“The Fifth Discipline was originally published in hardcover by Currency Doubleday, a division of Bantam Doubleday Dell Publishing Group, Inc.”

Generally, emphasized passages are direct quotations from The Fifth Discipline.

The Fifth Discipline and “learning organizations”

The Fifth Discipline brings word of “learning organizations,” organizations where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning how to learn together. Five disciplines are described as the means of building learning organizations. Case studies are provided to show how the disciplines have worked in particular companies.

The need for learning organizations is due to business becoming more complex, dynamic, and globally competitive. Excelling in a dynamic business environment requires more understanding, knowledge, preparation, and agreement than one person’s expertise and experience provides. David Garvin of Harvard University says that “Continuous improvement requires a commitment to learning.” Reference.

The five disciplines are systems thinking, personal mastery, mental models, shared vision and team learning. The first three disciplines have particular application for the individual participant, and the last two have group application. The author writes of the disciplines that these might just as well be called the leadership disciplines as the learning disciplines. Those who excel in these areas will be the natural leaders of learning organizations. Systems thinking has the distinction of being the “fifth discipline” since it serves to make the results of the other disciplines work together for business benefit.

The Fifth Discipline as a book consists of five parts – business setting that calls for change, systems thinking, four other disciplines, case studies, and final thoughts about future disciplines and the possible effect of learning organizations. In an additional section the systems thinking archetypes are explained.

The Five Disciplines

What fundamentally will distinguish learning organizations from traditional authoritarian “controlling organizations” will be the mastery of certain basic disciplines. That is why the “disciplines of the learning organization” are vital.

Individual disciplines

Systems Thinking

| Systems Thinking , | Personal Mastery , | Mental Models , | Shared Vision | Team Learning |

Systems thinking is based on system dynamics; it is highly conceptual; it provides ways of understanding practical business issues; it looks at systems in terms of particular types of cycles (archetypes); and it includes explicit system modeling of complex issues.

Systems thinking is a conceptual framework, a body of knowledge and tools that has been developed over the past fifty years, to make the full patterns clearer, and to help us see how to change them effectively.

Also, The essence of the discipline of systems thinking lies in a shift of mind:

• seeing interrelationships rather than linear cause-effect chains, and
• seeing processes of change rather than snapshots

The practice of systems thinking starts with understanding a simple concept called “feedback” that shows how actions can reinforce or counteract (balance) each other. It builds to learning to recognize types of “structures” that recur again and again: the arms race is a generic or archetypal pattern of escalation, at its heart no different from turf warfare between two street gangs, the demise of a marriage, or the advertising battles of two consumer goods companies fighting for market share. Eventually, systems thinking forms a rich language for describing a vast array of interrelationships and patterns of change. Ultimately, it simplifies life by helping us to see the deeper patterns lying behind the events and the details.

Systems Archetypes are basic and understandable cycles that systems go through.

The archetypes from The Fifth Discipline are -

Balancing Process with Delay

Limits to Growth

Shifting the Burden

Shifting the Burden to the Intervenor

Eroding Goals

Escalation

Success to the Successful

Tragedy of the Commons

Fixes that Fail

Growth and Underinvestment

Systems thinking uses archetypes for modeling the cycles that systems go through.

Consequences at a distance – keep us from easily seeing cause and effect.

Complexity and understanding – we need methods to increase understanding.

Leverage – is to find the point in the cycle where effort is most effective or to change the structure of the system.

Personal Mastery

| Systems Thinking , | Personal Mastery , | Mental Models , | Shared Vision | Team Learning |

Personal mastery is the discipline of continually clarifying and deepening our personal vision, of focusing our energies, of developing patience, and of seeing reality objectively.

Continually focusing

Vision, current reality, and creative tension

If we have a personal vision and we also see current reality objectively, then the difference between the two causes “creative tension”. That tension can be used to draw us from where we are – in current reality – to the vision.

What the vision does is to bring about the creative tension that is used to move a person toward the reality of the vision.

Commitment to the truth is the other part of the process. Understanding of current reality as well as a vision are necessary for creative tension to begin to work.

Using the subconscious is important in personal mastery. The author says that people committed to continually developing personal mastery practice some form of “meditation.” Whether it is through contemplative prayer or other methods of simply “quieting” the conscious mind, regular meditative practice can be extremely helpful in working more productively with the subconscious mind.

The following words are the first from the “Introduction to the Paperback Edition” of The Fifth Discipline. The vision that became The Fifth Discipline was born one morning in the fall of 1987. During my meditation that morning, I suddenly became aware that “the learning organization” would likely become a new management fad. The author decided that he wanted to take advantage of the fad and do something that would establish systems thinking, mental models, personal mastery, shared vision, and team learning and dialogue as inescapable elements in building learning organizations.

People creating the results in life that they truly seek

This is where the spirit of the learning organization is from.

Mental Models

| Systems Thinking , | Personal Mastery , | Mental Models , | Shared Vision | Team Learning |

“Mental models” are deeply ingrained assumptions, generalizations, or even pictures or images that influence how we understand the world and how we take action.

The discipline of working with mental models starts with turning the mirror inward; learning to unearth our internal pictures of the world, to bring them to the surface and hold them rigorously to scrutiny. It also includes the ability to carry on “learningful” conversations that balance inquiry and advocacy, where people expose their own thinking effectively and make that thinking open to the influence of others.

Balancing Inquiry and Advocacy

Scenarios

Leaps of Abstraction

Left-hand Column

Espoused theory versus theory-in-use

Team disciplines

Shared Vision

| Systems Thinking , | Personal Mastery , | Mental Models , | Shared Vision | Team Learning |

The practice of shared vision involves the skills of unearthing shared “pictures of the future” that foster genuine commitment and enrollment rather than compliance.

Openness

Pictures of the future

Team Learning

| Systems Thinking , | Personal Mastery , | Mental Models , | Shared Vision | Team Learning |

The discipline of team learning starts with “dialogue,” the capacity of members of a team to suspend assumptions and enter into a genuine “thinking together.”

The discipline of dialogue also involves learning how to recognize the patterns of interaction in teams that undermine learning. The patterns of defensiveness are often deeply engrained in how a team operates. If unrecognized, they undermine learning. If recognized and surfaced creatively, they can actually accelerate learning.

