Modul Pembelajaran Profesionalisme Kebidanan: Disus Un Oleh

MODUL PEMBELAJARAN
PROFESIONALISME KEBIDANAN
DISUSUN OLEH :
Dr. HERNA RINAY ANTI, S.Tr.Ke b., Bd , M.Kes
NIDN : 04-201085-01
STIKes MITRA HUSADA MEDAN

PRODI KEBIDANAN PROGRAM SARJANA
TAHUN 2022
Modul Profesionalisme Kebidanan

VISI DAN MISI
A. STIKes MITRA HUSADA MEDAN
1. VISI
"Mewujudkan Stikes Mitra Husada Medan Sebagai Pusat Penyelenggara Pengembangan Ilmu
Pengetahuan Dan Teknologi Di Bidang Kesehatan Yang Unggul Dalam Excellent Service
Yang Berintegritas Tinggi Dan Berdaya Saing Ditingkat Nasional Tahun 2030"
2. MISI
1. Menyelenggarakan Pendidikan, Penelitian Dan Pengabdian Kepada Masyarakat Di Bidang Kesehatan
Yang Inovatif Dan Berdaya Saing Secara Nasional Dan Internasional
2. Menyelenggarakan Iklim Akademik Yang Kondusif Yang Mendukung Perwujudan Visi Stikes Mitra
Husada Medan
3. Menyiapkan Peserta Didik Agar Menjadi Lulusan Yang Service Excellent, Berakhlak, Berintegritas
Tinggi Serta Berdaya Saing Di Tingkat Nasional
4. Mengembangkan Praktik Kesehatan Berbasis Fakta (Evidance Based Practise)
5. Menghasilkan Kerjasama Dengan Instansi Dan Lembaga Terkait Di Tingkat Nasional Dan
Internasional
B. PRODI KEBIDANAN PROGRAM SARJANA
1. VISI
Menjadi Program Studi Kebidanan Program Sarjana sebagai Pusat Pengembangan Ilmu
Pengetahuan dan Teknologi di Bidang Kebidanan Yang Unggul Service Excellent Dalam
Pelayanan Kebidanan Yang Berintegritas Tinggi Dan Berdaya Saing Di tingkat Nasional
Tahun 2030.
2. MISI
1) Menyelenggarakan pendidikan, penelitian dan pengabdian kepada masyarakat di bidang
kebidanan yang inovatif dan berdaya saing secara nasional dan internasional
2) Menyelenggarakan iklim akademik yang kondusif yang mendukung perwujudan visi Prodi
Kebidanan Program Sarjana STIKes Mitra Husada Medan
3) Menyiapkan peserta didik agar menjadi lulusan yang Service Excellent, berakhlak,
berintegritas tinggi serta berdaya saing di tingkat nasional

4) Menghasilkan praktik kebidanan berbasis fakta (evidance based practice) yang bercirikan
Terapi Komplementer dan Kewirausahaan
5) Menyelenggarakan kerja sama dengan lembaga/instansi terkait baik di tingkat nasional dan
internasional

K a t a P e ng a nt a r
Puji syukur kami panjatkan kepada Tuhan Yang Maha Esa, atas rahmat dan
hidayahNya, sehingga kami dapat menyelesaikan modul Profesionalisme Kebidanan. Modul
ini diperuntukan bagi pegangan mahasiswa semester VI Program Studi Kebidanan Program
Sarjan STIKes Mitra Husada Medan.
Modul ini disusun dengan tujuan untuk memudahkan mahasiswa pada proses
pembelajaran khususnya Profesionalisme Kebidanan. Diharapkan modul ini menjadi bahan
pembelajaran bagi mahasiswa Program Studi Kebidanan Program Sarjana STIKes Mitra
Husada Medan.
Pada kesempatan ini penyusun menyampaikan terimakasih kepada semua pihak yang
telah membantu penyusunan modul praktek ini.
Kami menyadari bahwa modul praktek ini belum sempurna, untuk itu penyusun
mengharapkan masukan demi kesempurnaan modul Profesionalisme Kebidanan. Semoga
modul ini dapat bermanfaat.
Medan, Februari 2022
Tim Penyusun

KONTRAK PERKULIAHAN
I. Identitas Mata Kuliah

a. Nama mata kuliah : Profesionalisme Kebidanan
b. Nama Dosen : Herna Rinayanti Manurung, S.Tr.Keb, Bd, M. Kes
II. Deskripsi Mata Kuliah
Pada mata kuliah ini mahasiswa mampu menjalankan Evidence-based midwifery untuk
keperluan pelayanan kebidanan, Sejarah perkembangan pelayanan kebidanan, Pengantar
kepemimpinan dalam kebidanan, Pengenalan pada politik dalam pelayanan kebidanan dan
medical model dalam pelayanan obstetrik, penggunaan media social dan profesionalisme,
Peran dan tanggung jawab bidan pada berbagai tatanan pelayan kesehatan promosi kesehatan,
Peran bidan di pelayanan kesehatan primer termasuk kesehatan masyarakat dan lingup
praktik, Kajian gender dalam pelayanan kebidanan, Keilmuan kebidanan, definisi normal
childbirth (kehamilan, persalinan dan nifas), standard ICM, budaya/tradisi dalam kebidanan
yang dapat dimanfaatkan sebagai terapi komplementer dalam asuhan kebidanan, Rujukandan
record keepingnya dengan menggunakan teknologi, Etik biomedis dan aplikasinya dalam
praktik kebidanan, Pengembangan profesional berkelanjutan (continuous professional
development)dan pentingnya belajar sepanjang hayat, Hubungan bidan-ibu dan keterampilan
dan komunikasi efektif dalam pelayanan, Prinsip partnership dalam promosi kesehatan:
interprofesional, interagency, dan intersektor, Modul asuhan dan peran professional kesehatan
lain dalam memberikan asuhan yang berkualitas.
III. Mata Kuliah

Mata kuliah media pembelajaran ini merupakan salah satu mata kuliah yang berperan
didalam pembentukan keprofesionalan calon bidan, oleh karena itu mahasiswa perlu dibekali
dengan berbagai teori belajar dan pembelajaran.Keterampilan dasar bidan dan berlatih
menggunakan teori-teori yang ada. Pemanfaatan media pembelajaran yang relevan dalam
kelas dapat mengoptimalkan proses pembelajaran. Bagi dosen, media membantu memotivasi
peserta belajar aktif. Bagi mahasiswa, media dapat menjadi jembatan untuk berpikir kritis dan
berbuat. Dengan demikian media dapat membantu tugas dosen dan mahasiswa mencapai
kompetensi dasar yang ditentukan agar media pembelajaran dapat dimanfaatkan dengan baik,

dosen perlu mengetahui kebutuhan pembelajaran dan permasalahan-permasalahan yang
dihadapi mahasiswa tentang materi yang akan diajarkan. Terkait dengan itu, media perlu
dikembangkan berdasarkan relevansi, kompetensi dasar, materi dan karakteristik mahasiwa.
Dosen dapat berperan sebagai kreator yaitu menciptakan dan memanfaatkan media yang
tepat, efisien, dan menyenangkan bagi mahasiswa.
IV. Standar Kompetensi Lulusan
Mampu merancang asuhan kebidanan secara efektif, aman dan holistik dengan
memperhatikan aspek budaya terhadap Profesionalisme Kebidanan.
V. Kompetensi Dasar
Mahasiswa diharapkan mampu mengaplikasikan Praktik Profesionalisme Bidan.
VI. Bahan Kajian

1. Evidence-based midwiferyuntuk keperluan pelayanan kebidanan
2. Sejarah perkembangan pelayanan kebidanan
3. Pengantar kepemimpinan dalam kebidanan
4. Pengenalan pada politik dalam pelayanan kebidanan dan medical model dalam pelayanan
obstetrik
5. penggunaan media social dan profesionalisme
6. Peran dan tanggung jawab bidan pada berbagai tatanan pelayan kesehatan promosi
kesehatan
7. Peran bidan di pelayanan kesehatan primer termasuk kesehatan masyarakat dan lingup
praktik
8. Kajian gender dalam pelayanan kebidanan
9. Keilmuan kebidanan, definisi normal childbirth (kehamilan, persalinan dan nifas),
standard ICM
10. budaya/tradisi dalam kebidanan yang dapat dimanfaatkan sebagai terapi komplementer
dalam asuhan kebidanan
11. Rujukandan record keepingnya dengan menggunakan teknologi
12. Etik biomedis dan aplikasinya dalam praktik kebidanan

13. Pengembangan profesional berkelanjutan (continuous professional development)dan
pentingnya belajar sepanjang hayat
14. Hubungan bidan-ibu dan keterampilan dan komunikasi efektif dalam pelayanan
15. Prinsip partnership dalam promosi kesehatan: interprofesional, interagency, dan
intersektor
16. Modul asuhan dan peran professional kesehatan lain dalam memberikan asuhan yang
berkualitas
VII. Metode Pembelajaran

T : dilaksanakan dikelas dengan menggunakan contextual learning, small group discussion,
case based study, colaboratif learning, problem based learning, seminar, reflektif learning,
project based learning, discovery learning, self direct learning, penugasan individu, case
report.
P : dilaksanankan dikelas, Laboratorium (baik di kampus maupun di lahan praktek) dengan
menggunakan metode simulasi, skill laboratory, roleplay.
VIII. Strategi Perkuliahan

Strategi pembelajaran menggunakan metode Student Centered learning (SCL),
mahasiswa diarahkan untuk lebih aktif didalam kelas ataupun diluar kelas. Mahasiswa
dituntut untuk belajar mandiri dengan mencari bahan referensi melalui internet atau buku-
buku yang berhubungan dengan materi yang dimanfaatkan sebagai bahan diskusi setelah
ceramah interaktif di kelas. Sebab dosen hanya bertindak sebagai fasilitator dan pemandu
disetiap aktifitas mahasiswa baik pada tatap muka dikelas maupun pada pertemuan-pertemuan
diluar kelas. Selanjutnya mahasiswa juga di pandu dalam mengerjakan tugas-tugas yang
terkait dengan topic-topik yang diberikan dan mahasiswa ditugaskan membuat media sesuai
dengan materi yang ditampilkan. Mahasiswa dituntut dalam berdiskusi yang baik. Mahasiswa
dibagi menjadi kelompok-kelompok kecil. Masing- masing kelompok diberikan topik sesaui
dengan yang tertera di RPS.Setiap kelompok diminta menulis paper/makalah kemudian
dipresentasikan didepan kelas. Kegiatan ini dimaksudkan untuk menanamkan pemahaman
konsep setiap topik yang diberikan. Disamping itu, mahasiswa secara individu diminta untuk
menulis makalah dan reviewer literatur media pembelajaran Profesionalisme Kebidanan. Pada

akhir pertemuan perkuliahan dilakukan seminar kelompok dan presentasi tugas individu
mahasiswa.
IX. Kriteria Penilaian
Penilaian dilakukan dalam bentuk Penugasan, Kuis, Ujian Tulis.
Nilai Real Mata Kuliah Huruf Mutu Angka Mutu Keterangan
79-100 A 4,00 Sangat Baik
65-78 B 3,00 Baik
56-64 C 2,00 Cukup
20-55 D 1,00 Kurang
<20 E 0,00 Sangat Kurang
Penilaian dilakukan dalam bentuk penugasan, Ujian Tulis, Lisan dan Praktek Klinik
Sikap : 5 %
Kuis :5%
Tugas : 45 % (TR:5 % ; CBR:5 % ; CJR :5 % ; RI : 5 % ; MR : 5 % ; PR : 20%)
Seminar :5 %
UTS : 15 %
UAS : 25 %
Praktek 100 %
X. Jadwal Perkuliahan
Terlampir
XI. Tata Tertib perkuliahan

1. Kehadiran : - Minimal kehadiran 85% dalam setiap semester
- Wajib mengisi daftar hadir dengan tanda tangan mahasiswa
menggunakan tinta hitam.
2. Waktu :- Mahasiswa hadir maksimal 5 menit sebelum perkuliahan dimulai.
3. Penugasan : - Wajib menyerahkan makalah penugasan (baik individu maupun
kelompok)
- Mengerjakan dan mengumpulkan tugas mandiri, yaitu 1 minggu setelah
tugas diberikan. Keterlambatan mengumpulkan tugas dari waktu
yangditentukan akan mendapat konsekuensi

4. Pakaian : - Menggunakan seragam rapi sesuai dengan ketentuan hari bagi, yang tidak
berhijab memakai hairnet, bersepatu putih memakai kaos kakidantidak menggunakan
perhiasan.
5. PBM : - Setiap materi yang telah dicantumkan dalam RPS harus dibaca terlebih
dahulu sebelum mengikuti perkuliahan pada hari yang sudah ditetapkan.
- Setiap Mahasiswa wajib memiliki catatan perkuliahan dan buku pegangan/
buku bacaan Profesionalisme Kebidanan.
- Mahasiswa menyiapkan ruang kelas dan sarana pembelajaran untuk siap
digunakan saat proses pembelajaran sebelum Dosen memasuki ruangan.
- Boleh membawa makanan (berupa snack) dan minuman, dikonsumsi
diluar proses pembelajaran. Tidak dibenarkan membawa handphone
ataupun alat elektronik lainnya ke kelas.
- Menjaga kebersihan kelas.
- Wajib memenuhi semua tugas dan kewajiban yang di agendakan oleh
dosen.
XII. KONSEKUENSI
1. Kehadiran :
- Mahasiswa hanya boleh absen paling banyak 3 kali pertemuan, Apabila lebih dari 3
kali (tanpa alasan yang jelas), maka Mahasiswa tidak dibenarkan mengikuti ujian dan
harus mengulang mata kuliah ini pada semester berikutnya.
2. Waktu :
- Apabila mahasiswa datang terlambat > 15 menit maka mahasiswa tersebut tidak
diperkenankan masuk ruangan atau boleh memasuki ruangan akan tetapi kehadirannya
tetap tidak dihitung (jika tidak ada pemberitahuan terlebih dahulu). Serta mendapat
punishment berupa mencari artikel untuk bahan bacaan perkuliahan untuk pertemuan
selanjutnya.
- Apabila dosen datang terlambat > 15 menit maka mahasiswa boleh meningggalkan
perkuliahan atau menyerahkan kepada mahasiswa perkuliahan akan dilanjut atau
tidak.
3. Penugasan :

- Ketepatan waktu dalam mengumpulkan tugas dapat menambah nilai mahasiswa
4. Keterlambatan dalam mengumpulkan tugas mengurangi nilai tugas mahasiswa
(toleransi jika mahasiswa memberitahukan terlebih dahulu dan memberikan alasan).
5. PBM :
- Mahasiswa boleh minta izin pada saat perkuliahan berlangsung, tetapi apabila setelah
keluar tidak masuk lagi di anggap absen.
6. Wajib mengisi daftar hadir, apabila tidak menandatangani kehadiran, akan dianggap
alpa pada saat jadwal perkuliahan tersebut.
XIII. PERJANJIAN DAN KOMITMEN MAHASISWA

Mahasiswa diwajibkan memiliki dokumen RPS (Rencana Pembelajaran
Semester).Setelah membaca kedua dokumen tersebut, mahasiswa wajib memahami capaian
pembelajaran, model pembelajaran yang digunakan, jadwal kuliah dan praktikum, jenis dan
jadwal pengumpulan tugas dari matakuliahini.
1. Mahasiswa harus masuk ke dalam kelas sebelum perkuliahan dimulai
2. Mahasiswa yang datang terlambat 15 menit setelah dosen memberikan kuliah tidak
diperbolehkan masukkelas.
3. Apabila dosen tidak hadir setelah 15 menit dari jadwal, mahasiswa menghubungi
dosen tersebut via telp./hp untuk menanyakan apakah perkuliahan ada atautidak.
4. Mahasiswa minimal hadir 75% dari jumlah perkuliahan yang direncanakan untuk
dapat mengikuti ujianfinal.
5. Apabila mahasiswa tidak hadir, harus ada pemberitahuan kepada dosen.
6. Mahasiswa dilarang merokok sewaktu perkuliahan (dalam kelas)
7. Mahasiswa dan dosen memakai pakaian yang rapi dan sopan sewaktu pelaksanaan
perkuliahan.
8. Sewaktu mulai perkuliahan, mahasiswa telah menyiapkan perangkat/sarana yang
dibutuhkan untuk kelancaran perkuliahan, seperti papan tulis, proyektor,dll.
9. Setelah selesai perkuliahan, mahasiswa menyelesaiakan/merapikan semua
peragkat/sarana kuliah yang dipakai, misal: memulangkan infokus,dll.
10. Mahasiswa harus memiliki komitmen untuk mengikuti perkuliahan dengan baik dan
melaksanakan semua tugas yang disepakati secaraoptimal.

11. Mahasiswa harus mengerjakan semua tugas yang sudah disepakati secaraoptimal.
12. Mahasiswa harus menyerahkan tugas sesuai dengan kesepakatanbersama.
13. Masih dimungkinkan dalam perkuliahan timbul perjanjian/komitmen baru, untuk
mendukung keberhasilan pelaksanakanperkuliahan.
XIV. LAIN-LAIN
Apabila ada hal – hal yang diluar kontrak perkuliahan ini untuk perlu disepakati dapat
dibicarakan secara teknis pada saat proses perkuliahan dan dapat diatasi/ diputuskan
berdasarkan kesepakatan anatara Dosen dan Mahasiswa. Apabila ada perubahan isi
kontrak perkuliahan, akan ada pemberitahuan terlebih dahulu.

Petunjuk Penggunaan Modul
Modul ini sebagai penuntun dalam proses pembelajaran, sangat penting untuk dipelajari karena akan
sangat berkaitan dengan materi berikutnya dalam mata kuliah Profesionalisme Kebidanan. Nah, untuk
dapat memahami uraian materi dalam modul ini dengan baik, maka ikuti petunjuk dalam penggunaan
modul ini, yaitu:
1. Bacalah dengan cermat bagian pendahuluan ini sampai Anda memahami betul apa, untuk apa dan
bagaimana mempelajari modul ini.
2. Bacalah modul ini secara teratur dimulai dari Kegiatan Belajar I, dengan mengikuti setiap materi-
materi yang dibahas,temukan kata kunci dan kata-kata yang dianggap baru. Carilah arti dari kata-
kata tersebut dalam kamus anda.
3. Carilah informasi sebanyak-banyaknya tentang materi modul untuk lebih memahami materi yang
anda pelajari
4. Pada akhir kegiatan belajar akan ada latihan untuk menguji pemahaman anda mengenai materi
yang telah dibahas. Apabila pemahaman anda belum mencapai sedemikian, maka anda
ditugaskan kembali untuk mempelajari materi yang terkait hingga memahami sehingga dapat
melanjutkan pada kegiatan belajar berikutnya.
5. Apabila anda hasil evaluasi menyatakan anda mampu melakukan keterampilan dengan tepat dan
sistematis maka anda telah menyelesaikan kegiatan pembelajaran pada modul ini.

