Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

REGIONAL STRATEGY, RISK APPROACH TO INNOVATIVE REFERRAL

Author

Rochjati P 1 , Prabowo P 1 , Rihadi S 2 , Djaeli A 2 , Basuki S 3

Institution

1 Department of Obstetrics and Gynaecology Medical Faculty Airlangga University / Dr. Soetomo Hospital
2 East Java Provincial Health Office
3 Probolinggo District Health Office

Abstract

Introduction: Indonesia with high MMR 228/100 000LB (2007), in rural community almost 60% pregnant women live far from referral access. Geographical condition caused delayed referral, culturally and with limited cost caused delayed decision making by family for seeking better care. Objectives: Develop innovative Referral Model to reducing MMR.

Methods: Conduct Risk Approach study within Safe Motherhood program, 1993, applying: 1. Regional strategy (district) in Probolinggo district, achieving political will, commitment from policy makers, 2. Risk concept for all pregnant women with repeated IEC, Early Planned Referral for healthy Obstetric- risk and Prompt Timely Referral for Obstetric- emergency women. Low-risk women were delivered by TBAs.

Results: 1.Significant MMR different between intervention area 372/100 000LB and controle area 732/100000LB on p< 0.05. 2. Developed Maternal Health Care system with ‘safe pregnancy and delivery’ package and innovative referral within district Referral System 3. Since 1994 this developed system were replicated to all 29 districts and 9 cities in East Java province.

Conclusion: 1. Continuous, sustainable innovative referral was replicated to other districts with reduced MMR. 2. In 2010 Probolinggo district, MMR 86,7/100 000 LB, East Java province the average MMR 102,4/100 000 LB