scholarly journals Maternal Mortality Rate before and after BPJS Health services Era

Author(s):  
Hermie M. M. Tendean ◽  
Anastasia M. Lumentut ◽  
Maimun Ihsan

Abstract Objective: To compare maternal death in RSUD dr. Aloei Saboe Gorontalo before BPJS (in 2011-2013) and after BPJS (2014-2016)Methods: Descriptive Retrospective. Data in this study obtained from the secondary data. This data obtained by the researcher from medical records in RSUD Prof. Dr. Aloei Saboe Gorontalo.Results: In this study, the number of delivery in hospitals Prof. Dr. Aloei Saboe before BPJS (2011-2013) of 7906 deliveries of live births after 7735 and health services BPJS (years 2014-2016) of 6493 deliveries of live births BPJS 6333. Maternal mortality before and after as many as 34 cases BPJS many as 42 cases, so we get the MMR before BPJS 4.39 ‰ and 6.63 ‰ after BPJS.Conclusion: There is a significant increase in maternal mortality rate in Prof. Dr. Aloei Saboe Gorontalo (p = 0.036), after BPJS maternal mortality (years 2014-2016) was 42 cases, compared with a prior health services BPJS (2011-2013) was 34 cases. This increase occurred because of a referral system BPJS make the decreasing number of births was in the hospital decreased, and hospitals Prof. Dr. Aloei Saboe a referral centre in Gorontalo province and surrounding areas.Keywords: death, BPJS, maternal, mortality. Abstrak Tujuan: Untuk membandingkan kematian maternal di RSUD Prof. Dr. Aloei Saboe sebelum BPJS (2011-2013) dan sesudah layanan kesehatan BPJS (2014-2016).Metode: Deskriptif Retrospektif. Jenis data yang digunakan dalam penelitian ini adalah data sekunder yang diperoleh dari rekam medik di RSUD Prof. Dr. Aloei Saboe Gorontalo.Hasil: Pada penelitian ini didapatkan jumlah persalinan di RSUD Prof. Dr. Aloei Saboe sebelum BPJS (2011-2013) sebanyak 7906 persalinan dengan kelahiran hidup 7735 dan sesudah layanan kesehatan BPJS (2014-2016) sebanyak 6493 persalinan dengan kelahiran hidup 6333. Kematian maternal sebelum BPJS sebanyak 34 kasus dan sesudah BPJS sebanyak 42 kasus, sehingga didapatkan AKI sebelum BPJS 4.39 ‰ dan sesudah BPJS 6.63 ‰.Kesimpulan: Ternyata terdapat peningkatan yang bermakna (p=0,036) kematian maternal sesudah BPJS (2014-2016) sebanyak 42 kasus, bila dibandingkan dengan sebelum layanan kesehatan BPJS (2011-2013) sebanyak 34 kasus. Peningkatan ini terjadi karena sistem rujukan BPJS membuat menurunnya jumlah persalinan yang ada dirumah sakit menurun, dan RSUD Prof. Dr. Aloei Saboe merupakan pusat rujukan di propinsi Gorontalo dan sekitarnya.Kata Kunci: BPJS, kematian, maternal,mortalitas

Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat

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.


2018 ◽  
Vol 10 (2) ◽  
pp. 32-43
Author(s):  
Desi Desi Nurseha Meirita

Based on the 2016 National Health Indicator Survey the maternal mortality rate in Indonesia is still high at 305 dead mothers per 100,000 people. The high maternal mortality rate was influenced by 28.8% due to preeclampsia. With the SDGs planned, 13 targets in point number three, one of which mentions by 2030, reduce maternal mortality to below 70 per 100,000 live births. Find out the correlation of maternal age, gestational age and gravides with the incidence of preeclampsia in RSUD Hospital Bogor in 2018. This type of research is analytical with retrospective research design. The researcher use 89 respondents to conudct this research. The Date collection is obtained by secondary methods, namely data taken from medical records. The analysis used is univariate, bivariate and multivariate analysis. Based on the results of the study found maternal age as many as 56 (62.9%) respondents, gestational age in the third trimester 70 (78.7%) respondents, multigravida as many as 59 (66.3%). Bivariate variables were found to correlate maternal age with the incidence of preeclampsia with p value of 0,004, The correlation of gestational age and the incidence of preeclampsia with p value of 0,069, The correlation of gravida with the incidence of preeclampsia with p value of 0,013. The results of multivariate analysis showed that the maternal age gravida variable had an opportunity of 0,013times greater than the gravida who experienced the incidence of preeclampsia. Maternal age variables have a greater chance of 3,006 times compared to the gravidaand gestational age that experienced the incidence of preeclampsia.


