RELATIONSHIP ATTITUDE AND THE ROLE OF THE MIDWIFE OF EXCLUSIVE BREAST

RESEARCH ARTICLES
27 30
29 28
26

FEEDING PROGRAM IN THE AREA OF WORK HEALTH JAMBU

CENTRAL DISTRICT OF BIRDS
YEAR 2014

Hj.Erni Setiawati 1), M.Mukhtar 2 /) Hj.Norhayati.Maslani 3)

1,2,3) Polytechnic of Banjarmasin MoH Department of Obstetrics

ABSTRACT

The purpose of this study to determine the relationship of the attitude and role of midwives in the provision of exclusive
breastfeeding programs in Puskesmas Jambu Birds lie within the region of 2014, the entire population of midwives working area
health centers were 30 orang.Sampel Bird Jambu entire working area health centers midwives Jambu Bird, sampling is saturated
samples ie 30 respondents. Data analysis is the analysis of univariate and bivariate analysis. The relationship test using the test Chi
Square to determine whether there is a relationship between independent variables and the dependent variable with a value of
significance α = 0.05 and 95% confidence intervals,

Attitude research results to the test Chi-Square earned value p = 0.123 means greater
of (α) so Ho dsiterima meaning there is no relationship between attitude to the provision of exclusive breastfeeding programs
and the role of test results obtained value p = 0,001, or less than (α) so that Ho refused meaning there is a relationship
between the midwife's role against exclusive breastfeeding in Puskesmas Jambu 2014 birds.

Keywords : Attitude, The Role of Midwives, exclusive breastfeeding Program

Abstract
The attitudes and the Midwives against the granting of exclusive breast-fed in the work
of the Health Center is from banjo 2014 Hj.Erni guava

Setiawati 1), HMMukhtar 2), Hj.Norhayati.Maslani 3)

1,2,3) Poltekkes MoH banjarmasin the department of obstetrics

The purpose of this research to know the relationship the attitudes and the role of the midwife in the provision of the
program of work lie within the region of exclusive breastfeeding in the Health Center of cashew a bird of the year the midwife in 2014

Population health center the midwife working cashew birds a total of 30 person sample of the midwife be area
cashew birds work of health centers, Data analysis is the analysis of univariate and bivariate analysis. Relations chi squere
use the test to find out the Whereabouts the relations between variables free and variable bound with the value of meaning α
= 0:05 and intervals of trust of 95%, he results of research by this attitude chi-square Obtained the value of p = 0.123 greater
meaning from (α) so that ho received it means there was no contact between attitude by the provision of the program and
exclusive breastfeeding guava 2014