Dialogue

The discipline of team learning involves mastering the practices of dialogue and discussion, the two distinct ways that teams converse. In dialogue, there is the free and creative exploration of complex and subtle issues, a deep “listening” to one another and suspending of one’s own views. By contrast, in discussion different views are presented and defended and there is a search for the best view to support decisions that must be made at this time. Dialogue and discussion are potentially complementary, but most teams lack ability to distinguish between the two and to move consciously between them. Emphasis added.

David Bohm’s necessary conditions for dialogue are as follows:

1. all participants must “suspend” their assumptions, literally to hold them “as suspended before us”;
2. all participants must regard one another as colleagues;
3. there must be a “facilitator” who “holds the context” of dialogue.

The following information about dialogue is from Organizational Dynamics. Autumn 1993. “Taking Flight: Dialogue, Collective Thinking, and Organizational Learning”, William N. Isaacs, director of the Dialogue Project at MIT’s Organizational Learning Center.

Dr. Isaacs mentions these first steps and four Levels and Stages of Dialogue.

• Early requirement – people developed an initial grasp of inquiry skills, such as how to detect an abstract statement and invite people to explain their thinking.
• gradually people recognize that they can either begin to defend their points of view, finding others as somewhat or totally wrong, or suspend their view, and begin to listen without coming to a hard and fast conclusion about the validity of any of the views yet expressed. They become willing to loosen the “grip of certainty” about all views, including their own.
• At this stage, people may find themselves feeling frustrated, principally because the underlying fragmentation and incoherence in everyone’s thought begins to appear.

Extreme views become stated and defended. All of this “heat” and instability is exactly what should be occurring. The fragmentation that has been hidden is surfacing in the container.

They ask: “Where am I listening from? What is the disturbance going on in me (not others)? What can I learn if I slow things down and inquire (to seek within)?”

• People notice, for example, that they differ in their pace and timing of speaking and thinking, and begin to inquire into and respect these facts.

Sometimes in this phase the flow takes on a powerful and undeniable intensity. Inquiry within this phase of the container is subtle; people here can become sensitive to the cultural “programs” for thinking and acting that they have unwittingly accepted as true. In these later stages of dialogue, the term “container” becomes limiting. It is more accurate to describe it as a kind of shared “field” in which meaning and information are being exchanged.

This phase can be playful and penetrating. Yet it also leads to another crisis. People gradually realize that deeper themes exist, behind the flow of ideas. They come to understand and feel the impact that holding fragmented ways of thinking has had on them, their organizations, and their culture. They sense their separateness. While people may understand intellectually that they have had limits to their vision, they may not yet have experienced the fact of their isolation. Such awareness brings pain–both from loss of comforting beliefs and from the exercise of new cognitive and emotional muscles. People recognize that their thoughts–in the form of collective assumptions and choices–create and sustain fragmentation and separation.

Moving through this crisis is by no means a given nor necessary for “success” in dialogue. Groups may develop the capacity for moving to the final level of dialogue over a considerable period of time. It is a deep and challenging crisis, one that requires considerable discipline and collective trust.

• If this crisis can be navigated, a new level of awareness opens. People begin to know consciously that they are participating in a pool of common meaning because they have sufficiently explored each other’s views. They still may not agree, but their thinking takes on an entirely different rhythm and pace. At this point, the distinction between memory and thinking becomes apparent. People may find it hard to talk together using the rigid categories of previous understanding. The net of their existing thought is not fine enough to begin to capture the subtle and delicate understandings that begin to emerge. This too may be unfamiliar and disorienting. People may find that they do not have adequate words and fall silent. Yet the silence is not an empty void, but one replete with richness.

Tabling or suspending assumptions

Other topics to mention and some concerns

Microworlds – computer enactions of businesses and business processes.

Where is training or knowledge going to come from?

metanoia – Greek word meaning “change of mind”

The apostle Paul said “if we have hope in this life only, we are of all men most miserable.”

The cost of advancing principles where there are views that are held religiously may not be pleasant. Some thoughts that arise from this are that opposition may be great enough to make hope for “the next life” needed for workers. Also, apostolic dedication to the task was to a task and an objective that were real.

Instinct – actions that don’t result from thoughtfulness may not be easily overcome through dialogue.

Criticism – harsh and possibly personal disagreement may not be manageable through simple openness.

There is a need for principles beyond what individuals make up for them own selves. The natural affections such as love and nurturing do not simply distribute to everyone or through the business climate.

New Age

One author says:

Does Senge think his movement is New Age? Asked directly, he replies: “The term carries a lot of baggage, but yes, Deming always talked about a new economic age. That was his term, and he said that the principles by which success is going to be determined in this new economy will be different. So it’s New Age.”

The above is from an article about Peter Senge and learning organizations in Fortune. 130(8): 147-157. 1994 Oct 17. “Mr. Learning Organization”, Brian Dumaine.

In Organizational Dynamics. Autumn 1993. Communities of Committment: The Heart of Learning Organizations”, Fred Kofman and Peter M. Senge say the following.

Joseph Cambell spoke of the ancient Indo-European myth of the Goddess who “teaches compassion for all living beings. There also you come to appreciate the real sanctity of the earth itself, because it is the body of the Goddess.” Recent advances in archeological research are suggesting that the myth of the Goddess may have predominated throughout central Europe in the late Paleolithic and early Neolithic cultures. These cultures may have been neither warlike nor male dominated, as long assumed.

On the other hand, I found a copy of Authur Koestler’s book “Ghost in the Machine”, written in 1967, in the New Age section of a local bookstore. The use of the name “new age” does not necessarily mean that a viewpoint really is part of the new age. Nevertheless, use of the idea of a goddess for decency and possibly attentiveness do have something in common with new age imagery.

Life in a body.

Integrity and the inability to manage the body.

“unvoiced longing toward a truer world” as W. E. B. Du Bois wrote about the blues in The Souls of Black Folk.

Self-Control as a biblical version of personal mastery.

Anecdotes and case studies

Pleasant conversation

“Bright Ideas”

The difference between delayed on-line communication and dialogue.

Integrity – being true to our understanding or our promise.

Authenticity – being real and genuine.

Collective intelligence – the benefit of combining the understanding of individuals.

Aspiration – hopes, desires for the future, vision, direction.

Conceptualization – seeing the future through imagination and system thinking.

The concert pianist thinks only of the aesthetics of the performance, not the mechanics.