EGALITA ◽  
2012 ◽  
Author(s):  
Imamah Imamah

In terms of Indonesian women’s health services are still treated unfairly and still are the number two. It can be seen from the report reporting Indonesia Human  Development Report 2005 on maternal mortality rate (MMR) delivery, which is currently listed at number 307 out of every 100,000 live births. This shows that the government has not seriously and equitable in the provision of health services particularly for women. Maternal mortality can be used as indicators of poor health services received by mothers and children and low access to information owned by mother and child.<br /><br />Keywords: Perempuan, Human Development Report, Angka Kematian Ibu, Indikator dan Kesehatan.<br /><br />


2017 ◽  
Vol 5 (3) ◽  
pp. 28-35
Author(s):  
Ike Johan Prihatini ◽  
Sri Achadi Nugraheni ◽  
Sutopo Patria Jati

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


2021 ◽  
Vol 3 (1) ◽  
pp. 52
Author(s):  
Ria Febrina

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


2020 ◽  
Vol 2 (2) ◽  
pp. 174-181
Author(s):  
Suko Pranowo

The maternal mortality rate (MMR) is an important indicator of the degree of public health. In 2019, Indonesia's MMR was still high, namely 305 per 100,000 live births, while Indonesia's MMR target in 2015 was 102 per 100,000 live births. Problems related to pregnancy and childbirth, including the maternal mortality rate (MMR) and infant mortality rate (IMR) cannot be separated from the various factors that influence it, including maternal health status and readiness for pregnancy, antenatal examinations (pregnancy), delivery assistance. and immediate care after delivery, as well as socio-cultural factors. Pregnancy with a distance that is too close will increase the risk of bleeding, miscarriage, and postpartum death. One of the efforts to prevent it is by joining the family planning program to restore conditions after being pregnant before. This community service is carried out in RW 14, Sidanegara Village, Cilacap Tengah District. The purpose of this community service is to provide an understanding to couples of childbearing age about family planning in the view of Islamic nursing. It is hoped that couples of childbearing age can understand and finally decide to participate in family planning in order to improve the health of mothers and children. After the health education was carried out, data showed that there was a significant increase in knowledge, namely the good category before the health education intervention as many as 0 people (0%) and the good category after the health education intervention as many as 17 people (94.44%). There was an increase in the number of participants who had knowledge in good categories, namely 17 people. Has a difference in the average pre and post test knowledge value of 3.33. It is hoped that couples of childbearing age become family planning acceptors to prevent the risk of pregnancy and be able to plan their families well.    


2021 ◽  
Author(s):  
Santiago García-Tizón Larroca ◽  
Juan Arevalo Serrano ◽  
Maria Ruiz Minaya ◽  
Pilar Paya Martinez ◽  
Ricardo Perez Fernandez Pacheco ◽  
...  

Abstract Backround: The available literature indicates that there are significant differences in maternal mortality according to maternal origin in high income countries. The aim of this study was to examine the trend in the maternal mortality rate and its most common causes in Spain in recent years and to analyse its relationship with maternal origin.Methods: This was a cross-sectional study of all live births as well as those resulting in maternal death in Spain during the period between 2000 and 2018. A descriptive analysis of the maternal mortality rate by cause, region of birth, maternal age, marital status, human development index and continent of maternal origin was performed. The risk of maternal death was calculated using univariate and multivariate logistic regression analyses, with adjustment for certain variables included in the descriptive analysis.Results: There was a total of 293 maternal deaths and 8,439,324 live births during the study period. The most common cause of maternal death was hypertensive disorders of pregnancy. The average maternal death rate was 3.47 per 100,000 live births. The risk of suffering from this complication was higher for immigrant women from less developed countries; therefore, a decrease of 0.01 in the maternal human development index score significantly increased the risk of this complication by 2.4%.Conclusions: The results of this study indicate that there are inequalities in maternal mortality according to maternal origin in Spain. The human development index of the country of maternal origin could be a useful tool when estimating the risk of this complication, taking into account the origin of the pregnant woman.