PENDAHULUAN
I. Diskripsi dan Relevansi
Pada mata kuliah ini mahasiswa belajar tentang profesionalisme kebidanan yang akan
digunakan kelak pada saat mengaplikasikan ke lingkungan masyarakat. Mahasiswa belajar
penggunaan media social dan profesionalisme, Peran dan tanggung jawab bidan pada
berbagai tatanan pelayan kesehatan promosi kesehatan Peran bidan di pelayanan kesehatan
primer termasuk kesehatan masyarakat dan lingkup praktik, budaya/tradisi dalam kebidanan,
Rujukan dan record keepingnya, Etik biomedis dan aplikasinya dalam praktik kebidanan,
pengembangan profesional berkelanjutan, komunikasi efektif Prinsip partnership dalam
promosi kesehatan, dan membuat modul asuhan dan peran profosional kesehatan lain dalam
memberikan asuhan yang berkualitas
II. Capaian Pembelajaran
Setelah membaca modul ini, mahasiswa Program Studi Kebidanan Program Sarjana STIKes Mitra
Husada Medan mampu:
1. Evidence-based midwifery untuk keperluan pelayanan kebidanan
2. Sejarah perkembangan pelayanan kebidanan
3. Pengantar kepemimpinan dalam kebidanan
4. Pengenalan pada politik dalam pelayanan kebidanan dan medical model dalam pelayanan
obstetrik
5. penggunaan media social dan profesionalisme
6. Peran dan tanggung jawab bidan pada berbagai tatanan pelayan kesehatan promosi
kesehatan
7. Peran bidan di pelayanan kesehatan primer termasuk kesehatan masyarakat dan lingup
praktik
8. Kajian gender dalam pelayanan kebidanan
9. Keilmuan kebidanan, definisi normal childbirth (kehamilan, persalinan dan nifas),
standard ICM
10. budaya/tradisi dalam kebidanan yang dapat dimanfaatkan sebagai terapi komplementer
dalam asuhan kebidanan
11. Rujukandan record keepingnya dengan menggunakan teknologi
12. Etik biomedis dan aplikasinya dalam praktik kebidanan
13. Pengembangan profesional berkelanjutan (continuous professional development)dan
pentingnya belajar sepanjang hayat

14. Hubungan bidan-ibu dan keterampilan dan komunikasi efektif dalam pelayanan
15. Prinsip partnership dalam promosi kesehatan: interprofesional, interagency, dan
intersektor
16. Modul asuhan dan peran professional kesehatan lain dalam memberikan asuhan yang
berkualitas

KEGIATAN BELAJAR 1
KEGIATAN BELAJAR 1
MIDWIVES USING RESEARCH: EVIDENCE-BASED

PRACTICE (EBP) & EVIDENCE-INFORMED MIDWIFERY
It might seem obvious to the current generation of midwives and other health care providers
that practice should be informed by evidence as this is now an accepted approach to health care. When
the concept of evidence-based medicine (EBM) was introduced in the early 1990s however, this idea
was harkened as a ‘paradigm shift’ and even a “revolutionary movement.” The concept of EBM
evolved to EBP to be inclusive of not only other health care professions but also other professional
disciplines. The need to use evidence as the basis for decision-making has become an expected, if
challenging, approach to practice and policy-making in all areas.
Midwifery, particularly midwifery in Canada, has a unique relationship to EBP, and a history that
provides insights into both our profession and the ongoing evolution of the application of evidence to
maternity care. EBP offers much to midwives and health care practice, but it is important to understand
the potential limitations and unexpected effects of a naïve application of EBP. For example, in Ontario,
Canada midwives have generated an integrated approach to EBP through midwifery clinical practice
guidelines (CPGs) and other evidence-based resources for midwives and clients that combine a
rigorous look at evidence with a values-based approach to the application of evidence.
WHAT IS EBP???
EBP is commonly defined as a commitment to base health care on the best available scientific
evidence. The term EBM was first used in an article in the Journal of the American Medical
Association (JAMA) in 1992, and it had evolved from previous labels including, research-based practice.
EBP is used interchangeably with evidence-based health care and has generated labels specific to
particular health professions such as evidence-based midwifery, nursing, physiotherapy. The concept is

also now applied outside healthcare professions, such as evidence-based social work and teaching;
and evidence-based policy and evidence-based management.
EBP uses well-defined criteria to evaluate the quality of clinical research, creating a hierarchy
of evidence (Table 1-1). The most scientific and therefore highest quality research is generally
considered to be the randomized controlled trial (RCT). RCTs may be blinded, such that study
participants and/or health care providers and/or those evaluating the results do not know which
participants received which intervention. Blinded RCTs are frequently referred to as single-, double- or
triple-blind, despite these terms having been found to be used and interpreted inconsistently. The
present guidelines state that reports of blinded RCT should include explanation of who was blinded after
assignment to interventions and how.
Table 1-1. Hierarchies of Evidence, after Sacket et. al

1. a) Systemic reviews of RCTs
b) Individual RCTs with narrow confidence interval
2. a) Systematic reviews of cohort studies
b) Individual cohort studies and low-quality RCTs
3. a) Systematic reviews of case-control studies
b) Case-controlled studies
4. Case series poor-quality cohort and case-control studies
5. Expert opinion
In clinical research, such as maternity care research, blinding of the participants and health care
providers is often not possible as both the care provider and patient know the nature of the treatment
being applied or not applied, such as would be the case if the intervention involves, e.g. physical
therapy. However, participants should still, if at all possible, be randomly assigned to their groups and it
is ‘still desirable and often possible to blind the assessor or obtain an objective source of data for
evaluation of outcomes.’ (10) In maternity care, both childbearing clients and care providers involved in
trials are commonly aware of the treatments, but patients are randomized in allocation to their group to
either receive or not receive the treatment. The randomization process that distinguishes the evidence
from RCTs from cohort or case-control studies and outcomes research, as it reduces systematic bias.
What is now the Canadian Task Force on Preventive Health Care (CTFPHC) developed a system for
grading the level and quality of research evidence in 1979 (revised in 2003), which was used in the first
EBP ‘how-to’ guide in 2000. This system established the RCT at the top of the research hierarchy and
evolved to systematic review or meta-analysis being preferred to single RCTs.

A sense of the rationale for these hierarchies of evidence is contained in the following quote
from the 2004 Centre for Health Evidence User’s Guide.
Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and
pathophysiologic rationale as sufficient grounds for clinical decision-making, and stresses the
examination of evidence from clinical research. Evidence-based medicine requires new skills of the
physician, including efficient literature-searching, and the application of formal rules of evidence in
evaluating the clinical literature. (p.2420)
EBP claims to be both epistemological and clinical, as it proposes optimal ways to develop
knowledge and asserts that information obtained from high-quality scientific research is the foundation
for effective clinical practice. Some advocates of EBP argue strongly that the use of scientific research
is superior to the use of other forms of knowledge, such as individual clinical experience, physiologic
principles, expert opinion and understanding of patient, professional, or social values. Hierarchies of
evidence place expert opinion and individual case reports at the lowest level of quality. Others argue
that scientific evidence must be part of a decision making process that integrates all of these forms of
knowledge. Rather than shifting away from expertise and expert opinion, the shift towards EBP is a shift
towards a new kind of expertise , that of critically appraising relevant evidence and applying it to clinical
practice.
Practitioners engage in EBP in a series of steps. EBP demands that clinicians learn first to find,
then analyze and finally to apply evidence in appropriate situations. Over time many tools for EBP have
evolved, such as systematic reviews and CPGs, which can make EBP easier. Midwifery professional
organizations often create their own CPGs, but midwives will often also use reviews and other evidence-
based tools from other professions, such as obstetrics, pediatrics, family practice and nursing, to inform
their practice.
Advocates in the early nineties posed EBP as a central paradigm shift for clinical care
providers, promising not only a more systematic and scientific approach to clinical practice but also a
challenge to practices based on tradition, professional opinion and authority. (1,5) Since that time, the
concept that quality scientific evidence is fundamental to health care has been universally accepted,
while at the same time debate about how to best produce, evaluate and apply evidence continues.
Good evidence is now argued to be essential to both care providers and the recipients of care.
Medical, midwifery, and nursing education have enthusiastically adopted EBP. In 2003, the
journal, Evidence-Based Midwifery, began publication and there are now also many scholarly texts to
guide evidence-based midwifery. (20,21) Linked with not only health care practice but also with

education and with institutions that produce or support research, EBP is deeply entwined with research
funding decisions and academic career paths (see Midwife as Researcher chapter). EBP has now
become so ubiquitous, some worry that “evidence-based everything”, dilutes the meaning of the term.
WHAT EBP CAN & CAN’T

DO???
Despite the debates, the hopes and expectations for EBP in maternity care were high. As noted
above, some hoped that EBP would help humanize childbirth and counted on it to bring change and
choice. Others hoped that if practice was based on best evidence it would bring clarity and take some of
the uncertainty out of clinical practice. However, although scientific evidence can determine which test
or treatment may work best over a population it does not eliminate the need for clinician skills, judgment
and decision-making on the scale of individuals. One of the early goals was to eliminate the need to rely
on expert opinion, yet EBP has increasingly demanded a new kind of expertise. Clinicians are now
required to provide guidance through the lens of both scientific evidence and judgement based on
experience. Advocates embraced the idea that EBP challenges authoritarian approaches to health care
and demands life-long reflective practice from all practitioners. Despite these hopes, some worried that
strong pressures in the system would lead to the use of evidence to support a pre-existing belief or
practice.
The law and ethics of health care demand that people are informed about and participate in
decisions about their care. ECPC concisely states that the goal of scientific evaluation of health care is
to determine the “most effective means to achieve” the objectives of care, but cannot set the objectives.
EBP does not eliminate the need to need to explore goals and objectives, client values and preferences
to inform how evidence is applied to individuals. ECPC challenges the health care system to look at
goals and objectives at an institutional level and for the system as a whole.
It is increasingly clear that some important questions cannot be addressed with RCTs and that
the hierarchy of evidence does not apply to all questions about childbirth. Pregnancy and birth are
complex phenomena with many interdependent factors that may confound results of RCTs when results
are applied in a real life setting. As the evidence movement has matured, the value of different kinds of
knowledge to answer many questions in maternity care has become clear, including observational
studies, findings based on the analysis of large data sets, practice audits, and qualitative research and
mixed methods approaches.

Many hoped that evidence would settle the debates about appropriate rates of intervention in
childbirth. After more than two decades of EBP variations in rates of induction and cesarean remain
problematic all over the world. The application of evidence sometimes leads to unexpected effects, such
as the recommendation for induction of labour between 41-42 weeks appearing to increase the rate of
induction prior to 41 weeks. Both the research process itself and the application of the evidence it
provides involve interpretation. It is clear that personal beliefs and values and institutional norms can
influence how evidence is interpreted. Some evidence is taken up very readily and other evidence
seems almost impossible to implement widely. An example is intermittent auscultation of the fetal heart
(IA) in a low risk pregnancy. Despite national obstetric guidelines advocating IA for low risk pregnancy,
high rates of routine electronic fetal heart rate monitoring are difficult to change. Many factors far
beyond evidence have an impact on how and if evidence is applied. Societies in the developed world
seem to have a tendency to default towards technology, and evidence that advocates for more
technology seems to be taken up more easily than evidence that advocates less technology. Workplace
demands for efficiency and staffing pressures can influence what evidence is applied and wha t
evidence is not. Evidence that provides multiple interpretations should facilitate client choices, however
health systems commonly aim to standardize rather than individualize care and implement singular
understandings and routine practice rather than client choice. Clearly, the debates about EBP will
continue to evolve and change.
EVIDENCE-INFORMED MIDWIFERY
Midwives around the world enthusiastically support EBP and there is
extensive literature and many resources to support evidence-based midwifery. Most
midwifery education programs are built around enabling students to acquire and
use the skills required for EBP, such as how to search the research literature and
how to critically appraise research articles. Many midwifery education programs
are designed to expose students to both science and social science knowledge and
expect them to use both to inform practice.
Many midwives feel most comfortable using the label, evidence-informed
midwifery. The term integrates the concept of informed choice and EBP. It
acknowledges the need for midwives to explore the values and preferences of their

clients. It fits well with the midwifery philosophy in which clients are the primary
decision makers, working in partnership with midwives to determine the best
course of care. The term also acknowledges that midwifery decisions will include
contextual factors. The midwifery model of care is an ideal model for what could
be called the integrative approach to EBP, one that uses clinical research evidence
as one of the many sources of knowledge that are essential to consider in assisting
clients to make decisions
FOR NORMAL BIRTH

Much midwifery work on EBP looks at the evidence through the lens of
normal birth. Many midwifery researchers actively focus their research on topics
relevant to normal birth, including how to preserve as much normalcy as possible
even in complex situations. There are many evidence-based tools produced by
midwives to support normal birth such as the Royal College of Midwives’
Campaign for Normal Birth in the UK and the American College of Nurse
Midwives’ Normal Birth: Pearls in your pocket or the Wales Normal Birth
Pathway. Midwifery research supporting the safety of out of hospital birth has been
integrated into national guidelines in the UK through the advocacy of midwives
working on inter-professional guidelines committees.
FOR ADVOCACY
Many midwives find EBP a powerful tool for advocacy and actively use
evidence both in day-to-day practice and in policy making at every level from
practice to institution to broad health system forums. Midwives have described
carrying a file of important studies, reviews and CPGs with them, so that if other
care providers questioned the care they were providing they could produce the
evidence and have a more informed discussion with their colleagues. International
work studying the implementation of evidence-based midwifery reveals that

midwives often face barriers in the hospital setting, including particularly lack of
autonomy. Some jurisdictions have created midwifery staff positions and research
networks, to promote and support EBP. Research in New Zealand shows higher
rates of EBP at home births than hospital births even when the same midwives have
been in attendance, which may support the case that autonomous midwifery
practice is an ideal setting for EBP.
FOR EVALUATION
Midwives also contribute to evidence-informed midwifery by critically appraising research done
by others. The midwifery model supports spending enough time with clients to explore multiple
interpretations of the evidence. Much of the important RCT evidence about childbirth that has emerged
over the past two decades, for example from RCTs about post-term pregnancy or pre-labour rupture of
membranes at term, is open to multiple interpretations and approaches, with risks and benefits to either
a decision to intervene or take an expectant management approach. The differences in outcomes
between alternate approaches may be similar or small; therefore, the importance of discussion and
choice rather than routine care is heightened. The midwifery model, with its commitment to informing
clients of risks, benefits and alternatives and exploring the client’s goals and values, is ideal for
exploring multiple options rather than one right way.
Midwifery professional associations, such as the Association of Ontario Midwives (AOM), have
produced an impressive set of CPGs formed through a values based approach. These values include
providing guidance to midwives hoping to support normal birth and informed choice. They prioritize
areas of practice where midwifery interpretations of the evidence differ from current medical guidelines
and look at multiple rather than singular interpretations of evidence. They create companion resources
and cell phone apps for clients to use. The following example is of a recommendation from a midwifery
CPG on post-term pregnancy. Note that it integrates information, critical appraisal, choice and support
for normal birth, and uses the evidence grading system of the CTFPHC.
Inform clients that the absolute risk of perinatal death from 40+0 weeks to 41+0 weeks to 42+0
weeks’ gestational age changes from 2.72/1000 to 1.18/1000 to 5.23/1000; currently available research
is not of high quality and has not established an optimal time for induction. Therefore, women with
uncomplicated postdates pregnancies should be offered full support in choices that will allow them to
enter spontaneous labour. A policy of expectant management to 42+0 weeks following an informed

choice discussion is the most appropriate strategy for women who wish to maximize their chance of
normal birth.
CLINICAL APPLICATIONS
What would an evidence-informed midwifery practice look like? It would mean that
as a midwife you listen to the clients and families you work with and find out what is
important to them. You continually update your knowledge of the evidence. To do this you
use relevant guidelines such as the AOM, Society of Obstetricians and Gynaecologists of
Canada (SOGC), or National Institute for Health and Care Excellence (NICE) guidelines and
other evidence-based resources. You know how to search the web to find high-quality
systematic reviews and use the Cochrane database. You get alerts to your preferred journals to
keep abreast of new findings. In clinical practice you ask yourself key questions, including:
 What is the clinical situation and the specific findings for this client?
 What does your client say? What do other family members think? What is important
to them?
 What is the evidence? How is it relevant to the general clinical situation? To the
individual?
 What does your experience tell you?
 How can you best communicate the risks, benefits and the alternatives?
You use evidence to inform and support choice and actively give permission for
reasonable alternatives. You develop your skills of critical appraisal and clinical reasoning
and you become a skilled advocate for your clients and the profession, using evidence. By
actively interpreting evidence to support normal birth you help lower rates of intervention in
your practice settings. You let evidence challenge you and your worldview. You try to be
open about your biases and engage in open dialogue about philosophies of birth and childbirth
care. You respect evidence but know there is more to good practice than good evidence.
CONCLUSION
Midwives have an enthusiastic and critically aware engagement with EBP. Midwives
have an ideal model of practice to implement evidence-informed care, with the benefits of
autonomy and continuity of care. A commitment to EBP and participating in the creation of
evidence-based tools provides an important common ground for midwives and other health

professionals. Internationally, midwives recognize that evidence is an essential part of
providing good care. Midwives contribute to the development of EBP by advocating for
evidence-based approaches to care in their practice settings and at higher policy levels. While
midwives want to contribute to the research, which creates better evidence and want to use
evidence to inform their practice, they recognize that evidence alone cannot determine
individual values and objectives of care. Midwives can and are playing a valuable role in the
scholarship of EBP and in the integration of evidence with client choices and values.
PLEASE MAKE YOUR ANALYZE FOR THIS JOURNAL ABOUT PANDEMIC COVID -19
JOURNAL :
1. Coronavirus in Pregnancy and Delivery : Rapid Review and Experti Consesus
2. Vertical Transmission of Coronavirus Disease 19 (COVID 19) from Infected Pregnant Mothers to
Neonates : A Review
3. Infants Born to Mothers With a New Coronavirus (COVID-19).

SEKOLAH TINGGI ILMU KESEHATAN (STIKes) MITR HUSADA
MEDAN PROGRAM STUDI KEBIDANAN PROGRAM SARJANA
RUBRIK PORTOFOLIO
No. Dokumen Halaman Tanggal Berlaku Revisi
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( )

KEGIATAN KEGIATAN BELAJAR 1I
BELAJAR II
International Confederation of Midwives

Global Standards for Midwifery Regulation
Background
The International Confederation of Midwives (ICM) has developed the ICM
Global Standards for Midwifery Regulation, in response to requests from midwives,
midwifery associations, governments, UN Agencies and other stakeholders. The goal of
these standard sistopromote regulatory mechanisms that protect the public (women and
families) by ensuring that safe and competent midwives provide high standards of
midwifery care to every woman and baby. The aimof regulation is to support midwives
to work autonomously within their full scope of practice. By raising the status of
midwives through regulation the standard of maternity care and the health of mothers
and babies will be improved.
These standards were developed during 2010 in tandem with the development of
global standards for midwifery education and there vision of the ICM essential
competenciesfor basic midwifery practice. Together, the ICM essential competencies and
the global standards for regulation and education providea professional frame work that
can be used by midwifery associations, midwifery regulators, midwifery educators and
governments to streng then the midwifery profession and raise the standard of midwifery
practice in their jurisdiction. When midwives work with insucha professional frame work
the yare supportedan denabled to fulfil their role and contribute fully to the delivery of
maternal and newborn care in their country.
Development of the standards
Background
In 2002 ICM adopted a position statement titled “Framework for midwifery
legislation and regulation”. This position statement defined midwifery legislation and
regulation as follows:

Midwifery regulation is the set of criteria and processes arising from the
legislation that identifies who is a midwife and who is not, and describes the scope of
midwifery practice. The scope of practice is those activities which midwives are
educated, competent and authorised to perform. Registration, sometimes called
licensure, is the legal right to practise and to use the title of midwife. It also acts as a
means of entry to the profession. The primary reason for legislation and regulationis to
protect the public from those who attempt to provide midwifery services inappropriately.
In some countries midwifery practice is regulated through midwifery legislation whilstin
others regulation is through nursing legislation. It has be come in creasing lyapparent
that nursing legislation is inadequate to regulate midwifery practice.
With adoption of the 2002 position statement ICM identified the need to:
Establish guidelines for the development of regulatory standards to further enable
member associations to achieve regulatory processes appropriate for the practice of
midwifery in their country.
ICM adoptedafur ther position state menttitled“Legislation to govern midwifery
practice”. This position statement provided a set of statements about what midwifery
regulatory legislation should provide. These statements are asfollows:
 Enable midwives to practise freely in anysetting.
 Ensure the profession is governed bymidwives.
 Support the midwife in the use of life-saving knowledge and skill sinavariety of
setting sin countries where there is no ready accessto medical support.
 Enable midwives to have access to ongoingeducation.
 Require regular renewal of right topractise.
 Adopta‘Definition of the Midwife’ appropriate to the country with in the
legislation.
 Provide for consumer representation on the regulatory body.
 Recogn is ethatall women have a right to beat tended by a competent midwife.
 Allow for the midwife to practise in her own right.
 Recogn is ethe importance of separate midwifery regulation and legislation which
supports and enhances the work of midwive sinimproving maternal, child and
public health.
 Provide for entry to the profession that is based on competencies and standards

and which makes no distinction on routes ofentry.
 Provide the mechanism for are gulatory body that is governed by midwives with the
aim of protecting the public.
 Provide for regular review of the legislation to ensure it remain sappropriate and
not outdated, as midwifery education and practice and the health service sadvance.
 Encoura gethe use of peer review and analysisof perinatal, maternaland newborn
outcomes in the legislative review process.
 Provide for transition education program mesin the adoption of new legislation
requiring increased levels of competency of the midwife.
These statements in effect provide a set of criteria against which midwifery

regulatory legislation can be measured. However, member associations are seeking more
detail and guidance to enact these statements and to assist development of midwifery
regulation in various countries. To this end the ICM Councilin 2008, decided to develop
global standards for midwifery regulation and appointed a Task for ceto carry out the
work. The co-chair sand members of the ICM Regulatory Standing Committee and the
ICM Board member responsible for liaison with the regulatory committee formed the
Task for ceand managed the project on behalf of ICM.
Process of development
The standards formid wifery regulation were initially draf tedbyasub-groupof the
Task force during a meeting in Hong Kong in April. In drafting the standards this
group drew on information obtained through regulation workshops held at the ICM
Asia-Pacific region conference in Indiain November 2009 and at the ICM/UNFPA
South Asia midwifery meeting in Bangladesh in March 2010. The group also drew on
a literature review undertaken to identify the purpose, types, and functions of health
regulation and midwifery regulation in particular. It was evident that there is an urgent
need for midwifery regulation in many countries and that such regulation needs to
support midwifery auto no my within the full scope of midwifery practice as defined
by the ICM, protect the title ‘midwife’, support standardised midwifery education and
ensure continuing competence ofmidwives.