System Dream

The first full day I worked on this review, I probably spent about ten hours gathering notes, searching The Fifth Discipline for definitions, and writing the beginning of the review. That night I slept and dreamed of flying. I was thinking that my dream might not be very beneficial for publication; however, I bought the Fifth Discipline Fieldbook 7-Dec-95, and during lunch at a cafeteria that day I heard someone say, “I’m going to tell you a dream I had last night.” Then when I was leaving, I heard someone else from another table say as I walked past “here’s my dream.” So, here’s my system dream.

I see a flying saucer/platform-type vehicle. My vantage point seems to be a little above the saucer and not far from it. It may be hovering in the air; however, it doesn’t seem like a space vehicle, more like a hovercraft. The vehicle seems to have something to do with my brother. Maybe he is accustomed to flying these vehicles. The saucer is not awesome or forbidding and is about the width of 1-2 chairs. I think of flying it as a privilege and think of the vehicle in terms of a taken-for-granted F-14. Soon I am flying it. There are no visible controls; it seems to go where I want it to, responding to my thought. I am flying fairly slow, maybe at a height of 100-300 feet over a suburban residential area. I see my destination, beside or near someone’s house, across a small field. My flight is wobbly, and I don’t know how to control the part of my thinking that controls the vehicle. I’m descending to my destination with a trace of shame and embarrassment as I try to avoid and am not sure I can avoid power lines between me and my destination. Somehow, maybe by guessing or chance, I avoid the power lines and everything is OK.

My Contribution

Is “learning organization” the answer to my question?

If someone asked how to start a car and received an answer in terms of the laws of physics, the answer would be unusual. Usually we have some idea of the kind of answer we’ll receive and may even expect it. The learning disciplines are not an “expected answer” for the question “how can my workplace become a learning organization?” Or, more directly, “what can I do to be part of a learning organization?” We would expect answers like “just start learning” and “help promote learning”. The Fifth Discipline in not directed to meeting those expectations and with good reason. Learning in an environment where there is little receptivity to what is learned is not fully useful to a company. And “ivory tower” learning that separates people does not further the development of a learning organization.

The five disciplines relate to business needs

Individual learning should prepare the individual for being a part of the group (personal mastery), and what is learned needs to prepare receptivity to others’ learning, experience, questions, and manner of thought (mental models). A viewpoint that is sufficient for understanding business cycles and system relationships is required for working with cycles and toward better relationships both of systems and with people (systems thinking). Without a guiding purpose and shared values (shared vision), corporate effort will have the Tower of Babel problem and the confusion resulting from different languages. For everyone to learn together (team learning), a receptive process of listening to one another is needed.

The disciplines may not be what we were looking for

In these terms, the disciplines of learning may seem less foreign; yet there is a great distance between the idea of personal mastery and behaviors such as looking for stuff on the network. How can purposeful, person-as-resource principles be furthered? This is when the vision and a real understanding of the present show that we must change our minds. The first step for the individual in being part of a learning organization is wanting to be a part, and maybe that’s the first thing that has to be settled. Do you want to go? If you want to go, then you can.

Object-oriented design and the mental work required for system design

Object-oriented design and object-oriented computer programming languages have increased in emphasis in the last few years. While Steve McConnell’s Code Complete isn’t directly concerned with object-oriented programming, it is very informative about programming research and methods, and part of the author’s purpose in writing the book was to reduce the significant gap between research and practice. If procedural programming practice differs greatly, object-oriented programming shares the same language elements plus new language elements and more design options. The emphasis of object-oriented programmers and designers is often very different with programmers seeming to think that the technical elements of the language result in useful objects, while designers who are working at a higher level than a programming language, a level that is possibly lacking from some projects, marvel at the uncertainties, mental effort and difference between design choices.

Object-oriented design has understandable means

One thought that may benefit the learning organization is that object-oriented system modeling, though based on very definite “finding methods”, continues to be conceptually difficult. The finding methods such as CRC cards and Use Case modeling give an investigator real starting points or starting questions. Systems archetypes, on the other hand, seem to be based on business analysis expertise and experience of same-type cycles. There’s less information presented about how to find the archetypes in a system than object system designers have needed, wanted and received in their work. If you don’t see the archetypes, there’s not much guidance for how to find them. And evidence of the full effectiveness of modeling with the archetypes is not presented, either. The conclusion might be that further development of systems thinking models and modeling is needed and possible. Maybe I should mention here that I’ve purchased The Fifth Discipline Fieldbook, and it may answer some of my questions.

Systems thinkers view of the archetypes

In The Fifth Discipline Fieldbook: Strategies and Tools for Building a Learning Organizationsystems thinking professionals evaluate the use of systems archetypes and write the following. The comments from the book are not intended as being disrespectful of modeling methods.

• An archetype is nothing more than a mental model made visible. 164
• Translating a complex organizational issue into a model that makes sense is still a high-level craft, and the modeling programs contain no built-in criteria for helping you see whether a model is credible or appropriate. 176
• Peter Senge has referred to them, correctly in my opinion, as “training wheels.” 177
• Predicting the behavior of even the simplest archetype would mean solving a high-order nonlinear differential equation in your head. Human beings do not have the cognitive capacity to do so. 178

How much of life is made of visible cycles?

Another thought is that object-oriented design seems to focus much more on the intended use and functionality of systems rather than emphasizing visually defined cycles within a system. The cycles are almost taken for granted in some modeling, since programming generally involves repeated processes. I don’t have enough business experience to say whether a given case study is exemplary and useful for general application or whether it is an example of a story-teller’s skill and the human interest of stories.

Explanatory Notes

Importance of the fifth discipline, systems thinking

There is some disagreement on the importance of systems thinking relative to the other disciplines. One article about Peter Senge says that systems thinking is no more important than any of the other disciplines and that the term “fifth discipline” was used because it sounded good. On the other hand, the book says that the discipline makes the other disciplines “work”. The author writes It is vital that the five disciplines develop as an ensemble. This is challenging because it is much harder to integrate new tools than simply apply them separately. But the payoffs are immense.

This is why systems thinking is the fifth discipline. It is the discipline that integrates the disciplines, fusing them into a coherent body of theory and practice. It keeps them from being separate gimmicks or the latest organization change fads. Without a systemic orientation, there is no motivation to look at how the disciplines interrelate. By enhancing each of the other disciplines, it continually reminds us that the whole can exceed the sum of its parts.

