Volume 4, No. 7 July 2023

p-ISSN 2722-7782 | e-ISSN 2722-5356

DOI : https://doi.org/ 10.46799/jsa.v4i8.648

THE RELATIONSHIP BETWEEN THE ROLE OF MIDWIVES, MATERNAL KNOWLEDGE AND HUSBAND SUPPORT WITH COMPLIANCE OF PREGNANT WOMEN IN HBSAG EXAMINATION AT PMB WAGI KOJA, NORTH JAKARTA IN 2023

Dina Arihta T, Maesaroh

Midwifery Undergraduate Study Program, STIKes Mitra RIA Husada Jakarta

E-mail : ditabayu26 @gmail.com

Abstract

Pregnant women are a vulnerable group to infection with the Hepatitis B virus. Based on World Health Organization data in 2019, an estimated 296 million people are infected with chronic hepatitis B with 1.5 million new infections per year. In 2019 in Indonesia, the number of pregnant women tested for hepatitis B using the HBsAg rapid diagnostic test (RDT) was 2,540,158 people (48.25%) of the target pregnant women. the purpose of this study was to determine the relationships between the roles of midwives, mothers' knowledge, husbands' support, and compliance of pregnant women in carrying out HBsAg examinations at PMB Wagi Koja, North Jakarta in 2023. This research method uses an observational survey and is a type of quantitative research, with a cross-sectional study design. The number of samples in this study was 32 people, with a sampling technique that is total side. The results in this study are P value <α, where Ha is accepted and H0 is rejected, so it can be concluded that there is a relationship between the role of the midwife (P value = 0.036 and OR=6.500), knowledge (P value=0.015 and OR=8.750) and support husband (P value=0.029 and OR=7.333) with compliance of pregnant women in carrying out HBsAg examinations at PMB Wagi Koja North Jakarta in 2023. This study concludes that there is a relationship between the roles of midwives, husband's knowledge, and support with compliance of pregnant women in carrying out HBsAg examinations at PMB Wagi Koja North Jakarta in 2023. it is hoped that PMB Koja will provide counseling and education about the important of prenatal checkups, especially HBsAg checks, and advise husbands and families to provide emotional and instrumental support and facilitate the needs of mothers during checkups.

Keywords: Knowledge, Roles of the midwife, Roles of the Husband, HBsAg Compliance

INTRODUCTION

Hepatitis B is a serious infectious disease and generally infects The liver is caused by the Hepatitis B virus (HBV) which can cause disease acute or chronic. Most people do not realize they have been infected (Mulyani & Salsabil, 2020) . Woman Pregnant women are a vulnerable group to be infected with Hepatitis B virus (Gobel & Kurnaesih, 2021) . Infection hepatitis B (HBV) in pregnant women has become a world concern because of its transmission most common worldwide, especially in endemic areas, namely transmission from mother to child in the prepartum or perinatal period with risk contract hepatitis B infection (HBV) in children more than 90% (Pither et al., 2021) . Most cases new infection is known after pre-natal examination. That's because it's not There is hepatitis B virus screening in early pregnancy. Screening is also useful for inspect various disease from virus infectious other (Dhyanaputri et al., 2019) .

Non-compliance in inspection pregnancy cause No can known various complications that affect pregnancy (Pratiwi & KM, 2021) . Therefore so Mother pregnant need do inspection HBsAg For prepare control risk, when Mother pregnant caught Hepatitis. Results test HBsAg positive will threaten the safety of mother and fetus. In addition, the risk of hepatitis B virus infection can also occur in medical personnel who assist pregnant women during childbirth (Dunggio, 2020) . Studies show that chronic HBV infection can lead to an increase risk diabetes gestational, bleeding prenatal, And birth premature. Mother with complications of abnormal liver function are more likely to experience postpartum hemorrhage, postpartum infection, low birth weight, fetal distress, preterm labour , and stillbirth (Susanti et al., 2017) . Negative effects of Hepatitis on the current neonate labor is happening asphyxia baby (Putri et al., 2019) .

