scholarly journals Kualitas Pelayanan Pemeriksaan Antenatal oleh Bidan di Puskesmas

2018 ◽  
Vol 46 (2) ◽  
pp. 97-108
Author(s):  
Harimat Hendarwan
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Antenatal Care ◽  
Maternal Mortality ◽  
Health Center ◽  
Health Centers ◽  
Maternal Deaths ◽  
Live Births ◽  
Screening Services

Abstract The maternal mortality rate in Indonesia is still high and still far from the established target of SDG's, which is 305 compared to 102 maternal deaths per 100,000 live births. Adequate pregnancy screening services are needed to reduce maternal mortality. This study aims to determine the quality of antenatal care (ANC) services at public health centers (midwives competence and support facilities and service infrastructure). Data collection was conducted in 212 health centers and the sample size is 224 midwives in the health centers. Midwives were observed at the time of antenatal care. The observed ANC components were 5T, 7T, and 9T. In addition, it was observed also the availability of facilities, infrastructure, and medicines related to ANC in health centers. The midwives who performed the ANC correctly and well for the 9T, 7T, and 5T components were 18.8%, 23.2%, and 31.7%. Only 20.4% of health center have all equipment, medicines, and supporting media of ANC 9T service. Only one-fifth of midwives perform complete and correct ANC services for the 9T service components. Midwife knowledge in doing ANC 9T is better for those who have profession less than 20 years old and hold at least diploma degree midwifery. Keywords : Antenatal Care, Midwives, Health Center Abstrak Angka kematian ibu di Indonesia masih tinggi dan masih jauh dari target SDG’s yang telah ditetapkan, yaitu 305 dibandingkan dengan 102 kematian ibu per 100.000 kelahiran hidup. Pelayanan pemeriksaan kehamilan yang adekuat sangat dibutuhkan untuk menurunkan angka kematian ibu. Penelitian ini bertujuan mengetahui kualitas pelayanan pemeriksaan kehamilan atau antenatal care (ANC) di puskesmas (kompetensi bidan serta dukungan sarana dan prasarana pelayanan). Pengumpulan data dilakukan di 212 puskesmas dengan jumlah sampel 224 orang bidan. Bidan diamati pada saat melakukan pelayanan ANC. Komponen ANC yang diamati adalah 5T, 7T, dan 9T. Selain itu diamati juga ketersediaan sarana, prasarana, dan obat-obatan terkait dengan ANC di puskesmas. Bidan yang melakukan ANC dengan benar dan baik untuk komponen 9T, 7T, dan 5T secara berturut – turut adalah 18,8%, 23,2%, dan 31,7%. Hanya 20,4% puskesmas telah memiliki seluruh peralatan, obat, dan media penunjang pelayanan ANC 9T. Hanya seperlima bidan melakukan pelayanan ANC secara lengkap dan benar untuk komponen pelayanan 9T. Pengetahuan bidan dalam melakukan ANC 9T lebih baik pada mereka yang menjalani profesinya kurang dari 20 tahun dan berpendidikan minimal D3 kebidanan. Kata kunci : ANC, Bidan, Puskesmas

scholarly journals Maternal mortality at a tertiary care teaching hospital in Dibrugarh district, Assam: a retrospective study

2017 ◽  
Vol 4 (9) ◽  
pp. 3342
Author(s):  
Lima Hazarika ◽  
Pranay Phukan ◽  
Anand Sharma ◽  
Nabajit Kr. Das
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Teaching Hospital ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Deaths ◽  
Tertiary Care Teaching Hospital ◽  
Live Births ◽  
Care Teaching