The author also writes I call systems thinking the fifth discipline because it is the conceptual cornerstone that underlies all of the five learning disciplines of this book. Go to context

Reference
David Garvin, Building a Learning Organization, Business Credit, 96(1): 19-28. 1994 January.

From the same publication, “David A. Garvin is the Robert and Jane Cizik Professor of Business Administration at the Harvard Business School. His current research focuses on the general managers role and successful change processes.” Go to context. More information.

The Author of The Fifth Discipline

From the book cover, Peter M. Senge is Chair of the Council for the Society for Organizational Learning and a founding partner of Innovation Associates in Framingham, Massachusetts, and Toronto, Canada. He has introduced thousands of managers at Ford, Digital, Procter & Gamble, AT&T, Herman Miller, Hanover Insurance, Royal Dutch/Shell, and at other major corporations to the disciplines of the learning organization through the seminars offered by Innovation Associates. Go to context

A Learning Organization is the term given to a company that facilitates the learning of its members and continuously transforms itself. Learning Organizations develop as a result of the pressures facing modern organizations and enables them to remain competitive in the business environment. A Learning Organization has five main features; systems thinking, personal mastery, mental models, shared vision and team learning.

Definition of a Learning Organization

There are varying definitions of a Learning Organization in published literature, although the core concept between them all remains clear and has been summarised by Pedler et al. as, “an organization that facilitates the learning of all its members and continuously transforms itself”. Pedler et al later redefined this concept to “an organization that facilitates the learning of all its members and consciously transforms itself and its context”, reflecting the fact that change should not happen just for the sake of change, but should be well thought out. Some definitions are broader and encompass all kinds of organizational change rather than just change through learning , whereas others include specifics about how a Learning Organization works. Senge defines Learning Organizations as “Organizations where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning to learn together.”

Why do Learning Organizations develop?

Organizations do not organically develop into Learning Organizations; there are usually factors prompting their change. It has been found that as organizations grow, they lose their natural capacity to learn as company structures and individual thinking becomes rigid.When problems arise in the company, the solutions that are proposed often turn out to be only short term (single loop learning) and re-emerge in the future. To remain competitive, many organizations have restructured, which has resulted in fewer people in the company. This means those who remain need to work more effectively. To create a competitive advantage, companies need to be able to learn faster than their competitors and also develop a customer responsive culture. Argyris identified that in light of these pressures, modern organizations need to maintain knowledge about new products and processes, understand what is happening in the outside environment and produce creative solutions using the knowledge and skills of all employed within the organization. This requires co-operation between individuals and groups, free and reliable communication, and a culture of trust. These needs can be met through embracing the tenets of the Learning Organization.

Benefits of being a Learning Organization

There are many benefits to improving learning capacity and knowledge sharing within an organization. The main benefits are;

• Maintaining levels of innovation and remaining competitive
• Being better placed to respond to external pressures
• Having the knowledge to better link resources to customer needs
• Improving quality of outputs at all levels
• Improving corporate image by becoming more people orientated
• Increasing the pace of change within the organization

Characteristics of a Learning Organization

A Learning Organization exhibits five main characteristics; systems thinking, personal mastery, mental models, a shared vision and team learning.

Systems thinking

The idea of the Learning Organization originally developed from a body of work called systems thinking. This is a conceptual framework that allows people to study businesses as bounded objects. Learning Organizations employ this method of thinking when assessing their company and will have developed information systems that measure the performance of the organization as a whole and of its various components. Systems thinking also states that all the characteristics listed must be apparent at once in an organization for it to be a Learning Organization. If one or more of these characteristics is missing then the organization will fall short of its goal. However O’Keeffee believes that the characteristics of a Learning Organization are factors that are gradually acquired, rather than developed simultaneously.

Personal mastery

Personal mastery is the commitment by an individual to the process of learning. There is a competitive advantage for an organisation whose workforce can learn quicker than the workforce of other organisations. Individual learning is acquired through staff training and development, however learning cannot be forced upon an individual if he or she is not receptive to learning. Research has shown that most learning in the workplace is incidental, rather than the product of formal training, therefore it is important to develop a culture where personal mastery is practiced in daily life. A Learning Organisation has been described as the sum of individual learning, but it is important for there to be mechanisms by which individual learning is transferred into organisational learning.

Mental models

Mental models are the terms given to ingrained assumptions held by individuals and organisations. To have become a Learning Organisation, these mental models must have been challenged. Individuals tend to espouse theories, which they intend to follow, and theories-in-use, which is what they actually do. Similarly, organisations tend to have ‘memories’ which preserve certain behaviours, norms and values. In the creation of a learning environment it is important to replace confrontational attitudes with an open culture that promotes inquiry and trust. To achieve this, the Learning Organisation will have mechanisms for locating and assessing organisational theories of action. If there are unwanted values held by the organisation, these need to be discarded in a process called ‘unlearning’. Wang and Ahmed refer to this as ‘triple loop learning.’

Shared vision

The development of a shared vision is important in incentivising the workforce to learn as it creates a common identity that can provide focus and energy for learning. The most successful visions build on the individual visions of the employees at all levels of the organisation and the creation of a shared vision is likely to be hindered by traditional structures where a company vision is imposed from above. As a result, Learning Organisations tend to have flat, decentralised organisational structures. The topic of shared vision is often to succeed against a competitor, however Senge states that these are transitory goals and suggests that there should also be long term goals that are intrinsic within the company.

Team learning

Team learning is the accumulation of individual learning. The benefit of sharing individual learning is that employees grow more quickly and the problem solving capacity of the organisation is improved through better access to knowledge and expertise. Learning Organisations have structures that facilitate team learning with features such as boundary crossing and openness. Team learning requires individuals to engage in dialogue and discussion, therefore it is important that team members develop open communication, shared meaning and understanding. Learning Organisations also have excellent knowledge management structures, which allow creation, acquisition, dissemination, and implementation of this knowledge throughout the organisation.

Problems/issues that may be encountered in a Learning Organisation

Even within a Learning Organisation, problems may be encountered that stall the process of learning or cause it to regress. Most of the problems arise from an Organisation not fully embracing all the facets outlined above that are necessary in a Learning Organisation. If these problems can be identified, work can begin on improving them.