World Health Organization data in 2019 it is estimated 296 million people are infected with chronic hepatitis B with 1.5 million new infections per year. In 2019, there were an estimated 820,000 deaths from hepatitis B, some big Because cirrhosis And carcinoma hepatocellular (cancer heart primary) (Salama et al., 2023) . On year In 2019, in Southeast Asia, almost 60 million people are known to be living with the infection virus hepatitis B (HBV) chronic (Organization, 2006) .

In 2019 in Indonesia, The number of pregnant women who are in hepatitis B test use rapid diagnostics test (RDT) HBsAg as much 2,540,158 person (48.25%) from target Mother pregnant. Results test RDT-HBsAg disclose that

46,064 (1.81%) pregnant women had HBsAg reactive (positive) (WulanSari, 2022) . based on data Ministry Health, in year 2021 as much 2,946,013 Mother pregnant has detected early and it is known, as many as 1.61% (47,550) of pregnant women were detected positive infected hepatitis (Side, 2015) . Based on data year 2019 is known amount percentage Mother pregnant HBsAg reactive in Jakarta as much 1.36% (Andriana & Yuningsih, 2023) .

Behavior Mother pregnant moment done inspection HBsAg will influenced by factors like understanding And support husband (Hanurawati, 2022) . Factor other Which influence inspection HBsAg between other predisposing (knowledge, attitude, level of education, economy, etc.), supporting factors (availability sanitation, accessibility and household food security, sources of information, and other etc), factor amplifier (support family, Friend, husband, officer health) (Hanurawati, 2022) .

In care pregnancy, midwife role in give KIE (counseling, information and education) to protect pregnant women from threats health and safety of mother and fetus . Knowledge is information someone knows. Notoatmodjo states that knowledge is the result human perception or the result of a person recognizing an object through perception (eyes, nose, ears, etc.). On the other hand, the point where perception produce knowledge very influenced by attention And intensity perception object (Wawan Kurniawan & Aat Agustini, 2021) . Support husband is form concern And love Darling. Support Can form physique or psychological. Husband role important in determine status health Mother. Support husband Which Good can become that motivation Good for a Mother to do test pregnancy (Rachmawati et al., 2017) .

Test prenatal on Mother pregnant filter risk infection hepatitis B using the HbsAg test. The HBsAg test is important for detecting hepatitis B in pregnant women and should be performed on the first visit by a service provider healthcare for disease prevention and control (Hanurawati, 2022) . Internal non-compliance Pregnancy checks cause various complications to be unknown affecting pregnancy (Citrawati & Laksmi, 2021) . This research is in accordance with Hanurawati (2022) Where from 118 person respondent, obtained respondent with obedience No sure as many as 61 people (51.7%) and respondents with definite compliance as much 57 person (48.3%) (Hanurawati, 2022) .

Based on the initial survey conducted on November 1, 2022 through document review and interviews at PMB Wagi. From the document review obtained in 2021 there are 127 targeted pregnant women with the number of mothers pregnant Which checked HbsAg as much 76 person And Which positive on moment HbsAg examination of 3 people. In 2022 there are 101 targets for mothers pregnant with the number of pregnant women who were examined for HBsAg as many as 58 mothers pregnant And Which positive on moment examination HBsAg as much 1 person. From results interview to 10 response was obtained 4 person obedient in do inspection HBsAg And 6 person No obey in Do Inspection HBsAg. Based on the midwife's role, it was found that 6 people received education and support from midwife as well as get information about importance HBsAg examination and 4 people did not receive education, motivation or information from midwives regarding HBsAg examination. Based on knowledge obtained 4 person own knowledge Good about Hepatitis And importance HBsAg examination and 6 people had poor knowledge. Viewed from _ shaman g an husband got 5 person get support from inside husband do inspection pregnancy in a manner thorough as well as accompany And motivating Mother And 5 person No get support husband.

Objective study This is For know connection role midwife, knowledge, support husband with obedience Mother pregnant in do inspection HBsAg in PMB WAGI Koja Jakarta North Year 2022.

METHODOLOGY

This research is a type of quantitative research using method study survey observational. Survey observational describe How And Why something phenomenon, like: connection between because And consequence or risk and consequence factors. You can then check how big reason or factor risk contribute on effect or results. With use design study cross-sectional (Sahabuddin et al., nd) .