2019 ◽  
Vol 7 (2) ◽  
pp. 178
Author(s):  
Hazar Rochmatin

Maternal mortality rate is one of indicator in assessing the welfare of the community in a region. The high level of Maternal Mortality Rate is a low level signals of public health. Data on maternal mortality in the city of Surabaya shows a decrease in the last 6 years from 144.66 in 2012 to 79.40 in 2017. Although it has shown a decline in progress, this figure still puts Surabaya as the second largest contributor to maternal deaths in East Java in 2017. The study aims to describe the determinants of maternal mortality in Surabaya based on contextual, intermediate and proxy determinants for 2015-2017. This research is descriptive by using secondary data in the form of recapitulation of Maternal Verbal Autopsy (OVM) data on maternal deaths at Surabaya City Health Office The results showed that based on education, the majority of mothers who died had secondary education of 52.29% (57 people). Based on work, the majority of mothers have jobs as housewives of 68.81% (75 people). Based on the age of the mother, the majority of deaths occurred in women aged 20-34 years with a percentage of 66.97% (73 people). According to parity, the majority of mothers who died occurred during pregnancy of the second child by 31.19% (34 people). Based on the period of death, the majority occurred in the puerperium with a percentage of 66.97% (70 people). According to the cause of single death, the majority of maternal deaths were caused by pre-eclampsia/eclampsia with a percentage of 26.61% (29 people). This study recommends the need for early recognition of mothers about antenatal care and danger during pregnancy, childbirth and the puerperium period and increased alertness of health workers to complications of pregnancy, especially in mothers with a history of disease.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sarah Milder ◽  
Jamie Kenealy ◽  
Mary Ann Honors ◽  
Thomas Eckstein

Background: Among developed countries, the United States has the highest maternal mortality rate. Between 1987 and 2011, the US maternal mortality rate more than doubled from 7.2 to 17.8 deaths per 100,000 live births. More than 1,300 pregnancy-related deaths occurred in the United States in 2011-2012. Additionally, an increasing number of women have chronic health conditions, such as hypertension, diabetes, and chronic heart disease, that increase their risk of pregnancy complications, including maternal mortality. Reducing the prevalence of these diseases may be an important step toward reducing maternal mortality. To examine the current state of maternal mortality and chronic diseases in the United States, the geographical variation of these factors was examined. Methodology: State-level prevalence estimates were calculated for diabetes, heart disease, and hypertension awareness among women of reproductive age (18 to 44 years) using data from the 2013-2014 Behavioral Risk Factor Surveillance System. State-level maternal mortality rates were calculated using CDC’s 2010-2014 National Vital Statistics System. Maternal mortality was defined as the number of deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births. Results: The maternal mortality rate is 6.8 times higher in Georgia (39.3 deaths per 100,000 live births) than in Massachusetts (5.8 deaths per 100,000 live births). Nationally, there are an estimated 19.9 maternal deaths per 100,000 live births. The prevalence of chronic diseases that increase risk of pregnancy complications also vary by state. For example, diabetes (excluding gestational diabetes) ranges from a low of 1.9% of women aged 18 to 44 in Alaska, Minnesota, and Wisconsin to a high of 4.8% in Alabama. Nationally, an estimated 3.1% of women aged 18 to 44 have been told by a doctor that they have diabetes. Conclusion: The prevalence of chronic diseases in women of reproductive age vary based on state of residence, as does the maternal mortality rate. Raising awareness about the variation in these measures is an important step toward identifying what strategies are being utilized in states with a low prevalence of diabetes, heart disease, and hypertension, and determining how their public health efforts may help those states facing challenges in these areas.


2020 ◽  
Author(s):  
yuanfang zhu ◽  
Yali Luo ◽  
Wei Wang ◽  
Liling Wang ◽  
Yuli Cheng ◽  
...  

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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