Latar Belakang : Pemanfaatan persalinan JPKMM-Askeskin di Puskesmas yang ditolong tenaga kesehatan cenderung meningkat setiap tahunnya. Dinas Kesehatan Kabupaten Banjar menyelenggarakan Program Pelayanan Kesehatan Dasar Gratis (PKDG) dengan tarif paket persalinan di Puskesmas sebesar Rp 250.000,- sedangkan tarif JPKMM-Askeskin Rp 350.000,-. Akibat perbedaan tarif tersebut mempengaruhi utilisasi pelayanan persalinan program PKDG dan JPKMM-Askeskin. Tujuan penelitian: mengidentifikasi faktor-faktor yang mempengaruhi utilisasi pelayanan persalinan JPKMM-Askeskin di Puskesmas Kabupaten Banjar. Metode penelitian: Jenis penelitian analitik, menggunakan metode kuantitatif dan kualitatif dengan rancangan cross sectional. Responden yang menggunakan JPKMM-Askeskin sebanyak 182 orang dan responden PKDG sebanyak 30 orang . Pengambilan sampel dengan cara systematic sampling. Variabel terikat adalah utilisasi pelayanan persalinan JPKMM-Askeskin dan variabel bebas yaitu tingkat pendapatan, tingkat pendidikan, pengetahuan, PPK, akses dan persepsi kehamilan. Analisis data secara univariat, bivariat menggunakan uji t test, chi square dan odds ratio, multivariat menggunakan uji two way Anova dan pengolahan data kualitatif. Hasil: Hasil analisis univariat menunjukkan rata-rata pendapatan responden JPKMM-Askeskin Rp628.241,80,-/bulan sedangkan responden PKDG Rp1.299.333,33,-/bulan. Hasil analisis bivariat menunjukkan adanya perbedaan bermakna rata-rata pendapatan, pendidikan, peran PPK, akses dan persepsi kehamilan (p<0,05) sedangkan rata-rata pengetahuan tidak mempunyai perbedaan bermakna (p>0,05). Hasil analisis multivariat menunjukkan faktor paling dominan yang mempengaruhi utilisasi adalah akses (F hitung = 16,045, OR = 25,412). Hasil analisis kualitatif mengungkapkan adanya perbedaan tarif persalinan JPKMM-Askeskin dengan PKDG dan kemudahan dalam mendapatkan SKTM dapat meningkatkan utilisasi pelayanan persalinan dengan menggunakan dana JPKMM-Askeskin. Kesimpulan: Akses adalah faktor yang paling dominan mempengaruhi utilisasi pelayanan persalinan JPKMM-Askeskin di Puskesmas. Perbedaan tarif persalinan antara PKDG dan JPKMM-Askeskin mendorong petugas Puskesmas menggunakan klaim persalinan dengan dana JPKMM-Askeskin.

Background: The utilization of childbirth service through the program of Askeskin at health centers assisted by health staff tended to increase. Banjar District Health Office implements the program of Free Basic Health Service with tariff for childbirth package at health centers as much as Rp 250,000 whereas tariff of Askseskin as much as Rp 350,000. This differing tariff affects the utilizaton of childbirth service through free basic health service and Askeskin. Objective: To identify factors affecting the utilization of childbirth service through Askeskin at the health centers of District of Banjar. Method: The study was analytical that used quantitative and qualitative method and cross sectional design. Respondents from Askeskin consisted of 182 people and respondents of free basic health service consisted of 30 people. Samples were taken with systematic sampling technique. The dependent variable was the utilization of childbirth service through the budget of Askeskin and free basic health service. The independent variables were income, education, knowledge, health service providers, access and perception about pregnancy. Data analysis used univariable, bivariable with t- test and chi square, multivariable with two way Anova and qualitative data processing. Result: The result of univariable analysis showed the average income of respondents of Askeskin was Rp 628,241.80/month whereas respondents of free basic health service was Rp 1,299, 333.33/month. The result of bivariable analysis showed there was significant difference in average income, education, role of health service providers, access and perception about pregnancy (p<0.05); but there was no difference in average knowledge (p>0.05). The result of multivariable analysis showed the factor most dominantly affected the utilization was access (Fcalculation=16.045, OR=25.412). The result of qualitative analysis showed there was difference between tariff of Askeskin and free basic health service and ease in obtaining certificate for poor people could increase the utilization of childbirth service through the budget of Askeskin. Conclusion: Access was the factor most dominantly affected the utilization of childbirth service through Askeskin at the health centers. The difference in tariff between free basic health service and Askeskin encouraged staff of the health centers to use claims for childbirth service through the budget of healthcare insurance for poor communities – Askeskin.

Kata Kunci : Askeskin,Utilization,Childbirth service, program JPKMM-Askeskin di Puskesmas, dana persalinan JPKMM-Askeskin, utilisasi pelayanan persalinan JPKMM-Askeskin