Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia

Pedrana, Alisa; Qomariyah, Siti; Tholandi, Maya; Wijayanto, Bambang; Gandawidjaja, Trisnawaty; Amelia, Dwirani; Apriatni, Mandri; Sudirman, Sudirman; Zazri, Ali; Sethi, Reena; Emerson, Mark R.; Ahmed, Saifuddin

doi:10.1002/ijgo.12733

Cited by 15 publications

(18 citation statements)

References 24 publications

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“…In countries similar to Indonesia, where the healthcare system is less centralised, cultural context, particularly in rural areas, plays a key role and can potentially pose as a barrier in this route 10. Although there are reports of successful interventions in some regions,11 such programme might fail to achieve their goals without appropriate cultural consideration 12 13…”

Section: Introductionmentioning

confidence: 99%

Healthcare providers’ perception of the referral system in maternal care facilities in Aceh, Indonesia: a cross-sectional study

et al. 2019

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ObjectivesOur study investigates the barriers perceived by staff in the referral systems in maternal healthcare facilities across Aceh province in Indonesia.DesignWith a cross-sectional approach, two sets of surveys were administered during September to October 2016 in 32 sampling units of our study. We also collected referral data in the form of the frequency of ingoing and outgoing referral cases per facility.SettingIn three districts, Aceh Besar, Banda Aceh and Bireuen, a total of 32 facilities including hospitals, community health centres, and private midwife clinics that met the criteria of providing at least basic emergency obstetric and neonatal care (BEonC) were covered.ParticipantsAcross the 32 healthcare centres, 149 members of staff (mainly midwives) agreed to participate in our surveys.Primary and secondary outcome measuresThe first survey consisted of 65 items focusing on organisational measures as well as case numbers for example, patient counts, mortality rate and complications. The second survey with 68 items asked healthcare providers about a range of factors including attitudes towards the referral process in their facility and potential barriers to a well-functioning system in their district.ResultsOverall, mothers’/families’ consent as well as the complex administration process were found to be the main barriers (36% and 12%, respectively). Healthcare providers noted that information about other facilities has the biggest room for improvement (37%) rather than transport, timely referral of mothers and babies, or the availability of referral facilities.ConclusionsThe largest barrier perceived by healthcare providers in our study was noted to be family consent and administrative burden. Moreover, lack of information about the referral system itself and other facilities seemed to be affecting healthcare providers and mothers/families alike and improvements perhaps through a shared information system is needed.

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Section: Introductionmentioning

confidence: 99%

Healthcare providers’ perception of the referral system in maternal care facilities in Aceh, Indonesia: a cross-sectional study

et al. 2019

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“…Memorandums of Understanding (MOU) also integrated private providers and facilities into districtbased NOC, creating opportunities for better collaboration among a wide range of providers in the catchment area. 20 Purposeful arrangements can address gaps in services and unsafe practices. For example, the availability of blood for transfusion is a perennial challenge in obstetric emergency response, and can mean the difference between survival and death.…”

Section: Purposeful Arrangementsmentioning

confidence: 99%

Developing a Common Understanding of Networks of Care through a Scoping Study

Carmone

Kalaris

Leydon

et al. 2020

Health Systems & Reform

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The phrase "Networks of Care" seems familiar but remains poorly defined. A health system that exemplifies effective Networks of Care (NOC) purposefully and effectively interconnects service delivery touch points within a catchment area to fill critical service gaps and create continuity in patient care. To more fully elaborate the concept of Networks of Care, we conducted a multimethod scoping study that included a literature review, stakeholder interviews, and descriptive case studies from five low-and middle-income countries. Our extended definition of a Network of Care features four overlapping and interdependent domains of activity at multiple levels of health systems, characterized by: 1) Agreement and Enabling Environment, 2) Operational Standards, 3) Quality, Efficiency and Responsibility, and 4) Learning and Adaptation. There are a series of key interrelated themes within each domain. Creating a common understanding of what characterizes and fosters an effective Network of Care can drive the evolution and strengthening of national health programs, especially those incorporating universal health coverage and promoting comprehensive care and integrated services. An understanding of the Networks of Care model can help guide efforts to move health service delivery toward goals that can benefit a diversity of stakeholders, including a variety of health system actors, such as health care workers, users of health systems, and the wider community at large. It can also contribute to improving poor health outcomes and reducing waste originating from fragmented services and lack of access.

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“…Conversely, a review by Eikelder et al, 2016 [69] reported that a Foley catheter, compared to Oral Misoprostol, shows less hyper-stimulation and is associated with instrumental deliveries, fewer caesarean deliveries for those with non-reassuring foetal heart rate but no differences in neonatal outcomes were reported. Additionally, appropriate referral services and hospital networking facilitates effective management of emergency obstetrics cases like eclampsia and minimized delay in access to treatment [70].…”

Section: Plos Onementioning

confidence: 99%

Generating evidence on screening, diagnosis and management of non-communicable diseases during pregnancy; a scoping review of current gap and practice in India with a comparison of Asian context

et al. 2021

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Background Children born to high-risk pregnancies are more likely to experience adverse health outcomes later in life. As estimated, 15% of all pregnancies are at risk of various life-threatening conditions leading to adverse maternal and foetal outcomes. Millennium Development Goal resulted in the global reduction of maternal death from 390,000 to 275000 in 1990–2015). Similarly, to keep this momentum, the current United Nations Sustainable Development Goal (SDG: 3.1) aims at reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030, and this can be achieved by addressing high-risk pregnancy contributing to significant mortality and morbidity. In India, gestational diabetes, gestational hypertension, and gestational hypothyroidism were identified as factors contributing to the high-risk pregnancy. This review summarises the commonly used approach for screening, diagnosis, and management of these conditions in the Asian population. It draws a comparison with the current protocols and guidelines in the Indian setting. Methods Electronic search in PubMed and Google Scholar, reference snowballing, and review of current guidelines and protocols were done between January 2010 to October 2019. Published studies reporting Screening, diagnosis, and management of these conditions were included. Articles selected were then screened, appraised for quality, extract relevant data, and synthesised. Results Screening, diagnosis, and management of these three conditions vary and no single universally accepted criteria for diagnosis and management exist to date. In India, national guidelines available have not been evaluated for feasibility of implementation at the community level. There are no national guidelines for PIH diagnosis and management despite the increasing burden and contribution to maternal and perinatal morbidity and mortality. Criteria for diagnosis and management of gestational diabetes, gestational hypertension, and gestational hypothyroidism varies but overall early screening for predicting risk, as reported from majority of the articles, were effective in minimizing maternal and foetal outcome. Conclusion Existing National guidelines for Screening, Diagnosis, and Management of Gestational Diabetes Mellitus (2018) and Gestational Hypothyroidism (2014) need to be contextualized and modified based on the need of the local population for effective treatment. Findings from this review show that early screening for predicting risk to be an effective preventive strategy. However, reports related to a definitive diagnosis and medical management were heterogeneous.

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Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia

Cited by 15 publications

References 24 publications

Healthcare providers’ perception of the referral system in maternal care facilities in Aceh, Indonesia: a cross-sectional study

Healthcare providers’ perception of the referral system in maternal care facilities in Aceh, Indonesia: a cross-sectional study

Developing a Common Understanding of Networks of Care through a Scoping Study

Generating evidence on screening, diagnosis and management of non-communicable diseases during pregnancy; a scoping review of current gap and practice in India with a comparison of Asian context

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