Analisis Penyebab Kematian Maternal Di Kabupaten Garut (Studi Epidemiologi dalam Upaya Menurunkan Kematian Maternal di Provinsi Jawa Barat)

Abstract

Maternal mortality is still a problem globally and especially occur in developing countries, including Indonesia. The maternal mortality rate is one indicator of the health status of a country. Garut is one part of West Java province with the count of maternal mortality case was 45 deaths in 2015. Most of the causes of maternal death is preventable, ie factors of patients, healthcare workers, facilities, and referral. Recording and reporting of maternal deaths has not to be going well yet, so that intervention can not be set to decrease maternal mortality significantly. Research carried out by sequential explanatary mixed method. The first phase, data collection and analysis is done quantitatively, followed by collection of qualitative data in the second phase which aims to strengthen the results of quantitative research. Quantitative research using cross sectional and qualitative study using in-depth interviews and focus group discussions. The study was conducted in October-November, 2016. Based on the research showed that 96% of maternal deaths occur in Garut regency are preventable maternal deaths that caused by multifactorial, a combination of healthcare workers factors, patient factors, and referral factors. Maternal deaths are also caused by the referral process has been delayed. Besides that, recording and reporting have not been able to run well, with the availability of human resources, but the existing policy has not been adequate. Patient factors such as age, parity, and birth spacing is at risk, as well as negative perceptions of mothers and families to health facilities contributed to preventable maternal deaths. Health workers factor prefer to unqualified health workers in conducting effective communication and counseling. Access, financing, and poor communication between health professionals and patients have contributed to the occurrence of resistance in the referral process.

Causative Factor of Delay in Maternal Referral - Systematic Review

“…The distribution of the area where it is obtained from 3 continents. Four literatures discuss research on the Asian continent, namely Indonesia and India (Jeffery & Jeffery, 2010;Nataria et al, 2020;Octaviani et al, 2019;Rizkianti et al, 2020). Four studies from African continent, namely South Africa, Ghana, Tanzania, and Zambia (Annoon et al, 2020;Kaiser et al, 2019;Maro et al, 2016;Sibiya et al, 2018).…”

“…Two of the literatures discuss researches on rural areas, namely India and Zambia (Jeffery & Jeffery, 2010;Kaiser et al, 2019), one of the literature discusses research in an urban area, namely Ghana (Annoon et al, 2020) , and one literature discusses research in both rural and urban areas, which is Tanzania (Maro et al, 2016). In countries with upper middle income, there are two literatures researched in rural areas, namely Mexico and South Africa (Gamlin, 2020;Sibiya et al, 2018) and three literatures studied in rural and urban areas, namely Indonesia (Nataria et al, 2020;Octaviani et al, 2019;Rizkianti et al, 2020).…”

“…I: Household Questionnaire, Women's Questionnaire, and Men's Questionnaire A: Descriptive statistics, frequency with percentage, Chisquare test, and logistic regression with STATA SE version 15.1 and the appropriate IDHS weights and were taken into account for the IDHS survey design. 10 administration of government health insurance but also not preparing maternity funds (Octaviani et al, 2019), bad experiences with the attitude of health workers (Sibiya et al, 2018).…”

“…Meanwhile mothers who can make decisions at various levels, tend to choose to give birth in health facilities and be assisted by experts. (Rizkianti et al, 2020) The causes of delays to get the healthcare are mostly the result of previous referral problems (Maro et al, 2016), transportation (Gamlin, 2020), geography, activestandby villages have not started (Octaviani et al, 2019), transparency of health service information (operating hours, patient capacity, patient rights), and finances (Sibiya et al, 2018). In this case, things that affecting the travel time such as transportation and communication can be made easier using application innovation.…”

“…In this case, things that affecting the travel time such as transportation and communication can be made easier using application innovation. (Nataria et al, 2020) The causes of delays in receiving the healthcare are lack of drug preparations, lack of equipment, lack of skills of health workers, lack of human resources for health workers (Maro et al, 2016), blood services are not ready 24 hours and preparations are not always available, operating rooms and ICU are not always ready (Maro et al, 2016;Nataria et al, 2020), the lack of responses from the hospital in receiving patient complaints, the attitude of health workers, the condition of the referred patient is in an unstable state (Octaviani et al, 2019), inadequate infrastructure, no record card of maternity cases are provided from the hospital, and previous reference. (Sibiya et al, 2018) C. Socioeconomic Factors…”