scholarly journals Kasus-Kasus Maternal di Berita Online Menyangkut Hak Asasi yang Patut Menjadi Pelajaran dalam Pendidikan Bidan di Indonesia

2019 ◽  
pp. 140-152
Author(s):  
Mahindria Vici Virahayu ◽  
D. Dasuki ◽  
O. Emilia ◽  
M. Hasanbasri ◽  
M. Hakimi
Keyword(s):  
Human Rights ◽  
Maternal Health ◽  
Health Services ◽  
Low Income ◽  
Community Involvement ◽  
Health Workers ◽  
Professional Associations ◽  
Maternal Health Services ◽  
Online News ◽  
Scientific Publications

Abstrak Gerakan menghormati hak asasi manusia dalam pelayanan kesehatan maternal di berbagai negara mendorong petugas kesehatan bertindak lebih manusiawi. Perempuan selama ini diam karena tidak ingin memutus hubungan harmonis dengan bidan serta jarangnya isu ini diangkat dalam pertemuan profesi dan publikasi ilmiah menyebabkan perhatian yang rendah terhadap hak asasi manusia dalam pelayanan kesehatan maternal. Penelitian ini bertujuan untuk mengidentifikasi kegagalan dalam pemenuhan hak kesehatan ibu hamil dan bersalin serta mengeksplorasi alasan-alasan yang menyebabkan hal tersebut terjadi. Metode penelitian dilakukan dengan melakukan penelusuran berita online kompas.com, tribunnews.com, dan detiknews.com tahun 2016-2018 dengan kata kunci “malpraktik” dan “bidan”, tentang persoalan hak asasi manusia dalam pelayanan bidan. Kami mengikuti kasus dalam lebih dari satu media online, disertai perkembangan berita tentang kasus tersebut. Hasil penelitian menunjukkan bahwa dominasi bidan dalam pelayanan kesehatan maternal di Indonesia, berdampak pada pengabaian hak asasi perempuan dan keselamatan. Kejadian ini pada kelompok orang dengan pendapatan rendah dan kelompok yang mampu. Didapatkan praktik bidan di luar kewenangan, kemungkinan motivasi mendapatkan keuntungan, dominasi bidan, posisi sosial perempuan yang rendah dalam pelayanan kesehatan maternal, dan keterlibatan masyarakat yang rendah untuk mendukung perempuan yang mengalami ketidakadilan dalam layanan kesehatan. Kepercayaan dan ketergantungan perempuan pada bidan, berdampak pengabaian hak asasi dan keselamatan ibu, tindakan di luar kewenangan, untuk pencarian keuntungan dalam praktik pribadi. Organisasi profesi dan pendidik bidan harus memasukkan penerapan hak asasi manusia dalam praktik kebidanan melalui kasus-kasus dari berita online dalam pertemuan berkala asosiasi profesi, serta kurikulum pendidikan, untuk mencegah dampak buruk pengabaian hak asasi ibu di masa depan. Kata kunci: pengabaian hak asasi dalam layanan bidan, kasus malpraktik bidan, penguatan pendidikan bidan Abstract The movement to respect human rights in maternal health services in various countries encourages health workers to act more humanely. Low attention to human rights issue in maternal health services due to the silent of the victims-because women do not want to break the harmonious relationship with midwives, and this issue is rarely raised in professional meetings and scientific publications. This study aims to identify failures in fulfilling the health rights of pregnant women and childbirth and explore the reasons for this. The research method is done by searching online news kompas.com, tribunnews.com, and detiknews.com in 2016-2018 with the keywords “malpractice” and “midwife”, about human rights issues in midwifery services. We followed the case in more than one online media, accompanied by the case progress report. The results of the study show that the dominance of midwives in maternal health services in Indonesia has an impact on neglecting women’s human rights and safety. This event is in the group of people with low income and groups who are able. The practice of midwive’s out of authority, possible motivations for profit, dominance of midwives, low social position of women in maternal health services, and low community involvement in supporting women who experience inequality in maternal health services. Trust and dependence of women on midwives, impact on neglecting human rights and maternal safety, actions that are beyond authority, for seeking profit in private practice. Midwife professional organizations and educators must incorporate the application of human rights in midwifery practice through cases from online news in periodic meetings of professional associations, as well as educational curricula, to prevent the adverse effects of neglecting maternal rights in the future. Keywords: neglect of human rights in midwife services, midwife malpractice case, strengthening midwifery education

scholarly journals Community perceptions on demand-side incentives to promote institutional delivery in Oyam district, Uganda: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026851
Author(s):  
William Massavon ◽  
Calistus Wilunda ◽  
Maria Nannini ◽  
Caroline Agaro ◽  
Simon Amandi ◽  
...  
Keyword(s):  
Maternal Health ◽  
Qualitative Study ◽  
Health Services ◽  
Low Income ◽  
Health Workers ◽  
Qualitative Content Analysis ◽  
Community Support ◽  
Maternal Health Services ◽  
Health Seeking ◽  
Team Members