Background: Maternal mortality is a measure of quality of health care in a community. Assam has the highest maternal mortality rate among all India’s states, which is almost double the national average, with around 328 deaths per 100 000 live births. Three quarters of these deaths are among the tea plantations community. It has serious implications on the family, the society and the nation. Maternal mortality rate (MMR) is a very sensitive index that reflects the quality of reproductive care provided to the pregnant women. The objective of the study was to assess the Institutional maternal mortality and the causes of maternal death over a period of a year at a Tertiary Care Teaching Hospital in Dibrugarh district, Assam.Methods: A retrospective hospital based study of maternal death cases from September 2015 to August 2016 was conducted to assess the maternal mortality. The study was carried out in the Obstetrics and Gynaecology Department of Assam Medical College and Hospital (AMCH), Assam. The study included 48 maternal deaths in the year. The information regarding reproductive parameters was collected from the maternal death register and the results were analyzed by using percentage.Results: Out of 9789 total deliveries, Institutional Maternal Mortality was found to be 490 per 1, 00,000 live births. The maternal death was high among the Tea Garden community (66.7%) at the age group 15–20 years and was prevalent mainly in the illiterates (31.3%). Anaemia (29.1%) was the leading cause of death; followed eclampsia (23.0%) and septicaemia (17.0%) while cardio respiratory failure was indirect leading cause for maternal deaths.Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths were preventable. Most maternal deaths can be limited by utilisation of existing medical facilities and identifying the barriers in accessing health delivery system. Early identification of high risk pregnancies and regular ante-natal check up with timely referral to tertiary care centre can help reduce the mortality among the women. 

scholarly journals Quality of Antenatal Care at Urban and Rural Puskesmas (Public Health Center) in Jeneponto Regency

2020 ◽  
Vol 8 (T2) ◽  
pp. 177-182
Author(s):  
Nurul Fauziah ◽  
Ansariadi Ansariadi ◽  
Darmawansyah Darmawansyah ◽  
Wahidin M. Wahidin ◽  
Reski Amaliah ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Antenatal Care ◽  
Health Center ◽  
Health Centers ◽  
Blood Type ◽  
Height Measurement ◽  
Public Health Center ◽  
Rural And Urban

BACKGROUND: Increased coverage antenatal care (ANC) occurring in developing countries do not guarantee the success of the ANC, it is because a high rate of maternal and neonatal mortality associated with inadequate and poor quality of maternal care, including ANC. AIM: This study aimed to find out the differences in the quality of ANC in rural and urban primary health centers in Jeneponto Regency. METHODS: This research aims to determine the different quality of ANC at urban and rural puskesmas (public health center), Jeneponto regency. The type of the research was observational analysis with cross-sectional design. There were 139 fixed samples of rural and urban pregnant women visiting the puskesmas, from October 2015 to May 2016. The samples were selected using stratified random sampling method from two puskesmas of each area. RESULTS: The results indicate that 52.6% of ANC quality is categorized bad. There is different ANC quality based on body weight, the height of fundus uteri, and administration of Fe tablet (0.038, 0.029, and 0.006). There is no difference of antenatal quality based on body height, LILA, fetus’ heartbeat, fetus presentation, blood type and Hb, and immunization of TT (0.068, 0.501, 1.000, 1.000, 0.133, 0263, and 0530). Blood pressure is not analyzed. CONCLUSION: There are three components that show differences in rural and urban health centers, namely, weight measurement, fundal height measurement, and FE tablet administration. As for the components of height measurement, assessment of nutritional status (MUAC), fetal presentation, examination of fetal heart rate, administration of TT immunization, and examination of blood type and hemoglobin. The component of blood pressure measurement was not included in the statistical test because all respondents received the examination.

Pelaksanaan Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4K) Melalui Peran Keluarga

2019 ◽  
Vol 18 (2) ◽  
pp. 49-58
Author(s):  
Yusriani Yusriani ◽  
Muh. Said Mukharrim ◽  
Reza Aril Ahri
Keyword(s):  
Public Health ◽  
Maternal Mortality ◽  
Health Center ◽  
Sampling Technique ◽  
Maternal Deaths ◽  
Live Births ◽  
South Sulawesi ◽  
Work Area ◽  
The Family

