Implementasi Pelayanan Neonatal Emergensi Komprehensif di Rumah Sakit PONEK di Indonesia

Abstrak Angka kematian neonatal dan angka kematian balita di Indonesia masih tinggi. Kasus kegawatdaruratan merupakan penyebab tingginya angka kematian tersebut. Rumah sakit Pelayanan Obstetrik dan Neonatal Emergensi Komprehensif (PONEK) 24 jam merupakan rumah sakit rujukan dengan visi mempercepat penurunan angka kematian neonatus dan angka kematian balita. Penelitian ini bertujuan untuk mengetahui implementasi pelayanan neonatal emergensi pada rumah sakit PONEK 24 jam di Indonesia. Penelitian didesain dengan pendekatan mix method yaitu pembauran antara studi kuantitatif dan kualitatif. Studi kuantitatif adalah cross sectional dan studi kualitatif adalah Rapid Assesment Procedure yang dilakukan pada tahun 2014. Penelitian dilakukan di rumah sakit di Indonesia dengan kriteria rumah sakit PONEK 24 jam, telah menerima sosialisasi tentang PONEK, dipilih secara random di 7 provinsi di Indonesia masing-masing 2 rumah sakit tiap provinsi. Berdasarkan kriteria tersebut sebanyak 14 rumah sakit diobservasi dalam penelitian ini. Data kuantitatif yang dikumpulkan meliputi pelayanan klinis, manajemen, sarana dan prasarana, ketenagaan dan pendanaan. Data dikumpulkan dengan cara observasi, telaah dokumen dan wawancara. Data kualitatif yang dikumpulkan meliputi proses, hambatan, dan keberhasilan PONEK dengan cara indepth interview dengan informan kunci direktur rumah sakit, ketua komite medik dan dokter spesialis. Hasil penelitian menunjukkan bahwa sebagian besar rumah sakit telah melaksanakan pelayanan neonatal emergensi 24 jam, KMC dan aksesibilitas darah yang memadai. Pelayanan neonatal emergensi telah didukung dengan jenis tenaga profesional, komitmen direktur rumah sakit yang tinggi, MoU dengan IDI, kerjasama dengan NGO serta ruangan, sarana dan prasarana yang memadai. Keberhasilan rumah sakit PONEK 24 jam didukung oleh kesadaran masyarakat untuk memanfaatkan layanan rumahsakit. Namun di beberapa rumah sakit kurangnya tenaga terlatih, jumlah tenaga, tidak ada tim, sarana dan prasarana serta ruangan menjadi alasan rumah sakit tidak melaksanakan PONEK. Kesimpulan: beberapa rumah sakit telah melaksanakan pelayanan neonatal emergensi komprehensif 24 jam, namun masih perlu mendapat perhatian dalam hal pelatihan dan jumlah tenaga, biaya, sarana dan prasarana serta ruangan yang memadai. Kata kunci: neonatal, emergensi, rumah sakit, rujukan Abstract Neonatal under-five mortality rate in Indonesia was still high, while the emergency cases were the most of its causes. Emergency neonatal care (EmNC) hospital was a referral provider to accelerate decline in neonatal and under-five mortality. This research aimed to observe the implementation of emergency neonatal services at referal hospitals in Indonesia. This study was a cross sectional study with quantitative and qualitative design. The study was conducted in all of referal hospital in Indonesia with criterian socialized emergency neonatal care. Based on these criteria as many as 14 hospitals in 7 provinces were observed in this study. The quantitative data collected includes clinical services, management, facilities and infrastructure, manpower and funding. Data were collected by observation, document review and interview. The qualitative were collected including the process, constraints, and attainment of emergencies services by indepth interviews to directors, medical committee heads, and specialists as informants. The results show that most hospitals provided 24-hour emergency neonatal services, KMC and adequate blood accessibility. Emergency neonatal care has been supported by professionals (i.e doctor, obsgyn, anaesthetician, etc), commitment of hospital director, MoU with IDI and NGOs. The attainment of emergency neonatal care was supported by public awareness to utilize hospital services. Skilled physician, room, essensial supplies and equipment for performing certain emergency neonatal care functions were not available in several surveyed hospital. Some hospitals have implemented comprehensive emergency neonatal care, but still need number of skilled pshycisian, budget facilities, supplies and equipment. Keywords: neonatal, emergency, hospital, referal system

Student riots to rock South Africa political landscape

Significance Protests against the fee increases, which disproportionately hurt poor, mostly black students, are occurring across the country. The most dramatic incident occurred on October 21 when hundreds of students marched on parliament during the finance minister's budget speech. Impacts In poorer communities, frustration over lack of social mobility could mix with xenophobic sentiment and result in attacks on foreigners. Universities' funding crisis will accelerate decline in standards and probably exacerbate skills shortages affecting firms. The ANC may use the fees issue to justify a review of the autonomy of universities, which has been a source of political criticism. Social media campaigns could fuel solidarity protests in foreign cities with large diasporic communities, such as London.