Efektivitas penerapan audit maternal perinatal surveilans responsif (AMPSR) dalam mengidentifikasi faktor risiko kematian ibu
DOI: https://doi.org/10.33024/hjk.v19i9.1537
Audit Maternal Perinatal Surveilans Responsif (AMPSR) Faktor Risiko Kematian Ibu
Abstract
Background: Maternal mortality remains a major challenge in Indonesia's health system, including in Banda Aceh. Responsive Maternal Perinatal Surveillance Audits (AMPSR) are recognized as a crucial strategy for reducing maternal mortality, but their implementation is often hampered by poor documentation quality, follow-up, and interprofessional team involvement. A Point of Care Quality Improvement (POCQI) approach is proposed to strengthen the audit's effectiveness.
Purpose: To evaluate the effectiveness of the implementation of maternal perinatal audit responsive surveillance (AMPSR) in identifying risk factors for maternal mortality.
Method: The study used a quasi-experimental one-group pretest-posttest design with a sample of 16 AMPSR team members at three healthcare facilities (Meuraxa Regional Hospital, Banda Aceh Women's Hospital, and Meuraxa Community Health Center). Data were collected through audit forms, compliance checklists, and POCQI questionnaires, then analyzed using the Wilcoxon Signed Rank Test and logistic regression.
Results: POCQI training significantly improved knowledge (p=0.001), practice and documentation (p=0.001), audit effectiveness (p=0.000), and perceived barriers and support (p=0.025). Multivariate analysis showed that practice and documentation were the dominant factors influencing the effectiveness of AMPSR implementation (OR=4.75; p=0.017).
Conclusion: The implementation of the POCQI-based AMPSR has proven effective in strengthening the capacity of interprofessional teams and improving the quality of maternal audits. This strategy has the potential to become a sustainable approach to maternal mortality prevention in Indonesia.
Keywords: Maternal Mortality; Maternal Perinatal Surveillance Responsive Audit (AMPSR); Risk Factors.
Pendahuluan: Angka kematian ibu masih menjadi tantangan besar dalam sistem kesehatan di Indonesia, termasuk di Kota Banda Aceh. Audit Maternal Perinatal Surveilans Responsif (AMPSR) diakui sebagai strategi penting untuk menurunkan angka kematian maternal, namun pelaksanaannya sering terkendala kualitas dokumentasi, tindak lanjut, serta keterlibatan tim lintas profesi. Pendekatan Point of Care Quality Improvement (POCQI) ditawarkan untuk memperkuat efektivitas audit.
Tujuan: Untuk mengevaluasi efektivitas penerapan audit maternal perinatal surveilans responsif (AMPSR) dalam mengidentifikasi faktor risiko kematian ibu.
Metode: Penelitian ini menggunakan desain quasi experiment one group pretest-posttest dengan sampel 16 anggota tim AMPSR di tiga fasilitas kesehatan (RSUD Meuraxa, RSIA Banda Aceh, dan Puskesmas Meuraxa). Data dikumpulkan melalui formulir audit, checklist kepatuhan, dan kuesioner POCQI, kemudian dianalisis menggunakan Wilcoxon Signed Rank Test dan regresi logistik.
Hasil: Pelatihan POCQI meningkatkan secara signifikan pengetahuan (p=0.001), praktik dan dokumentasi (p=0.001), efektivitas audit (p=0.000), serta persepsi hambatan dan dukungan (p=0.025). Analisis multivariat menunjukkan bahwa praktik dan dokumentasi merupakan faktor dominan yang memengaruhi efektivitas penerapan AMPSR (OR=4.75; p=0.017).
Simpulan: Penerapan AMPSR berbasis POCQI terbukti efektif dalam memperkuat kapasitas tim lintas profesi dan meningkatkan kualitas audit maternal. Strategi ini berpotensi menjadi pendekatan berkelanjutan dalam pencegahan kematian ibu di Indonesia.
Kata Kunci: Audit Maternal Perinatal Surveilans Responsif (AMPSR); Faktor Risiko; Kematian Ibu.
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