The maternal mortality rate (MMR) is one of the important indicators of public health. AKI describes the number of women who die from a cause of death related to pregnancy disorders or treatment (excluding accident or incidental cases) during pregnancy, childbirth and during the puerperium (42 days after delivery) regardless of the length of pregnancy per 100,000 live births. South Sulawesi Province is one of the regions experiencing high maternal mortality problems, especially in Gowa Regency, namely in 2018 as many as 17 cases of maternal deaths, the highest cases of which were in the work area of Somba Opu Health Center, namely 5 cases. The general objective of this study is to analyze the role of the family in implementing the P4K program. The design of this study was qualitative with descriptive explanative design using purposive sampling technique with 33 informants consisting of 6 pregnant women, 4 husbands, 5 posyandu cadres, 3 village midwives, 1 coordinator midwife puskesmas, 8 heads environment and 6 village heads. The role of the family in implementing the P4K program in the work area of Somba Opu Health Center in Gowa Regency has been carried out but not optimally, there are still some indicators that have not been fulfilled.

scholarly journals Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2283
Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Mortality Ratio

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.

scholarly journals PENGETAHUAN DAN SIKAP BIDAN MENGENAI PENGGUNAAN PARTOGRAF DALAM PERSALINAN DI PUSKESMAS PONED KOTA MANADO

e-CliniC ◽  
2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Jacqueline P. Toemandoek ◽  
Freddy Wagey ◽  
Maria Loho
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Health Center ◽  
Positive Attitude ◽  
Health Workers ◽  
Good Knowledge ◽  
Poor Knowledge ◽  
Public Health Center ◽  
Knowledge And Attitude

Abstract: The high maternal mortality rate is mostly due to pregnancies and labours. Health workers who can help labour are inter alia midwives. A health center that has the facilities and the ability to provide 24-hours services to cope emergency cases of obstetric and neonatal care is called PONED Public Health Center (PHC). This study aimed to obtain the knowledge and attitude of midwives about partograph in PONED PHCs in Manado. There were 33 respondents of 6 PONED PHCs in Manado. The results showed that most of the midmives (90.9%) in PONED PHCs had good knowledge about the usage of pantograph in labour; 2 respondents (6.1%) had fair knowledge, and 1 respondent (3.0%) had poor knowledge. All midwives (100%) had positive attitude about the usage of partograph. Conclusion: Most midwives in PONED PHC in Manado had good knowledge and positive attitude about the usage of partograph in labour.Keywords: midwives, PONED Public Health Center, partographAbstrak: Tingginya angka kematian ibu terutama pada saat kehamilan dan persalinan. Tenaga kesehatan yang dapat menolong persalinan yaitu salah satunya bidan. Puskesmas yang memiliki fasilitas dan kemampuan memberikan pelayanan untuk menanggulangi kasus kegawatdaruratan obstetrik dan neonatal selama 24 jam yaitu puskesmas PONED. Pada penelitian ini terdapat 33 responden dari 6 puskesmas PONED di Kota Manado. Hasil penelitian memperlihatkan bahwa tingkat pengetahuan bidan tentang penggunaan partograf dalam persalinan di Puskesmas PONED Kota Manado umumnya (90,9%) baik, 2 responden (6,1%) cukup, dan 1 responden (3,0%) kurang. Mengenai distribusi sikap, semua bidan (100%) mempunyai sikap positif. Simpulan: Umumnya bidan di puskesmas PONED Kota Manado mempunyai pengetahuan yang baik dan sikap yang positif mengenai penggunaan partograf dalam persalinan.Kata kunci: bidan, puskesmas PONED, partograf

scholarly journals Bottleneck Pelayanan Nifas pada Upaya Penurunan Risiko Kejadian Kematian Ibu di Wilayah Dinas Kesehatan Kota Semarang

2017 ◽  
Vol 5 (3) ◽  
pp. 28-35
Author(s):  
Ike Johan Prihatini ◽  
Sri Achadi Nugraheni ◽  
Sutopo Patria Jati
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Health Services ◽  
Maternal Mortality ◽  
Risk Reduction ◽  
Post Partum ◽  
Scale Up ◽  
Monitoring And Evaluation ◽  
Maternal Mortality Rate

