Correspondent: Eva Fauzia
Email: [email protected]
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INTRODUCTION
Health development
public For Towards a healthy Indonesia is to
increase awareness, willingness, and ability to
live a healthy life to realize optimal public health status throughout
Indonesia. (Lardo, 2020).
A cord is
a unique network consisting of two arteries and one vein protected by sheathed mucoid connective tissue by a thin mucous membrane. During pregnancy, the placenta
provides all the nutrients for the growing fetus and excretes waste products
through the umbilical cord (Yuanita, 2022).
care is to
prevent the occurrence of tetanus in newborns. This disease is caused by
entering tetanus germ spores into the body through the umbilical cord, either
from unsterile tools, using drugs, powders, or leaves sprinkled on the
umbilical cord. so it can cause infection (Nurbiantoro
dkk., 2022).
Topical drugs such as triple dry (2.29 g brilliant greens;
1.14 g of proflavine hemisulfate and 2.29 g crystal violet in water, bacitracin
ointment, silver cream sulfadiazine, betadine 10% (Wasiah
& Artamevia, 2021). These
drugs can inhibit or reduce bacterial colonization in the umbilical cord,
especially staphylococci aureus. Alcohol, often used in the hospital or after
returning home from the hospital, accelerates the drying of the umbilical cord
and the release of the umbilical cord. Tetanus neonatorum is a tetanus disease
that occurs in neonates (infants less than one-month-old), caused by
Clostridium tetani. This germ secretes a toxin (poison) and invades the central
nervous system. The spores of the germ enter the baby's body through the only
entrance, namely the umbilical cord, which can occur at the time of cutting the
umbilical cord when the baby is born or at the time of its care before
discharge (detachment of the umbilical cord): incubation period 3-28 days,
average six days. If the incubation period is less than seven days, the disease
is usually more severe and has a high mortality rate (Armina, 2022).
One of the infections that can cause death in the neonatal
period is neonatal tetanus infection. In 2013, it was reported in Indonesia
that there were 78 cases of Tetanus Neonatorum, with 42 cases of death. This shows the case number Fatality Rate
(CFR). Tetanus Neonatorum was 53.8%, an increase compared to 2012 49.6%.
According to data from the Ministry of Health, 75% of infant
deaths occur during the perinatal period. The highest neonatal mortality in the
8-28 days age group was an infection of 57.1% (including tetanus sepsis,
pneumonia, and diarrhea); the proportion of deaths due to neonatal tetanus was
9.5% (Viva BK, 2022).
Infant mortality is still very high, as evidenced by the fact
that many cases of infant mortality still occur in Indonesia and other
countries; this happens because we still lack the awareness to maintain
personal and environmental hygiene to avoid infection. According to the
Ministry of Health, Indonesia's Infant Mortality Rate (IMR) is still the
highest compared to other ASEAN countries. According to data from the 2007
Indonesian Demographic and Health Survey (IDHS), the Infant Mortality Rate
(IMR) in Indonesia is 34 per 1000 live births(Viva
Budy, 2022)
The highest cause of neonatal death is caused by infection,
one of which is neonatal tetanus infection which can result from poor umbilical
cord care resulting in infection of the umbilical cord. (Sari, 2020). The incidence of IMR in West Java Province in 2013 was 30 per 1,000 live
births, and the number of cases of tetanus neonatorum was 3 cases with two
deaths. This shows the CFR Tetanus Neonatorum figure of 66.7% (Nurhayati & Mulyanti, 2023).
The Infant Mortality Rate in Cirebon City has decreased; in
2014, the mortality rate became 38 per 5455 live births. The leading causes of
infant death caused by LBW are infection and asphyxia. (Cirebon City Health
Office, 2014). According to data from the Gunungsari Health Center in 2015, 2
cases of newborn death were recorded as the leading cause of infection.
(Gunungsari Health Center, 2015).
Based on data obtained at the Puskesmas Gunungsari, obtained results knowledge Mother
childbirth about maintenance rope center, got part Mother childbirth Still Not yet know about
maintenance rope good center. So, researchers want to give education to mothers about childbirth. For a
start, do and know method maintenance rope good and faithful center, so _ the
number infections of in babies newly born will be reduced.
METHODS
Research uses a descriptive research method,
namely a study conducted to describe or describe a phenomenon that occurs in
society. This research will be
conducted at the Gunungsari Community Health Center, Cirebon City. This
research was conducted from February to
March 2023. In this research, researchers used
secondary data in the form of total data Mother pregnant taken from the monthly
report at the health center Mount Sari from February to March 2023.
RESULTS AND DISCUSSION
The results of
This research will be presented in the form of a table distribution frequency
simple and given descriptions narratively so you can give precise information
about the research results.