Organisational barriers to learning

Some organisations can find it hard to embrace personal mastery because as a concept it is intangible and the benefits cannot be quantified. Additionally, personal mastery can be seen as a threat to the organisation. This threat can be real, as Senge points out, that “to empower people in an unaligned organisation can be counterproductive”. In other words, if individuals do not engage with a shared vision, personal mastery could be used to advance their own vision. In some organisations a lack of a pro-learning culture can be a barrier to learning. It is important that an environment is created where individuals can share learning without it being devalued and ignored, so more people can benefit from their knowledge and the individual becomes empowered. A Learning Organisation needs to fully embrace the removal of traditional hierarchical structures. These are a barrier to the development of shared vision and to the sharing of knowledge.

Individual barriers to learning

Resistance to learning can occur within a Learning Organisation if there is not sufficient buy in at an individual level. This is often encountered by people who feel threatened by change or believe that they have the most to lose. The same people who feel threatened by change are likely to have closed mind sets are not willing to embrace engagement with mental models. Unless implemented coherently across the whole organisation, learning can be viewed as elitist and restricted to more senior levels within the organisation. If this is the case, learning will not be viewed as a shared vision. If training and development is compulsory, it can be viewed as a form of control, rather than a form of personal development. Learning and the pursuit of personal mastery needs to be an individual choice, therefore enforced take up will not work.

INISIASI MENYUSU DINI DI KOTA PAREPARE

Muhammad Idris¹, H. M. Rusli Ngatimin², Muh. Syafar²

¹Dinas Kesehatan Kota Parepare Sulawesi Selatan

²Konsentrasi Promosi Kesehatan PPS Unhas

Alamat Korespondensi    :

Dinas Kesehatan Jl. Ganggawa No.3 Kota Parepare

Telepon/Fax : (0421) 26816 / Mobile : 085796923686

Email : midris70@yahoo.co.id

KONSENTRASI PROMOSI KESEHATAN

PROGRAM PASCASARJANA

UNIVERSITAS HASANUDDIN

MAKASSAR

2009

ABSTRACT

In behavioral context, successful of early breastfeeding initiation by breast crawl was influenced by internal and external behavioral factors. This research’s aims are to exploration information concern role of behavioral factors and also describe    officer’s communication strategies to apply early breastfeeding initiation. This research purposed inductive paradigm with ethno-methodology approach to assisted researcher viewed community opinions about various behavioral choices in their everyday life related decision to conducted early breastfeeding initiation.

Result of qualitative analysis showed relevance between some internal and external behavioral factors with early breastfeeding initiation. Internal factors which role to early breastfeeding initiation were attitude and knowledge about colostrums, knowledge about early breastfeeding initiation, lactation experience and motivation.  Mother’s motivation to conduct lactation practice constituted by social, economics, trust, and health aspect, while motivation to conduct early breastfeeding initiation stimulated by desire to try something new (novelty). External factors which roles to early breastfeeding initiation were health service facility, delivery helper and behavioral tendency in living place related lactation practices, also family and closest people. The main source of information concerning early breastfeeding initiation for mother was midwife.

This research concluded the existence of role from internal and external behavioral factors to readiness of mother to conduct early breastfeeding initiation, and recommended ‘ready to handle plan’ and advocate training of midwife concern early breastfeeding initiation  and also research follow-up to get more useful result.

Keywords: initiation, colostrums, midwife (17: 1994-2009)

PENDAHULUAN

Berbagai penelitian telah membuktikan secara ilmiah manfaat dari perilaku menyusu dini, baik bagi ibu maupun bayinya. Manfaat tersebut antara lain menurunkan angka kematian bayi dan menghentikan perdarahan paska melahirkan dengan lebih cepat^1,2, mempercepat terlepasnya placenta dan meningkatkan interaksi antara ibu dan bayi³, meningkatkan keberhasilan dan lama menyusui^4,5, mereduksi angka kejadian diare dalam usia 6 bulan pertama⁶, menurunkan angka kematian bayi dibawah usia 28 hari^2,7, serta meningkatkan keberhasilan pemberian ASI ekslusif^4,8.

Dalam konteks perilaku, keberhasilan inisiasi menyusu dini dengan cara membantu bayi mencari dan menyusu pada payudara ibu dengan instinknya sendiri (breast crawl), dapat dipengaruhi oleh faktor internal dan faktor eksternal perilaku. Pada kenyataannya, sampai saat ini informasi mengenai berbagai faktor perilaku yang berperan terhadap perilaku inisiasi menyusu dini masih sangat terbatas padahal informasi tersebut dapat membantu merumuskan strategi penerapannya secara efektif di masyarakat.

Penelitian ini difokuskan pada upaya menggali informasi mengenai faktor perilaku serta kondisi yang mendukung dalam melakukan inisiasi menyusu dini serta mengidentifikasi cara petugas memperkenalkan inisiasi menyusu dini kepada ibu dan keluarganya.

BAHAN DAN METODE

Desain dan Lokasi Penelitian

Penelitian tentang peran faktor perilaku dalam penerapan inisiasi menyusu dini menggunakan paradigma induktif dengan pendekatan etnometodologi dan dilaksanakan di Kota Parepare, pada bulan Maret – Juni 2009. Kota Parepare berpenduduk 115.076 jiwa dengan rincian 54.769 jiwa laki-laki dan 60.307 jiwa perempuan⁸.

Informan dan Informan Kunci

Informan dipilih secara purposif dengan teknik bola salju⁹. Informan terdiri dari 6 orang ibu IMD, 4 orang ibu bukan IMD, 3 orang bidan dan 1 orang informan kunci. Informan kunci adalah sosok yang berpengaruh secara struktural, sosial dan budaya serta mempunyai pengetahuan mengenai topik yang dibahas.

Pengumpulan Informasi

Pengumpulan data dilakukan melalui indepth interview. Untuk keperluan ini peneliti membuat kerangka dan garis-garis pokok materi yang akan ditanyakan dalam proses wawancara. Pelaksanaan wawancara dan urutan pertanyaan disesuaikan dengan keadaan informan.

Teknik Analisis

Informasi yang terhimpun diolah dengan model analisa editing, untuk menemukan bagian-bagian yang bermakna terkait topik penelitian¹⁰. Akurasi dan keabsahan informasi diuji dengan metode triangulasi sumber dan pengecekan ulang kepada informan (member check)¹¹.

HASIL PENELITIAN DAN PEMBAHASAN

Hasil wawancara mendalam menunjukkan adanya keterkaitan antara beberapa faktor perilaku baik yang bersifat internal maupun eksternal terhadap kesediaan ibu melakukan inisiasi menyusu dini.