The keywords: attitudes, the nurses, granting exclusive breast-fed program

Health Scale Journal Volume 6 No. 1 2015

PRELIMINARY
A. BACKGROUND
The success of health development which is
one of the guidelines in the Human Depelovment
Index which plays an important role in improving the
quality of human resources of a country. Four of all
the commitments proposed by countries
Develovment UN millennium Goals ( MDGs) closely
related to health problems, especially on maternal
and child health is an important element of
development, it implies that a mother will be born
candidates for the nation's future. Until now, maternal
and child mortality rate is still ranked highest in Asia
although it has decreased each year ( MDG's), ( Sanyoto,
2006)
Improving the quality of human should be
started as early as possible that since I was a baby,
one of the factors that play important roles are
breastfeeding (breast milk). Breastfeeding as much
as possible is an important activity in the
maintenance of children and the preparation of the
next generation front dimassa. Policies on
breastfeeding
exclusive reflected with
proclaimed National Movement Increased Use of
mother's milk (GNPPASI). (Wikia, 2013)
Exclusive breastfeeding in Indonesia to date
This is very alarming,
where people tend to give infant formula at a very
young age. So that it resulted in a lot of infants are
exclusively breastfed lost opportunity,
More than 5 million children under five
suffering from malnutrition and about 1.7 million children under five
suffering from severe malnutrition.
On basic mentioned WHO
recommend, all baby need
gets colostrum (the milk first and second day) to fight
infection and receive exclusive breastfeeding
6 months to
ensure adequate infant nutrition. In line with the
results of the WHO study above, Minister of Health
through the Health Ministry Decree
Republic
Health Scale Journal Volume 6 No. 1 2015
450 / Menkes / IV in 2004 set the extension Exclusive
breastfeeding from the previous 4 months to 6
months
(Sanyoto, 2006).
Based on the Indonesian Demographic and
Health Survey (IDHS) in 2007- 2008 of exclusive
breastfeeding in infants aged 2 months only 64%.
This percentage decreased clearly to 45% in infants
aged 2-3 months and 14% in infants aged 4-5
months. Only 40% of babies breastfed within one
hour of birth, while exclusive breastfeeding in the city
of Surabaya on 15 983 babies aged 6 months, only
3,302 of them were breastfed infants. Only about
20.66% of infants exclusively breastfed ( Ririn, 2009).
Data Basic Health Research (Riskesdas) in
2010 showed breastfeeding in Indonesia is
concerned, the percentage of infants exclusively
breastfed until 6 months only 15.3%. The main
problem of the low use of breast milk in Indonesia is a
socio-cultural factors, lack of knowledge of pregnant
women, families and communities about the
importance of breastfeeding, as well as health
personnel were not fully support breastfeeding
Improvement (PP-ASI). This problem is compounded
by
incessant promotion of infant formula and a lack of
support from the community, including institutions that
employ women who have not given a place and
opportunity for breastfeeding mothers in the workplace
such as space ASI ( Riskesdes, 2010).
Midwives have a very special role in
supporting breastfeeding. The role of the midwife can
help mothers to breastfeed properly and prevent
common problems occur.
According to a survey conducted in South
Kalimantan Provincial Health Office in 2006
there are breastfeeding
Exclusive 48.92% being in 2007
decreased to 27.64%. Data from the Health
Department in 2011 that gives Banjarbaru exclusive
breastfeeding in Banjarbaru of 32.5%, in 2012 62.5%,
in the region of the Bird Jambu Health Center in 2011
amounted to 50.7% and the
Indonesia
In 2012 there was an increase to 56.9% ( SKDDKB, Univariate and bivariate analysis using statistikuji test
2012). The achievement is felt still very low when Chi Square
compared to the expected target of 80% of infants to know there is least
are exclusively breastfed. One of the factors that relationship between independent variables and the dependent
affect the low exclusive breastfeeding is a mother's variable with a value of significance α = 0.05 and 95% confidence
lack of knowledge about the benefits of breastfeeding intervals,
for babies and benefits of breastfeeding for mothers,
health care, promotion of infant formula and a clerk RESULTS AND DISCUSSION
working mothers. The role of the midwife is quite
central A. RESEARCH RESULT
Midwives Attitude Toward Support Program
socializing Exclusive breastfeeding
This exclusive breastfeeding. As part of the health Attitudes of Respondents Frequency Table 1.Distribusi
workers, midwives are required to provide an against Support ASI program
understanding of exclusive breastfeeding. Exclusive 2014 No.
Attitude Amount Percentage (%)
Based on preliminary data from interviews with 1 Positive 17 56.67
midwives and health centers Nutrition Birds Jambu 2 Negative 13 43.33
that the data obtained from 10 mothers with babies total 30 100
6-12 months exclusive breastfeeding only 7 people
and the remaining 3 are not exclusive breastfeeding. Based on Table 4.1 the number of respondents as many
In 2013 target of 75% that exclusive breastfeeding in as 30 people are known to most of the respondents have
Puskesmas a positive attitude to support exclusive breastfeeding
programs as many as 17 respondents (56.67%) and the
remaining 13 respondents (43.43%) had a negative
guava Burung.Berdasarkan attitude.
Preliminary observation on the 5 midwives practice
independently, found three people who do Early Initiation 1. Role of Midwives Against Exclusive Breastfeeding

of Breastfeeding (IMD), Support Program Table 2. Frequency Distribution of

and 2 people can not do, because once the baby
Respondents role
born directly given honey by
her family and midwife just do aid delivery was alone, To Support
so the midwife can not do the IMD. Exclusive breastfeeding Program 2014 No

In accordance with the statement midwife above, Role Amount Percentage (%)
it can be concluded that there are still some midwives 1 Good 18 60
who have not fully provide early initiation of 2 Self 12 40
breastfeeding in newborns appropriately and still delay 3 Less 0 0
the process of early initiation of breastfeeding in the first number 30 100
hour after birth the baby.

