“Alert Village Program” as an Effort to Reducing Maternal Mortality Case in Brebes, Central Java

Infant mortality (0-11 months) and maternal mortality (during pregnancy, childbirth, and postpartum) are significant indicators in determining the level of public health. Central Java Province which has 35 regencies/cities is included in the top five regions with the highest number of infant and maternal mortality in Indonesia. The data characteristics of the number of infants and maternal mortality are count data. Therefore, the Poisson Regression method can be used to analyze the factors that influence the number of infants and maternal mortality. In Poisson regression analysis, there must be a fulfilled assumption, called equidispersion. Frequently, the variance of count data is greater than the mean, which is known as the overdispersion. The research, binomial negative bivariate regression is used as a solutions to overcome the problem of overdispersion in poisson regression. This method produce a global model. In reality, the geographical, socio-cultural, and economic conditions of each region will be different. This illustrates the effect of spatial heterogeneity, so it needs to be developed into Geographically Weighted Negative Binomial Bivariate Regression (GWNBBR). The model of GWNBBR provides weighting based on the position or distance from one observation area to another. Significant variables for modeling infant mortality cases included the percentage of obstetric complications treated (X1), the percentage of infants who were exclusively breastfed (X3), and the percentage of poor people (X5). Significant variable for modeling maternal mortality cases is the percentage of poor people (X5). Based on the AIC value, GWNBBR model is better than binomial negatif bivariat regression model because it has a smaller AIC value.

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Development of a Tool to Measure Nurse Clinical Judgment During Maternal Mortality Case Review

Journal of Obstetric Gynecologic & Neonatal Nursing ◽

10.1016/j.jogn.2016.03.143 ◽

2016 ◽

Vol 45 (6) ◽

pp. 870-877 ◽

Cited By ~ 2

Author(s):

Marla J. Seacrist ◽

Danielle Noell

Keyword(s):

Maternal Mortality ◽

Clinical Judgment ◽

Case Review ◽

Mortality Case

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Estimating maternal mortality by sisterhood method in Purworejo district of Central Java

Journal of Clinical Epidemiology ◽

10.1016/s0895-4356(97)87229-0 ◽

1997 ◽

Vol 50 ◽

pp. S21

Author(s):

Mohammad Hakimi ◽

Siswanto A. Wilopo ◽

Abdul Wahab

Keyword(s):

Maternal Mortality ◽

Central Java ◽

Sisterhood Method

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Case Study in the COVID-19 Pandemic: Stunting, Low Birth Weight, Maternal Mortality and Infant Mortality in Semarang, Central Java-Indonesia

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2021/v42i2030544 ◽

2021 ◽

pp. 10-22

Author(s):

Sulistiyowati . ◽

Ika Pantiawati ◽

Evina Widianawati ◽

Slamet Isworo

Keyword(s):

Birth Weight ◽

Infant Mortality ◽

Low Birth Weight ◽

Maternal Mortality ◽

Child Mortality ◽

Maternal Death ◽

Secondary Data ◽

Central Java ◽

Analysis Strategy ◽

Quantitative Descriptive

Background and Objective: Stunting, low birth weight, maternal death, and child mortality have all become public health issues in recent years, particularly in Semarang, Indonesia. Simultaneously, the COVID-19 pandemic is spreading. Between the years 2019 and 2021. Methods: The Semarang City Health Service's secondary data analysis strategy was combined with a quantitative descriptive research methodology in this study. To evaluate numerical patterns in stunting, low birth weight, maternal death, and infant mortality in the data, simple regression were utilized. Results: According to the findings, the trend of stunting (modeling results y = 35,236 x + 361.77) and maternal mortality (modeling results 0.0218x+1.2921) increased between 2019 and 2021, whereas the trend of low birth weight (modeling results y = - 0.5425x+60.008) and child mortality (modeling results y = -0.0028x+ 2.202) decreased. The number of low birth weight has the lowest trend value, while the stunting rate has the greatest. Conclusion: Stunting rates increased, the low birth weight dropped, maternal mortality increased, and child mortality decreased in Semarang. The conditions of the Covid-19 epidemic have at least influenced this condition.