The draft standard swereend or sed by the full Task force, translated into
English, Frenchand Spanish, and disseminated for feed back. The consultation process
comprised both written feedback and focus group discussion. Questionnaires were sent
to every ICM member association which were also asked to send the questionnaires on
to the relevant regulatory author it yoragency responsible for regulationin the particular
country. Questionnaireswere circulated twice during 2010 and responses were received
from 33 member associations (33% of total membership) representing all four of the
ICM regions. In addition the rewere 21 fur ther individual and group responses from
regulators, educators, ICM Task for cechairs and others. Task force members also
facilitated focus group discussions on the draft standards with group sof regulators
from Europe, Canada, South East Asia and the Western Pacific. All feedback was
considered by the Task force.
It was apparent that the concurrent consultation son the ICM Global Standards
for Midwifery Education and the Essential Competencies for Basic Midwifery Practice
caused some confusion amongst ICM member associations as to which questionnaire
and which round of consultation they were responding to. Nevertheless, the respon
serate on the regulation standards was satisfactory. The final report will provide more
detail on the consultation process and responses. The Task for ceamended the
standards in response to feed back and the final standards were approved by the ICM
Boardin February. The approvedst andards will be presented to the ICM Council in
Durban, South Africa.
ICM Global Standards for Midwifery Regulation
Category Standard Explanation

1. Model of Regulation is Midwifery requires legislation that establishes a
regulation midwifery specific midwifery-specific regulatory authority with adequate
statutory powers to effectively regulate midwives,
support autonomous midwifery practice and enable
the midwifery profession to be recognised as an
autonomous profession.
Midwifery-specific legislation protects the health of
mothers and babies by ensuring safe and competent
midwifery practice.

Regulation Where possible regulation should be at a national
should be at a level. However, if this is not possible there must be a
national level mechanism for collaboration and communication
between the midwifery regulatory authorities.
National regulation enables uniformity of
practice standards and facilitates freedom of
movement of midwives between jurisdictions.
2. Protection of Only those Mothers and their families receiving care from a
title authorised under midwife have a right to know that they are being
relevant legislation cared for by a legally qualified practitioner. A legally
may use the title qualified practitioner is individually responsible and
‘midwife’ endowed accountable for her actions and is required to adhere
by that legislation to professional codes and standards.
Reserving the title ‘midwife’ for legally qualified
midwives identifies legally qualified midwives from
others who provide aspects of maternity care.
Legislative protection of the title enables the
midwifery regulatory authority to prosecute someone
who breaches the legislation by holding themselves
out to be a midwife when they are not on the register
of midwives.
3. Governance The legislation Because there is no evidence for any specific model
sets a transparent of selection of members for regulatory authorities the
process for ICM recommends a combination of appointment and
nomination, election for all members of the midwifery regulatory
selection and authority. The choice will depend on feasibility and
appointment of local acceptance.
members to the
All members of the regulatory authority should
regulatory
demonstrate experience and expertise against pre-
authority and
determined selection criteria such as broad
identifies roles and
experience in the midwifery profession; business
terms of
and finance expertise; education expertise and legal
appointment.
expertise.
The majority of Midwife members should be appointed or elected
members of the from nominees put forward by the midwifery
midwifery profession. The midwife members need to reflect the
regulatory diversity of midwives and of midwifery practice in the
authority are country, have credibility within the profession and be
midwives who authorised to practise in the jurisdiction.
reflect the diversity
Midwives must make up the majority membership of
of midwifery
any regulatory authority to ensure that midwifery
practice in the
standards are utilised in decision-making.
country.
There must be Lay members of the midwifery regulatory authority
provision for lay should reflect the diversity of the country including
members ethnicity. Ideally lay members will provide
perspectives that reflect those of childbearing
women.

3.4 The The midwifery regulatory authority has systems and
governance processes in place to specify roles and
structures of the responsibilities of board or council members; powers
midwifery of the council; process of appointment of
regulatory chairperson.
authority should
The midwifery regulatory authority determines the
be set out by the
processes by which it carries out its functions under
legislation.
the legislation. Such processes must be transparent
to the public through publication of an annual report
and other mechanisms for publicly reporting on
activities and decisions.
3.5 The The members of the midwifery regulatory authority
chairperson of the should select the chairperson from amongst the
midwifery midwife members.
regulatory
authority must be a
midwife.
3.6 The midwifery Payment of fees is a professional responsibility that
regulatory entitlesmidwivestoobtainregistrationoralicenseto
authority is funded practise if that midwife meets the required
by members of the standards.
profession
Fees paid by midwives provide politically
independent funding of the midwifery regulatory
authority. Ideally the midwifery regulatory authority is
entirely funded by the profession. However, in
countries where the midwifery workforce is small or
poorly paid some government support may be
required. Government funding has the potential to
limit the autonomy of the midwifery regulatory
authority and therefore needs to be provided through
a mechanism that minimises such a consequence.

3.7 The midwifery The midwifery regulatory authority’s processes
regulatory should be based on principles of collaboration and
authority works in consultation.
collaboration with
The midwifery regulatory authority needs to work in
the midwifery
partnership8 with other midwifery organizations that
professional
also have a role in public safety and standard setting
association(s).
such as the midwifery association.
3.8 The midwifery Collaboration with other regulatory authorities, both
regulatory nationally and internationally, promotes
authority works in understanding of the role of regulation and more
collaboration with consistent standards globally.
other regulatory
Collaboration can provide economies of scale for
authorities both
developing shared systems and processes that
nationally and
improve quality.
internationally.
4.Functions
Scope of practice The midwifery The midwifery profession determines its own scope
regulatory authority of practice rather than employers, government, other
defines the scope of health professions, the private health sector or other
practice of the commercial interests. The scope of practice provides
midwife that is the legal definition of what a midwife may do on her
consistent with the own professional responsibility.
ICM definition and
The primary focus of the midwifery profession is the
scope of practice of
provision of normal childbirth and maternity care.
a midwife.
Midwives are required to demonstrate the ICM
essential competencies for basic midwifery care
regardless of setting, whether it be tertiary/acute
hospitals or home and community-based
services/birthing centres.
The scope of practice must support and enable
autonomous midwifery practice and should therefore
include prescribing rights, access to
laboratory/screening services and admitting and
discharge rights. As autonomous primary health
practitioners midwives must be able to consult with
and refer to specialists and have access to back up
emergency services in all maternity settings.
Associated non-midwifery legislation may need to
be amended to give midwives the necessary
authorities to practise in their full scope. For
example, other legislation that controls the
prescription of narcotics/medicines or access to
laboratory/diagnostic services may need to be
amended.

Pre-registration The midwifery The midwifery profession defines the minimum
midwifery regulatory authority standards for education and competence required
education sets the minimum for midwifery registration. The ICM definition and
standards for pre- scope of practice of a midwife, essential
registration competencies for basic midwifery practice and
midwifery education standards for midwifery registration should provide
and accreditation of the framework for pre-registration midwifery
midwifery education education programmes.
institutions that are
By setting these minimum standards for pre-
consistent with the
registration midwifery education the profession (via
ICM education
the midwifery regulatory authority) ensures that
standards. midwives are educated to the
qualification/standard/level required for midwifery
registration and that programmes are consistent.
By setting the minimum standards for accreditation
of midwifery education institutions the profession
(via the midwifery regulatory authority) ensures that
the education institution is able to provide quality
midwifery education and that there is
standardisationacrossprogrammesandeducational
institutions.
The midwifery regulatory authority utilises a
transparent process of consultation with the wider
midwifery profession, maternity consumers and
otherstakeholdersInsettingtheminimumstandards
for pre-registration midwifery education and
accreditation. It also draws upon the ICM Global
Standards for Midwifery Education(2011).
The midwifery
regulatory authority
The midwifery regulatory authority establishes the
approves pre-
processes to approve midwifery education
registration
programmes and accredit midwifery education
midwifery education
organisations in order to ensure that the
programmes leading
programmes and graduates meet the approved
to the qualification
education and registration standards and the ICM
prescribed for
Global Standards for Midwifery Education.
midwifery
registration. In countries where national accreditation
organisations exist the midwifery regulatory authority
The midwifery
collaborates in the processes of approval and
regulatory authority
accreditation. In these situations each organisation
accredits the
may focus on its own specific standards and area of
midwifery education
expertise and accept the assessment of the other.
institutions providing
For example, a midwifery regulatory authority will
the approved pre-
need to ensure that the programme leads to the
registration
standards for midwifery registration while a specific
midwifery education
education accreditation organisation will assess
programme.
whether the programme or the education institution
meets the standards necessary to grant the relevant
academic qualification.

The midwifery The midwifery regulatory authority establishes the
regulatory authority processes for ongoing monitoring and audit
audits pre- mechanisms of pre-registration midwifery education
registration programmes and the midwifery education
midwifery education institutions providing the programmes in order to
programmes and ensure that appropriate standards are maintained.
midwifery education
While it establishes the processes the midwifery
institutions.
regulatory authority may employ external auditors to
carry out this work.
4.3. Registration The legislation sets To enter the register of midwive sapplicants
the criteria for must meet specific standards set by profession
midwifery (viathe midwifery regulatory authority).
registration and/or
For example, such standards may include:
licensure.
 demonstration of having metthe
competencies for entry to the register (refer
The midwifery
regulatory authority ICM essential competencies);
develops standards  successful completion of the approved pre-
and processes for registration midwifery education
registration and/or programme to the required standard;
licensure
 success ful completion of
anational examination;
 demonstration of having met standards of
fitness for practice including being of good
character (possible police check for
criminal record), being able to
communicate effectivelyin the professional
midwifery role and having no health issues
that could prevent safepractice.
The midwifery Midwifery registrants from other countries must
regulatory authority meet the same registration standards as local
develops processes midwifery registrants.
for assessing
The assessment process should be comprehensive
equivalence of
and may include:
applicants from
other countries for  sighting and assessing original
entry to the qualifications and post-registration
midwifery register/or midwifery experience of applicants and
licensure. comparing these with the educational
preparation of local new graduate
midwives;
 assessing the competence of applicants
against the competencies for entry to
the register;
 obtainingacertificateofgoodstandingfrom
other regulatory authorities with whom the
midwife isregistered.

Assessment methods may include examinations
and clinical assessment of competence.

Midwives from other countries who meet registration
standards should be required to complete an
adaptation programme to orientate to local society
and culture, health system, maternity system and
midwifery profession. Midwives can hold provisional
registration until these requirements are met within
the designated timeframe.
Regulatory authorities should cooperate and
collaborate to facilitate international mobility of
midwives without compromising midwifery standards
or public safety or breaching international guidelines
on ethical recruitment from other countries.
Mechanisms exist for From time to time midwifery regulatory authorities
a range of need flexibility to temporarily limit the practice of a
registration and/or midwife, for example, while a midwife is having her
licensure status. competence reviewed or is undertaking a
competence programme or has a serious health
issue that may compromise safe practice.
Legislation should include categories of registration
to provide for particular circumstances. For example
provisional, temporary, conditional, suspended and
full midwifery registration/licensure.
The midwifery regulatory authority develops policy
and processes to communicate the registration
status of each registered midwife.
The midwifery The midwifery regulatory authority demonstrates
regulatory authority public accountability and transparency of its
maintains a register registration processes by making the register of
of midwives and midwives available to the public. This may be
makes it publicly electronically through a website or by allowing
available. members of the public to examine the register.
Women and their families have a right to know that
their midwife is registered/licensed and has no
conditions on her practice. Therefore this
information needs to be accessible to the public.
The midwifery Where midwives from other countries do not meet
regulatory authority the registration standards a range of options can be
establishes criteria, considered including examination, education
pathways and programmes, clinical assessment.
processes leading to
Some midwives may not be able to meet the
registration/licensure
registration standards without first completing
for midwives from
another pre-registration midwifery education
other countries who
programme.
do not meet
registration
requirements.
The midwifery The midwifery regulatory authority has a role in
regulatory authority supporting workforce planning. Information collected
collects information can inform planning for pre-registration and post-
about midwives and registration midwifery education and inform
their practice to governments about workforce needs and strategies.
contribute to
Some information will be collected from the register
workforce planning
of midwives but the midwifery regulatory authority
and research.
may also collect specific information about midwifery
practice through surveys of midwives on the register.
Themidwiferyregulatoryauthorityisanappropriate
bodytoprovideanationaloverviewofthemidwifery
workforce for planningpurposes.
Midwifery regulatory authorities may be the
appropriate body to manage workforce deployment
to prevent over or under supply of midwifery
workforce numbers. It is an issue of public safety to
ensure access to midwives for all women regardless
of location.
4.4.Continuing The midwifery Midwifery competence involves lifelong learning and
competence regulatory authority the demonstration of continuing competence for
implements a registration/licensure.
mechanism through
Eligibility to continue to hold a licence to practise
which midwives
midwifery is dependent upon the individual midwife’s
regularly
ability to demonstrate continuing competence.
demonstrate their
continuing Assessment and demonstration of continuing
competence to competence is facilitated by a recertification or
practise. relicensing policy and process that includes such
things as continuing education, minimum practice
requirements, competence review (assessment) and
professional activities.
The legislation sets A requirement for regular relicensing separates the
out separate registration/first licensing process from the
requirements for subsequent application to practise process.
entry to the
Historically in many countries relicensing required
midwifery register
only the payment of a fee. Internationally there is an
and/or first license
increasing requirement for demonstration of ongoing
and relicensing on a
competence (including updating knowledge) as a
regular basis.
requirement for relicensure of health professionals.
This is achieved through the issuing of a practising
certificate on a regular basis to those who meet the
requirements for ongoing competence.
A mechanism exists Midwives may be on the midwifery register for life
for regular (unless removed through disciplinary means or by
relicensing of the death). However, the establishment of separate
midwife’s practice. processes to approve the ongoing practice of
midwives will enable the midwifery regulatory
authority to monitor the continuing competence of
each midwife. Separation between the processes for
registration and approval for ongoing practice also
provide a more flexible mechanism for placing
conditions and/or restrictions on a midwife’s practice
if required.
The register of midwives must show the practising
status of the midwife and must be publicly available.
Mechanisms exist The midwifery regulatory authority is responsible for
for return to practice ensuring that all midwives are competent. As part of
programmes for a continuing competence framework the midwifery
midwives who have regulatory authority ensures that standards and
been out of practice guidelines are set that identify the timeframes and
for a defined period. pathways for midwives returning to practice after a
period out of practice.
Complaints and The legislation The midwifery regulatory authority has a public
discipline authorises the protection role and increasingly there is a public
midwifery regulatory expectation that all professions are transparent and
authority to define effectiveinsettingstandardsforpracticethatprotect
expected standards the public.
of conduct and to
The midwifery regulatory authority sets the
define what
standardsofprofessionalconductandethicsand
constitutes
judges when midwives fall below expected
unprofessional
standards.
conduct or
professional
misconduct.
The legislation The midwifery regulatory authority requires a range

authorises the of penalties, sanctions and conditions including
midwifery regulatory censure; suspension; midwifery supervision;
authority to impose, requirement to undertake an education programme;
review and remove requirement to undergo medical assessment;
penalties, sanctions restricted practice; conditional practice; and removal
and conditions on from the register.
practice
The midwifery regulatory authority utilises due
process and a sets a time frame whereby the
midwife can apply to have penalties, sanctions or
conditions reviewed and or removed.
The legislation sets Appropriate mechanisms must be in place to
out the powers and effectively manage issues of competence, health
processes for and conduct. The mechanisms must ensure natural
receipt, justice. The detail in the legislation will depend on
investigation, the judicial system and cultural context in place in
determination and anycountry.Veryprescriptivelegislationmayrestrict
resolution of the development of a flexible and responsive
complaints. midwiferyworkforce.
The midwifery Complaint processes enable anyone to make a

regulatory body has complaint about a midwife (consumer/service user,
policy and other health professional, employer, another
processes to midwife, or regulator can initiate a complaint).
manage complaints
In addressing competence, health or conduct
in relation to
matters a philosophy of rehabilitation and re-
competence,
education provides the framework for decision
conduct or health
making system in the interests of an effective
impairment in a
maternity system.
timely manner.
The legislation Separation of investigation and hearing and
should provide for determination allows for fairness to the midwife and
the separation of transparency to the public.
powers between the
Separation of powers prevents a conflict for the
investigation of
midwifery regulatory authority between protecting
complaints and the
the interests of the midwifery profession and
hearing and
ensuring public safety. The decision is made in the
determining of
public interest, rather than that of the profession.
charges of
professional
misconduct.
Complaints A freely available and accessible appeal process

management should be in place.
processes are
transparent and
afford natural justice
to all parties.
Code of conduct The midwifery The codes of conduct and ethics are a baseline for
and ethics regulatory authority the practice and professional behaviour expected
sets the standards from a midwife and the midwifery profession. The
of conduct and profession sets these standards via the midwifery
ethics. regulatory authority.
Internationally, common elements in codes include
rules around personal value systems, professional
boundaries, inter-professional respect, collegial
relationships, informed consent, advertising, and
product endorsement.
Codes of ethics should be consistent with the ICM
Code of Ethics.
This document includes the purpose of regulation, founding values and principles,
principles of good regulation, a glossary of terms, the intended use of the standards and the
global standards for midwifery regulation with an accompanying explanation for each
standard.
Purpose of Regulation
Regulatory mechanisms, whether through legislation, employ ment or other regulation,
aimto ensure the safety of the public. This is achieved through the following six main
functions of:
1. Setting the scope ofpractice
2. Pre-registration education;
3. Registration;
4. Relicensing and continuingcompetence;
5. Complaints and discipline;and
6. Codes of conduct andethics.
The purpose of these standards is to describe the regulatory framework necessary for
effective midwifery regulation. The frame work defines the elements of regulation in order
to:
 Determine who may use the title ofmidwife;
 Describe the scope of practice of amid wife consistent with the ICM definition of a
midwife;
 Ensure that midwive senter the register following education consistent with the
ICM Global Standards for Midwifery Education
 Ensure that midwive senter the register able to demonstrate the ICM Essential
Competencies for Basic Midwifery Practice
 Ensure that midwivesare able to practise auto nomously with in their prescribed
scope of practice;
 Ensure that midwives demonstrate continuing competence topractise;
 Ensure that midwives and women (asusers of midwifery services) are part of the
governance of midwifery regulatory bodies
 Ensure public safety through the provision of acompetent and autonomous
midwifery work force.
1. Make your analyse for the historical development of Midwifery !

2. Make some difrent about historical development of midwifery in Indonesia and
Overseas!
SEKOLAH TINGGI ILMU KESEHATAN (STIKes) MITR HUSADA MEDAN
PROGRAM STUDI KEBIDANAN PROGRAM SARJANA
RUBRIK SKALA PERSEPSI

FM-PM-I.IV.Pd2-05/05-18/03- 1-1 18 Oktober 2017 00
Profesionalisme Bidan
Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Sangat Kurang
DEMENSI Sangat Baik Baik Cukup Kurang
SKOR Skor ≥79 (65-78) (56-64) (55 -41) <40