Maternal and child health was a priority of health program in Indonesia. Maternal Mortality Rate in Semarang was ranked second highest in Central Java. The highest proportion of maternal deaths occurred during puerperium. That’s indicates, there was a problem in a process of maternal health services during puerperium period in health facilities. This study was conducted to examine constraints on health systems that limit range of interventions or health services that were important for postpartum, bottlenecks related to postpartum services in Public Health Center (PHC), especially infrastructure, human resources, access to PHC, post partum visits (KF1 and KF3), as well as quality of post partum services on risk reduction of maternal mortality. This case study used a qualitative approach. Data collection through interviews to five midwives as main informants, 5 midwives coordinator and 5 heads of PHC as informant triangulation. Data analsyis used content analysis method, then assigned priority bottleneck through MCUA (Multiple Criteria Utility Assessment) techniques. WHO's scale-up BNA plan to analyze bottleneck causes. Results showed, there was a bottleneck on childbirth services in PHC. The causes of bottleneck risk reduction efforts of maternal mortality incidence in puerperium period has never been analyzed workload of health personnel in PHC, lack of monitoring and evaluation of an availability infrastructure facilities in PHC, there has not been regular training, especially on delivery until puerperium services, and PHC has not received more detailed and operational information about puerperium so their maternal knowledge about puerperium has not increased much and couldn’t raise mother's awareness to do so. Semarang Public Health Office (Dinas Kesehatan Kota Semarang) needs to conduct periodic monitoring and evaluation implementation of postpartum services and improve quality of childbirth services in PHC.Keywords: Bottleneck analysis, health services, post partum, Primary Health Care, Puskesmas, Maternal Mortality Rate

scholarly journals Mengenal Tanda-Tanda Bahaya Kehamilan di Puskesmas Pakuan Baru Kota Jambi

2021 ◽  
Vol 3 (1) ◽  
pp. 52
Author(s):  
Ria Febrina
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Community Service ◽  
Health Workers ◽  
Obstetric Complications ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Danger Signs

Maternal Mortality Rate (MMR) in Indonesia is still high compared to other ASEAN countries. MMR in Indonesia according to the 2017 Indonesian Demographic and Health Survey (IDHS) is 305 per 100,000 live births. The global target of SDGs (Suitainable Development Goals) is to reduce the Maternal Mortality Rate (MMR) to 70 per 100,000 live births. While in Jambi Province in 2017 recorded maternal deaths were 29 cases. Maternal deaths that occur during 90% of pregnancy are caused by obstetric complications. Direct obstetric complications are bleeding, infection and eclampsia. Indirectly maternal mortality is also influenced by delays at the family level in recognizing danger signs of pregnancy and making decisions to immediately seek help. Delay in reaching health facilities and assistance in health service facilities. Pregnancy danger signs must be recognized and detected early so that they can be handled properly because any danger signs of pregnancy can lead to pregnancy complications. Therefore it is necessary to provide counseling to improve the knowledge of pregnant women about the danger signs of pregnancy. This community service activity was carried out by Pakuan Baru Kota Jambi Public Health Center. The time of implementation in April 2020. The target is pregnant women. Community service methods include a survey and lecture approach. The results obtained are pregnant women able to understand the danger signs of pregnancy. It is recommended for health workers to continue to provide education related to pregnancy to pregnant women

Historical and Recent Changes in Maternal Mortality Due to Hypertensive Disorders in the United States, 1979 to 2018

Hypertension ◽  
2021 ◽  
Vol 78 (5) ◽  
pp. 1414-1422
Author(s):  
Cande V. Ananth ◽  
Justin S. Brandt ◽  
Jennifer Hill ◽  
Hillary L. Graham ◽  
Sonal Grover ◽  
...  
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Birth Cohort ◽  
White Women ◽  
Gestational Hypertension ◽  
The United States ◽  
Chronic Hypertension ◽  
Maternal Deaths ◽  
Live Births