ObjectiveTo examine the perceptions of community members and other stakeholders on the use of baby kits and transport vouchers to improve the utilisation of childbirth services.DesignA qualitative study.SettingOyam district, Uganda.ParticipantsWe conducted 10 focus group discussions with 59 women and 55 men, and 18 key informant interviews with local leaders, village health team members, health facility staff and district health management team members. We analysed the data using qualitative content analysis.ResultsFive broad themes emerged: (1) context, (2) community support for the interventions, (3) health-seeking behaviours postintervention, (4) undesirable effects of the interventions and (5) implementation issues and lessons learnt. Context regarded perceived long distances to health facilities and high transport costs. Regarding community support for the interventions, the schemes were perceived to be acceptable and helpful particularly to the most vulnerable. Transport vouchers were preferred over baby kits, although both interventions were perceived to be necessary. Health-seeking behaviours entailed perceived increased utilisation of maternal health services and ‘bypassing’, promotion of collaboration between traditional birth attendants and formal health workers, stimulation of men’s involvement in maternal health, and increased community awareness of maternal health. Undesirable effects of the interventions included increased workload for health workers, sustainability concerns and perceived encouragement to reproduce and dependency. Implementation issues included information gaps leading to confusion, mistrust and discontent, transport voucher scheme design; implementation; and payment problems, poor attitude of some health workers and poor quality of care, insecurity, and a shortage of baby kits. Community involvement was key to solving the challenges.ConclusionsThe study provides further insights into the implementation of incentive schemes to improve maternal health services utilisation. The findings are relevant for planning and implementing similar schemes in low-income countries.

scholarly journals Health Workers’ Perspectives on Infrastructure to Support Maternal Health Services in Rural Areas of Vietnam

2017 ◽  
Vol 12 (2) ◽  
pp. 55-61
Author(s):  
Thi Hoai Thu Nguyen ◽  
Fiona McDonald ◽  
Andrew Wilson
Keyword(s):  
Primary Care ◽  
Developing Countries ◽  
Maternal Health ◽  
Health Services ◽  
Rural Areas ◽  
Health Workers ◽  
Maternal Health Services ◽  
District Health ◽  
Health Centres ◽  
The Impact

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam. Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis. Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities. Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres. Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.

scholarly journals Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia

2021 ◽  
Vol 9 (T4) ◽  
pp. 18-26
Author(s):  
Arlina Dewi ◽  
Sri Sundari ◽  
Nursetiawan Nursetiawan ◽  
Supriyatiningsih Supriyatiningsih ◽  
Dianita Sugiyo ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Urban Area ◽  
Urban Areas ◽  
Health Workers ◽  
Maternal Health Services ◽  
Health Facilities ◽  
Integrated System

BACKGROUND: Maternal mortality is a sentinel event used globally to monitor maternal health and the overall quality of reproductive health care. Globally, maternal mortality is mostly due to direct causes; apparently, it is not limited by the setting or geographic region. However, Indonesia has failed to achieve the Millenium Development Goals (MDGs) target for maternal mortality. AIM: This study aims to explore health workers' and stakeholders' expectations in maternal health services to reduce maternal mortality in urban areas. METHODS: It is qualitative research through naturalistic, conducted in one of the regencies in Indonesia, the urban area with the highest Maternal Mortality Rate (MMR) in one province by 2019. Data were obtained in the form of information from Focus Group Discussions (FGDs). FGDs were carried out with stakeholders at the Health Service level (n=3), first-level health facilities or public health centres (n=3), and advanced health facilities or hospitals (n=7). Data analysis in this study employed software (Nvivo Release 1.0) to utilise transcripts in coding and categorising. RESULTS: The expectations that emerged from health workers' perspectives in the field were an integrated system of collaboration between health facilities, affordability of Hospital with Comprehensive Emergency Obstetric Care (CEmOC) in action for maternal-neonatal referral urgency, and the skilled health workers as a golden opportunity. CONCLUSION: Health workers’ expectations can improve the quality of maternal health services in urban areas, thereby reducing the MMR with a system of collaboration between health facilities, the affordability of maternal-neonatal emergency referral facilities, and the availability of Obstetricians who standby.

scholarly journals Maternal health services for pregnant adolescent girls in Uganda: Barriers and Opportunities

2020 ◽  
Author(s):  
Vivian Namuli ◽  
Gorgeous Sarah Chinkonono ◽  
Catherine Atuhaire ◽  
Betty Nyawira Christensen ◽  
Vitalis Pemunta ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Adolescent Pregnancy ◽  
Adolescent Mothers ◽  
Health Workers ◽  
Maternal Health Services ◽  
Sub Saharan Africa ◽  
Pregnant Adolescents ◽  
Care Services