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“Sharp downward, blunt upward”: district maternal death audits’ challenges to formulate evidence-based recommendations in Indonesia - a qualitative study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04212-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ratnasari D. Cahyanti ◽

Widyawati Widyawati ◽

Mohammad Hakimi

Keyword(s):

Qualitative Study ◽

Maternal Mortality ◽

Maternal Death ◽

Audit Committee ◽

Maternal Mortality Ratio ◽

Audit Committees ◽

Evidence Based ◽

District Health ◽

Clinical Indicators ◽

Central Java

Abstract Background Indonesia, the largest archipelago globally with a decentralized health system, faces a stagnant high maternal mortality ratio (MMR). The disparity factors among regions and inequities in access have deterred the local assessments in preventing similar maternal deaths. This study explored the challenges of district maternal death audit (MDA) committees to provide evidence-based recommendations for local adaptive practices in reducing maternal mortality. Methods A qualitative study was conducted with four focus-group discussions in Central Java, Indonesia, between July and October 2019. Purposive sampling was used to select 7–8 members of each district audit committee. Data were analyzed using the thematic analysis approach. Triangulation was done by member checking, peer debriefing, and reviewing audit documentation. Results The district audit committees had significant challenges to develop appropriate recommendations and action plans, involving: 1) non-informative audit tool provides unreliable data for review; 2) unstandardized clinical indicators and the practice of “sharp downward, blunt upward”; 3) unaccountable hospital support and lack of leadership commitment, and 4) blaming culture, minimal training, and insufficient MDA committee’ skills. The district audit committees tended to associated maternal death in lower and higher-level health facilities (hospitals) with mismanagement and unavoidable cause, respectively. These unfavorable cultures discourage transparency and prevent continuing improvement, leading to failure in addressing maternal death’s local avoidable factors. Conclusion A productive MDA is required to provide an evidence-based recommendation. A strong partnership between the key hospital decision-makers and district health officers is needed for quality evidence-based policymaking and adaptive practice to prevent maternal death.

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Improving Knowledge of Antenatal Care (ANC) among Pregnant Women: A Field Trial in Central Java, Indonesia

Asia Pacific Journal of Public Health ◽

10.1177/101053950501700102 ◽

2005 ◽

Vol 17 (1) ◽

pp. 3-8 ◽

Cited By ~ 11

Author(s):

E. Nuraini ◽

E. Parker

Keyword(s):

Antenatal Care ◽

Maternal Mortality ◽

Pregnant Women ◽

Economic Status ◽

Intervention Group ◽

Control Group ◽

New Approach ◽

Advantages And Disadvantages ◽

Central Java ◽

Back Ground

The need for reducing maternal mortality has become a paramount concern in developing countries including Indonesia. One of the strategies for reducing maternal mortality in Indonesia is the provision of antenatal care (ANC). Previous studies have reported the advantages and disadvantages of ANC. The purpose of this study is to ascertain if a new approach to ANC can improve pregnant women's knowledge of its benefits. An experimental design with 60 pregnant women from 10 cluster villages is used in this study. The intervention group received the new approach to ANC, while the control group received routine ANC. The findings show that the improvement of knowledge in the intervention group is significant particularly in the knowledge about healthy pregnancy ( p=0.012), pregnancy complications ( p=0.01), safe birth ( p=0.01) and taking care of the newborn ( p=0.012). The improvement of knowledge was significantly influenced by the respondents' educational back ground ( p=0.002) and socio-economic status ( p=0.027). This study recommends that the new approach to ANC be considered to educate pregnant women regarding safe birth and it is considered as one of the strategies that may be adopted to reduce maternal mortality. Asia Pac J Public Health 2005: 17(1): 3-8.

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