Kemapuan komunikasi
Penguasaan materi
Kemampuan menghadapi
pertanyaan
Penggunaan alat praga

presentasi
Ketepatan menyelesaikan
masalah
Nilai Akhir =
Dosen
1 Medan, .........................2020
2 Mahasiswa
( )
KEGIATAN BELAJAR 3
KEGIATAN
BELAJAR 3
PENGANTAR KEPEMIMPINAN DALAM PELAYANAN KEBIDANAN
BACK GROUND
Kepemimpinan berasal dari bahasa kata “pimpin” yang berarti tuntun, bina ataupun
bimbing, dapat juga diartikan memnunjukan jalan yang baik atau benar, tetapi dapat juga berarti
mengepalai suatu pekerjaan atau kegiatan. Menurut P. Robbins “ Kepemimpinan adalah
kemampuan untuk mempengaruhi suatu kelompok untuk mencapai suatu tujuan:.
Menurut Wahjosumidjo, dalam praktek organisasi, kata “memimpin” mengandung
konotasi menggerakkan, mengarahkan, membimbing, melindungi, membina, memberikan
teladan, memberikan dorongan, memberikan bantuan dan sebagainya”. Di dalam teori
kepemimpinan ini berisi tentang pembahasan teori-teori yang terkandung di dalam memimpin
suatu organisasi, macam-macam pemimpin dan cara memimpin suatu organisasi. Melalui teori
kepemimpinan ini diharapkan tumbuh jiwa kepimpinan di dalam diri mahasiswa serta mampu
menjadi seorang pemimpin yang dapat memimpin anggotanya mencapai tujuan organisasi.
TEORI TENTANG ASAL USUS TERBENTUK SEORANG PEMIMPIN
1. Teori Genetik – menyatakan bahwa pemimpin itu terlahir dengan bakat yang yang sudah
terpendam di dalam diri seseorang.
2. Teori Sosial – menyatakan bahwa seseorang dapat menjadi pemimpin melalui latihan,
kesempatan dan pendidikan.
3. Teori Ekologis – teori ini merupakan gabungan dari 2 teori di atas.
SIFAT PEMIMPIN
1. Intelejensi – Kemampuan bicara, menafsir, dan bernalar yang lebih kuat daripada para
anggota yang dipimpin.
2. Kepercayaan Diri – Keyakinan akan kompetensi dan keahlian yang dimiliki
3. Determinasi – Hasrat untuk menyelesaikan pekerjaan yang meliputi ciri seperti
berinisiatif, kegigihan, mempengaruhi, dan cenderung menyetir
4. Integritas – Kualitas kejujuran dan dapat dipercaya oleh para anggota
5. Sosiabilitas – Kecenderungan pemimpin untuk menjalin hubungan yang
menyenangkan, bersahabat, ramah, sopan, bijaksana, dan diplomatis. Menunjukkan
rasa sensitif terhadap kebutuhan orang lain dan perhatian atas kehidupan mereka.
CRITICAL THINGKING DAN CLINICAL REASONING
Schafersman (1991) menyatakan bahwa berfikir kritis adalah berfikir dengan benar
berdasarkan pengetahuan yang relevan dan reliable, atau cara fikir yang beralasan,
reflektif, bertanggung jawab dan mahir.
John Dewey: critical thinking adalah pertimbangan yang aktif dan tepat serta berhati-hati
atas keyakinan dan keilmuan untuk mendukung kesimpulan.
Ennis: critical thinking adalah kegiatan berfikir yang beralasan dan reflektif yang
memfokuskan pada apa yang diyakini dan apa yang akan dilakukan (Fisher, 2001).
The APA (American Philosophical Association) Consensus Definition berfikir
kritis sebagai keputusan yang memiliki tujuan dan dilakukan sendiri oleh pelaku kegiatan
berfikir, sebagai hasil dari kegiatan interpretasi, analisis, evaluasi dan inferensi serta
penjelasan dari pertimbangan yang didasarkan pada bukti, konsep, metodologi,
kriteriologi dan kontekstual, yang kemudian melandasi keputusan yang dibuat oleh orang
tersebut.
CRITICAL THINGKING MERUPAKAN LANDASAN CLINICAL REASONING
Clinical reasoning adalah proses kognitif yang terjadi ketika berbagai informasi yang
diperoleh dokter baik melalui anamnesis dan pemeriksaan fisik atau melalui kasus klinik yang
diberikan pada mahasiswa kedokteran disintesis dan diintegrasikan dengan pengetahuan dan
pengalaman yang telah dimiliki sebelumnya oleh dokter dan mahasiswa tersebut yang kemudian
dipergunakan untuk mendiagnosis dan menatalaksana masalah pasien. (Groves dkk, 2002).
Cevero (1988) & Harris (1993) Clinical reasoning adalah pola berpikir seorang klinisi untuk
menempuh tindakan bijaksana (memiliki dasar benar, dampak baik) dalam arti melakukan
tahapan tindakan terbaik sesuai dengan konteks yang spesifik. (Higgs & Jones, 2000).
Graber (2005) Penyebab paling sering diagnositic error dan cognitive error .
Cognitive error:
1. Kesalahan pengetahuan
2. Kesalahan pengumpulan data/ informasi
3. Kesalahan mensintesis informasi dan menyimpulkan terlalu awal
4. Kesalahan dalam verifikasi.
Clinical reasoning yang kuat akan menghasilkan diagnosis yang presisi.
PMB Budi Luhur merupakan PMB yang sudah berdiri sejak tahun 1987 dan merupakan salah
satu PMB dengan visi menjadi PMB yang diminati oleh masyarakat. PMB Budli Luhur selalu
berusaha mengevaluasi program dan pasien yang dating sehingga dapat tetap bertahan ditengah
persaingan fasilitas kesehatan lainnya di daerah tersebut. Kenyataan dilapangan bahwa usaha
yang dilakukan oleh PMB Budi Luhur belum menunjukkan bahwa usah yang telah dilakukan
oleh pihak PMB belum menunjukkan hasil yang maksimal. Muncul keluhan masyarakat
mengenai pelayanan yang diberikan PMB Budi Luhur dan jumlah pasien yang belum
menunjukkan peningkatan adalah bukti yang mengindikasikan bahwa PMB Budi Luhur belum
mampu untuk mewujudkan visi tersebut. Berdasarkan wawancara awal di[eroleh informasi
mengenai ketidakpuasan pasien terhadap kualitas pelayan yang diberikan oleh pegawai PMB
Budi Luhur. Oleh karena itu pelayanan pegawai merupakan factor penentu citra dan kualitas
PMB ini.
1. Apakah masalah yang dihadapi oleh PMB Budi Luhur ?

2. Anda selaku pemimpin di PMB Budi Luhur bagaimana cara menyelesaikan masalah
tersebut ?
3. Lakukan bermain peran dalam mengatasi masalah tersebut !
SEKOLAH TINGGI ILMU KESEHATAN (STIKes) MITRA HUSADA MEDAN
PRODI PENDIDIKAN KEBIDANAN PROGRAM SARJANA
RUBRIK ROLEPLAY
No. Dokumen Halaman Tanggal Revisi
Berlaku
1-2 18 Oktober 2017 00
FM-PM-I.IV.Pd2-05/05-18/19- Profesionalisme Bidan
Nama :
NPM :
Wahana Praktik :
Hari/ Tanggal :
No Aspek Penilaian Kurang Cukup Baik

(0-69) (70-85) (86-100)
1 Ekspresi Dapat menyesuaikan Kurang dalam Tidak menyesuaikan dialog
dialog sesuai tokoh menyesuaikan dialog sesuai tokoh yang diperankan
yang diperankan sesuai tokoh yang
diperankan
2 Penghayatan Sangat menghayati Kurang menghayati Sama sekali tidak menghayati
karakter tokoh yang karakter tokoh yang karakter tokoh yang diperankan,
diperankan, sesuai diperankan, sesuai sesuai dengan alur dan tuntutan
dengan alur dan dengan alur dan tuntutan naskah
tuntutan naskah naskah
3 Gerak Saat kemunculan Kemunculan pertama Sangat terlihat gugup dan ragu-
pertama terlihat terlihat sedikit ragu-ragu,ragu, gerakan canggung, dan
mantap, gerakan gerakan bersifat alami tidak sesuai dengan dialog.
bersifat alami, namun kurang
menyesuaikan dialog menyesuaikan dengan
dan dapat dialog juga kurang dapat
memposisikan tubuh memposisikan tubuh
dengan baik dengan baik
4 Intonasi Dapat mengatur jeda Dapat mengatur jeda, Sama sekali tidak dapat mengatur
dengan tepat, intonasi intonasi cukup bervariasijeda, berbicara seolah membaca
bervariasi sesuai sesuai tuntutan naskah, dan tidak jelas
tuntutan naskah, pembicaraan kurang
pembicaraan lancar danlancar, sedikit terbata-
tidak terputus-putus bata.
5 Artikulasi Pengucapan keras, Pengucapan cukup keras,Pengucapan sama sekali tidak
terdengar jelas dan terdengar jelas, tetapi dapat dimengerti
dapat dimengerti kurang dapat dimengerti
TOTAL NN1 = N2 = N3 =
Nilai Akhir (NA) = N1 + N2
+N3 =
5
Preseptor
1 Medan, .........................2020
2 Mahasiswa
Mentor
1
( )
2
RUBRIK ROLEPLAY
Nama :
NPM :
Wahana Praktik :
Hari/ Tanggal :

(0-69) (70-85) (86-100)
1 Ekspresi
2 Penghayatan
3 Gerak
4 Intonasi
5 Artikulasi
+N3 =
5
Preseptor
1 Medan, .........................2020
2 Mahasiswa
Mentor
1
( )
2
KEGIATAN BELAJAR 4
KEGIATAN BELAJAR 4
PENGENALAN POLITIK DALAM
PELAYANAN KEBIDANAN
Terdapat beberapa kasus tentang pelayanan kesehatan di Indonesia, ironisnya kasus

tersebut selalu menunjukkan betapa buruknya pelayanan kesehatan di negeri tercinta ini,
meskipun telah dibentuk badan ombusdman yang bertugas mengawasi jalannya pelayanan publik
saat ini. Di bentuk Standart Operational Programme yang menjadi pedoman dalam
penyelenggaraan pelayanan. Namun demikian masih ditemukan permasalahan-permasalahan
yang seakan menunjukkan rendahnya komitmen pemerintah dalam menjalankan instrumen yang
mereka buat sendiri.
Tahun 2004 dikejutkan dengan laporan hasil penelitian Governance and Desentralization
Survey (GDS) tahun 2002 yang meniympulkan bahwa menyimpulkan bahwa pelayanan publik di
Indonesia masih sangat rendah. Fakta lain menunjukkan bahwa sejak periode November 1998
hingga Juli 2003, Yayasan Pemberdayaan Konsumen Kesehatan Indonesia (YPKKI), telah
mencatat 257 kasus pengaduan dari masyarakat tentang buruknya pelayanan kesehatan. Sebanyak
30 persennya adalah dugaan adanya mal-praktik (Harsono&Worotikan, 2004).
Permasalahan yang terjadi dalam pelayanan sosial khusus pelayanan kesehatan di Indonesia
saat ini sesungguhnya sejak lama telah ditemukan indikatornya, namun hal ini tidak mudah untuk
diselesaikan karena sudah menjadi sebuah sistem dalam penyelenggaraan program bahkan dalam
birokrasi kita.
Sebagaimana kita pahami, meskipun reformasi sudah berjalan lebih dari sepuluh tahun, situasi
dan kondisi ternyata tidak jauh berbeda dengan masa orde baru. Hal ini disebabkan sulitnya
membongkar konspirasi negatif dalam penyelenggaraan negara termasuk dalam pelayanan
kesehatan. Hasil survey Governance and Desentralization Survey (GDS) tahun 2002
menunjukkan salah satu permasalahan dalam pelayanan publik di Indonesia adalah adanya
kesempatan yang mendukung terjadinya konspirasi yang berujung KKN. Menariknya lagi apa
yang disampaikan Prof. Susetiawan bahwa reformasi bukannya meruntuhkan spirit orde baru,
hanya mengganti nama rezim yang lebih populis, akan tetapi sistem dan spirit yang diusung
masih saja mewarnai rezim pemerintahan saat ini, sehingga tidak mengherankan apabila
ditemukan kasus-kasus klasik sebagaimana pada masa orde baru. Oleh karena itu, dalam
pembahasan ini dipakai pendekatan sistem politik dan pendekatan birokrasi.
Implementasi program pelayanan kesehatan di Indonesia yang merupakan salah satu wujud
intervensi pemerintah untuk memujudkan kesejahteraan masyarakat membutuhkan dukungan dari
sistem politik yang kuat. Untuk menciptakan situasi dan kondisi yang kondusif, diperlukan
kemampuan sistem politik dalam menghadapi permasalahan dan tantangan aktual dalam negara.
Bagaimana sistem politik kita menyikapi tuntutan masyarakat khususnya dalam pelayanan sosial
bidang kesehatan. Dalam perspektif ini terdapat pandangan menarik dari Gabriel Almond, bahwa
kemampuan sistem politik (political system capabilities) dapat diukur dengan beberapa indikator.
Pertama, kemampuan sistem politik dalam ekstraksi sumber daya. Baik sumber daya alam
maupun sumber daya manusia bahkan sumber daya sosial. Kedua, kemampuan regulatif,
bagaimana sebuah negara mampu mengendalikan perilaku warga negaranya dengan regulasi
yang berlaku termasuk dalam perilaku hukum, ekonomi, sosial dan politik. Ketiga, kemampuan
responsif, bagaimana tingkat responsifitas pemerintah dalam merespon permasalahan yang
sedang terjadi dalam masyarakat. Ketidakmampuan distributif, dalam pemerataan hasil-hasil
pembangunan dan lain-lain, termasuk pemerataan pendapatan, pemerataan lapangan pekerjaan
serta hal-hal lainnya. Keempat, kemampuan simbolik. Kelima, kemampuan dalam dan luar
negeri, ketika semua kapabilitas dalam negeri maka kapabilitas tersebut akan memancar dan
berpengaruh dalam dunia internasional.
Permasalahan dalam pelayanan kesehatan saat ini berkutat masalah buruknya pelayanan,
baik dari kualitas maupun aksesibilitas serta keberterimaan, harga obat-obatan yang mahal,
hingga diskriminasi pelayanan. Tentu saja ini menyangkut permasalahan regulasi pemerintah
khususnya pedoman teknis pelaksanaan sebuah kebijakan. Standar pelayanan yang sudah
ditentukan terkadang tidak dilaksanakan oleh petugas pelayanan dikarenakan tidak ada sanksi
tegas dari pihak supervisi pelaksana pelayanan sehingga pelanggaran oleh pelaksana seringkali
dilakukan karena tidak ada sisi penegakan standar pelayanan secara tegas. Hal ini sejalan dengan
pemikiran George Homans tentang keterulangan perilaku, menurutnya
ketidakjelasan punishment (sanksi) menyebabkan keterulangan pelanggaran. Dalam hal ini
kapabilitas regulatif pemerintah masih sangat rendah karena tidak mampu mengendalikan
perilaku para pelaksana pelayanan kesehatan. Secara distributif, terjadi ketidakmerataan
pendistribusian pelayanan, sehingga kelompok tertentu tidak mendapatkan pelayanan yang layak.
Bahkan belakangan memunculkan istilah “orang miskin dilarang sakit”, karena buruknya
pelayanan kesehatan di Indonesia yang sangat tidak berpihak pada golongan miskin. Buruknya
pelayanan kesehatan telah lama menjadi permasalahan publik di Indonesia, namun demikian
kapabilitas responsif pemerintah masih sangat rendah, hal ini terbukti dengan berlarut-larutnya
permasalahan tersebut.
Berdasarkan analisis di atas dapat kita pahami bahwa permasalahan pelayanan kesehatan di
indonesia disebabkan oleh sistem yang lemah serta komitmen birokrasi yang sangat rendah.
Untuk itu untuk mengatasi permasalahan tersebut diperlukan reformasi birokrasi khususnya yang
menangani masalah pelayanan kesehatan. Reformasi birokrasi ini mengedepankan akuntabilitas,
transparansi, selain itu juga diperlukan pemenuhan empat syarat utama efektifitas dan efisiensi
implementasi kebijakan, yaitu komunikasi yang baik, sumberdaya yang berkualitas, disposisi
yaitu karakteristik implementor yang jujur, komitmen dan bertanggung jawab serta struktur
birokrasi yang kondusif. Selanjutnya, masalah ini tidak hanya bersumber dari implementor atau
oknum pelaksana, melainkan juga sangat ditentukan oleh sistem yang menaunginya.
Pelayanan kesehatan merupakan salah satu upaya intervensi pemerintah untuk
menciptakan kesejahteraan masyarakat. Di Indonesia, upaya ini merupakan respon atas situasi
krisis ekonomi yang disinyalir menyebabkan penurunan kualitas hidup masyarakat termasuk
kesehatan. Menyikapi situasi demikian, pemerintah meluncurkan beberapa program diantaranya
program Jaring Pengaman Sosial – Bidang Kesehatan (JPS-BK) pada 1998. Program ini
didukung oleh sarana pelayanan kesehatan meliputi Bidan desa, Puskesmas dan rumah sakit
pemerintah.
Pelayanan kesehatan sebagai bentuk intervensi pemerintah dalam menciptakan kesejahteraan
membutuhkan daya dukung yang memadai, baik sarana dan prasarana maupun kualitas
sumberdaya. Meskipun telah didukung dengan berbagai Undang-undang dan kebijakan
pemerintah, ternyata pelayanan kesehatan di indonesia masih saja menyisakan permasalahan.
Permasalahan tersebut meliputi diskriminasi pelayanan, ketidakpastian biaya dan prosedur,
birokrasi yang berbelit serta buruknya kualitas pelayanan medisnya bahkan dari data diatas
banyak juga yang menjadi korban mal-praktik.
Menyikapi hal tersebut kiranya perlu dilakukan reformasi birokrasi guna menciptakan
birokrasi yang bersih, akuntabel dan transparan dalam memberikan pelayanan. Hal ini dapat
dilakukan apabila kapabilitas pemerintah khususnya kapabilitas regulatif, kapabilitas distributif
dan kapabilitas responsif mampu dimaksimalkan. Lingkungan pemerintah yang bersih dan
bertanggung jawab akan menciptakan budaya kerja yang bersih juga, termasuk dalam pelayanan
kesehatan. Dengan adanya pembenahan pada level sistem dan oknum birokrasi diharapkan
pelayanan kesehatan di Indonesia tidak lagi ditemukan diskriminasi dan ketidakadilan.
1. Apa saja masalah dalam pelayanan kebidanan yang menjadi masalah nasional ?
2. Bagaimana peran politik bagi pelayanan kebidanan saat ini?
3. Apa saja program terbaru yang sudah dibuat oleh pemerintah dalam mengatasi masalah
dalam pelayanan kebidanan?
4. Program apa yang bisa anda tawarkan kepada pemangku kebijakan untuk meningkatkan
kualitas pelayanan kebidanan ?

Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Sangat Kurang
SKOR Skor ≥79 (65-78) (56-64) (55 -41) <40

Kemapuan komunikasi
Penguasaan materi
pertanyaan

presentasi
masalah
Nilai Akhir =
Dosen
1 Medan, .........................2020
2 Mahasiswa
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KEGIATAN BELAJAR 5
KEGIATAN BELAJAR 5
PENGGUNAAN MEDIA SOSIAL DALAM
PRAKTIK PELAYANAN KEBIDANAN
BACK GROUND
Kebidanan (Informatic Technology). Perkembangan dunia IT berimbas pada
perkembangan berbagai macam aspek kehidupan manusia. Salah satu aspek yang terkena
efek perkembangan dunia IT adalah kesehatan khususnya kebidanan., yang di mana untuk
menurunkan kematian ibu dan anak berbagai upaya telah dilakukan tidak terkecuali
peningkatan akses yang erat hubungannya dengan teknologi kebidanan dan kualitas
pelayanan melalui peningkatan kapasitas tenaga kesehatan termasuk bidan. Salah satu
bukti kesungguhan pemerintah dalam peningkatan pelayanan kesehatan ibu dan anak ini
tertulis pada Permenkes nomor 97 tahun 2014 tentang pelayanan kesehatan masa hamil,
persalinan dan sesudah melahirkan, penyelenggaraan pelayanan kontrasepsi serta
pelayanan kesehatan seksual.
Untuk meningkatkan sistem tesebut maka diperlukan teknologi. Pengenalan
teknologi yang berkembang saat ini teknologi tradisional, atau lebih dikenal dengan
teknologi tepat guna atau teknologi sederhana dan proses pengenalannya banyak
ditentukan oleh keadaan lingkungan. Untuk memperkenalkan teknologi tepat guna perlu
disesuaikan dengan kebutuhan yang berorientasi kepada keadaan lingkungan geografis
atau propesi kehidupan masyarakat yang bersangkutan. Teknologi tersebut diperkenalkan
dengan maksud masyarakat yang bersangkutan dapat merubah kebiasaan tradisional
dalam proses pembangunan dan peningkatan kesejahteraan masyarakat.
Sehingga Bidan harus melek IT untuk menjalani hidup lebih percaya diri dan
mandiri, terkait tugas bidan sebagai pendidik, pelaksana, pengelola dan peneliti. Untuk
dapat mengembangkan kompetensi dan produktivitas dalam bekerja, lebih inisiatif,
inovatif, dan kreatif., menjadi pemain bukan penonton tidak hanya menikmati teknologi
tetapi juga mampu menciptakan teknologi yang lebih canggih, dan mencapai efektivitas
dan efesiensi.
PROMOSI KESEHATAN KEBIDANAN
BERBASIS TEKNOLOGI
Tujuan Pembelajaran:
1. Mengaplikasikan Intervensi SMS Gateway
2. Menganalisis Efektifitas Promosi Kesehatan Berbasis SMS
3. Mengkaji Persepsi Ibu Terhadap Media Promosi Kesehatan Berbasis Telepon
Selular
PROMOSI KESEHATAN KEBIDANAN BERBASIS TEKNOLOGI
A. Intervensi SMS Gateway

Terbatasnya jumlah tenaga kesehatan dalam memberikan komunikasi informasi dan
edukasi (KIE) merupakan salah satu faktor kurangnya pelayanan kesehatan. Diperlukan sebuah
alternatif sebagai upaya mengatasi dampak yang diakibatkan masalah tidak sampainya pesan
dari petugas kesehatan dalam memberikan asuhan kepada ibu dalam masa ANC, INC, PNC,
Kespro KB dan kepada anak dalam masa neonatus, bayi baru lahir, bayi, balita dan anak pra
sekolah. Alternatif yang paling tepat digunakan adalah dengan memanfaatkan perkembangan
teknologi yaitu pemanfaatan telepon seluler (mobile phone), karena masyarakat Indonesia melek
terhadap teknologi dapat dibuktikan dengan tingginya pemakaian smartphone, lebih dari 80 %
masyarakat sudah menggunakan smartphone.
1. Definisi SMS Gateway

SMS gateway merupakan sebuah sistem aplikasi yang digunakan untuk mengirim dan atau
menerima SMS, dan biasanya digunakan pada aplikasi bisnis, baik untuk kepentingan broadcast
promosi, servis informasi terhadap pengguna, penyebaran content produk / jasa dan lain lain.
SMS Gateway merupakan sebuah aplikasi yang terdiri fitur yang dapat dimodifikasi sesuai
dengan kebutuhan pemakai. Fitur yang terdapat dalam aplikasi SMS Gateway :
a. Auto Replay
b. Broadcast message
c. Gambar
d. Penyimpanan Kontak Person
e. Alarm sebagai reminder
Seiring dengan perkembangan Ilmu Pengetahuan dan Teknologi (IPTEK) banyak peneliti
yang sampai saat ini mengemmbangkan fitur dalam SMS Gateway yang bisa kita akses sesuai
kebutuhan kita.
Gambar 3.1 Aplikasi SMS Gateaway
B. Efektifitas Promosi Kesehatan Berbasis SMS

