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Culture Documents
MONINGKEY Mkes
Family and community department
FoM Pelita Harapan University
Annually, 585,000
women die of
pregnancy related
complications
99% in developing
world
~ 1% in developed
countries
Every Minute...
Sumber: Laporan rutin KIA, 2010 & koreksi jumlah kematian ibu dg AKI menuru
kesehatan Ibu
Sumber
Data : Data Rutin Kesehatan Ibu 2013
KECENDERUNGAN ANGKA
KEMATIAN BALITA, BAYI DAN
NEONATAL,
1991 -2015
33%
37%
50% kematian
(86.111)
25% kematian
(42.845)
25% kematian
(41.313)
Unknown
3.7 %
Unknown 5.5 %
Tetanus, 1.5 %
Kongenital
Anomaliies 5.7
%
Meningtis, 5.1 %
Pneumonia, 12.7 %
Neonatal
Problems
46,2 %
Neonatal
Problems 36
%
Kongeni
tal
Anomali
es4.9 %
Pneumonia, 13.2 %
Diarrhea 15
%
Tetanus, 1.7
%
Neonatal problems:
Asphyxia Low Birth Weight - Infection
Sources; Basic Health Survey
2007
Diarrhea
17.2 %
kesehatan Ibu
Sumber
Data : Data Rutin Kesehatan Ibu 2013
KECENDERUNGAN ANGKA
KEMATIAN BALITA, BAYI DAN
NEONATAL,
1991 -2015
33%
37%
FAKTA:
Risfaskes 2011 &
data rutin KIA
2011:
70.15% Bidan
tinggal di desa
64.86% Bidan di
Desa yang
mempunyai Kit
BdD mampu GDON:
10.80%,
BdD telah dilatih
APN: 45.63%.
47,4% puskesmas
perawatan mampu
PONED
42,6% puskesmas
PONED tersedia
MgSO4
Studi Banten,
sebab
keterlambatan 474
Ibu
Selama
t
Persalin
an
85% normal
15% perkiraan
komplikasi, tak
dpt diprediksi tp
dapat dicegah
I. Pemanfaatan
penolong
persalinan
terampil di
pelayanan
fasikes Kualitas
Pencegahan
A
AY
BI
III.
Kualitas
pelayan
an di RS
Akses ke RS
tepat waktu
komplikasi
Identifikasi komplikasi
Pertolongan pertama
thd
Komplikasi
&
penstabilan
sebelum
II.Rujukan
rujukan
Efektif
FAKTA:
SP 2010 Litbangkes 2012:
49.7%-75.3% meninggal di RS
pemerintah dan swasta (tgt jenis
komplikasi); 17.1-37.8% di rumah
sendiri
Studi di Banten: 66% terlambat
mencapai fasilitas rujukan
FAKTA:
Risfaskes 2011
21% RS
Pemerintah
Memenuhi
Kriteria Umum
PONEK
52.7% RSU
pemerintah
dengan Dr telah
terlatih PONEK
50.4 % RSU
pemerintah
dengan Bidan
telah terlatih
PONEK
Studi di Banten:
44% terlambat
mendapatkan
pelayanan di RS
25
26
27
Historical Review
Traditional birth attendants
Antenatal care
Risk screening
Current Approach
Skilled attendant at delivery
28
29
Advantages
Community-based
Sought out by women
Low tech
Teaches clean delivery
30
Disadvantages
Technical skills limited
May keep women away from
life-saving interventions due to
false reassurance
Current Approach to
Reduction of Maternal
31
Current Approach to
Reduction of Maternal
32
33
Current Approach to
Reduction of Maternal
Mortality
34
Improvements in
nutrition, sanitation
Maine 1999.
Antenatal
care
WHO 1999.
36
Disadvantages
Very-poorly predictive
Costly: Removes woman to maternity waiting
homes
If risk-negative, gives false security
Conclusion: Cannot identify those at risk of
maternal mortality every pregnancy is at risk
37
KELEMAHAN
Prediksi sangat buruk
Mahal memberikan keamanan palsu
Proven effective
Malaysia: basic maternity services 320 157
Cuba: national priority 118 31
China: facility based childbirth 1500 50
40
komplikasi
hepatitis
Hepatitis
Malaria
Prematur, IUGR
Unwanted pregnacy,
Peningkatan risiko
mrbidits dan mortlitas,
child abuse,neglect
Infeksi, tetanus
Komplikiasi
Anemia berat
Cardiac failure
Perdarahan
Asfiksia, stillbirth
Hipertensi
Eklampsia, CVA
Sepsis puerpuralis
Septikemia, shock
Partus lama
Fistula, ruptura
uterin,prolaps, amnionitis,
sepsis
Causes of maternal
deaths
Proven intervention
Postpartum
Haemorrhage
Treat anemia
Skilled attendant at birt
Prevent/treat bleeding with
correct drugs
Replace fluid loss/tranfusion
Skilled attendant
Clean practise
Antibiotics if infection arises
Proven intervention
Hypertension during
pregnancy
Detect in pregnancy
Refer to hospital
Treat eclampsia with appropriate
anticonvulsive
Referunconscious woman
Obstructed labour
Indirect causes
Proven intervention
TT immunization, syphillis
screening and treatment, clean
delivery, early and exclusive
breastfeeding, early recognition
and management
Proven intervention