Knowledge-Based Understanding Cord Care
From 34 respondents obtained results
distribution frequency knowledge postpartum about understanding cord care as follows:
Table 1 . Frequency Distribution of Knowledge
of Postpartum Mothers About the Definition of Umbilical Cord Care in Newborns
at the Gunungsari Health Center
|
Understanding
|
Frequency (F)
|
Percentage (%)
|
|
Good
|
15
|
44.12%
|
|
Enough
|
12
|
35.29%
|
|
Not enough
|
7
|
20.59%
|
|
Amount
|
34
|
100%
|
Source: Results from a questionnaire
Based on table 1 above regarding the notion of cord
care shows that 15
respondents (44.12%) had good knowledge, 12 respondents (35.29%) had sufficient
knowledge, while those who had sufficient knowledge less seven respondents
(20.59%).
Knowledge-Based Purpose Cord Care
From 34 respondents obtained results
distribution frequency knowledge postpartum about objective umbilical cord care in tabular form, as follows:
Table 2. Frequency Distribution of Knowledge
of Postpartum Mothers About the Purpose of Umbilical Cord Care in Newborns at
the Gunungsari Health Center
|
Understanding
|
Frequency (F)
|
Percentage (%)
|
|
Good
|
11
|
32.35%
|
|
Enough
|
12
|
35.30%
|
|
Not enough
|
11
|
32.35%
|
|
Amount
|
34
|
100%
|
Source: Results from a questionnaire
Based on table 2 above regarding the purpose of cord
care shows that 11 respondents, or (32.35%) have good knowledge, 12
respondents, or (35.30%) have sufficient knowledge, while those who have less
knowledge, as many as 11 respondents (32.35%).
Knowledge-Based Management Cord Care
From 34 respondents obtained results
distribution frequency knowledge postpartum about management umbilical cord care in tabular form, as follows:
Table 3 . Frequency Distribution of Knowledge
of Postpartum Mothers About the Management of Umbilical Cord Care in Newborns
at the Gunungsari Health Center
|
Understanding
|
Frequency (F)
|
Percentage (%)
|
|
Good
|
14
|
41.18%
|
|
Enough
|
14
|
41.18%
|
|
Not enough
|
6
|
17.64%
|
|
Amount
|
34
|
100%
|
Source: Results from a questionnaire
Based on table 3 above regarding the management of
cord care shows that 14 respondents, or (41.18%) had good knowledge, 14
respondents, or (41.18%) had sufficient knowledge, while those who had sufficient
knowledge less six respondents, or (17.64%).
Knowledge-Based Benefits Cord Care
From 34 respondents obtained results
distribution frequency knowledge postpartum about the benefits of umbilical cord care in tabular form, as follows:
Table 4 . Frequency Distribution of Knowledge
of Postpartum Mothers About the Benefits of Umbilical Cord Care in Newborns at
the Gunungsari Health Center
|
Understanding
|
Frequency (F)
|
Percentage (%)
|
|
Good
|
14
|
41.18%
|
|
Enough
|
12
|
35.29%
|
|
Not enough
|
8
|
23.53%
|
|
Amount
|
34
|
100%
|
Source: Results from a questionnaire
Based on table 4 above regarding the benefits of cord
care shows that 14 respondents, or (41.18%) have good knowledge, 12 respondents,
or (35.29%) have sufficient knowledge, while those who have less knowledge, as
many as eight respondents or (23.53%).
Knowledge-Based Ways Prevention Or Countermeasures
Umbilical Cord Infection
From 34
respondents, the results of the frequency distribution of postpartum mothers'
knowledge about how to prevent or treat infections in umbilical cord care were
obtained in tabular form, as follows:
Table 5. Frequency Distribution of Knowledge
of Postpartum Mothers About How to Prevent or Manage Infections for Umbilical
Cord Care in Newborns at the Gunungsari Health Center
|
Understanding
|
Frequency (F)
|
Percentage (%)
|
|
Good
|
11
|
32.35%
|
|
Enough
|
13
|
38.24%
|
|
Not enough
|
10
|
29.41%
|
|
Amount
|
34
|
100%
|
Source: Results from the questionnaire
Based on table 5
above on how to prevent or treat infections in cord care shows that 11
respondents (32.35%) have good knowledge, and 13 respondents (38.24%) have
sufficient knowledge. In comparison, ten respondents have less knowledge (29.41%).
Got conclusion that knowledge of postpartum
mothers about umbilical cord care in newborns from 34 respondents obtained results as follows:
Table 6. Frequency Distribution of Knowledge
of Postpartum Mothers About Umbilical Cord Care in Newborns at the Gunungsari
Health Center
|
Understanding
|
Frequency (F)
|
Percentage (%)
|
|
Good
|
19
|
55.88%
|
|
Enough
|
11
|
32.35%
|
|
Not enough
|
4
|
11.77%
|
|
Amount
|
34
|
100 %
|
Source: Results from a questionnaire
Based on table 6 . above about the Knowledge of
Postpartum Mothers About Umbilical Cord Care in Newborns shows that respondents
have good knowledge 19 respondents, or (55.88%) have sufficient knowledge 11
respondents, or (32.35%). In contrast, those who have less knowledge, as much
as 4 respondents or (11.77%).