Software adalah perangkat lunak suatu mesin produk yang memberikan petunjuk ataupun
mengarahkan mesin produk tersebut untuk melakukan operasi tertentu. Dengan bahasa yang
lebih sederhana software dapat diartikan sebagai aplikasi perangkat lunak. Dalam praktiknya
software membantu dan mempermudah pekerjaan manusia karena bersifat efisien.
1. Pengembangan Aplikasi Software Dalam Mobile Phone
Di era globalisasi ini perangkat handphone merupakan bagian dari kehidupan sehari-hari.
Saat ini lebih dari 80 % masyarakat sudah menggunakan smartphone. Penggunaan ponsel
khususnya meledak di dunia berkembang dan banyak digunakan untuk kepentingan kesehatan.
Ada beberapa alasan pengembangan penggunaan software aplikasi kesehatan dalam
smartphone :
a. Rasio dokter dengan penduduk sangat rendah.
b. Kondisi sosial-ekonomi yang buruk dari masyarakat pedesaan
c. Kurangnya tenaga dokter dan perawat yang terlatih di daerah pedesaan
d. Adanya kesulitan dalam bidang transportasi di kota besar
e. Distribusi geometris yang tidak merata
Pengembangan aplikasi software dalam mobile phone artinya dengan menggunakan

perangkat lunak khusus yang dirancang untuk proses tertentu pada smarthphone, tablet,
komputer dan perangkat mobile lainnya. Untuk tujuan kesehatan, software yang dipasang pada
smartphone dapat digunakan pasien dan dokter untuk dapat saling berkomunikasi tanpa harus
mengunjungi klinik sehingga dapat menghemat waktu dan biaya. Software aplikasi medis
pada smartphone sangat membantu pasien dalam mendapatkan pengobatan walaupun dengan
jarak yang jauh tanpa harus datang ke klinik pengobatan dengan demikian dapat menghemat
waktu. Keuntungannya untuk para dokter ialah dapat mendiagnosa dan mengobati pasien pada
waktu yang tepat. Pemasangan aplikasi software pada smartphone cukup sederhana dan
berdaya guna sosio-ekonomi bagi masyarakat.
2. Pengembangan Aplikasi Kesehatan Dalam Mobile Phone
Aplikasi kesehatan mobile telah banyak tersedia untuk di-download pada perangkat mobile
(misalnya smartphone dan tablet). Aplikasi kesehatan banyak digunakan oleh para profesional
kesehatan, konsumen dan pasien karena aplikasi ini dapat membantu dalam mengelola
kesehatan secara mandiri, membantu dalam mempromosikan hidup sehat dan mendapatkan
informasi medis untuk kesehatan sendiri, dapat digunakan dimana saja dan kapan saja. Aplikasi
kesehatan mobile akan membantu dalam mengatasi hambatan komunikasi yang terjadi antara
petugas kesehatan, fasilitas dan pasien. Berdasarkan hasil penelitian, pada tahun 2014 terdapat
9 dari 10 petugas kesehatan yang menggunakan smartphone/dan atau tablet dalam
melaksanakan praktek klinis mereka. Menurut temuan Pew Research Center, 31 % dari pemilik
ponsel mencari informasi kesehatan melalui aplikasi kesehatan yang diinstal dalam smartphone
mereka. Lebih dari 500 juta dari total 1,4 miliar pengguna smartphone diseluruh dunia
setidaknya menggunakan satu aplikasi kesehatan. Pada tahun 2018, 50 % dari 3,4 milliar dari
pengguna smartphone akan telah men-download aplikasi kesehatan pada mobile phone mereka.
Aplikasi mobile kesehatan memengaruhi perilaku kesehatan secara nyata. Aplikasi mobile
health ini juga dapat meningkatkan akses dalam promosi kesehatan dan intervensi kesehatan.
Semua aplikasi medis yang tersedia sesuai dengan kebutuhan pengguna aplikasi.
3. Interaksi Antara Teknologi dan Manusia serta Kontribusinya Untuk Kesehatan.
Kemajuan teknologi menawarkan potensi dalam peningkatan kapan, dimana dan bagaimana
intevensi kesehatan disampaikan. Zaman sekarang ini banyak orang yang memanfaatkan
teknologi, salah satu contohnya adalah penggunaan mobile phone untuk mendapatkan intervensi
kesehatan, dibandingkan datang ke klinik harus antri dan menghabiskan banyak waktu.
Pemanfaatan mobile phone dalam memberikan intervensi kesehatan yang sesuai dengan
keperluan pasien. Mobile phone merupakan suatu alat komunikasi yang dewasa ini tidak bisa
lepas dari kebutuhan manusia. Penggunaan mobile phone dalam pemberian intervensi kesehatan
terbukti dapat merubah perilaku kesehatan. Terbukti dengan memasukkan informasi kesehatan
kedalam mobile phone baik itu kedalam email ataupun jejaring sosial media lainnya dapat
membantu pengguna mobile phone mendapatkan intervensi kesehatan yang sesuai dengan
kebutuhannya. Contoh lainnya adalah dengan memasukkan intervensi kesehatan berupa pesan
untuk merubah perilaku diet, aktivitas fisik, perilaku tidur sehat dan manajemen penyakit kronis.
Pesan dikirimkan kemobile phone pasien yang berguna sebagai pengingat untuk merubah
perilaku pasien sehingga perilaku pasien berubah menjadi lebih baik dan pemanfaatan
kemandirian pasien ini dapat meningkatkan kesembuhan pasien.
Smartphone sangat membantu dalam mempermudah pekerjaan manusia termasuk membantu
manusia untuk mendapatkan informasi. Dalam dunia kesehatan, smartphone dimanfaatkan untuk
melakukan pendekatan kepada pasien sehingga terjadi perubahan perilaku dan kepatuhan pasien
dalam menaati aturan sehingga tercapai kesehatan yang optimal serta melibatkan dan mendidik
pasien untuk berperilaku hidup sehat. Telah terbukti pemanfaatan teknologi ini dapat
meningkatkan kesadaran seseorang dalam perawatan kesehatan dirinya.
Dengan menambah perangkat mobile elektronik dengan sistem pengingat akan meningkatkan
kepatuhan dan perubahan perilaku dengan hanya membutuhkan waktu yang singkat. Aplikasi
tersebut membantu seseorang menjadi patuh terhadap suatu ketetapan dengan sedikit atau tanpa
biaya yang dapat dimanfaatkan oleh siapapun dan kapan saja.
Satu studi mencatat bahwa remaja dengan menggunakan sistem khusus melalui sistem
pengingat akan mempertinggi penerimaan, kemudahan dalam penggunaan dan meningkatkan
kepatuhan seseorang.
Penilaian kepatuhan seseorang dapat dilakukan dengan observasi secara langsung dari petugas
kesehatan atau dari relawan yang sudah terlatih atau disebut pengamatan langsung. Hal tersebut
sesuai dengan anjuran dari World health organization (WHO). Sistem pengingat merupakan
aplikasi yang dibuat untuk meningkatkan kesehatan seseorang dalam waktu tertetu. Sistem
pengingat atau reminder mampu meningkatkan kepatuhan seseorang.
4. Penggunaan Aplikasi Smartphone dan Kepatuhan Pengobatan Pasien
Menurut Masyarakat Internasional Untuk Farmako ekonomi dan Hasil Penelitian ( ISPOR
) kepatuhan adalah sejauh mana pasien bertindak sesuai dengan pengobatan yang ditentukan
baik dalam interval maupun dosis dalam mengkonsumsi obat. Ketidakpatuhan dalam
mengkonsumsi obat adalah masalah yang umum yang dapat memberikan kontribusi untuk hasil
pengobatan yang buruk karena akan mempengaruhi kesehatan pasien. Ketidakpatuhan dalam
mengkonsumsi obat menyebabkan sekitar 33% - 69% pasien harus dirawat inap dan
menghabiskan biaya perawatan kesehatan sebesar 100 miliar pertahun.Pemantauan kepatuhan
dapat diukur secara rutin untuk memastikan keberhasilan terapi.
Banyak metode yang dapat dilakukan untuk meningkatkan kepatuhan pengobatan. Kebanyakan
metode yang digunakan mencoba untuk mengubah perilaku pasien dengan menggunakan
pengingat, konseling, penguatan, pendidikan, dosis penyederhanaan dan kombinasi dari beberapa
metode tersebut.
Penggunaan aplikasi smartphone dalam intervensi untuk meningkatkan kepatuhan dalam
mengkonsumsi obat merupakan suatu pendekatan yang baru. Teknologi dalam aplikasi
smartphone ini sangat menarik karena terdapat banyak fitur yang dapat dirancang untuk
membantu pasien dan penyedia layanan kesehatan dalam meningkatkan kepatuhan pengobatan.
Dengan aplikasi smartphone pasien dapat mengkonsolidasikan semua informasi spesifik obat
dengan demikian dapat memberikan proses yang efisien kepada pasien serta dapat mendidik
pasien tentang penyakitnya dan perawatannya. Di antara yang selama ini beredar salah satunya
fitur pengingat yang didalam fitur ini terdapat aturan mengkonsumsi obat , dosis serta kapan
harus periksa kembali ke dokter. Dalam aplikasi ini juga ditambahkan alarm semacam kalender
pengingat sehingga dapat membantu pasien dalam pengobatan. Dengan aplikasi pengingat dalam
smartphone terbukti dapat meningkatkan kepatuhan pasien dalam mengkonsumsi obat sehingga
berdampak positif terhadap pemulihan kesembuhan pasien.
C.Persepsi Ibu Terhadap Media Promosi Kesehatan Berbasis Telepon Selular
1. Penggunaan Pesan Kesehatan Untuk Meningkatkan Kesehatan Konsumen Mencakup
Pengetahuan, Perilaku dan Hasil Akhir Kesehatan Pasien
Ekspansi yang cepat dari infrastruktur teknologi mobile memberikan kesempatan untuk
meningkatkan kesehatan dan perawatan kesehatan melalui bentuk-bentuk baru dari mobile
interaktif kesehatan (mHealth). Layanan yang mempromosikan kesehatan pribadi, perawatan
pencegahan, dan manajemen penyakit. Menyadari efektifnya potensi program pesan teks untuk
meningkatkan pelayanan kesehatan.
Ponsel merupakan infrastruktur teknologi yang digunakan hampir di mana-mana karena murah,
nyaman utuk diakses, dan mudah digunakan. Pada Desember 2012, ada 326 juta pelanggan
nirkabel koneksi di Amerika Serikat, dengan 2,2 triliun pesan yang dikirim selama 2012. Pada
2013, 91 persen dari penduduk AS berusia 18 dan lebih tua yang memiliki ponsel, dan 56 persen
dimiliki ponsel pintar (Rainie 2013; Smith 2013). Kepemilikan ponsel pintar meningkat dari 35
persen pada 2011 menjadi 46 persen pada 2012 dan 56 persen pada tahun 2013; ponsel pintar
sekarang lebih umum daripada ponsel fitur (Smith 2013). Tingkat kepemilikan ponsel cerdas dan
kepemilikan telepon bervariasi dipengaruhi oleh pendapatan rumah tangga dan tingkat
pendidikan.
Sebuah badan penelitian besar telah menunjukkan bahwa program pesan teks kesehatan dapat
membawa perubahan perilaku untuk meningkatkan kesehatan konsumen seperti hasil berhenti
merokok serta keberhasilan pengobatan diabetes hasil manajemen dan klinis (meningkatkan
frekuensi pemantauan glukosa darah) dalam jangka pendek. Penelitian juga menunjukkan bahwa
pesan teks meningkatkan kepatuhan pengobatan baik itu kepatuhan dalam mengkonsumsi obat
serta kepatuhan hadir untuk konsultasi pemeriksaan kembali ke petugas kesehatan. Penelitian
menunjukkan bahwa pesan teks dapat meningkatkan tingkat imunisasi, meningkatkan
pengetahuan kesehatan seksual, dan mengurangi perilaku berisiko terkait penularan HIV.
2. Pengetahuan dan Persepsi Ibu Hamil Terhadap Penerapan Model SMS Gateway
Berdasarkan data Riset Kesehatan Dasar (Riskesdas) Tahun 2007 terdapat 40,1 % ibu hamil yang
mengalami kekurangan gizi. Ibu yang mengalami kekurangan gizi merupakan salah satu
penyebab kematian ibu secara tidak langsung. Adapun penyebab kematian ibu terjadi akibat
komplikasi secara langsung yaitu perdarahan (25 %), infeksi (15 %), aborsi tidak aman (13 %),
preeklampsia dan eklampsia (12 %), serta partus lama (8 %). Kesehatan ibu hamil sangat
menentukan kesehatan bayi yang dilahirkannya. Karena kurangnya asupan gizi ibu hamil selama
trimester I akan menyebabkan masalah seperti hiperemesisgravidarum, kelahiran prematur
(BBLR), kematian janin, keguguran dan kelahiran prematur (BBLR), kematian janin, keguguran
dan kelainan pada sistem saraf pusat, sedangkan kurangnya asupan gizi pada ibu hamil pada
trimester II dan III berpengaruh terhadap tumbuh kembang janin selama dalam kandungan.
Semua kandungan gizi seperti mineral, kalsium, vitamin, protein, karbohidrat harus terpenuhi
selama kehamilan. Karena jika ibu hamil kekurangan mineral contohnya Iodium dampaknya
dapat meningkatkan resiko keguguran, sedangkan jika ibu hamil kekurangan kalsium dampaknya
dapat meningkatkan resiko ibu mengalami eklampsi karena tekanan darahnya meningkat.
Penyebab lain yang menyebabkan ibu kekurangan asupan gizi seperti adanya pengaruh adat
istiadat yang masih membudaya sampai saat ini yang tidak sesuai dengan aturan –aturan
kesehatan. Adanya mitos “Pantang Makan” akan berdampak sulitnya melahirkan karena ibu
dilarang makan-makanan tertentu yang sebenarnya diperlukan oleh tubuh ibu yang sedang hamil.
Hal ini perlu mendapat perhatian khusus karena sangat berdampak negatif bagi perkembangan
janin karena asupan gizi yang kurang.
Penyebab lain yang menyebabkan tingginya angka kematian ibu adalah lokasi tersebar geografis
yang sulit dijangkau oleh tenaga kesehatan sehingga menjadi kendala dalam melakukan promosi
serta pelayanan kesehatan yang berkaitan dengan kesehatan Ibu dan Anak. Promosi kesehatan
merupakan cara untuk menambah pengetahuan serta wawasan ibu dalam mengatasi masalah yang
dihadapinya selama hamil sampai kepada perawatan bayinya. Pengetahuan merupakan faktor
penting dalam terbentuknya perilaku, jika ibu hamil memiliki pengetahuan tentang gangguan dan
penyulit kehamilan, maka kecenderungan akan lebih besar ia akan berperilaku menjaga,
mencegah, menghindari atau mengatasi resiko terjadinya komplikasi.
Pengembangan media promosi kesehatan dalam manajemen pencegahan penyakit sudah banyak
dilakukan. Akan tetapi pemberian informasi khusus pada ibu hamil masih sedikit dilakukan.
Penekanan promosi kesehatan terletak pada upaya pendidikan kesehatan melalui media koran,
radio, televisi, leaflet, majalah, poster, brosur, dan lainnya. Namun media ini masih terbatas
penggunaannya. Peningkatan kapasitas pengetahuan Ibu melalui pendidikan kesehatan baik
secara langsung maupun tidak langsung penting dilakukan. Meskipun dukungan tenaga kesehatan
sudah memberikan pelayanan konseling pada ibu hamil saat pemeriksaan ANC (Antenatalcare),
namun tidak menjangkau kelompok ibu hamil masih rendah kesadarannya untuk melakukan
pemeriksaan kesehatan. Terbatasnya jumlah tenaga kesehatan terutama dalam penyampaian
komunikasi informasi dan edukasi (KIE) masih menjadi kendala dalam pelayanan kesehatan,
sehingga diperlukan strategi alternatif massal sebagai sarana komunikasi efektif yang berpotensi
mengatasi masalah dan komplikasi yang terjadi selama kehamilan.
Pemanfaatan IPTEK (Ilmu Pengetahuan dan Teknologi) sebagai sarana untuk menyampaikan
informasi kesehatan yang diperlukan ibu hamil sangat efektif dalam menambah pengetahuan ibu
hamil dan adanya persepsi yang positif dari ibu hamil dalam penggunaan media telepon selular.
Dengan adanya penyampaian pesan dari tenaga kesehatan berupa informasi tanda bahaya dalam
kehamilan kepada ibu hamil sehingga pengetahuannya tentang tanda bahaya bertambah dan sikap
ibu hamil sangat positif dengan pemanfaatan handphone sebagai media penyampaian informasi,
karena pada umumnya mayoritas ibu hamil menggunakan handphone sebagai alat komunikasi.
Terdapat ibu hamil yang datang ke fasilitas kesehatan setelah mengalami pusing dan pusing yang
dirasakan ibu hamil tidak sembuh juga setelah diistirahatkan. Ibu hamil tersebut telah mengetahui
bahwa pusing yang berlebihan merupakan tanda bahaya dalam kehamilan, sehingga ia langsung
ke fasilitas kesehatan untuk melakukan pemeriksaan lanjutan. Ini merupakan sikap positif yang
ditunjukkan ibu hamil dan dengan kemudahan dengan pemanfaatan telepon seluler maka tenaga
kesehatan maksimal dalam memberikan asuhan sehingga dapat menurunkan angka morbiditas
dan mortalitas.
Rangkuman
Di era globalisasi ini perangkat handphone merupakan bagian dari kehidupan sehari-hari.
Saat ini lebih dari 80 % masyarakat sudah menggunakan smartphone. Penggunaan ponsel
khususnya meledak di dunia berkembang dan banyak digunakan untuk kepentingan kesehatan.
SMS gateway merupakan sebuah sistem aplikasi yang digunakan untuk mengirim dan atau
menerima SMS, dan biasanya digunakan pada aplikasi bisnis, baik untuk kepentingan broadcast
promosi, servis informasi terhadap pengguna, penyebaran content produk / jasa dan lain lain.
Seseorang yang menggunakan SMS Gateway secara tidak langsung akan berinteraksi dengan
aplikasi atau sistem melalui SMS Gateway, diperlukan nomer tujuan dan pean sebagai bahan
untuk menyampaiakan pesan pengguna SMS Gateway.
Aplikasi kesehatan mobile telah banyak tersedia untuk di-download pada perangkat mobile
(misalnya smartphone dan tablet). Aplikasi kesehatan banyak digunakan oleh para profesional
kesehatan, konsumen dan pasien karena aplikasi ini dapat membantu dalam mengelola
kesehatan secara mandiri, membantu dalam mempromosikan hidup sehat dan mendapatkan
informasi medis untuk kesehatan sendiri, dapat digunakan dimana saja dan kapan saja. Sebuah
badan penelitian besar telah menunjukkan bahwa program pesan teks kesehatan dapat
membawa perubahan perilaku untuk meningkatkan kesehatan konsumen seperti hasil berhenti
merokok serta keberhasilan pengobatan diabetes hasil manajemen dan klinis (meningkatkan
frekuensi pemantauan glukosa darah ) dalam jangka pendek. Pesan teks meningkatkan
kepatuhan pengobatan baik itu kepatuhan dalam mengkonsumsi obat serta kepatuhan hadir
untuk konsultasi pemeriksaan kembali ke petugas kesehatan. Pesan teks dapat meningkatkan
tingkat imunisasi, meningkatkan pengetahuan kesehatan seksual, dan mengurangi perilaku
berisiko terkait penularan HIV. Pemanfaatan IPTEK sebagai sarana untuk menyampaikan
informasi kesehatan yang diperlukan ibu hamil sangat efektif dalam menambah pengetahuan
ibu hamil dan adanya persepsi yang positif dari ibu hamil dalam penggunaan media telepon
selular.
EXERCISE
1. Pembuatan Simulasi Aplikasi SMS Gateway Dalam Menyampaikan Informasi Manfaat
Kunjungan Ibu Hamil Sehingga Hasil Luarannya Dapat Meningkatkan Cakupan Kunjungan Ibu
Hamil !
2. Rancanglah sebuah teknologi dengan pemanfaatan media social untuk mengembangkan
praktik professional bidan !
RUBRIK HOLISTIK
Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Kemampuan tentang penyusunan rancangan pembelajaran