research methodology
According to the table above can be seen from 30
The study was observational analytic with
respondents as many as 12 respondents (40%) have a
cross sectional
significant role to support exclusive breastfeeding
and samples
program, which has a good role as much as 18
penelitianladalah entire midwives were working area
respondents (60%).
health centers Jambu Birds were 30 data was
2. Exclusive breastfeeding program
collected using primary data and secondary data. The
design of processing with

Health Scale Journal Volume 6 No. 1 2015

 Table 3. Frequency Distribution of exclusive breastfeeding in the does not support. Of 12 people (40%) who have a
health center program Bird Jambu Year significant role where as many as four people (13.3%)
2014. who support exclusive breastfeeding programs and the
No. Program total remaining 8 (26.7%) do not support exclusive
Percentage (%) 1 Support breastfeeding programs. Test results Chi-Square the ( α) 0.05
21 70 earned value p = 0,001, or less than ( α)
2 supports 9 30
total 30 so that Ho is rejected, it means that there is a relationship
100 between the midwife's role to support
Exclusive breastfeeding program.
The above table shows that of the 30 respondents were 9 B. Discussion
respondents (30%) do not support exclusive breastfeeding 1. Midwives Attitude Toward Exclusive
programs and support exclusive breastfeeding programs
Breastfeeding Support Program. Respondents were
as much as 21 respondents (70%)
positive attitude 17 (56.7%), 14 (46.7%) support

3. Cross tabulation attitude Midwife Program In exclusive breastfeeding programs and 3 (10.0%) do not

Support of exclusive breastfeeding. Table 4.Tabulasi support breastfeeding program Eksklisif. From the

Cross Midwives Attitude Toward Exclusive negative category amounted to 13 (43.3%) consisted of

Breastfeeding Support Program Puskesmas Jambu 7 people (23.3%) support exclusive breastfeeding

Bird 2014. programs and 6 (20.0%) were

Program Support Not Support Total Attitude

N% N % N% does not support exclusive breastfeeding programs.
Positive 14 46.7 3 10.0 17 56.7
Negative 7 23.3 6 20.0 13 43.3
Total 21 70.0 9 30.0 30 100 According to Green (1980); behavior
influenced by three main factors predisposing factors
In the cross-tabulation table obtained 17 respondents ( Predisposing factor),
(56.7%) were positive and that supports as many as 14 enabling factors ( Enambling Factor)
people (46.7%) and the negative attitude many as 13 and factors brace (Reinforcing
people (43.3%) 7 (23.3%) were support exclusive Factor). Attitude is one of the predisposing factors that
breastfeeding programs and the remaining 6 does not influence a person's behavior changes,
support exclusive breastfeeding program but on results
This research on get no relationship between the
, Test results Chi-Square the ( α) 0.05 earned value p = 0.123attitude of a midwife to support exclusive
means greater than ( α) so Ho accepted, atinya no breastfeeding programs. This may be due to the
meaningful relationship between midwives attitude factor other
toward program support exclusive breastfeeding influence the attitude of someone like
education, age, experience and
trust.
Table 5 Cross Tabulation Midwife Role Of Support
Exclusive breastfeeding program in Process formation attitude too
PHC Jambu Birds 2014 influenced by other factors such as the quality of the
program Support Does not support Total five senses someone in
Attitude N% N % N%
Well 76 56.7 1 3.3 18 60
identified stimulus (Sensitive / no)
Enough 4 13.3 8 26.7 12 40 level awareness someone in
Less 0 0 0 0 0 0
Total 21 70.0 9 30.0 0100
express a message, and the maturity of someone
thinking in analyzing the message. ( Mahendratto, 2007).
of 18 people (60%) who have a good role there were attitude and behavior

17 (56.7%) who support exclusive breastfeeding someone possibility of interrelated depend on other
programs and 1 (3.3%) factors, which are