Analisa Faktor Internal

Faktor internal perilaku yang menjadi sasaran analisis meliputi pengetahuan, sikap, pengalaman, persepsi dan motivasi terkait perilaku menyusui, kolostrum dan inisiasi menyusu dini. Komponen pengetahuan yang dinilai berperan terhadap penerimaan inisiasi menyusu dini (IMD) adalah pengetahuan tentang kolostrum. Konklusi ini didasarkan pada hasil analisis yang memperlihatkan perbedaan respon antara kelompok ibu IMD dan ibu bukan IMD. Ibu IMD dapat mengidentifikasi apa yang disebut kolostrum dan juga memberikan kepada bayinya. Sementara ibu bukan IMD tidak memahami dan juga tidak memberikan kepada bayinya dengan berbagai alasan.

“…kolostrum itu air susu yang keluar pada hari pertama,… berwarna kekuning-kuningan… imunisasi yang pertama untuk bayi kita…”(Ny.UH, 30 tahun-IMD)

“ …waktu kulahirkanki anakku, lemas sekali ka’ jadi mamakku bilang, janganmi dulu susuiki…” (Ny.Er, 21 tahun-bukan IMD)

Informan yang mengetahui manfaat kolostrum cenderung bersikap positif terhadap kolostrum dan sangat mungkin menjadi salah satu alasan untuk menerima praktek IMD. Hubungan antara pengetahuan dan sikap terhadap kolostrum dan IMD antara lain disimpulkan dari penelitian yang dilakukan di Ghana, … many women from Northern ethnic groups had strong beliefs about colostrum being dirty and harmful to the baby and thus delayed breastfeeding until the ‘good’ milk arrived¹².

Ibu yang merasa kolostrum itu penting, akan lebih mudah menerima saran bidan untuk melakukan inisiasi. Apalagi kepercayaan yang besar terhadap petugas yang menolong persalinan akan membuat mereka tetap melakukannya. Ibu bukan IMD meski mengaku sering mendengar istilah  ‘kolostrum’ baik melalui tayangan televisi, siaran radio lokal maupun melalui posyandu, tapi pemahaman mereka tidak memadai, sehingga keputusan untuk memberikan kolostrum tersebut mudah dipengaruhi oleh faktor lain yang berasal dari dalam maupun dari luar dirinya.

Komponen pengetahuan yang lain seperti manfaat, frekuensi dan cara menyusui yang benar tidak berperan terhadap praktek inisiasi menyusu dini. Hal ini ditunjukkan oleh kemiripan respon dari kedua kelompok informan, sehingga dapat disimpulkan bahwa baik ibu IMD maupun ibu bukan IMD mempunyai pengetahuan yang sama terkait komponen pengetahuan yang disebutkan.

Komponen pengetahuan tentang inisiasi menyusu dini tidak berperan ketika perilaku tersebut dilakukan untuk pertama kalinya, hal ini terlihat dari respon yang menunjukkan bahwa baik ibu IMD maupun ibu bukan IMD tidak mempunyai pengetahuan tentang inisiasi menyusu dini. Ibu IMD ketika melakukannya untuk pertama kali tidak berdasarkan pada pengetahuannya, melainkan semata-mata karena kepercayaannya kepada petugas penolong persalinan.

“…iye’ saya tidak pernah dikasi tau sebelumnya, nantipi lahir anakku terus itu bidan kasi naik ke perutku, dia bilang tidak usah takut ini tidak apa-apa…” (Ny. Rkm, 36 tahun-IMD)

Namun demikian, ibu yang telah melakukan inisiasi menyusu dini lebih berpeluang untuk mengulangi perilaku tersebut.

“…iya, kalau bidannya kasi begituki lagi kita pasti bersedia karena sudah pernah…”(Ny. Ftm, 25 tahun-IMD)

Faktor sikap yang berperan terhadap kesediaan ibu melakukan inisiasi menyusu dini, adalah sikap terhadap kolostrum. Komponen sikap ini terlihat cukup positif pada ibu IMD. Sementara ibu bukan IMD memperlihatkan respon yang negatif.

“…itu kan banyak manfaatnya untuk bayi jadi seharusnya dikasih, pak …”(Ny.UH, 30 tahun-IMD)

“…pas melahirkan tidak tegaka’ kurasa kasiki anakku (alasan yang diberikan oleh informan tidak dijelaskan lebih lanjut)…”(Ny. Hst, 21 tahun-bukan IMD)

Komponen sikap yang lain seperti sikap terhadap keharusan menyusui dan sikap terhadap langkah-langkah inisiasi menyusui dini tidak memberikan informasi yang memperlihatkan peran yang jelas terhadap penerimaan praktek inisiasi menyusu dini.

Pengalaman menyusui berperan dalam meningkatkan kepercayaan diri ibu IMD untuk melakukan inisiasi menyusu dini, dan pengalaman melakukan inisiasi menyusu dini berperan untuk menguatkan keyakinan ibu IMD mengulangi inisiasi menyusu dini secara sukarela. Respon ini tidak terlihat pada ibu bukan IMD.

“…biasaji…waktu bidan kasi tau’ka langsungji…penasaranka juga mau liatki…” (Ny.UH, 30 tahun-IMD)

“…bagus betul pak, anakku kuat sekali netek…yah kalau nakasi’ki tuhan rejeki na ada ade’na, lebih baik dikasi begitu, apalagi ini pernahmi…”(Ny. Idh,27 tahun-IMD)

Persepsi tentang menyusui berperan terhadap perilaku menyusui secara umum tapi tidak berperan secara langsung terhadap inisiasi menyusu dini. Baik ibu IMD maupun ibu bukan IMD menganggap bahwa menyusui merupakan keharusan bagi ibu yang melahirkan dan mereka melakukannya sesuai apa yang mereka ketahui.

“…untuk apa kita melahirkan kalau tidak mauki susui anatta’…?”(Ny.Db, 25 tahun-bukan IMD)

“…itumi tugasta jd mama’ kasi makan ana’ta dengan air susu ta…”(Ny.UH,30 tahun-IMD)

Motivasi ibu untuk menyusui antara lain distimulasi oleh aspek sosial, ekonomi, keyakinan (agama) dan faktor kesehatan, tapi aspek-aspek ini tidak mempunyai keterkitan dengan penerimaan ibu terhadap praktek inisiasi menyusu dini. Khusus dikalangan ibu multipara, didapatkan informasi yang tidak dapat diberlakukan secara umum mengenai dorongan melakukan inisiasi menyusu dini berdasarkan keinginan mencoba sesuatu yang baru (novelty).