Study This will be held at PMB Wagi, Monument Village North, Koja District, North Jakarta City, in January-February 2023. Population The total number of pregnant women in this study was Trimester III at PMB Wagi 32 people, sampling with total side technique . Independent variable in research are the role of midwives, mother's knowledge, and husband's support and variable dependent is obedience Mother Pregnant in Inspection HBsAg. Data analysis on the univariate test using the frequency distribution and on the test bivariate use test Chi-Square.

RESULTS AND DISCUSSION

Table 1

Distribution Frequency characteristics Mother Pregnant in Do ��Inspection HBsAg

Variable	Frequency (F)	Percentage (%)
Obedience
No obey	14	43.8
obey	18	56.3
The Role of the Midwife
No role	15	46.9
role	17	53.1
Knowledge
Not enough Good	14	43.8
Good	18	56.3
Support Husband
No Support	17	53.1
Support	15	46.9
Total	32	100

Based on study Which done to 32 person respondent it was found that the average respondent complied with the HBsAg examination was 18 people (56.3%), with mothers stating that midwives played a role in compliance inspection HBsAg as much 17 person (53.1%), And Mother Which own knowledge Good as much 18 person (56.3%) as well as Mother pregnant state support husband not enough support as much 17 person (53.1%).

Table 2

Connection Role Midwife, Knowledge, And Support Husband with Obedience Do Inspection HBsAg

Obedience
Variable	Category	No ������������������������������ �obey�������������������������������������		obey		Total		P- Value	OR (95%)
		F	%	F	%	F	%
	No ������ role�����	10	31.3	5	15.6	15	46.9		6,500 (1.377- 30,682)
Role Midwife								0.036
	role	4	12.5	13	40.6	17	53.1
	Total	14	43.8	18	56.3	32	100
	Not enough Good	10	31.3	4	12.5	14	43.8		8,750 (1756- 43,600)
Knowledge	Good	4	12.5	14	43.8	18	56.3	0.015
	Total	14	43.8	18	56.3	32	100
Support Husband	Not enough �� �Support�������������������������������������������������������������������������������������	11	34.4	6	18.8	17	53.1		7,333 (1.467- 36,664)
								0.029
	Support	3	9.4	12	37.5	15	46.9
	Total	14	43.8	18	56.3	32	100

From the results of bivariate analysis, it was found that the average respondent stated the role of midwives with HBsAg compliance was 13 person. From the results of the Chi-Square test it was found that there was the relationship between the role of the midwife with compliance of pregnant women in carrying out HBsAg examinations at PMB Wagi North Jakarta Koja in 2023, with a P value of 0.036 and an OR value (odds Ratio) 6,500, which means that respondents stated the role of the midwife role own opportunity 6 time more big in obedience do inspection HBsAg.

Average respondent own knowledge respondent Good with obedience do inspection HBsAg obey as much 18 person. From results test Chi-Square it was found that there was a relationship between maternal knowledge and compliance of pregnant women in carrying out HBsAg examination at PMB Wagi Koja North Jakarta Year 2023, with a P value of 0.015 and an OR (odds Ratio) value of 8,750 which meaning that respondents who have good knowledge have 9 times more opportunities big in obedience do inspection HBsAg.

Got respondent Which state support husband not enough support with compliance with the HBsAg examination, 17 people complied and respondent Which state support husband support with obedience do inspection HBsAg obey as much 15 person. From results test Chi-Square obtained There is connection between support husband with obedience Mother pregnant l carrying out HBsAg examination at PMB Wagi Koja North Jakarta Year 2023, with P value as big 0.029 And mark OR (odds Ratio) as big 7,333 It means respondent Which own support husband Good own opportunity 7 time more big in obedience do inspection HBsAg.

A. Distribution Frequency characteristics Mother Pregnant in Do Inspection HBsAg

Based on study Which done to 32 person respondent it was found that the average respondent complied with the HBsAg examination was 18 people (56.3%), with mothers stating that midwives played a role in compliance inspection HBsAg as much 17 person (53.1%), And Mother Which own knowledge Good as much 18 person (56.3%) as well as mother pregnant state support husband not enough support as much 17 person (53.1%).

