Reducing Maternal and Neonatal Mortality in Indonesia Saving Lives, Saving the Future (2013) / Chapter Skim
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Chapter 5 The Quality of Care
Chapter 5 The Quality of Care
Pages 53-64
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From page 53... ...
Over the period 2005-2010, the physician ratio in Indonesia was 3 per 10,000 population, which was the lowest for the Association of Southeast Asian Nations (ASEAN) region.
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From page 54... ...
20/2003, which established the National Education System in 2005-2006. In doing so, the law transferred responsibility for health education, including the midwifery schools, from the Ministry of Health to the 2 Ikatan Bidan Indonesia (Indonesian Midwives' Association)
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From page 55... ...
The internal review evaluated the multiple educational routes of entry, including apprenticeship, private midwifery schools, and collegeand university-based midwifery programs. So far, these findings have elicited no response from the Ministry of Education and local health authorities (Ministry of Health, Directorate General of Medical Services, 2011; Ikatan Bidan lndonesia, 2012; AusAid-PMPK Gama-HOGSI, 2012)
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From page 56... ...
The midwife could have learned neonatal resuscitation in a midwifery school and trained to be competent in the anatomic model in basic delivery care or basic emergency neonatal care with the JNPK (JNPK, 2010, 2012; Ikatan Bidan Indonesia, 2012)
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From page 57... ...
This step is taken to avoid the administrative complications associated with employing graduates of specialist training centers. After six months of fulfilling this mandatory duty, the residents return to the training centers and complete their specialist training program (Kolegium Obstetri Ginekologi, 2009; Ministry of Health, Directorate General of Medical Services, 2009)
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From page 58... ...
The accreditation commission examines five key hospital activities: management and administration, medical services, emergency services, nursing, and medical records. According to Indonesia's health minister, as of 2012 only five of Indonesia's 1,800 hospitals were accredited internationally, and all five were privately owned.
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From page 59... ...
For example, 28-52 percent of midwives are unable to administer intrapartum care using a partograph (a tool for monitoring the first stage of labor) , identify the presenting part of the fetus, estimate fetal weight, actively manage the third stage of labor, measure blood pressure, and provide clean and safe delivery care.
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From page 60... ...
. Although doctors can potentially offer more effective emergency management of complications than midwives, gains in effectiveness are limited if births are in health centers that do not have surgical and blood transfusion capabilities.
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From page 61... ...
Comprehensive emergency obstetric and newborn care would add blood transfusion and cesarean section to the list. Staffing for basic emergency obstetric care would include the availability of at least two skilled birth attendants 24 hours a day, seven days a week.
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From page 62... ...
Although the Ministry of Health decree might be used as a legal foundation, the ministry itself must clearly set forth the scope of work for skilled birth attendants, including delegation of authority to perform lifesav ing functions and assurance that additional duties do not distract from the mission of maternal and neonatal care. A formal community participation strategy should engage the community in the monitoring and evaluation of services.
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From page 63... ...
JNPK (Jaringan Nasional Pelatihan Klinis, National Clinical Training Network)
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