We evaluated the contributions of maternal age, year of death (period), and year of birth (cohort) on trends in hypertension-related maternal deaths in the United States. We undertook a sequential time series analysis of 155 710 441 live births and 3287 hypertension-related maternal deaths in the United States, 1979 to 2018. Trends in pregnancy-related mortality rate (maternal mortality rate [MMR]) due to chronic hypertension, gestational hypertension, and preeclampsia/eclampsia, were examined. MMR was defined as death during pregnancy or within 42 days postpartum due to hypertension. Trends in overall and race-specific hypertension-related MMR based on age, period, and birth cohort were evaluated based on weighted Poisson models. Trends were also adjusted for secular changes in obesity rates and corrected for potential death misclassification. During the 40-year period, the overall hypertension-related MMR was 2.1 per 100 000 live births, with MMR being almost 4-fold higher among Black compared with White women (5.4 [n=1396] versus 1.4 [n=1747] per 100 000 live births). Advancing age was associated with a sharp increase in MMR at ≥15 years among Black women and at ≥25 years among White women. Birth cohort was also associated with increasing MMR. Preeclampsia/eclampsia-related MMR declined annually by 2.6% (95% CI, 2.2–2.9), but chronic hypertension–related MMR increased annually by 9.2% (95% CI, 7.9–10.6). The decline in MMR was attenuated when adjusted for increasing obesity rates. The temporal burden of hypertension-related MMR in the United States has increased substantially for chronic hypertension–associated MMR and decreased for preeclampsia/eclampsia-associated MMR. Nevertheless, deaths from hypertension continue to contribute substantially to maternal deaths.

scholarly journals THE The Application Of E-MTBS To Increase The Quality Of Midwife Service In Giving Midwifery Care For Under Five Years Old Toddler

2020 ◽  
Vol 9 (2) ◽  
pp. 1415-1421
Author(s):  
Muhasshanah Muhasshanah ◽  
Neny Yuli Susanti
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Center ◽  
Medical Personnel ◽  
Infant Mortality Rate ◽  
Midwifery Care ◽  
Public Health Center ◽  
Center Area

MTBS is one of the government’s efforts to reduce infant mortality rate. Most of sick toddler cases found in Situbondo regency are dealing with dengue fever and pneumonia, especially in Banyuputih Public Health Center area. One of the approaches to reduce the infant mortality rate is to consistently fill the MTBS format. However, due to limited manpower and the workload, medical personnel especially midwife could not optimally fill out the MTBS, so that toddler diseases could not be detected early. It is because the filling format and the reporting system of MTBS are not user friendly. The objective of this research is to develop MTBS implementation by using Information Technology System, in order to increase the quality of midwife service in giving midwifery care and reduce the infant mortality rate in Banyuputih Public Health Center area. This research generated a product in the form of information system called e-MTBS

scholarly journals Maternal mortality rate in Bao'an district, Shenzhen, China, 1999-2018

2020 ◽  
Author(s):  
yuanfang zhu ◽  
Yali Luo ◽  
Wei Wang ◽  
Liling Wang ◽  
Yuli Cheng ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Health Management ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Targeted Interventions ◽  
Live Births ◽  
Fast Decline ◽  
Rate Of Decline ◽  
Substantial Heterogeneity

Abstract Background China had achieved impressive success in reducing maternal mortality rate (MMR), while substantial heterogeneity still existed, and reports from Shenzhen region remained a blank. This study aiming to use all available data sources to evaluate the MMR from 1999 to 2018 in Bao’an district, Shenzhen, China. Methods Data on maternal deaths and key health-service-related indicators were obtained from registration forms and Shenzhen Maternal and Child Health Management System. The levels and trends of MMR, profiles and leading causes of death, as well as results from the maternal mortality review committee were analyzed. Results The MMR in Bao’an district declined from 95.31 per 100,000 live births in 1999 to zero in 2018, with an annualized rate of decline of 12.03% per year. A significant declining trend of MMR was observed over 5-year intervals (from 82.61 to 5.22 per 100,000 live births). MMR was higher among migrant population, women aged ≥ 35 years or those who given birth outside the hospital. The first three causes of maternal death included hemorrhage (27.69%), amniotic fluid embolism (22.31%) and internal medical disease complications (15.38%). Nearly ninety percent (86.78%) of maternal deaths were determined to be preventable. Conclusions Bao’an district had experienced a fast decline in MMR for a two-decade period, its experience in lowering MMR could provide a guideline for other regions to focus on those who needed particular attention and take targeted interventions to reduce maternal deaths.

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