Discussion
Knowledge-Based Understanding Cord Care
Knowledge of
postpartum mothers about the meaning of cord care at the Gunungsari Health
Center, it can be concluded that the majority of postpartum mothers at the
Gunungsari Health Center have knowledge with good criteria as many as 15
respondents (44.12%).
"Knowledge
included in the cognitive domain has six levels, one known ( know ), defined as
remembering a material that has been studied before." The material
referred to here is about umbilical cord care. When viewed from the education level
of mothers, most have high enough education that mothers can learn about cord
care from various sources, making it easier for mothers to get information,
especially about cord care (Anggreni, 2022).
Knowledge-Based Purpose Cord Care
Knowledge of
postpartum mothers about the purpose of cord care at the Gunungsari Health
Center, it can be concluded that most postpartum mothers at the Gunungsari
Health Center know with sufficient criteria as many as 12 respondents or
(35.30%).
As explained in
his book Health Research Methodology, "Knowledge included in the
cognitive domain has 6 levels, one of which is known (know), defined as
remembering a material previously studied". The material referred to here
concerns umbilical cord care (Adiputra, 2021). When viewed from the education level of mothers, most of
them have high enough education so that mothers can find out about umbilical
cord care from various sources, making it easier for mothers to get
information, especially about umbilical cord care.
Knowledge-Based Management Cord Care
Knowledge of
postpartum mothers about the meaning of cord care at the Gunungsari Health
Center, it can be concluded that the majority of postpartum mothers at the
Gunungsari Health Center know with good criteria as many as 14 respondents
(41.18%) and the criteria
Enough . as many
as 14 respondents or (41.18%).
This is under Faridi's theory (2021)
about acquiring knowledge, one of which is through experience and a way of
thinking. (Faridi dkk., 2021). Each
respondent has different knowledge; some respondents know and understand how to
prevent or treat infection and apply it in everyday life so that respondents
can answer questions correctly. Meanwhile, some respondents had difficulty
understanding how to prevent or treat infection and had not applied it in their
daily lives, making it difficult to answer questions from researchers.
Judging from the
low education of the respondents and a socio-economic perspective, most
respondents do not work; it is necessary to conduct counseling by health
workers, especially counseling about cord care.
Knowledge-Based Benefits Cord Care
Knowledge of
postpartum mothers about the benefits of umbilical cord care at the Gunungsari
Health Center, it can be concluded that most postpartum mothers at the
Gunungsari Health Center know the criteria as many as 14 respondents (41.18%).
This is under the book Health Research Methodology (2010)
theory about acquiring knowledge through experience and thinking. (Anjani
dkk., 2022). So, several respondents
learned about the benefits of umbilical cord care through personal experience.
So that respondents know about the benefits of umbilical cord care (I Made Sudarma Adiputra,
2021).
Nevertheless, there are times when experience is not always correct, so
providing information or counseling about the benefits of cord care is
necessary. Health promotion, in general, can be carried out through various
programs and sectors related to health, for example, approaches to community
leaders, providing information with engaging media carried out in villages,
health centers, posyandu,
and activities that involve moms cadres and the community. Implementation of the provision of
this information can be carried out with a predetermined schedule and
situation.
Knowledge-Based Ways Prevention Or
Countermeasures Umbilical Cord Infection
Knowledge of
postpartum mothers about how to prevent or treat umbilical cord infections at
the Gunungsari I Health
Center, it can
be concluded that the majority of postpartum mothers at the Gunungsari Health
Center know with sufficient criteria, as many as 13 respondents (38.24%).
As explained by Siregar (2022), knowledge included in the cognitive
domain has six levels, one of which is understanding (Comprehension),
which means the ability to explain a known material or object. In this case,
the object is not only knowledge but the respondent's ability to explain cord
care (Siregar dkk., 2022).
Each respondent
has different knowledge; some respondents know and understand how to prevent or
treat infection and apply it in everyday life so that respondents can answer
questions correctly. Meanwhile, some respondents had difficulty understanding
how to prevent or treat infection and had not applied it in their daily lives,
making it difficult to answer questions from researchers.
Judging from the
low education of the respondents and a socio-economic perspective, most
respondents do not work; it is necessary to conduct counseling by health
workers, especially counseling about cord care.
CONCLUSION
The level of knowledge of
postpartum mothers about the meaning of umbilical cord care in newborns is
included in the sufficient category, namely 15 respondents (44.12%). Meanwhile, the level of knowledge of postpartum mothers regarding the
purpose of umbilical cord care in newborns was included in the sufficient
category, namely 12
respondents (35.30%).
The level of knowledge of
postpartum mothers about managing umbilical cord care in newborns is included
in the excellent and sufficient categories, respectively 14 respondents
(41.18%). The level of knowledge of postpartum
mothers about the benefits of umbilical cord care in newborns is included in
the excellent category, namely 14 respondents (41.18%).
The level of knowledge of
postpartum mothers about how to prevent or deal with the infection in the care
of the umbilical cord in newborns is included in the sufficient category, namely 13 respondents (38.24%). The
level of
knowledge of postpartum mothers regarding umbilical cord care in newborns is
included in the less category, namely seven respondents (20.59%).
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