GRADE SKORE INDIKATOR KINERJA
Sangat Baik >81 Rancangan yang disajikan tersistematis, menyelesaikan masalah , dapat diimplementasikan dan
inovatif
Baik 61-80 Rancangan yang disajikan tersistematis, menyelesaikan masalah , dapat diimplementasikan,
kurang inovatif
Cukup 41-60 Rancangan yang disajikan tersistematis, menyelesaikan masalah namun kurang dapat
diimplementasikan
Kurang 21-40 Rancangan yang disajikan teratur namun kurang menyelesaikan permasalahan.
Sangat < 20 Rancangan yang disajikan tidak teratur dan tidak menyelesaikan permasalahan
Kurang
Nilai Akhir =
Dosen
1 Medan, .........................2020
2 Mahasiswa
( )
KEGIATAN BELAJAR 6
KEGIATAN
BELAJAR 6
The role of midwives in various

midwifery service settings
The International Confederation of Midwives (ICM) Essential Competencies for
Midwifery Practice outline the minimum set of knowledge, skills and professional behaviours
required by an individual to use the designation of midwife as defined by ICM 1 when entering
midwifery practice. The competencies are presented in a framework of four categories that sets
out those competencies considered to be essential and that “represent those that should be an
expected outcome of midwifery pre-service education”2.These competency statements are
“linked to authoritative clinical practice guidance documents used by the World Health
Organization” and ICM’s Core documents and Position Statements.
Approach to the Competencies
The updated competencies are organised into a framework of four inter-related categories; general
competencies that apply to all aspects of a midwife’s practice, and competencies that are specific to care
during pre-pregnancy, antenatal, labour, birth and the postnatal period.
The updated competencies are written as holistic statements that reflect the ICM’s Philosophy and
Model of Midwifery Care in addition to the ICM Definition and Scope of Practice of a Midwife.18 As such the
competencies promote:
• the autonomy of midwives to practise within the full scope of midwifery practice and in all settings
• the role of the midwife to support physiology and promote normal birth
• the role of the midwife to uphold human rights and informed consent and decision making for women
• the role of the midwife to promote evidence-based practice, including reducing unnecessary
interventions
• the role of the midwife to assess, diagnose, act, intervene, consult and refer as necessary, including
providing emergency interventions.
The competencies are integrated statements and not a list of tasks. Examples are illustrative and
not an exhaustive list. Midwife educators are expected to structure curricula and design learning activities
that will enable midwifery students to learn the knowledge and develop the skills and behaviours that are
integrated within each competency.
Competency Framework
The competencies are organised into four inter-related categories as outlined below.
1. GENERAL COMPETENCIES
Competencies in this category are about the midwife’s

autonomy and accountabilities as a health professional, the
relationships with women and other care providers and care
activities that apply to all aspects of midwifery practice. All
General Competencies are intended to be used during any aspect
of midwifery care whereas competencies in categories 2, 3, and
4 are each specific to a part of the reproductive process and
must be viewed as subsets of the General Competencies, not
stand-alone subsets. Educational and/or training providers
should ensure that the General competencies are interwoven
in any curriculum. Assessment of the competencies in
categories 2, 3, and 4 must include assessment of the
competencies in category 1.
2. COMPETENCIES SPECIFIC TO PRE- PREGNANCY
AND ANTENATAL CARE
Competencies in this category are about health assessment of the

woman and fetus, promotion of health and well-being, detection
of complications during pregnancy and care
of women with an unintended pregnancy.
3. COMPETENCIES SPECIFIC TO CARE DURING

LABOUR AND BIRTH
Competencies in this category are about assessment and

care of women during labour that facilitates
physiological processes and a safe birth, the immediate
care of the newborn infant, and detection and
management of complications in mother or infant.
4. COMPETENCIES SPECIFIC TO THE ONGOING CARE OF
WOMEN AND NEWBORNS
Competencies in this category address the continuing health

assessment of mother and infant, health education, support for breast
feeding, detection of complications, and provision of family
planning services.
Framework Structure
The diagram below provides a visual representation of the framework structure.
GENERAL
PRE-PREGNANCY CARE DURING

AND ANTENATAL LABOUR AND
CARE BIRTH
ONGOING CARE
Advanced, optional, context-specific indicators, and competencies

Competencies and indicators previously designated as advanced/optional/context specific
are not included as a separate category in the framework for essential competencies. Such
statements are conceptually inconsistent with defining the competencies that are expected of all
midwives. ICM will consider if it is necessary to develop, in the future, competencies that
extend/expand beyond those deemed as essential.
CATEGORY 1 GENERAL COMPETENCIES
Competencies in this category are about the midwife’s autonomy and accountabilities as a
health professional, the relationships with women and other care providers, and care activities that
apply to all aspects of midwifery practice. General Competencies apply across each of categories
2, 3 and 4.
. 1.a Assume responsibility for own decisions 1.b Assume responsibility for self-
and actions as an autonomous practitioner care and self-development as a
midwife
KNOWLEDGE KNOWLEDGE
• Principles of accountability and • Strategies for managing personal safety
transparency particularly within the facility or community
• Principles and concepts of autonomy setting
• Principles of self-assessment and reflective practice
• Personal beliefs and their influence on SKILLS & BEHAVIOURS
practice • Display skills in management of self in relation
• Knowledge of evidence-based practices to time management, uncertainty, change and
coping with stress
SKILLS & BEHAVIOURS • Assume responsibility for personal safety in various
• Demonstrate behaviour that upholds the public practice settings
trust in the profession • Maintain up-to-date skills and knowledge
• Participate in self-evaluation, peer review and concerning protocols, guidelines and safe
other quality improvement activities practice
• Balance the responsibility of the midwife to • Remain current in practice by participating in
provide best care with the autonomy of the woman continuing professional education
to make her own decisions (for example, participating in learning opportunities
• Explain the midwife’s role in providing care that is that apply evidence to practice to improve care such
based on relevant law, ethics, and evidence as mortality reviews or policy reviews.)
• Identify and address limitations in personal skill,
knowledge, or experience
• Promote the profession of midwifery, including
participation in professional organizations at the
local and national level
1.c Appropriately delegate KNOWLEDGE
aspects of care and provide • Principles of research and evidence-
supervision based practice
1.d Use research to inform practice
• Epidemiologic concepts relevant to
KNOWLEDGE maternal and infant health
• Policies and regulation related to • Global recommendations for
delegation practice and their evidence base
• Supportive strategies to supervise (e.g. World Health Organisation
others guidelines)
• Role of midwives as
preceptors, mentors,
SKILLS & BEHAVIOURS
supervisors, and role models
• Discuss research findings with
women and colleagues
SKILLS & BEHAVIOURS
• Support research in midwifery
• Provide supervision to ensure by participating in the conduct
that practice is aligned with of research
evidence-based clinical practice
guidelines
• Support the profession’s
growth through participation in
midwifery education in the
roles of clinical preceptor,
mentor, and role model
1.e Uphold fundamental human rights of individuals when providing

midwifery care
KNOWLEDGE
• Laws and/or codes that protect human rights
• Sexual, reproductive health rights of women and girls
• Development of gender identity and sexual orientation
• Principles of ethics and Human Rights within midwifery practice
SKILLS & BEHAVIOURS

• Provide information to women about their sexual and reproductive health
rights
• Inform women about the scope of midwifery practice and women’s rights and
responsibilities
• Provide information and support to individuals in complex situations where there
are competing ethical principles and rights
• Practice in accordance with philosophy and code of ethics of the ICM and
national standards for health professionals
• Provide gender sensitive care
1.h Demonstrate effective interpersonal communication
with women and families, health care teams, and
community groups
1.g Facilitate women to make
KNOWLEDGE
individual choices about care
KNOWLEDGE
• Cultural norms and practices surrounding
• The laws and regulations of the sexuality, sexual practices, marriage, the
jurisdiction regarding midwifery childbearing continuum, and parenting
• National/state/local community • Principles of empowerment
standards of midwifery practice • Methods of conveying health
• Ethical principles information to individuals, groups,
• ICM and other midwifery philosophies, communities
values, codes of ethics
SKILLS & BEHAVIOURS
SKILLS & BEHAVIOURS • Advocate for and support women to be
• Practise according to legal the central decision makers in their care
requirements and ethical principles • Assist women to identify their needs,
• Meet requirements for maintenance of knowledge, skills, feelings, and
midwifery registration preferences throughout the course of
• Protect confidentiality of oral care
information and written records • Provide information and anticipatory
about care of women and infants guidance about sexual and reproductive
• Maintain records of care in the health to assist women’s decision making
manner required by the health • Collaborate with women in developing a
authority comprehensive plan of care that respects
• Comply with all local reporting her preferences and decisions
regulations for birth and death
registration
• Recognize violations of laws,
regulations, and ethical codes and
take appropriate action
• Report and document incidents and
adverse outcomes as required while
providing care
1.i Facilitate normal birth processes in 1.j Assess the health status, screen for health
institutional and community settings, risks, and promote general health and well-
including women’s homes being of women and infants
KNOWLEDGE KNOWLEDGE
• Normal biologic, psychologic, social, and • Role and responsibilities of midwives and other maternal –
cultural aspects of reproduction and early life infant health providers
• Practices that facilitate and those that • Principles of effective communication
interfere with normal processes • Principles of effectively working in health care teams
• Policies and protocols about care of women in • Cultural practices and beliefs related to childbearing and
institutional and community settings reproductive health
• Availability of resources in various settings • Principles of communication in crisis situations, e.g. grief
and loss, emergencies
• Community views about and utilization of
health care facilities and place(s) of birth
SKILLS & BEHAVIOURS
SKILLS & BEHAVIOURS • Listen to others in an unbiased and empathetic manner

• Respect one others’ point of view
• Promote policies and a work culture that
• Promote the expression of diverse opinions and
values normal birth processes
perspectives
• Utilize human and clinical care resources to
• Use the preferred language of the woman or an interpreter to
provide personalized care for women and their
maximise communication
infants
• Establish ethical and culturally-appropriate boundaries
• Provide continuity of care by midwives
between professional and non-professional relationships
known to woman • Demonstrate cultural sensitivity to women, families, and
communities
• Demonstrate sensitivity and empathy for bereaved women and
family members
• Facilitate teamwork and inter-professional care with other care
providers (including students) and community groups/ agencies
• Establish and maintain collaborative relationships with
individuals, agencies, institutions that are part of referral
networks
• Convey information accurately and clearly and respond to the
needs of individuals
1.k Prevent and treat common health 1.l Recognize abnormalities and
problems related to reproduction and complications and institute appropriate
early life treatment and referral.
KNOWLEDGE
KNOWLEDGE
• Health needs of women related to
• Common health problems related to
reproduction
sexuality and reproduction
• Health conditions that pose risks during
• Common health problems and deviations from
reproduction
normal of newborn infants
• Health needs of infants and common risks
• Treatment of common health problems
• Strategies to prevent and control the
SKILLS & BEHAVIOURS
acquisition and transmission of
environmental and communicable diseases • Conduct a comprehensive assessment of sexual
and reproductive health needs
SKILLS & BEHAVIOURS
• Assess risk factors and at-risk behaviour
• Order, perform, and interpret laboratory and/ or
• Maintain/promote safe and hygienic imaging screening tests
conditions for women and infants
• Exhibit critical thinking and clinical
• Use universal precautions consistently reasoning informed by evidence when
• Provide options to women for coping with and promoting health and well being
treating common health problems • Provide health information and advice
• Use technology and interventions appropriately to tailored to individual circumstances of
promote health and prevent secondary women and their families
complications • Collaborate with women to develop and
• Recognize when consultation or referral is
implement a plan of care
indicated for managing identified health
problems, including consultation with other
midwives
• Include woman in decision-making about
referral to other providers and services
1.m Care for women who experience physical and sexual violence and abuse
KNOWLEDGE KNOWLEDGE
• Socio-cultural, behavioural, and economic conditions that often accompany violence • Complications/pathologic conditions related to
and abuse health status
• Resources in community to assist women and children • Emergency interventions/life-saving
• Risks of disclosure therapies
• Limits of midwifery scope of practice and own
experience
SKILLS & BEHAVIOURS
• Available referral systems to access medical
• Protect privacy and confidentiality and other personnel to manage complications
• Provide information to all women about sources of help regardless of whether there is • Community/facility plans and protocols for
disclosure about violence accessing resources in timely manner
• Inquire routinely about safety at home, at work
• Recognize potential signs of abuse from physical appearance, emotional affect, related SKILLS & BEHAVIOURS
risk behaviours such as substance abuse
• Maintain up-to-date knowledge, life-saving
• Provide special support for adolescents and victims of gender-based violence including
skills, and equipment for responding to
rape
emergency situations
• Refer to community resources, assist in locating safe setting as needed
• Recognize situations requiring expertise
beyond midwifery care
• Maintain communication with women about
nature of problem, actions taken, and referral if
indicated
• Determine the need for immediate
intervention and respond appropriately
• Implement timely and appropriate intervention,
inter-professional consultation and/or timely
referral taking account of local circumstances 19
• Provide accurate oral and written information to
other care providers when referral is made.
• Collaborate with decision-making if possible and
appropriate
CATEGORY 2
PRE-PREGNANCY 2.a Provide pre-pregnancy care 2.b Determine health status of
woman
AND ANTENATAL
KNOWLEDGE KNOWLEDGE
Competencies in this category are • Anatomy and physiology of • Physiology of menstrual and ovulatory
female and male related to cycle
about health assessment of the
reproduction and sexual • Components of a comprehensive
woman and fetus, promotion of development health history including psycho-social
health and well-being, detection • Socio-cultural aspects of human responses to pregnancy and safety at
of complications during pregnancy, sexuality home
and care of women with an • Evidence based screening for • Components of complete physical exam
unexpected pregnancy. cancer of reproductive organs • Health conditions including
and other health infections and genetic conditions
problems such as diabetes, detected by screening blood and
hypertension, thyroid biologic samples
conditions, and chronic
infections that impact SKILLS & BEHAVIOURS
pregnancy
• Confirm pregnancy and estimate
gestational age from history, physical
SKILLS & BEHAVIOURS exam, laboratory test and/or
• Identify and assist in reducing ultrasound
barriers related to accessing and • Obtain comprehensive health history
using sexual and reproductive • Perform a complete physical examination
health services • Obtain biologic samples for
• Assess nutritional status, current laboratory tests (e.g. venipuncture,
immunization status, health finger puncture, urine samples, and
behaviours such as use of vaginal swabs)
substances, existing medical • Provide information about
conditions, and exposure to conditions that may be detected by
known teratogens screening
• Carry out screening procedures • Assess status of immunizations, and
for sexually transmitted and other update as indicated
infections, HIV, cervical cancer • Discuss findings and potential
• Provide counseling about implications with woman and
nutritional supplements such as mutually determine
iron and folic acid, dietary intake, plan of care
exercise, updating immunizations
as needed, modifying risk
behaviours, and prevention of
sexually transmitted infections,
family planning, and methods of
contraception.
2.c Assess fetal well-being
2.d Monitor the progression of pregnancy

KNOWLEDGE
KNOWLEDGE
• Usual physiological and physical changes with
• Placental physiology, embryology, fetal growth
advancing pregnancy
and development, and indicators of fetal well-
• Nutritional requirements of pregnancy
being
• Common psychological responses to pregnancy
• Evidence-based guidelines for use of
and symptoms of psychological distress
ultrasound
• Evidence informed antenatal care policies and
guidelines, including frequency of antenatal
SKILLS & BEHAVIOURS visits20
• Assess fetal size, amniotic fluid volume, fetal
position, activity, and heart rate from SKILLS & BEHAVIOURS
examination of maternal abdomen • Conduct assessments throughout pregnancy of
• Determine whether there are indications for woman’s physical and psychological
additional assessment/examination and refer well-being, family relationships, and health
accordingly education needs
• Assess fetal movements and ask woman • Provide information regarding normal
about fetal activity pregnancy to woman, her partner, family
members, or other support persons
• Suggest measures to cope with common
discomforts of pregnancy
• Provide information (including written and/ or
pictorial) about danger signs, (e.g. vaginal
bleeding, signs of preterm labour, prelabour,
rupture of membranes) emergency prepared- ness,
and when and where to seek help
• Review findings and revise plan of care with
woman as pregnancy progresses
2.f Provide anticipatory guidance related to
pregnancy, birth, breastfeeding, parenthood,
and change in the family
2.e Promote and support health behaviours
KNOWLEDGE
that improve well being
• Complications of early pregnancy such as 2.g Detect, stabilse, manage, and refer
threatened or actual miscarriage, and ectopic women with complicated pregnancies
pregnancy
• Fetal compromise, growth restriction,
KNOWLEDGE
malposition, preterm labour KNOWLEDGE
• Signs and symptoms of maternal pathologic
• Impact of adverse social, environmental, and • Needs of Individuals and families for
conditions such as pre-eclampsia, gestational different information at different times in
economic conditions on maternal -fetal health
diabetes, and other systemic illnesses their respect ive life cycles
• Effects of inadequate nutrition and heavy physical
• Signs of acute emergencies such as • Methods of providing information to
work
hemorrhage, seizures, and sepsis individuals and groups
• Effects of tobacco use and exposure to second-
hand smoke, use of alcohol and addictive drugs • Methods of eliciting maternal feelings and
SKILLS & BEHAVIOURS expectations for self, infant, and family
• Effects of prescribed medications on fetus
• • Community
Stabilise in resources
emergencies
forand refer support,
income for food
21
treatment as necessary
access, and programs to minimize risks of substance SKILLS & BEHAVIOURS
• abuse
Collaborate in care of complications
• Participate in--and refer women and support
• Implement
• Strategies to critical
preventcare activities
or reduce to support
risks vital
of mother-to-child persons to--childbirth education programs
body functions (e.g. intravenous
disease transmission including infant feeding options22 • Convey information accurately and clearly
(IV) fluids, magnesium sulphate, antihemorrhagics)
for HIV infection and respond to needs of individuals
• Mobilize blood donors if necessary
• Effects of gender-based violence, emotional abuse, • Prepare the woman, partner, and family to
• Transfer to higher level facility if needed
and physical neglect recognize labour onset, when to seek care, and
progress of labour
SKILLS & BEHAVIOURS • Provide information about postpartum needs
• Provide emotional support to women to encourage including contraception, care of newborn
change in health behaviour infants, and the importance of exclusive
• Provide information to woman and family about breast feeding for infant health
impact on mother and fetus of risk conditions. • Identify needs or problems requiring further
• Counsel women about and offer referral to appropriate expertise or referral such as excessive fear, and
persons or agencies for assistance and treatment dysfunctional relationships
• Respect women’s decisions about participating in
treatments and programs
• Make recommendations and identify resources for
smoking reduction/cessation in pregnancy
2.h Assist the woman and her family to plan
for an appropriate place of birth
KNOWLEDGE KNOWLEDGE
• Complications of early pregnancy such as • Evidence about birth outcomes in different
threatened or actual miscarriage, and ectopic birthplace settings
pregnancy • Availability of options in specific location;
• Fetal compromise, growth restriction, limitations of climate, geography, means of
malposition, preterm labour transport, and resources available in facilities
• Signs and symptoms of maternal pathologic • Local policies and guidelines
conditions such as pre-eclampsia, gestational
diabetes, and other systemic illnesses SKILLS & BEHAVIOURS
• Signs of acute emergencies such as
• Discuss options, preferences and contingency
hemorrhage, seizures, and sepsis
plans with woman and support persons and
respect their decision
SKILLS & BEHAVIOURS • Provide information about preparing birth site
• Stabilise in emergencies and refer for if in community, e.g. travel and admission to
treatment as necessary21 facility
• Collaborate in care of complications • Promote the availability of a full range of birth
• Implement critical care activities to support vital settings
body functions (e.g. intravenous
(IV) fluids, magnesium sulphate, antihemorrhagics) 22
• Mobilize blood donors if necessary
• Transfer to higher level facility if needed
CATEGORY 3
CARE DURING LABOUR AND BIRTH
Promote physiologic labour and birth
KNOWLEDGE
• Anatomy of maternal pelvis and fetus; mechanisms of labour for different fetal presentations
• Physiologic onset and progression of labour
• Evidence informed intrapartum care policies and guidelines, including avoidance of
routine interventions in normal labour and birth23,24
• Cultural and social beliefs and traditions about birth
• Signs and behaviours of labour progress; factors that impede labour progress
• Methods of assessing fetus during labour
SKILLS & BEHAVIOURS

• Provide care for a woman in the birth setting of her choice, following policies and protocols
• Obtain relevant obstetric and medical history
• Perform and interpret focused physical examination of the woman and fetus
• Order and interpret laboratory tests if needed
• Assess woman’s physical and behavioural responses to labour
• Provide information, support, and encouragement to woman and support persons
throughout labour and birth
• Provide respectful one-to-one care
• Encourage freedom of movement and upright positions
• Provide nourishment and fluids
• Offer and support woman to use strategies for coping with labour pain, e.g. controlled breathing,
water immersion, relaxation, massage, and pharmacologic modalities when needed
• Assess regularly parameters of maternal-fetal status, and e.g. vital signs, contractions, cervical
changes, and fetal descent
• Use labour progress graphic display to record findings and assist in detecting complications, e.g.
labour delay, fetal compromise, maternal exhaustion, hypertension, infection
• Augment uterine contractility judiciously using non-pharmacological or pharmacological agents to
prevent non-progressive labour
• Prevent unnecessary routine interventions, e.g. amniotomy, electronic fetal monitoring, directed
closed glottis pushing, episiotomy
3.b Provide care of the newborn immediately after birth
KNOWLEDGE
• Normal transition to extra-uterine environment
• Scoring systems to assess newborn status
• Signs indicating need for immediate actions to assist
transition
• Interventions to establish breathing and circulation as covered
in training programs such as HBS27
• Appearance and behaviour of healthy newborn infant
• Method of assessing gestational age of newborn infant
• Needs of small for gestational age and low birth weight infants
SKILLS & BEHAVIOURS

