jimma, Ethiopia: A mixed-method needs assessment. Journal of Environmental and Public Health, 2014. https://doi.org/10.1155/2014/945164

Wilunda, C., Quaglio, G., Putoto, G., Takahashi, R., Calia, F., Abebe, D., … Atzori, A. (2015). Determinants of utilisation of antenatal care and skilled birth attendant at delivery in South West Shoa Zone, Ethiopia: a cross sectional study. Reproductive Health, 12(1), 74. https://doi.org/10.1186/s12978-015-0067-y

DOI: 10.26699/jnk.v7i1.ART.p011-023


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