Abstract Background: Globally, adolescent pregnancy is one of the major areas of concern. Over 16 million girls aged between 15-19 years give birth, while over 1 million become pregnant before 15 years, most of who are in Sub-Saharan Africa. Yet, very few adolescents access maternal health services. This study explored the available maternal health services, barriers in accessing them and possible strategies for improving accessibility to these services among pregnant adolescents, specifically in Uganda.Methods: The study was carried out at Naguru teenage information and health Centre (NTIHC), Nakawa division, Kampala district using a qualitative research approach. Data was obtained using in-depth face to face interviews from 31 independent pregnant adolescents and four health care providers. These participants were selected using convenient sampling technique. Data was manually analyzed and themes were extracted and used in the interpretation of results.Results: The study found out that adolescents use only antenatal health care services while the uptake of postpartum health services was side-lined much as they were found available in the health facilities. The dominant antenatal care services among adolescents include; testing and managing of STIs, measuring pressure, tetanus vaccine, measuring weight, counselling and guidance, peer education, and providing drugs. Adolescents also encountered challenges such as long distances, financial constraints, stigmatization, negative attitude of health workers and community expressed bias when accessing these services. It further revealed that through government intervention, community and health workers, accessibility to maternal health services would be improved. Specifically, increasing remuneration for health workers; sensitizing communities about adolescent pregnancy and rights; construction of labour suites; and health workers’ competence were highly emphasized.Conclusion: Advertising and promotion of maternal health services; sensitization of community members; and government involvement will be the key parameters for enhancing maternal health care among adolescent mothers.

scholarly journals e-income countries from a provider’s perspective: a systematic review

2020 ◽  
Vol 5 (6) ◽  
pp. e002371
Author(s):  
Aduragbemi Banke-Thomas ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Francis Ifeanyi Ayomoh ◽  
Oluwasola Banke-Thomas ◽  
Ejemai Amaize Eboreime ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Services ◽  
Low Income ◽  
Caesarean Delivery ◽  
Economies Of Scale ◽  
Grey Literature ◽  
Health Economic Evaluation ◽  
Maternal Health Services ◽  
Personnel Cost

IntroductionMaternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective.MethodsWe searched multiple peer-reviewed databases (including African Journal Online, CINAHL Plus, EconLit, Popline, PubMed, Scopus and Web of Science) and grey literature for relevant articles published from year 2000. Articles meeting our inclusion criteria were selected with quality assessment done using relevant cost-focused criteria of the Consolidated Health Economic Evaluation Reporting Standards checklist. For comparability, disaggregated costs data were inflated to 2019 US$ equivalents. Costs and cost drivers were systematically compared. Where heterogeneity was observed, narrative synthesis was used to summarise findings.ResultsTwenty-two studies were included, with most studies costing vaginal and/or caesarean delivery (11 studies), antenatal care (ANC) (9) and postabortion care (PAC) (8). Postnatal care (PNC) has been least costed (2). Studies used different methods for data collection and analysis. Quality of peer-reviewed studies was assessed average to high while all grey literature studies were assessed as low quality. Following inflation, estimated provision cost per service varied (ANC (US$7.24–US$31.42); vaginal delivery (US$14.32–US$278.22); caesarean delivery (US$72.11–US$378.940; PAC (US$97.09–US$1299.21); family planning (FP) (US$0.82–US$5.27); PNC (US$5.04)). These ranges could be explained by intercountry variations, variations in provider type (public/private), facility type (primary/secondary) and care complexity (simple/complicated). Personnel cost was mostly reported as the major driver for provision of ANC, skilled birth attendance and FP. Economies of scale in service provision were reported.ConclusionThere is a cost savings case for task-shifting and encouraging women to use lower level facilities for uncomplicated services. Going forward, consensus regarding cost component definitions and methodologies for costing maternal health services will significantly help to improve the usefulness of cost analyses in supporting policymaking towards achieving Universal Health Coverage.

scholarly journals Overview of relation between coverage of health services and maternal mortality in East Java Province in 2015

2017 ◽  
Vol 24 (2) ◽  
pp. 53
Author(s):  
Wahyul Anis ◽  
Kuntoro Kuntoro ◽  
Soenarnatalina Melaniani
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Workers ◽  
Spatial Regression ◽  
Secondary Data ◽  
Maternal Health Services ◽  
Facilities Management ◽  
Management Of Complications ◽  
Association Condition