Health Scale Journal Volume 6 No. 1 2015

irrational. For example, a midwife importance on
exclusive breastfeeding program is not necessarily to
run.
According to Jones Lancet (2003) and
Edmond (2006), the rate of breastfeeding mothers in
Indonesia is still low due to social and cultural factors
that have not been aware of the importance of
breastfeeding, competition with the publication of
formula in a variety of media is also an obstacle for
women to think there is milk can replace the entire nutisi
contained in breast milk. (Lancet, 2007).
The results showed no association between
attitude of midwives
Exclusive breastfeeding support program, because the
midwives have received and the program responds
so that the possibility that
Exclusive breastfeeding affects the program is the publication or
promotion of infant formula.
2. Role of Midwives Against Exclusive Breastfeeding
Support Program
The role of midwives to support exclusive breastfeeding
program, it was noted as many as 18
people (60.0%) were categorized as either where the
support exclusive breastfeeding programs were 17
(56.7%) and 1 (3.3%) that do not support exclusive
breastfeeding programs. A total of 12 people (40.0%) of
respondents were categorized fairly consisting on 4
0rang (13.3%) who support exclusive breastfeeding
programs and 8 (26.7%)
that do not support breastfeeding program
Exclusive.
Exclusive breastfeeding program is influenced by
three factors: predisposing factors, enabling factors, and
the deciding factor. The role is one of the determining
factors that influence exclusive breastfeeding program.
In commemoration of the world breastfeeding week
2007 in
palace state, said
problems that lead to the low use of breast milk in
Indonesia is a socio-cultural factors, lack of
knowledge about the importance of exclusive
breastfeeding, the promotion of
formula and
lack of support from the community
including institutions. Therefore that,
the success of breastfeeding mothers is also determined
Health Scale Journal Volume 6 No. 1 2015
by the continued support of husband, family, and
community health workers to continue to breastfeed
their babies.
( Yudhoyono, 2007).
According Rulina Suradi said several hospitals
give formula in a newborn baby before she is able to
produce milk, it causes the baby is not accustomed to
suck milk from the nipple and finally no longer willing
to consume the milk, it is in line with research
conducted by Nurcholish Madjid, known various
delinquency manufacturers of infant formula and
baby food supplement for them, by the promotion in
various forms to the health facilities and
power
health both doctors and midwives to contribute to
market their products. There were given intensive
monthly until there sponsored pilgrimage. ( Lukman,
2005).
Research shows that there is a relationship
between the midwife's role to support exclusive
breastfeeding programs due to the promotion of
infant formula can not be separated from the role of
midwife itself to be the one directly related to the
baby so that the role of midwives should not
encourage mothers to give formula to their babies in
the early
birth
but rather refer mothers to breastfeed their children in
exclusive until the baby is six months old.
3. The role of the midwife program Exclusive
breastfeeding greatly affects the program support
exclusive breastfeeding, the better the role of the
midwife, the better the level of achievement of
exclusive breastfeeding program, either through
counseling about the importance of exclusive
breastfeeding or other occasions such as pregnant
women and class Posyandu activities and other
activities .. in this study, it can be seen the
relationship role of midwife to support exclusive
breastfeeding programs in Puskesmas Banjar Bird
Jambu 2014.
Conclusion 5. Basic Health Section of the City Health Office Banjarbaru.
No association of midwives attitude towards 2011-2012. Exclusive breastfeeding.
exclusive breastfeeding program
P = 0.123. 6. (Http: //

There is a relationship role of midwife to the Asuh.wikia.com/wiki/manfaat_Asi. Accessed

program of exclusive breastfeeding. P= 23 June 2013)

0.001.
7. Karmila. 2008. Attitudes and Role Relationships
Midwife Program In Sub Martapura exclusive
Suggestion midwives should
breastfeeding.
participate in the
run a program of exclusive breastfeeding, and the 8. Karmila 2008. Relations attitude and role of midwife
midwife should do Initiation of breastfeeding Early on to the success of exclusive breastfeeding Martapura At
every mother who gives birth the sub-district.
9. propyl public health Office city
Banjarbaru Year 2011-2012
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Sanyoto.2006. Large Dien. down Number 10. (Http: // www.pencapaian Eks.com ASI targets.

Enjoy Exclusive breastfeeding baby Accessed 15 June 2013)

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2. Riskesdes 2010. Coverage of breastfeeding in
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Health Scale Journal Volume 6 No. 1 2015