• Use standardized method to assess newborn condition in the first
minutes of life (Apgar or other); refer if needed
• Institute actions to establish and support breathing and
oxygenation, refer for continuing treatment as needed
• Provide a safe warm environment for initiating breastfeeding and
attachment (bonding) in the first hour of life
• Conduct a complete physical examination of newborn in presence of
mother/family; explain findings and expected changes e.g. colour of
extremities, moulding of head. Refer for abnormal findings.
• Institute newborn prophylaxis e.g. ophthalmic infection, and
hemorrhagic disease, according to policies and guidelines
• Promote care by mother, frequent feeding and close
observation
• Involve partner/support persons in providing newborn care
CATEGORY 4
ONGOING CARE OF WOMENAND NEWBORNS
4.a Provide postnatal care for the 4.b Provide care to healthy newborn
healthy woman infant
KNOWLEDGE KNOWLEDGE
• Physiological changes following birth, • Appearance and behaviour of infant in early
uterine involution, onset of lactation, healing life; cardio-respiratory changes related to
of perineal-vaginal tissues adapting to extra-uterine life
• Common discomforts of the postnatal period • Growth and development in initial
and comfort measures weeks and months of life
• Need for rest, support, and nutrition • Protocols for screening for
to support lactation metabolic conditions, infectious
• Psychological responses to mothering role, conditions, and congenital
addition of infant to family abnormalities
• Protocols/guidelines for immunizations
SKILLS & BEHAVIOURS in infancy
• Evidence-based information about
• Review history of pregnancy, labour, and birth
infant circumcision; family values,
• Conduct a focused physical exam to assess
beliefs, and cultural norms
breast changes and involution. Monitor
blood loss and other body functions
• Assess mood and feelings about SKILLS & BEHAVIOURS
motherhood and demands of infant care • Examine infant at frequent intervals
• Provide pain control strategies if needed for to monitor growth and
uterine contractions, and perineal trauma developmental behaviour
• Provide information about self-care • Distinguish normal variation in
that enables mother to meet needs of newborn appearance and behaviour
newborn, e.g. adequate food, nutritional from those indicating pathologic
supplements, usual activities, rest periods, conditions
and household help • Administer immunizations, carry
• Provide information about safe sex, family out screening tests as indicated
planning methods appropriate for the • Provide information to parents about a safe
immediate postnatal period, and pregnancy environment for infant, frequent feeding,
spacing care of umbilical cord, voiding and
stooling, and close physical contact
EXERCISE :
Analysys journal about midwifery and midwifery care in now adays !
RUBRIK PORTOFOLIO
Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Metode Pembelajarn :

(6-10) (1-5) (6-10) (1-5) (6-10) ah
(1-5)

tahun terakhir

artikel
artikel
artikel

artikel
artikel
dipilih
Dosen
1 Medan, .........................2020
2 Mahasiswa
( )
KEGIATAN BELAJAR 7
KEGIATAN
BELAJAR 7
Bill of Rights for Women and Midwives
Background
The International Confederation of Midwives calls for governments globally to recognise and support
accessible and effective midwifery care as a basic human right of all women, babies and midwives.
The issues for women around gender equity and access to education also extend to midwives as a woman-
dominated profession. The Bill of Rights for Women and Midwives addresses those basic human rights of
women and midwives that have been systematically denied and adds another framework to approach
governments when demanding change to improve midwifery and maternity services.
Recognition and support of the ICM’s vision, mission, philosophy and standards by governments will enable
nations to meet the United Nation's Sustainable Development Goals. Specifically: Goal 3: Ensure healthy
lives and promote well-being for all at all ages,
 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births,
 3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including
for family planning, information and education, and the integration of reproductive health into
national strategies and programmes.
Goal 5 – Achieve gender equality and empower all women and girls
 5.1 End all forms of discrimination against all women and girls everywhere
 5.5 Ensure women’s full and effective participation and equal opportunities for leadership at all levels
of decision-making in political, economic and public life
5.6 Ensure universal access to sexual and reproductive health and reproductive rights as agreed in
accordance with the Programme of Action of the International Conference on Population and Development
and the Beijing Platform for Action and the outcome documents of their review conferences.
ICM believes women have a right to a midwife as the most appropriate care provider in
most situations and midwives have a right to obtain adequate education, regulations to foster their
practice and associations to forward their mission.
Bill of Rights
In keeping with other similar documents, the ICM believes that there should be recognition of the following
as basic human rights for women and midwives across the globe; namely that:
Women’s Rights
1. Every woman has the right to receive care in childbirth from an autonomous and competent midwife
2. Every newborn baby has the right to a healthy and well informed mother
3. Every woman has a right to be respected as a person of value and worth
4. Every woman has a right to security of her body
5. Every woman has a right to be free from any form of discrimination
6. Every woman has a right to up-to-date health information
7. Every woman has a right to participate actively in decisions about her health care and to offer
informed consent
8. Every woman has a right to privacy
9. Every woman has a right to choose the place where she gives birth
Midwives’ Rights
1. Every midwife has the right to a midwifery-specific education that will enable her to develop and
maintain competency as a midwife
2. Every midwife has the right to practise on her own responsibility within the International
Confederation of Midwives definition and scope of practice of a midwife
3. Every midwife has the right to be recognised, respected and supported as a health professional
4. Midwives have the right to access a strong midwifery association that can contribute to midwifery
and maternity policy and services at a national level
Analysa akar permasalah ketidaksetarann gender dan berikan ide anda untuk mengatasi masalah
ketidaksetaraan gender !

Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Sangat Kurang
SKOR Skor ≥79 (65-78) (56-64) (55 -41) <40

Kemapuan komunikasi
Penguasaan materi
pertanyaan

presentasi
masalah
Nilai Akhir =
Dosen
1 Medan, .........................2020
2 Mahasiswa
( )
KEGIATAN BELAJAR 8
KEGIATAN
BELAJAR 8
DEVELOP A CULTURE OF MIDWIFERY CARE
Background
Throughout the world midwifery has been practiced for centuries, and has features and characteristics that have
evolved differently according to local or regional cultural and social traditions and knowledge. This document
provides a universal, description of the philosophy and model of midwifery care, without compromising local or
regional characteristics of midwifery care.
According to the ICM definition of the midwifei: “A midwife is a person who has successfully completed a midwifery
education programme that is duly recognized in the country where it is located and that is based on the ICM
Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery
Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery
and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery.” Researchii indicates
that midwife-led continuity models of care are associated with benefits for mothers and newborns, such as reduction
in the use of epidural anaesthesia, fewer episiotomies and instrumental births, and increased spontaneous vaginal
births and increased breastfeeding. Women were less likely to experience preterm birth or lose the baby before 24
weeks gestation. The chances of being cared for in labour and birth by a midwife she had got to know increased.
ICM recognises midwives as the professionals of choice for childbearing women in all areas of the world. This
universal standard is based on initial and ongoing midwifery education that is competency based. ICM promotes the
midwifery model of care based on respect for human dignity, compassion and the promotion of human rights for all
persons.
ICM believes that midwives offer care based on a philosophy, which influences the model of midwifery care.
ICM Philosophy of Midwifery Care • Pregnancy and childbearing are usually normal physiological processes. •
Pregnancy and childbearing is a profound experience, which carries significant meaning to the woman, her family,
and the community. • Midwives are the most appropriate care providers to attend childbearing women. • Midwifery
care promotes, protects and supports women's human, reproductive and sexual health and rights, and respects
ethnic and cultural diversity. It is based on the ethical principles of justice, equity, and respect for human dignity. •
Midwifery care is holistic and continuous in nature, grounded in an understanding of the social, emotional, cultural,
spiritual, psychological and physical experiences of women. • Midwifery care is emancipatory as it protects and
enhances the health and social status of women, and builds women's self confidence in their ability to cope with
childbirth. • Midwifery care takes place in partnership with women, recognising the right to selfdetermination, and is
respectful, personalised, continuous and non-authoritarian. • Ethical and competent midwifery care is informed and
guided by formal and continuous education, scientific research and application of evidence.
ICM Model of Midwifery Care • Midwives promote and protect women’s and newborns’ health and rights. • Midwives
respect and have confidence in women and in their capabilities in childbirth. • Midwives promote and advocate for
non-intervention in normal childbirth. • Midwives provide women with appropriate information and advice in a way
that promotes participation and enhances informed decision-making. • Midwives offer respectful, anticipatory and
flexible care, which encompasses the needs of the woman, her newborn, family and community, and begins with
primary attention to the nature of the relationship between the woman seeking midwifery care and the midwife. •
Midwives empower women to assume responsibility for their health and for the health of their families. • Midwives
practice in collaboration and consultation with other health professionals to serve the needs of the woman, her
newborn, family and community. Midwives maintain their competence and ensure their practice is evidence-based. •
Midwives use technology appropriately and effect referral in a timely manner when problems arise. • Midwives are
individually and collectively responsible for the development of midwifery care, educating the new generation of
midwives and colleagues in the concept of lifelong learning
Recommendations Member Associations are recommended to: • Use this document as a guide in the education of
midwives, the organisation of midwifery care, and evaluation of midwifery care. • Use this document to guide the
relationship between the midwife and the woman and her family, and the midwife and other health professionals. •
Share this statement with other health professions and governments during the development of regulations and
legislation of midwifery practice.
BECAUSE OF OUR TOPIC WILL CONCERNT IN OVERSEAS, ABSOLUTELY WE MUST READING

RESEARCH ABOUT CULTURE AND MIDWEFERY CARE IN INDONESIA AND OVERSEAS....
INSTRUCTION 1 : I WILL GIVE YOU THREE RESEARCH IN OVERSEAS AND YOU WILL MAKE THE
RESUME
INSTRUCTION 2 : I WILL GIVE YOU PHILOSOFY ICM ABOUT CULTUR AND MIDWIFERY CARE, YOU
WILL CONNECT THIS ICM PHILOSOFY WITH YOUR JOURNAL RESEARCH
INSTRUCTION 3 : YOU WILL WRITE ALL OF THIS RESUME ON YOUR BLLOGER
LINK JOURNAL : 1.
file:///C:/Users/USER/Documents/DARING/PRAKTIK%20PROFESIONAL%20BIDAN/MATERI/CULTURE/th
e%20importance%20culture.pdf
file:///C:/Users/USER/Documents/DARING/PRAKTIK%20PROFESIONAL%20BIDAN/MATERI/CULTURE/re
ligions-10-00082.pdf
file:///C:/Users/USER/Documents/DARING/PRAKTIK%20PROFESIONAL%20BIDAN/MATERI/CULTURE/N
orwegia%20dan%20israel.pdf
file:///C:/Users/USER/Documents/DARING/PRAKTIK%20PROFESIONAL%20BIDAN/MATERI/CULTURE/IC
M%20eng-philosophy-and-model-of-midwifery-care.pdf
RUBRIK PORTOFOLIO
Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Metode Pembelajarn :

(6-10) (1-5) (6-10) (1-5) (6-10) ah
(1-5)

tahun terakhir

artikel
artikel
artikel

artikel
artikel
dipilih
Dosen
1 Medan, .........................2020
2 Mahasiswa
( )
KEGIATAN BELAJAR 9
KEGIATAN
BELAJAR 9
RECORD KEEPING DENGAN MENGGUNAKAN TEKNOLOGI
Perkembangan teknologi informasi dengan kecepatannya di era digital dalam dua dekade terakhir
telah membawa dampak yang esensial dalam bidang kearsipan. Pengelolaan arsip berbasis kertas yang
sebelumnya menjadi konsentrasi dengan segera digantikan oleh format elektronik yang membludak
secara kuantitas dan penggunaan. Di era digital, pengelolaan arsip elektronik menjadi tren sekaligus fokus
pengembangan pengelolaan dalam banyak institusi. Sejumlah riset telah banyak dihelat untuk
mendiskusikan kompleksitas peningkatan kualitas teknis secara konkrit, tantangan, resiko maupun
peluang secara umum dalam pengelolaan arsip elektronik agar mampu memberikan kontribusi yang lebih
konstruktif bagi pengguna. Seiring dengan proses modernisasi, arsip elektronik dianggap lebih sesuai
dengan kebutuhan zaman yang menuntut kecepatan berbagi, kemudahan akses dan fleksibilitas dalam
berjejaring. Oleh karenanya, kefasihan institusi dalam beradaptasi untuk mengelola arsip elektronik
menjadi penting untuk menjaga keberlangsungan bisnis dan memenuhi kebutuhan informasi. Kehadiran
arsip dalam format elektronik menawarkan sejumlah kemudahan dan berbagai peluang yang sebelumnya
tidak dimiliki arsip dalam format fisik dalam pengelolaannya. Sebagai contoh, arsip elektronik
memerlukan usaha yang lebih sederhana untuk digandakan atau justru dapat dibagi dengan mudah
sehingga dapat meminimalisir duplikasi. Arsip elektronik juga memberikan perubahan yang signifikan
dalam kemudahan dan kecepatan untuk melakukan proses pengiriman dan berbagi dibandingkan dengan
arsip berbentuk fisik.
Selain itu, arsip elektronik juga memberikan peluang bagi institusi untuk menghemat ruangan
penyimpanan secara fisik sekaligus membuka peluang akses yang lebih ringkas bagi pengguna. Namun,
di sisi lain arsip elektronik juga memerlukan tingkat pengelolaan yang memiliki kompleksitas berbeda
dibandingkan pengelolaan arsip fisik. Bagi institusi yang tengah melakukan transformasi pengelolaan dari
paperbased menuju paperless maupun digital, tentunya hal ini menimbulkan bermacam tantangan
tersendiri. Pertama, arsip elektronik dengan bentuknya yang tidak memiliki wujud fisik bisa
menimbulkan perdebatan terkait aspek legalitasnya. Misalnya, beberapa institusi masih belum dapat
sepakat bahwa surat elektronik memiliki kedudukan yang sama dengan surat fisik. Lebih lanjut, institusi-
insitusi lain juga masih mempertimbangkan stempel ataupun tandatangan basah sebagai parameter
otentisitas. Kedua, kemunculan arsip elektronik merupakan salah satu dampak dari perkembangan
teknologi informasi. Institusi-institusi yang sebelumnya mengelola arsip dan dokumen dalam bentuk
kertas tidak dapat menghindar pada keharusan untuk berbenah secara teknis maupun kebijakan yang
mengaturnya. Transformasi ini biasanya dimulai dengan formulasi kebijakan dan pergantian infrastruktur.
Arsip elektronik hanya dapat diakses melalui mesin pembaca seperti komputer dan pada
perkembangannya, membutuhkan dukungan jaringan internet untuk berbagi. Berbicara dalam segi
perlindungan dan keamanan, aspek elektronik juga rentan terkena virus dan formatnya pun lebih cepat
kedaluarsa dan tak terbaca. Juga, meskipun mampu menghemat ruang, kemudahannya mencipta dan
berbagi menimbulkan banjir dalam kuantitas. Faktanya, salah satu permasalahan yang umum ditemui
adalah bagaimana institusi kerap kali memandang perubahan pengelolaan dari paper-based ke digital
sebagai faktor teknis semata. Kebijakan pembelian infrastruktur ataupun penentuan sistem aplikasi yang
diyakini mampu meningkatkan kualitas fasilitas sering lalai untuk dikompromikan dengan pengelola dan
pengguna. Akibatnya, alihalih mampu memaksimalkan potensi peningkatan fasilitas, perubahan
pengelolaan arsip dan dokumen berbasis elektronik justru kerap menimbulkan ketakutan pada kegagapan
teknologi, kecemasan akan kompleksitas aplikasi, atau bahkan penolakan atas prosedur yang baru.
Perubahan pengelolaan arsip di era digital tidak seharusnya dipandang melalui satu sudut pandang
tunggal yang dimiliki institusi saja.
Modul ini akan mencoba untuk mendiskusikan bagaimana pengelolaan arsip di era digital dapat
mempertimbangkan kembali posisi dimensi sosial, termasuk di dalamnya sudut pandang pengelola
sebagai pengguna internal maupun masyarakat umum sebagai pengguna eksternal. Institusi tidak
semestinya abai terhadap perspektif maupun perilaku pengelola dan pengguna. Sehingga, pengelolaan
arsip elektronik sudah semestinya memberikan kontribusi yang lebih konstruktif dengan membuat
pengelola dan pengguna mampu mengerti keuntungan yang ditawarkan, kemudahan yang didapat
ataupun visi institusi di masa depan dan bukan rasa cemas akan kompleksitas pengelolaan dan akses.
Arsip elektronik Kemunculan informasi dalam bentuk elektronik ataupun tren digitalisasi merupakan hal
yang tidak terhindarkan sebagai bagian dari proses modernisasi di era digital. Harries menyatakan bahwa
saat ini pengelolaan informasi elektronik merupakan hal yang esensial bagi keberlangsungan bisnis suatu
institusi yang disebabkan tuntutan untuk beradaptasi dengan lingkungan maupun memenuhi kepatuhan
pada kebijakan (Harries, 2009, p. 18).
Kemunculan informasi elektronik memungkinkan penggunaan informasi dalam banyak tujuan yang
berbeda yang sebelumnya belum pernah mampu dicapai (Kallberg, 2012). Sehingga, institusi lebih
banyak menciptakan maupun saling berbagi informasi, tak terkecuali arsip dalam format elektronik.
Selain itu, pengelolaan arsip elektronik membuat insitusi pada saat terjadi bencana dapat memiliki opsi
recovery dengan back-up data (Johnston, G. P., & Bowen, D. V., 2005, p.134). Suatu hal yang tidak
dengan mudah mampu dilakukan dalam pengelolaan arsip fisik. Arsip elektronik diadopsi oleh banyak
stakeholders di sektor industri terkait dan karenanya dibutuhkan kemampuan untuk mengelolanya dengan
tujuan menciptakan sistem administrasi publik yang lebih efektif dan transparan Meskipun demikian,
pengelolaan arsip elektronik memiliki sejumlah tantangan yang kerap kali belum mampu diatasi oleh
institusi. Asogwa menyebut sejumlah tantangan yang dihadapi institusi dalam pengelolaan arsip
elektronik seperti keamaan dan privasi, resiko kehilangan data, isu otentisitas, sumber daya manusia dan
infrastruktur ataupun kebutuhan pengelolaan secara umum (Asogwa, 2012).
Secara umum, institusi pengelola informasi tengah melakukan transisi pengelolaan dari paper-based
menuju pengelolaan berbasis elektronik. Transisi ini tak terhindarkan dan bisa jadi dikarenakan apa yang
dikatakan Wilkins, Swatman dan Holt (2009, p. 40) bila arsip fisik memiliki sejumlah keterbatasan yang
menghambat kebutuhan untuk menyesuaikan tuntutan atas kecepatan informasi pada saat ini. Akan tetapi,
hal tersebut kerap kali menjadi kompleks dengan banyak aturan dan kebijakan institusi sebelumnya yang
bersifat paperbased (Reed, 2010, p. 125) sehingga implementasi secara bertahap dan transisi yang
dilakukan institusi mesti menyesuaikan budaya recordkeeping yang ada (Gregory, 2005, p. 80). Lebih
lanjut, dinamika sumber daya manusia menjadi salah satu hal yang memiliki dampak pada isu teknis
maupun kebijakan. Sebagai contoh, Harries (2009, p. 18) menyebut ketidakmampuan mengoperasikan
sistem ataupun kehilangan dokumen elektronik juga masih terus berlangsung. Menurut Reed (2010, p.
125), biaya pembelian software, lisensi ataupun perawatan kerap kali menimbulkan keengganan karena
dianggap terlalu mahal. Akibatnya, tantangan teknis tidak hanya muncul dari keterbatasan infrastruktur
melainkan resistensi dari sumber daya manusia yang ada. Padahal, arsiparis disebut Kallberg (2012, p.
112) harus memiliki tekad untuk terus belajar tanpa harus menunggu sumber daya yang mencukupi
sehingga membuat mereka dapat tetap relevan. Dimensi sosial dalam pengelolaan arsip Ismail dan
Jamaludin (2009, p. 140) menyatakan bahwa bukan hanya infrastruktur semata yang membutuhkan fokus
dalam pengembangan pengelolaan arsip elektronik di era digital, melainkan juga faktor manusia. Institusi
mesti memahami bahwa pendekatan yang menyeluruh terhadap berbagai elemen amat dibutuhkan di
dalam pengelolaan arsip di era digital. Hal ini ditegaskan oleh McLeod, Childs dan Hardiman (2011)
yang menemukan bahwa faktor manusia dan hal-hal yang menyertainya saling berkelindan erat dengan
faktor proses dan teknologi serta berperan kuat dalam mempercepat transisi yang berdampak positif.
Manusia tidak hanya bisa diartikan sebagai pengguna dalam artian masyarakat umum semata, melainkan
justru juga termasuk staff pengelola yang menjadi bagian dan mengoperasikan pengelolaan itu sendiri.
Maka, people issues merupakan hal utama, fundamental dan menantang (McLeod, 2012, p. 189) yang
dipercaya Harries (2009, p. 20) tidak boleh diabaikan oleh institusi dalam pengelolaan arsip elektronik di
era digital apabila prinsip utama arsip adalah salah satunya untuk meningkatkan akuntabilitas dan tata
kelola pemerintahan yang baik. Sebelum fokus kepada masyarakat atau siapapun pengguna di luar
institusi, ada baiknya pengelolaan arsip di era digital yang fokus pada perubahan teknologi dan format
elektronik ini mencoba untuk memahami pengguna internal yang tak lain adalah staff pengelola sendiri.
Sebab, Johsnton & Bowen (2005, p. 136) berpendapat bahwa staff kerap kali memposisikan pengelolaan
arsip dan dokumen elektronik kerap kali sebagai ancaman karena dianggap jauh lebih kompleks dan
bahkan tidak memberikan manfaat (Johnston & Bowen 2005, p. 136). Hal ini didukung oleh Reed (2010,
p. 125) yang berpendapat bahwa ada kendala dalam memberikan penjelasan akan manfaat konkrit yang
didapat dengan mudah dan bahwa di antara komunitas yang saling berinteraksi, kebijakan dan nilai kerap
kali mengalami dinamika penafsiran (Harries, 2009, p. 23).
Maka, tidak jarang ditemui keengganan staff untuk menerima sekaligus beradaptasi terhadap
perubahan model pengelolaan. Sebagai contoh, banyak pustakawan dan arsiparis senior di Afrika yang
secara psikologi memiliki fobia terhadap perkembangan teknologi karena mereka merasa harus belajar
hal baru kembali bersama mereka yang lebih muda dan sebagai akibatnya, tidak lagi merasa menjadi
expert dan terancam (Asogwa, 2012, p. 202). Padahal, resistensi staff disebut Wilkins, Swatman dan Holt
(2009, p. 43) sebagai salah satu penyebab kegagalan implementasi pengelolaan arsip elektronik. Maka,
kegagalan melakukan analisa pada perilaku pengguna internal dapat berakibat fatal. Sehingga, dibutuhkan
kemampuan dalam mengelola resistensi ini agar transisi pengelolaan tersebut dapat diimplementasikan
secara sukses (Asogwa, 2012, p. 202). Selain pengguna internal, perspektif dan perilaku publik sebagai
pengguna pada umumnya juga perlu mendapatkan pertimbangan untuk memenuhi tuntutan akan
keberlangsungan bisnis. Seperti kebanyakan cara berpikir konsumen yang menginginkan untuk mampu
melakukan banyak hal dengan lebih sedikit usaha, pengguna arsip pun juga berpandangan demikian
(Harries, 2009, p. 18). Maka, menjadi penting bagi arsiparis untuk mampu menganalisa pasar dan
menentukan metode terbaik guna terus membuat konsumen tertarik. Standar ideal mesti diterjemahkan
pada implementasi terbaik dengan menyesuaikan situasi dan kondisi institusi, maupun kebutuhan
pengguna (Sheperd, 2006, p. 10; Asogwa, 2012, p. 201) karena pada hakikatnya, nilai-nilai dan fungsi
dasar dari arsip memang diperuntukkan baik bagi pencipta dan pengguna (Dikopoulou & Mihiotis, 2012,
p. 125). Tanpa hal tersebut, pengelolaan arsip di yang berfokus pada transisi perubahan paper-based
menuju elektornik tidak akan mampu terimplementasi dengan maksimal. Dimensi sosial, dengan factor
people didalamnya merupakan hal yang signifikan karena terkait dengan budaya institusi, cara berpikir
dan kepedulian terhadap pengelolaan, preferensi dan kemampuan mengelola arsip (McLeod, 2012, p.
193).
Aplikasikan record copyng dengan menggunakan teknologi !