Objectives: to analyze the efforts of maternal health services that may affect maternal mortality rate.Materials and Methods: The study was conducted at the Health Office of East Java using secondary data from 38 districts/cities in East Java in 2015 that includes performance antenatal care K1 and K4, postnatal care, early detection of complications in pregnant women, natal in health workers and health facilities, management of complications by health workers and MMR. Data were analyzed with statistical method with spatial regression and illustrated with thematic maps by application ArcView statistics.Results: the highest MMR was in Bojonegoro district, Lumajang, Probolinggo, Bondowoso, Situbondo and Probolinggo city. Some districts/cities that have the highest maternal mortality has proximity of areas, namely the district Lumajang, Probolinggo, Bondowoso, Situbondo and Probolinggo city. Their proximity concluded an association condition and the causes of MMR between districts so they can be studied more in depth about the causes of MMR kind of social, cultural and geographical characteristics. The coverage maternal health services to all districts/cities in East Java province is not much difference.Conclusion: the maternal mortality rate in the district/city of East Java province in 2015 was not much affected by maternal health services so we need more research on other causes of MMR in districts/city of East Java Province.

scholarly journals IMPLEMENTASI PROGRAM JAMINAN KESEHATAN NASIONAL DAN PERMASALAHANNYA DALAM PENURUNAN ANGKA KEMATIAN IBU (STUDI DI KABUPATEN SOLOK, PROVINSI SUMATERA BARAT)

2019 ◽  
Vol 18 (1) ◽  
pp. 48-59
Author(s):  
Yulfira Media
Keyword(s):  
Health Insurance ◽  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
National Health Insurance ◽  
National Health ◽  
Health Workers ◽  
Maternal Health Services ◽  
Service Access ◽  
The Poor

ABSTRACT One of the government's efforts to reduce the high maternal mortality rate (MMR) is to implement the National Health Insurance (JKN) program. The purpose of the study was to determine the description of the implementation of the national health insurance program and its problems in an effort to reduce MMR. This research was conducted in Solok District, West Sumatra Province in 2017using qualitative methods with in-depth interviews with several informants from the Solok District Health Office, health workers, families who experienced cases of maternal deaths and community leaders. The results revealed that several public health insurance (JKN) efforts for pregnant and childbirth mothers, especially for the poor, have been provided and the outcome were quite good. However, there are still a number of problems including limited access to JKN, non-optimal JKN socialization and utilization of JKN service access, inadequate availability of health facilities and health workers. The alternative suggestions proposed include increasing periodic socialization of JKN programs and participation, especially in remote areas by involving cross-sectors, optimizing the utilization of JKN membership access through increasing the availability, quality and affordability of maternal health services, increasing health financing for the poor, and optimizing the system referral through strengthening application-based delivery referrals. Keywords: National health insurance, maternal health services, maternal mortality   ABSTRAK Salah satu upaya pemerintah untuk menekan tingginya Angka Kematian Ibu (AKI) adalah dengan menerapkan program Jaminan  Kesehatan  Nasional (JKN). Tujuan penelitian adalah untuk mengetahui gambaran implementasi program jaminan kesehatan nasional dan permasalahannya dalam upaya penurunan AKI. Penelitian ini dilaksanakan di Kabupaten Solok, Provinsi Sumatera Barat pada tahun 2017. Desain penelitian menggunakan metode kualitatif dengan teknik pengumpulan data melalui wawancara mendalam kepada beberapa informan dari Dinas Kesehatan Kabupaten Solok, petugas kesehatan, keluarga yang mengalami kasus kematian ibu dan tokoh masyarakat. Pengolahan dan analisis data dilakukan dengan menggunakan pendekatan kualitatif. Hasil penelitian mengungkapkan bahwa beberapa upaya penjaminan kesehatan masyarakat  untuk ibu hamil dan melahirkan terutama bagi masyarakat miskin sudah dilaksanakan, dan hasilnya sudah cukup baik. Namun, masih terdapat beberapa permasalahan di antaranya adalah masih terbatasnya akses kepesertaan JKN, belum optimalnya sosialisasi JKN, belum optimalnya pemanfaatan akses pelayanan JKN, belum memadainya ketersediaan sarana prasarana/fasilitas kesehatan dan tenaga kesehatan. Alternatif saran yang diusulkan antara lain adalah meningkatkan sosialisasi program dan kepesertaan JKN secara berkala terutama di daerah terpencil dengan melibatkan lintas sektor, mengoptimalkan pemanfaatan akses kepesertaan JKN melalui peningkatan ketersediaan, kualitas dan keterjangkauan pelayanan kesehatan ibu, peningkatan pembiyaan kesehatan pada kelompok miskin, dan mengoptimalkan sistem rujukan melalui penguatan rujukan persalinan yang berbasis aplikasi. Kata kunci: Jaminan kesehatan nasional, pelayanan kesehatan ibu, kematian  ibu

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