Perlu digaris bawahi bahwa keinginan informan untuk mencoba, bukan dalam konteks trial and error karena tidak didasari gejala yang bersifat symptomatic. Keinginan mencoba kemungkinan terkait dengan rangsangan (stimulus) yang bersifat novelty. Sesuatu yang baru (novelty) sendiri adalah suatu stimulus baru yang akan lebih menarik perhatian seseorang dibanding yang telah diketahuinya lebih dahulu¹³.

Namun demikian, motif tersebut dapat diarahkan untuk meningkatkan motivasi dalam melakukan praktek IMD, terlebih jika praktek tersebut sukses dilakukan. Kesuksesan yang berawal dari keinginan mencoba dapat menjadi pengalaman perilaku (empirical behavior) yang mempertahankan praktek tersebut. Hal ini sejalan dengan pendapat Ngatimin, bahwa jika tindakan trial and eror dilakukan di tempat pelayanan kesehatan dan tindakan tersebut memberikan kesuksesan (kesembuhan), pada akhirnya akan menjadi empirical behavior (pengalaman perilaku). Bahkan ditambahkan bahwa trial and error dapat menjadi bagian dari pola hidup menuju sehat bagi masyarakat yang masih belum tersentuh sempurna penyuluhan kesehatan¹⁴.

Analisa  faktor eksternal

Dari empat faktor eksternal yang diamati, yakni fasilitas kesehatan, petugas penolong persalinan, keluarga dan orang terdekat serta kecenderungan perilaku di lingkungan sekitar, semuanya memperlihat peran yang berarti terhadap diterimanya praktek inisiasi menyusu dini.

Peran fasilitas kesehatan kesehatan dapat dilihat melalui informasi yang terungkap, bahwa pada unit pelayanan kesehatan yang menyerahkan sepenuhnya pilihan kepada pasien terkait keputusan untuk menyusui, tidak mendorong terlaksananya inisiasi menyusu dini.

“…apaje’ itu pak?…waktu melahirkanka di RS ‘X’ tidak tonji na suruhka bidan…” (Ny.Nrh, 25 tahun –bukan IMD)

Peran fasilitas pelayanan kesehatan dalam hal praktek menyusui terkait dengan komitmen pihak manajemen unit pelayanan untuk memberikan perhatian khusus terhadap perilaku tersebut. Komitmen ini sangat dipengaruhi oleh perhatian petugas pada unit pelayanan yang menjadi pilihan masyarakat. Terkait dengan pemilihan fasilitas pelayanan ditemukan sebuah fenomena yang menarik termasuk yang dilakukan oleh beberapa informan. Fenomena yang dimaksud adalah ‘perpindahan’ informan dalam mendapatkan pelayanan kesehatan ibu dan anak. Ada diantara informan yang ketika melahirkan, memilih Rumah Sakit yang dalam pandangan mereka lebih ‘modern’ dengan pelayanan yang lebih baik, meskipun secara ekonomis jauh lebih mahal. Namun untuk pelayanan imunisasi dan pemeriksaan kesehatan sebelum dan sesudah melahirkan dilakukan di Puskesmas.

Informasi yang disampaikan mengungkapkan fakta, bahwa di tempat melahirkan tersebut petugas menyerahkan sepenuhnya pilihan kepada pasien apakah mau menyusui dini atau tidak, dan itu dianggap oleh pihak RS sebagai hak dari pasien yang harus di hormati. Namun pada gilirannya hal tersebut cukup menyulitkan petugas puskesmas untuk memberikan keyakinan tentang perilaku menyusui.

Hal ini juga memperlihatkan ketiadaan peran petugas untuk mendorong pasien melakukan inisiasi menyusu dini atau memberikan kolostrum kepada bayi yang baru lahir. Peran petugas lebih jelas terlihat pada informasi yang disampaikan oleh ibu yang bersedia melakukan praktek inisiasi menyusu dini.

“…saya sudah dikasi tau bidan puskesmas waktu periksaka’, bilang nanti kalo melahirkan kita mau coba program baru, tapi waktu itu belumpi kutau program apa maksudnya…”(Ny. UH, 30 tahun-IMD)

“…iye’ saya tidak pernah dikasi tau sebelumnya, nantipi lahir anakku terus itu bidan kasi naik ke perutku, dia bilang tidak usah takut ini tidak apa-apa…” (Ny. Rkm, 36 tahun-IMD)

Peran petugas juga terlihat dalam memanfaatkan persepsi masyarakat yang menganggap persalinan tidak terpisahkan dengan praktek menyusui, untuk mendorong pasien melakukan inisiasi menyusu dini.

Jelas terlihat dari informasi pelaku IMD bahwa sebenarnya kesediaan mereka melakukan IMD sangat ditentukan oleh kepercayaan mereka terhadap bidan. Peran bidan dalam menunjang keberhasilan praktek menyusui terutama inisiasi menyusu dini, sejalan dengan penelitian Daryati (2008) di Sanggau Kalimantan Barat, yang menyimpulkan bahwa terdapat hubungan yang bermakna antara pengetahuan dan sikap bidan dengan keberhasilan melakukan inisiasi menyusu dini (IMD)¹⁵.

Peran bidan dalam praktek inisiasi menyusu dini juga diungkapkan oleh Februhartanty, dalam penelitiannya bahwa sekitar 80% bayi baru lahir ini menerima makanan/minuman prelakteal berdasarkan anjuran dari petugas kesehatan¹⁶. Kutipan hasil penelitian di atas, menunjukkan bahwa terlaksana atau tidaknya inisiasi menyusu dini, ikut dipengaruhi oleh peran petugas kesehatan, dalam hal ini dokter atau bidan.

Keluarga dan orang terdekat juga berperan untuk mendukung kesediaan ibu melakukan inisiasi menyusu dini. Anggota keluarga yang berperan adalah nenek dan suami, meskipun dalam hal ini peran suami lebih pasif.