RUBRIK HOLISTIK
Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Kemampuan tentang penyusunan rancangan pembelajaran

GRADE SKORE INDIKATOR KINERJA
Sangat Baik >81 Rancangan yang disajikan tersistematis, menyelesaikan masalah , dapat diimplementasikan dan
inovatif
Baik 61-80 Rancangan yang disajikan tersistematis, menyelesaikan masalah , dapat diimplementasikan,
kurang inovatif
Cukup 41-60 Rancangan yang disajikan tersistematis, menyelesaikan masalah namun kurang dapat
diimplementasikan
Kurang 21-40 Rancangan yang disajikan teratur namun kurang menyelesaikan permasalahan.
Sangat < 20 Rancangan yang disajikan tidak teratur dan tidak menyelesaikan permasalahan
Kurang
Nilai Akhir =
Dosen
1 Medan, .........................2020
2 Mahasiswa
( )
KEGIATAN BELAJAR 10
KEGIATAN
BELAJAR 10
Code of Ethics and Professional
Conduct
Introduction: Fostering ethical behaviour
The World Health Organization (WHO) is a specialized agency of the United
Nations that embodies the highest aspirations of the peoples of the world. WHO’s primary
objective is the attainment by all peoples of the highest possible level of health.
The highest standards of conduct, competence and performance are expected of all
WHO staff members in order to reflect the Organization’s ethical principles. All staff have
a responsibility to contribute to the goals of WHO and to ensure that their conduct is
consistent with the standards of conduct established for international civil servants; and to
follow WHO Staff Regulations and Staff Rules.
The success of WHO in achieving its mandate rests with its staff. This Code of
Ethics and Professional Conduct (the Code) has been developed with WHO’s objectives in
mind and is to be applied in accordance with WHO’s Staff Regulations, Staff Rules and
policies.4 After reading the Code, staff members should have a greater understanding of the
importance of their role, and the privileges and responsibilities that go along with working
for WHO.
Responsibility for ethical behaviour and professional conduct lies with all staff
members at all levels, and must be taken seriously, as it forms the basis of WHO’s
reputation. The trust placed in WHO by Member States, its external stakeholders and the
general public must never be taken for granted. It is therefore essential that all staff
members know and understand the Code and utilize it as a guide for thought and action.
Moreover, as the Code is not intended to cover every situation or problem that may arise,
staff members are encouraged to seek guidance and assistance from the Office of
Compliance, Risk Management and Ethics (CRE) in order to resolve issues and ensure the
ethical performance and discharge of their professional responsibilities.
This Code applies to all WHO staff members, independent of their location or grade,
and including Temporary Appointment holders, Secondees and Junior Professional
Officers.
In its spirit and principles, this policy also applies to all WHO collaborators,
notwithstanding their contractual or remuneration status: i.e.: individuals who work for
WHO as non-staff members including consultants, holders of Agreements for Performance
of Work (APW), Technical Services Agreement (TSA) holders, Special Service
Agreements (SSA) or letters of agreement, Temporary Advisers, Interns, and Volunteers,
as well as third party entities such as vendors, contractors or technical partners who have a
contractual relationship with WHO.
Oath of office
The primary obligation of all WHO staff is set out in the Oath of Office and Loyalty
which is signed by WHO staff members. The oath states:
“I solemnly swear (undertake, affirm, promise) to exercise in all loyalty, discretion, and
conscience the functions entrusted to me as an international civil servant of the WHO, to discharge
those functions and regulate my conduct with the interests of the WHO only in view, and not to
seek or accept instructions in regard to the performance of my duties from any government or other
authority external to the Organization”5
WHO’s ethical principles
This Code incorporates the basic principles of ethical behaviour and standards of conduct
applicable to all WHO staff. The following basic principles of ethical behaviour must be followed at all
times by WHO staff:
Integrity
Accountability
Independence and Impartiality
Respect for the dignity, worth, equality, diversity and privacy of all persons
Professional commitment
Ethical Principles in practice
Integrity
WHO staff members are expected to demonstrate the highest standards of integrity and act in
good faith, with intellectual honesty and fairness, in all matters affecting their official duties and the
interests of WHO. Staff members are the face of WHO and act as representatives of the Organization
towards external entities. As such, they have a duty to represent WHO with loyalty and respect the
confidentiality and good name of the Organization. With regards to scientific integrity, WHO sets an
example with particular attention to matters relating to the development of WHO’s policies, guidelines
and research. WHO staff members are expected to adhere to the internationally accepted principles of
bioethics upheld by the Organization in order to ensure that confidence and trust in the integrity of WHO
as an Organization are maintained and enhanced.
WHO staff members are also expected to conduct themselves in a manner compatible with these
principles in their private affairs, as their behaviour may reflect on the image of WHO and the United
Nations and the principles they stand for.
Accountability
WHO defines accountability as the obligation of every member of the Organization to
be answerable for his/her actions and decisions, and to accept responsibility for them. WHO is
accountable to its Member States, and WHO staff are accountable for achieving objectives and
results in accordance with the Programme Budget and with regulations, rules and standards.
Within WHO’s
Seri Modul Profesionalisme Kebidanan 2020
results-based management framework and decentralized system of delegated authority, WHO

staff members take responsibility and ownership for their actions and decisions as well as their
consequences at all levels of the Organization. Working for WHO implies respecting and
safeguarding confidentiality and ensuring proper, effective and efficient use of WHO resources.
Staff members must act within the scope of their authority at all times. They must exercise
adequate control and supervision over matters for which they are responsible in accordance with
the WHO Accountability Framework.
Independence and Impartiality

WHO staff members are expected to conduct themselves with the interests of WHO only
in view and under the sole authority of the Director-General. Professional and ethical conduct
requires that the international character of WHO positions is respected and that staff maintain
their independence and not seek or receive instructions from any Government, external entity, or
person external to WHO. WHO staff members are required to always act with impartiality and
professionalism and to ensure that the expression of personal views and convictions do not
compromise the performance of their official duties or the interests of WHO. Bias, prejudice,
conflict of interest or undue influence must not be permitted to supersede the professionalism of
their conduct. Staff members must exercise the utmost discretion in their actions, refrain from
participating in any activity that is in conflict with the interests of WHO or might damage
WHO’s reputation, and respect and safeguard the confidentiality of information, which is
available or known to them because of their official functions. WHO staff members must show
tact and reserve in their communication and behaviour in a manner that is consistent with their
status as international civil servants.
Respect for the dignity, worth, equality, diversity and privacy of all persons
WHO enjoys a rich, multicultural workplace characterized by a high level of
professionalism and diversity of individual backgrounds. WHO is committed to fostering a
multifaceted and inclusive culture marked by the dignity and exemplarity of the way staff
members interact, view one another, and respect individual contributions. The extensive mix of
personalities, experiences, perspectives and talents across the Organization, makes for a stronger
and more skilled WHO. WHO expects its staff members to behave ethically at all times and with
utmost respect for each other and external stakeholders, without regard to gender, race, religion,
creed, colour, citizenship, national origin, age, marital status, family responsibilities and choices,
Prodi Kebidanan Pogram Sarjana STIKes Mitra Husada Medan 78
pregnancy, sexual orientation, or disability. This ethical behaviour applies to WHO’s
employment practices. WHO is committed to a respectful, safe and secure workplace to which all
WHO staff members are expected to contribute. Staff members working with data involving
private information about others in particular have a particular duty to respect their privacy and
ensure discreteness when handling and processing personal data.
Professional commitment
WHO provides global leadership in public health and the Organization’s performance is
ultimately a reflection of the professional commitment of WHO staff members. Starting with
senior managers, who are expected to act as role models and demonstrate leadership, WHO staff
members contribute to the Organization by building their professional competence on a
foundation of ethical principles, professional expertise, and personal commitment to the mandate
and objectives of WHO. WHO is committed to a culture that encourages professionalism and
excellence through learning and development, and supports innovative approaches and solutions,
and the continuous search for new ways to support the goals of the Organization.
All WHO staff are responsible for their own professional and personal conduct.
However, commitment to upholding WHO’s ethical principles and reputation requires the
concerted effort of all staff members, managers/supervisors, and the Organization. At each level,
it requires commitment to the WHO mandate, to each other and to creating a workplace that
reflects WHO’s ethical principles.
Analisa kasus pelanggaran kode etik yang dilakukan oleh bidan berikut ini :
1.Seorang Ibu Primigravida dibantu oleh seorang bidan untuk bersalin. Proses persalinannya telah
lama karena lebih 24 jam bayi belum juga keluar dan keadaan ibu nya sudah mulai lemas dan
kelelahan karena sudah terlalu lama mengejan. Bidan tersebut tetap bersikukuh untuk menolong
persalinan Ibu tersebut karena takut kehilangan komisi, walaupun asisten bidan itu mengingatkan
untuk segera di rujuk saja.Setelah bayi keluar, terjadilah perdarahan pada ibu, baru kemudian
bidan merujuk ibu ke RS.Ketika di jalan, ibu tersebut sudah meninggal.Keluarganya menuntut
bidan tersebut.
2.Adanya laporan dugaan penahanan bayi oleh seorang bidan di Palembang berinisial DW
mendapat kecaman dari Komisi Perlindungan Perempuan dan anak (KPAI) Palembang. Bidan
DW dinilai melanggar kode etik dan sumpah profesi. Ketua KPAI Kota Palembang, Adi Sangadi
mengungkapkan, tindakan bidan DW itu sangat tidak terpuji. Tindakannya dinilai sama saja
memisahkan orang tua dan anak. Padahal, bayi baru dilahirkan membutuhkan perawatan dan
kasih sayang oleh orangtuanya.


Nama Mahasiswa :
NPM :
Hari/ Tanggal :
Sangat Kurang
SKOR Skor ≥79 (65-78) (56-64) (55 -41) <40

Kemapuan komunikasi
Penguasaan materi
pertanyaan
Penggunaan alat praga presentasi
Ketepatan menyelesaikan masalah
Nilai Akhir =
Dosen
1 Medan, .........................2020
2 Mahasiswa
( )

KEGIATAN BELAJAR 11
KEGIATAN
BELAJAR 11
COLLABORATION AND PATNERSHIP FOR HEALTHY WOMEN AND INFANTS
For centuries midwives have worked in partnership with women, families and communities to
achieve good outcomes for pregnancy and birth. However it is increasingly apparent that the effective
promotion of health and prevention of disease within maternity and newborn care cannot be
accomplished by a single professional, community or policy-making group. Many women and babies
continue to die needlessly because there is delay in seeking midwifery care, no access to the next level of
health services when complications arise, or no medication available at community level to prevent or
treat complications. It is appropriate that midwives lead the way to expand the traditional partnerships for
care, to include other health professional groups, policy makers and global agencies that share a common
vision of healthy women and newborns throughout the world. ICM supports the demand for continuity of
care for childbearing women, and the collaboration with other health professionals that may be needed by
an individual pregnant woman. This collaborative chain links community health workers into family and
community-based primary care provided by professional midwives; and also with district and regional
hospital-based care from professional midwives and medical specialists. At each level of care, women
should be valued and her culture respected. She should receive quality care, timely consultation and
referral when necessary to doctors and other specialists. Collaboration between midwives, other health
professionals and consumer groups, and between ICM and other international partner organizations,
should be constructive and focused on women's and newborns’ needs at every level. Midwives
worldwide, as autonomous health professionals, are responsible not only for the care they give directly to
women and their newborns, but for the timely identification of those women who would benefit from
consultation at the next level of care, including referral for specialist attention when needed. It is also
acknowledged that, in many areas of the world, midwives are those to whom pregnant women are
referred by community health workers, when complications are suspected. ICM believes that all women
will benefit when there is continuity and collaboration among the range of health care providers from
community to district to regional settings, where such collaboration is based upon mutual trust and
respect. The power of partnerships goes beyond what each individual, group or agency can do alone,
thereby maximising the effectiveness of strategies to promote the health of women and newborns.
Position ICM recognises the importance of continuity of care that needs to be available to optimise health
outcomes for women and their newborns. At the same time such clinical collaboration needs to be
supported by partnerships at the level of national associations and international agencies.
The ICM encourages all midwives to:
 Work collaboratively with other health providers caring for childbearing women and their newborns
 Promote respect, trust and open communication among all levels of health care providers as the
hallmarks of midwifery care that result in the best possible health care available to all women. ICM is
also interested in establishing and strengthening partnerships that will promote the health and wellbeing
of women and newborns, and the advancement of the profession of midwifery, in keeping with the
following principles:
 Partners share the common goal or purpose of promoting the health of women, newborns and
childbearing families in keeping with the ICM Vision Statement.
 Each partner brings a special expertise to the table with a commitment to listen, learn and respect
others’ views and suggestions for joint actions.
 Shared leadership, based on the required expertise for a given strategic goal, along with teamwork, is
the norm.
 Each partner is able to commit resources to support individual participation in the group or coalition, in
keeping with financial guidelines and priorities of the partner agency.
EXERCISE
Make a roleplay about collaboration and partnership for healthy women and infants!

RUBRIK ROLEPLAY
1-2 18 Oktober 2017 00
FM-PM-I.IV.Pd2-05/05-18/19-
Nama :
NPM :
Wahana Praktik :
Hari/ Tanggal :

(0-69) (70-85) (86-100)
1 Ekspresi Dapat menyesuaikan Kurang dalam Tidak menyesuaikan dialog
dialog sesuai tokoh menyesuaikan dialog sesuai tokoh yang
yang diperankan sesuai tokoh yang diperankan
diperankan
2 Penghayatan Sangat menghayati Kurang menghayati Sama sekali tidak
karakter tokoh yang karakter tokoh yang menghayati karakter tokoh
diperankan, sesuai diperankan, sesuai yang diperankan, sesuai
dengan alur dan dengan alur dan dengan alur dan tuntutan
tuntutan naskah tuntutan naskah naskah
3 Gerak Saat kemunculan Kemunculan pertama Sangat terlihat gugup dan
pertama terlihat terlihat sedikit ragu- ragu-ragu, gerakan
mantap, gerakan ragu, gerakan bersifat canggung, dan tidak sesuai
bersifat alami, alami namun kurang dengan dialog.
menyesuaikan dialog menyesuaikan dengan
dan dapat dialog juga kurang
memposisikan tubuh dapat memposisikan
dengan baik tubuh dengan baik
4 Intonasi Dapat mengatur jeda Dapat mengatur jeda, Sama sekali tidak dapat
dengan tepat, intonasi intonasi cukup mengatur jeda, berbicara
bervariasi sesuai bervariasi sesuai seolah membaca dan tidak
tuntutan naskah, tuntutan naskah, jelas
pembicaraan lancar pembicaraan kurang
dan tidak terputus- lancar, sedikit terbata-
putus bata.
5 Artikulasi Pengucapan keras, Pengucapan cukup Pengucapan sama sekali
terdengar jelas dan keras, terdengar jelas, tidak dapat dimengerti
dapat dimengerti tetapi kurang dapat
dimengerti

+N3 =
5
Preseptor
1 Medan, .........................2020
2 Mahasiswa
Mentor
1
( )
2


RUBRIK ROLEPLAY
1-1 18 Oktober 2017 00
FM-PM-I.IV.Pd2-05/05-18/19-
Nama :
NPM :
Wahana Praktik :
Hari/ Tanggal :

(0-69) (70-85) (86-100)
1 Ekspresi
2 Penghayatan
3 Gerak
4 Intonasi
5 Artikulasi
+N3 =
5
Preseptor
1 Medan, .........................2020
2 Mahasiswa
Mentor
1
( )
2

DAFTAR PUSTAKA
1. ICM Documents ICM. 2011. Core Document. Definition of the midwife ICM. 2011.
2. Bill of rights for Women and Midwives (Amended 2014) ICM. 2011.
3. Position Statement. Midwifery led care, the first choice for all women ICM. 2011.
4. Position Statement. Midwives, women and human rights ICM. 2014.
5. Position Statement. The midwife is the first choice health professional for childbearing women ICM. 2014.
6. Position Statement. Partnership between women and midwives ICM. 2014.
7. Position Statement. Professional accountability of the midwife ICM. 2014.
8. Core Document. International Code of Ethics for Midwives
9. Hatem M, Sandall J, Devane D, Soltani H, Gates S. 2008.
10. Midwife-led versus other models of care for childbearing women. Cochrane Database of Systematic Reviews.
Issue 4. Art. No.: CD004667. Maassen MS, Hendrix MJC, Van Vugt HC, Veersema S, Smits F, Nijhuis JG. 2008.
Operative deliveries in low-risk pregnancies in The Netherlands: primary versus secondary care. Birth. 35:4
December 2008, 277-82

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STIKes MITRA HUSADA MEDAN

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A. STIKes MITRA HUSADA MEDAN

B. PRODI KEBIDANAN PROGRAM SARJANA

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Modul Profesionalisme Kebidanan

Medan, Februari 2022

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I. Identitas Mata Kuliah

II. Deskripsi Mata Kuliah

III. Mata Kuliah

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IV. Standar Kompetensi Lulusan

VI. Bahan Kajian

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VII. Metode Pembelajaran

VIII. Strategi Perkuliahan

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XI. Tata Tertib perkuliahan

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XIII. PERJANJIAN DAN KOMITMEN MAHASISWA

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I. Diskripsi dan Relevansi

II. Capaian Pembelajaran

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MIDWIVES USING RESEARCH: EVIDENCE-BASED

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Table 1-1. Hierarchies of Evidence, after Sacket et. al

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WHAT EBP CAN & CAN’T

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FOR NORMAL BIRTH

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Modul Profesionalisme Kebidanan

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Skor Tinggi Rendah Tinggi Rendah Tinggi Rend

1. Artikel berasal dari jurnal terindek dalam kurun waktu 3

2. Artikel berkaitan dengan tema persalinan

3. Jumlah artikel sekurang-kurangnya membahas pertolongan

8. Ketepatan meringkas pembahasan hasil penelitian dalam

Rata-rata skor yang diperoleh

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International Confederation of Midwives

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Modul Profesionalisme Kebidanan

These statements in effect provide a set of criteria against which midwifery

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ICM Global Standards for Midwifery Regulation

Category Standard Explanation

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Modul Profesionalisme Kebidanan

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