A COMPREHENSIVE STRATEGY TO DECREASE MATERNAL MORTALITY: THE IMPLEMENTATION OF MATERNAL SHELTER MODEL AND MID-LEVEL PROVIDERS
Date
2018-08-01Author
DEWI, ARLINA
SUGIYO, DIANITA
SUPRIYATININGSIH, SUPRIYATININGSIH
SUNDARI, SRI
LELLE, RALPH. J.
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According to the National Health Survey (2015), maternal mortality rate in Indonesia is 359 maternal death. The Local Government has established 209 maternal shelters under 17 Primary Health Centers (Puskesmas). However, the usage of these facilities was far from what it should be achieved. To respond the problem, it is important to develop a system to improve the management of the shelters by involving Mid-Level Providers (MLP) and setting up a model of the shelters as a community empowerment project. Method: Previous need assessment research was advantaged to develop the model for shelter system and how the MLP could deliver a better health services assistance. The MLP function is designed as a connector among the community at the rural areas with the nearest health facilities, either hospitals, clinics, or Puskesmas. They received serial basic maternal health training to provide support for mothers and their family during the waiting period for labor and after delivery. Shelter will be designed with comprehensive approach; as a place of living and access to obtain health education of pregnancy related issues. Two selected shelters in Bulukumba will be a pilot project to develop this model. As an accommodation, it provides meals for mother which funding supported by Jampersal, a health insurance for mother health. The health education given will cover a list of skills that useful for ante and post-natal care and early detection of maternal health problem. The post-natal care assistance will be designed through a regular post-partum visit. The communication between villagers, MLP’s, and health facilities will be connected by mobile connection. All activities in waiting homes is coordinated with village local government and midwifes at the nearest health facilities. Result: MLP and maternal shelter as key strategies in overcoming maternal mortality in remote rural areas will be evaluated in the third-year program, after their implementation in the second year. The evaluation of the effectiveness of MLP’s and shelters are resources for model development. All stake holders in the village and districts level will be encouraged to deliver their findings during the second-year implementation.