Measurement obedience Mother pregnant in do inspection HBsAg assessed after the mother gave birth, seen from the history of HBsAg examination during pregnancy in the KIA book. Where it is in accordance with government regulations, which stated that pregnant women should at least have 1 HBsAg test during pregnancy. And For support obedience the seen Also history previous mother's pregnancy, about inspection HBsAg.

Hepatitis itself is a disease that attacks the function of the liver in humans. Hepatitis causes inflammation of the liver so it makes performance of the liver function is severely impaired (PT. Ritonga et al., 2020) . Pregnant women are group Which prone to infected virus Hepatitis B (Nugroho et al., 2022) . Mother pregnant need do HBsAg examination to prepare for risk control, if pregnant women caught Hepatitis. Results test HBsAg positive will threaten safety Mother And fetus. In addition, the risk of hepatitis B virus infection can also occur in workers medical Which help Mother pregnant moment give birth to (Dunggio, 2020) .

The results of this study are similar to the study of Mangosa, et al (2022) where obtained the distribution of respondents based on compliance ANC at the Health Center Rijali is known that there is (74.3%) more obey do ANC (Asmin et al., 2022) . Surmiasih that is part big respondent own level knowledge

hepatitis B in the sufficient category, namely 19 (54.3%) (Surmiasih et al., 2020) . From research Hanurawati (2022) obtained respondent Which state midwife role as many as 55 people (46.6%) and respondents who stated their husband's support not enough support as much 65 person (55.1%) (Hanurawati, 2022) .

Several factors are thought to play a role in the implementation of the HBsAg examination in pregnant women including education, occupation, mother's knowledge about inspection HBsAg, perception will vulnerability, perception will severity, perception will benefit, perception will obstacle, place giver service inspection HBsAg, support family And service officer Health (Islahiyah, 2019) .

B. Connection Between Role Midwife With Compliance Mother Pregnant In Do Inspection HBsAg

Based on the results of statistical tests using the Chi-Square Test obtained the P value is 0.036 which means H0 is rejected and Ha is accepted. So that it can be concluded that there is a relationship between the role of the midwife and compliance pregnant women in carrying out HBsAg examination at PMB Wagi Koja Jakarta North Year 2023. With an OR value of 6,500, which means pregnant women who state role midwife role in inspection HBsAg has opportunity 7 time more big in obedience inspection HBsAg.

Based on Law no. 4 of 2019, there are 9 roles and functions of midwives namely midwifery service providers, midwifery service managers, counselors and educational counselors, mentors, and clinical facilitators, mobilizers of participation community and empowerment of women and researchers (Suhelianah et al., 2022) . In carrying out role as facilitator, midwife give guidance technical And empower party Which currently accompanied. As educator midwife provide education to individuals, families And society on period preconception, pregnancy, labor, postpartum, period lactation, KB, growth/development baby/child, nutrition, maintenance health And problem health public. Whereas as executor midwife give midwifery services to the community. This is where midwives act as executor service midwifery (Adesta et al., 2022) .

This research is in accordance with Hanurawati (2022), namely based on results analysis chi-square obtained mark p-values as big 0.18 < α (0.05), so that it can be concluded that there is a relationship between the role of the midwife and compliance pregnant women on HBsAg examination. And obtained OR value of 2.436 which means pregnant women who get support from midwives have a chance 2 times greater in adherence to HBsAg testing in comparison Mother pregnant Which No get support from midwife (Hanurawati, 2022) .

According to assumption researcher role midwife own connection with adherence of pregnant women in carrying out prenatal checks, especially in HBsAg examination, because midwives have a role as educator facilitators, And executor. Where in matter This midwife give information related health especially about Hepatitis B And importance do HBsAg test. Education provided by midwives regarding this information of course it can add to the mother's knowledge so that from that knowledge increase This can motivating and change attitude Mother to matter positive.

