Model Community-Based Digital Screening untuk Pencegahan Keterlambatan Rujukan pada Ibu Hamil Risiko Tinggi di Puskesmas Medan Johor
DOI:
https://doi.org/10.31004/joecy.v4i2.11150Keywords:
digital screening, ibu hamil risiko tinggi, keterlambatan rujukan, community-based health, mHealth, antenatal careAbstract
Latar Belakang: Keterlambatan rujukan pada ibu hamil risiko tinggi merupakan kontributor utama morbiditas dan mortalitas maternal di Indonesia. Sistem skrining konvensional menghadapi berbagai keterbatasan struktural yang menghambat deteksi dini dan koordinasi lintas tenaga kesehatan. Tujuan: Mengembangkan dan mengevaluasi efektivitas Model Community-Based Digital Screening (CBDS) dalam menurunkan keterlambatan rujukan ibu hamil risiko tinggi di wilayah kerja Puskesmas Medan Johor. Metode: Penelitian menggunakan desain Research and Development (R&D) dengan pendekatan ADDIE yang dilaksanakan pada Maret–Desember 2024. Subjek penelitian meliputi 120 ibu hamil, 20 kader kesehatan, dan 10 bidan yang dipilih menggunakan purposive sampling. Sistem CBDS dikembangkan dengan fitur integrasi skor KSPR, notifikasi otomatis, dashboard pemantauan, dan sistem rujukan digital. Data dianalisis menggunakan paired t-test, Wilcoxon test, chi-square, dan perhitungan effect size Cohen's d. Hasil: Model CBDS mendapatkan skor validasi ahli materi sebesar 90,3% dan ahli sistem informasi 89,8% (kategori sangat layak). Skor usability SUS mencapai 86,5–88,0 (grade A/Excellent). Waktu proses rujukan mengalami penurunan signifikan dari 7,8 ± 2,3 hari menjadi 2,9 ± 1,1 hari (p < 0,001). Keterlambatan rujukan turun dari 35,0% menjadi 11,7% (p < 0,001). Seluruh variabel efektivitas menunjukkan effect size besar (d > 0,80). Kesimpulan: Model CBDS terbukti efektif meningkatkan ketepatan deteksi risiko kehamilan, mempercepat proses rujukan, dan menurunkan angka keterlambatan rujukan secara bermakna. Model ini layak diimplementasikan dalam sistem pelayanan kesehatan ibu berbasis komunitas.
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