“…nene’nya yang dikasi tau sama bidan waktu mauka melahirkan, bilang sebentar kita mau coba langsung kasi menyusui anaknya…”(Ny. Str, 34 tahun –IMD)

“…dia bawa’ka saja ke puskesmas, waktu ditanya sama bidan dia bilangji terserah mama aji…” (Ny. Ftm, 25 tahun-IMD)

Dalam penelitian ini ditemukan bahwa ‘orang lain’ yang berperan dalam membantu ibu memutuskan untuk melakukan inisiasi menyusu dini, tidak selalu anggota keluarga.

Peran suami lebih banyak memberikan kebebasan dan mendukung pilihan istri. Dukungan suami antara lain dapat terlihat pada sikapnya yang pengertian dan tidak membebani istrinya dengan pekerjaan rumah tangga saat tiba waktu menyusui. Terkait dengan praktek IMD, peran suami lebih pasif dan menyerahkan sepenuhnya keputusan kepada istrinya. Informasi tentang peran suami juga terungkap dalam penelitian yang dilakukan Februhartanty, bahwa kehadiran ayah saat persalinan adalah sehubungan dengan peranannya untuk melengkapi beberapa dokumen administrasi dan memberikan pernyataan kesediaan dilakukannya suatu tindakan tertentu pada sang istri bila diperlukan. Ayah tidak menyadari peran mereka yang lainnya yaitu mempengaruhi praktek menyusui segera setelah bayi dilahirkan.¹⁶

Strategi Penyampaian Informasi

Faktor eksternal lainnya adalah sumber dan cara penyampaian informasi terkait inisiasi menyusu dini. Dari wawancara mendalam didapatkan informasi bahwa sumber informasi utama bagi ibu dalam hal inisiasi menyusu dini adalah petugas kesehatan, yakni bidan yang membantunya sejak pemeriksaan kehamilan sampai melahirkan.

“…saya sudah dikasi tau bidan puskesmas waktu periksaka’, bilang nanti kalo melahirkan kita mau coba program baru, tapi waktu itu belumpi kutau program apa maksudnya…” (Ny. UH, 30 tahun-IMD)

“…nene’nya yang dikasi tau sama bidan waktu mauka melahirkan, bilang sebentar kita mau coba langsung kasi menyusui anaknya…”(Ny. Str, 34 tahun –IMD)

Informasi inisiani menyusu dini (IMD) dominan didapatkan dari bidan yang menangani pemeriksaan kehamilan dan persalinan, meskipun ada juga diantara informan yang mendapatkannya dari media. Yang menjadi masalah karena informasi tersebut tidak selamanya disampaikan bidan jauh sebelum praktek IMD dilakukan, bahkan terkadang nanti diberi tahu sesaat setelah melahirkan. Namun demikian yang paling dominan, adalah yang mendapatkan informasi saat pemeriksaan kehamilan. Seorang bidan puskesmas mengungkapkan bahwa pasien yang datang memeriksakan kehamilannya umumya diberi informasi mengenai ASI ekslusif maupun IMD, meskipun terkadang informasi itu diberikan pada umur kehamilan yang mendekati persalinan. Keterlambatan penyampaian informasi menyebabkan masih adanya ibu yang ragu mengambil keputusan untuk IMD. Disinilah peran pengetahuan dan sikap bidan diperlukan, seperti kesimpulan Daryati (2008) bahwa terdapat hubungan yang bermakna antara pengetahuan dan sikap bidan dengan keberhasilan melakukan inisiasi menyusu dini (IMD)¹⁵.

Cara penyampaian informasi juga berperan menentukan kesediaan ibu melakukan inisiasi menyusu dini.

“ …biasanya ibu-ibu yang melahirkan acuh tak acuh kalau diberi tahu soal itu…tapi saya selalu kasi tau, kalau mauki’ tidak lama perdarahan yah kasi begituki’ kalau tidak mau yah…apa boleh buat…”(Bd. Nrh, 42 tahun)

Bidan menyiasati penyampaian informasi, meskipun menurut mereka terkadang harus melanggar prinsip persuasif. Bidan menempuh cara penyampaian dengan menjelaskan dan memberikan pehamanan tentang risiko yang bisa didapatkan ibu melahirkan tapi dapat dicegah jika melakukan inisiasi menyusu dini (IMD).

Topik yang paling sering menjadi isi penyampaiannya adalah risiko perdarahan. Bidan menggunakan informasi bahwa IMD dapat mempercepat berhentinya perdarahan pada ibu melahirkan. Secara ilmiah, cara yang ditempuh oleh bidan memiliki kesesuaian dengan konsep Disability Oriented Approach (DOA) yang dikemukakan oleh Ngatimin (2005), bahwa DOA adalah pendekatan promosi kesehatan inovatif, berbasis trias epidemiologi dan dikembangkan melalui proses komunikasi guna menyadarkan dan memotivasi masyarakat untuk hidup sehat melalui upaya pencegahan guna menghindari disability serta ancaman kematian¹⁴.

KESIMPULAN

Penelitian ini menyimpulkan bahwa baik faktor internal maupun faktor eksternal berperan terhadap penerimaan inisiasi menyusu dini. Faktor internal yang berperan adalah pengetahuan dan sikap mengenai kolostrum dan pengetahuan mengenai inisiasi menyusu dini (untuk mengulangi praktek IMD). Sedangkan Faktor eksternal adalah fasilitas kesehatan, petugas kesehatan, keluarga dan orang terdekat. Sumber informasi utama mengenai inisiasi menyusu dini bagi ibu sekaligus yang menjadi penentu diterima atau tidaknya praktek ini adalah bidan.

Peneliti merekomendasikan perlunya perencanaan yang matang dalam mempromosikan praktek inisiasi menyusu dini, termasuk didalamnya pelatihan bagi bidan. Selain itu penelitian ini perlu ditindak lanjuti melalui penelitian dengan skala yang lebih luas serta dengan metode yang lebih bervariasi untuk memberikan keyakinan terhadap hasil yang diperoleh, sehingga hasilnya lebih bermanfaat dan dapat diterapkan.

DAFTAR PUSTAKA

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16. Februhartanty, Judhiastuty, 2008. Peran Strategis Ayah Dalam  Optimalisasi Praktek Pemberian ASI : Sebuah Studi di Daerah Urban Jakarta (di download dari http: // www.gizi.net/ makalah/ download/ Summary-Eng-Indo-Yudhi.pdf. pada 14 Pebruari 2009), Ringkasan Disertasi Universitas Indonesia, Jakarta.