C. Relationship Between Mother's Knowledge and Compliance in Pregnant Women Do Inspection HBsAg

Based on the results of statistical tests using the Chi-Square Test obtained the P value is 0.015 which means H0 is rejected and Ha is accepted. So that can concluded that There is connection between knowledge Mother with obedience Mother pregnant in do inspection HBsAg in PMB Wagi Koja North Jakarta in 2023. With an OR value of 8,750 which means Mother Pregnant women who have good knowledge have a 9 times greater chance in obedience inspection HBsAg.

Knowledge about pregnancy can be obtained through counseling about pregnancy, growth And development fetus, maintenance self during pregnancy, as well sign danger Which must watch out during pregnancy

(Asmin et al., 2022) Romlah et al ., found that good knowledge leads to behavior And understanding Which Correct. So will lead on attitude positive ²⁵ . As well as someone who has good knowledge, will have motivation self For apply in his life.

This research is in accordance with Noviani and Sanjaya (2022), namely obtained average respondent own knowledge Which Good as much 17 (54.8%) respondent, from results test spearmen rank is obtained mark p-value 0.002 < 0.05 It means There is influence of knowledge Mother pregnant with inspection Hepatitis B in UPT Public health center treat Stay Acquainted Subdistrict Belalau Regency Lampung West Year 2021 (M. Ritonga, 2019) .

According to assumption researcher knowledge own connection in obedience inspection pregnancy especially inspection HBsAg, Because Good knowledge can encourage mothers to act in a more positive direction positive. Of course good knowledge about HBsAg and impact hepatitis on Mother pregnant, will make Mother more guard her pregnancy. Knowledge Can obtained from education Mother, source information such as print or electronic media, information from midwives and staff health other, nor information from husband as well as family.

D. Relationship Between Husband's Support and Compliance in Pregnant Women Do Inspection HBsAg.

Based on the results of statistical tests using the Chi-Square Test obtained the P value is 0.029 which means H0 is rejected and Ha is accepted. So that can concluded that There is connection between support husband with obedience Mother pregnant in do inspection HBsAg in PMB Wagi Koja North Jakarta in 2023. With an OR value of 7,333 which means Mother pregnant Which own support husband Which support own opportunity 7 time more big in obedience inspection HBsAg.

Husband own share Which Enough big in determine health Mother. Support Which Good from husband can become motivation Which Good for Mother For do a pregnancy check. Some argue that support social, especially in context connection intimate or quality connection marriage and family, may be a source of social support the most important (Sari & Kusparlina, 2017) . Husband's support during pregnancy will make it feel comfortable. Husband is one of the keys for mothers to keep emotions positive during pregnancy. A positive attitude and good support from the husband will be make process pregnancy become pleasant, And fetus will always Healthy And strong. Support husband is help Which make person Which accept support feel loved, valued, And comfortable. Support This form encouragement, motivation, empathy, or help Which can make person other feel more relax And safe (Harahap et al., 2019) .

This study is in accordance with Hanurawati (2022), namely from the chi- square obtained mark p-values as big 0.000 < α (0.05), so that can concluded that There is connection between support husband with obedience Mother pregnant on HBsAg test. And the OR value is 5.023 which is obtained meaning that pregnant women with the support of their husbands have the same chance 5 time more big in obedience inspection HBsAg in compare Mother pregnant with support husband Which not enough support.

According to assumptions support researchers husband own connection with compliance with pregnancy checks because the husband has an active role in accompany Mother during pregnancy. Husband is partners life Mother, Where on duty Also take decision in House ladder, as well as provider all the facilities needed by mothers in carrying out examinations, such as deliver treatment, give information related pregnancy, buy the needs of the mother and fetus, and others. In this case of course, the husband who supporting the mother in all the examinations carried out will make the mother feel loved, accompanied And make Mother more motivated in do inspection And guard her pregnancy.

CONCLUSION

From the results of the study it was found that there was a relationship between the role of the midwife, husband's knowledge and support with pregnant women's compliance in doing HBsAg examination at PMB Wagi Koja North Jakarta in 2023. Expected PMB Koja provides counseling and education about the importance of examinations pregnancy, especially HBsAg examination and stating it to husband and family For give support emotional And instrumental And facilitate need Mother during inspection.

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Dina Arihta T, Maesaroh (2023)

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