Knowledge And Interest Of Pregnant Mother Towards Pregnant Mother's Implementation

ABSTRACT


Health
Development is the implementation of health efforts to increase awareness, willingness and ability to live a healthy life for each population in order to realize an optimal degree of health. Understanding Health development also includes health-oriented development, community and family empowerment, and community service. Health development in Indonesia is still prioritized in efforts to improve the health status of mothers and children, especially in the most vulnerable groups of health, namely pregnant women, maternity women, infants and the perinatal period1.
The World Health Organization (WHO) reports 500,000 maternal deaths annually, 99% of which occur in developing countries. Indicators of community health and well-being are maternal and perinatal mortality. While in Indonesia the figure is still high. The target maternal mortality rate (MMR) in Indonesia in 2015 is 102 / 100,000 live births2. Maternal deaths, according to the WHO definition, are deaths during pregnancy or within 42 days after the end of pregnancy, due to all causes related to or exacerbated by pregnancy or treatment, but not caused by accident / injury3. WHO estimates that around 15% of all pregnant women will develop complications related to pregnancy, childbirth and childbirth and can be life threatening.
Infant Mortality Rate (IMR) in Indonesia according to WHO (2015) is 27%. This is still far from the target expected by the Sustainable Development Goals (SDGs), which is 12 per 1,000 live births that must be achieved until 2030. Based on the results of the Indonesia Demographic Health Survey (IDHS) in 2012, the maternal mortality rate (MMR) was recorded at 359 per 100,000 live births. In 2016, the MMR of East Java Province reached 91.00 per 100,000 live births. This figure has increased compared to 2015 which reached 89.6 per 100,000 live births. the SDG target to reduce the MMR ratio to 72 per 100,000 live births is impossible3. The increase in maternal mortality in East Java in 2016 was caused by Pre Eklamsi / Eklamsi in the amount of 30.90%, causes of bleeding 24.72%, Heart Disease 10.86%, infection by 4.87% and others 28.65% .
The number of pregnant women attending the pregnant women class in the Wuasa Poso Health Center Area was 35 people in June 2018. The results of a preliminary study of 10 pregnant women found that 6 people had insufficient knowledge about classes of pregnant women and pregnant women did not seem to pay attention to the material in the class of pregnant women .
The increase in maternal mortality is influenced by several factors including the quality of health services, the health referral system, health insurance. Besides these factors, there are also cultural factors where gender inequality is still a problem when women want to give birth. Some regions in Indonesia even still hold the principle that women are not entitled to determine their own birth processes. The impact or the impact that will occur if maternal health declines it will increase the incidence of mortality and morbidity in mothers and infants In addition to maternal deaths, infant mortality in East Java is also relatively high. Infant mortality is an important indicator to reflect the state of health in a community, because newborn babies are very sensitive to the environmental conditions in which the parents of the baby live and are very closely related to the social status of the baby's parents. One of the efforts to reduce IMR is breastfeeding. Breast milk is specifically designed for babies and is the best nutrition from other alternatives. At present efforts to increase coverage of exclusive breastfeeding have become a global goal. Sustainable Development Goals (SDGs) in the second goal of ending hunger that has a target in the year 2030 is expected to end all forms of malnutrition, including achieving the international target of 2025 for reducing stunting and wasting in infants and addressing nutritional needs in adolescent girls, pregnant women and breastfeeding and the elderly5 The class of pregnant women has several advantages for the class of pregnant women including the material given in a comprehensive and planned manner in accordance with the guidelines, the discussion time of the material is effective because the presentation of the material is well structured, there is interaction between health workers and pregnant women when the material discussion is carried out and carried out continuously. Based on this background the researcher is interested in researching with the title Knowledge and Interest of Pregnant Women on the Implementation of Pregnant Women Classes in the Wuasa-Poso Community Health Center.

Method
The design used in the study is correlation. Population is all pregnant mother during ANC visits in the Wuasa-Poso Health Center area. The sample size was 33 respondents using Accidental sampling technique. Independent variables of research are knowledge and interests. The dependent variable is implementation. Data was collected using a questionnaire, then the data were analyzed using the Spearment rho test with a significance level of α ≤ 0.05. The results showed that most respondents had sufficient knowledge of 18 respondents (54.5%). The results showed that almost half the respondents had sufficient interest as many as 16 respondents (48.5%). The results showed that almost all respondents carried out the implementation of classes of pregnant women as many as 28 respondents (84.8%).

Discussion
The statistical test in this study used the rho spearmen test with a <0.05 obtained p = 0,000 where H1 was accepted and H0 was rejected, which means that there is a relationship between the Knowledge and Interest of Pregnant Women and the Implementation of Pregnant Women Classes in the District of Wuasa-Poso Health Center. The results showed that most respondents had carried out classes of pregnant women with enough knowledge of 18 respondents (54.5%). The results showed that almost half of respondents had carried out classes of pregnant women with enough interest of 15 respondents (45.5%). The results showed that almost half of respondents had sufficient interest with sufficient knowledge of 14 respondents (42.4%).
Based on the Ministry of Health of the Republic of Indonesia (2011) the specific objectives of Pregnant Mothers Class (KIH) are the occurrence of interaction and sharing of experiences between participants (pregnant women with pregnant women) and between pregnant women with health workers / midwives about pregnancy, body changes and complaints during pregnancy, pregnancy care , childbirth, postpartum care, post-natal birth control, newborn care, myths / beliefs / local customs, infectious diseases and birth certificates, Improve understanding, attitudes and behavior of pregnant women. Participants in the pregnant mothers class based on the pregnant mothers class guide should be pregnant women at 4 to 36 weeks' gestation, because at this gestational age the mother's condition is strong, not afraid of miscarriages, effective for doing pregnancy exercises. The maximum number of participants in pregnant mothers is 10 people per class. Husband / family participates at least 1 time meeting. Pregnant mothers class meetings are held 3 times during pregnancy or in accordance with the results of the facilitator's agreement with the participants. At each meeting, maternal class material to be delivered is tailored to the needs and conditions of pregnant women but still prioritizes the subject matter. At the end of each meeting, pregnancy exercises are performed. Pregnant women exercise is an extra activity / material in the class of pregnant women, if it is carried out, after arriving at home it is expected to be practiced. The meeting time is adjusted to the readiness of mothers, can be done in the morning or evening with a length of meeting time of 120 minutes including pregnancy exercises 15-20 minutes (MOH RI, 2009