mch mainstream

7/30/2019 MCH Mainstream

1/19

Key Activities and currentissue on progressing MCH

related MDGs


2/19

Objective

MDGs Reduce by three-quarters,

between 1900 and 2015,the maternal mortality

ratio

RPJMN Depkes 2009

Life Expectancy Rate from66,2 years 70,6 years

Infant Mortality Ratio from

35/1000 Live Birth 26/1000

Maternal Mortality Ratiofrom 307/100.000

226/100.000 Malnutrition among under

5 Prevalence from 25,8% 20%


3/19

Indicators

1. Maternal Mortality Ratio

2. Percentage of births attended by

skilled health personnel3. Contraceptive prevalence rate


4/19

Maternal Mortality Ratio

There are huge disparity between provinces(Central Java 248/100.000 live birth andPapua 1025/100.000 live birth)

Indonesian MDGs target is hard to achieved.Needs breakthrough activities to accelerateMMR decline.


5/19

390

334307

125

0

50100

150

200

250300

350

400

450500

1980 1985 1990 1995 2000 2005 2010 2015 2020

SDKI Target Linear (SDKI)

Maternal Mortality RatioSDKI 1994, 1997, 2002


6/19

Cause of Maternal DeathSKRT 2001

Others

12%

Infection

12%

Eklamsia

25%

Bleeding

30%

Abortus

5%

Puerperium

complication

8%

Prolonged Labour

5%

Emboli obst

3%


7/19

Jumlah BumilJumlah Bulin

Jumlah Bayi

Cakupan K 1

Cakupan K 4Cakupan Linakes

Cakupan K N

PONED

Bidan Desa

Kematian Ibu

Kematian Neonatus

5.136.325 jiwa4.757.653 jiwa

4.630.244 jiwa

88,09 %

77 %74,27 %

58.4 %

56 %

61 %

3.525 jiwa

15.258 jiwa

Current Situation:

Indicators of Maternal and Neonatal Health


8/19

0

10

20

30

40

50

60

70

80

90

100

K 1 K 4 P N K N

20012002

2003

2004

Target 04

Trend of Maternal Health Service


9/19

3 Key Massages of MPS

Birth attendance by Skilled Health Personal

Adequate Health Services for everyobstetric and neonatal complication

WORA have access to unwantedpregnancy prevention and post abortioncare


10/19

MPS strategies

Improve access to and coverage of quality careBuild effective partnerships through intra

sector, inter sector and other partner-collaborations

Encourage women and family empowermentthrough improving their knowledge to ensureappropriate practices and utilization MNH services

Encourage community involvementinensuring the provision and utilization of MNHservices


11/19

Maternal Health Focus

Maternalhealth

Supply Side

Demand Side

Deliveryby HealthProvider

Obst-NeoComplication Service

PostAbortionCare

ANCDeliveryPost Natal ServComplication ServFamily PlanningMPR-MPS

MCH Hand Book BPCRBirth Preparedness

Management

4

S

TRATEGy


12/19

Supply Side

Improve Quality Services of ANC, Delivery, PostDelivery, Complication, Family Planning

Provide Competence Health Provider (Comm.

Midwives, Midwives, Doctor in Health Center &Hospital)

Provide of Supplies (Equipment, Facilities, Drugs)

Strengthen MCH Referral System from Family

Integrated Post Maternity Huts/Polindes HealthCenter District Hospital


13/19

Demand Side

Improve knowledge of Family andCommunity Regarding Birth Preparednessand Complication Readiness (BPCR)

Increase MCH Hand Book Used, in order toincrease coverage of MCH Program

Establish and Strengthen of Village Alert onMCH


14/19

Management

Planning Through DTPS - MPS

Advocacy

SocializationSupervision

Monev

Mapping


15/19

The role of Central MOH

Development and socialization of guidelinesand standards.

Technical assistance

Advocacy

Starting from 2006: Provision of Dekon

funds for MCH activities:+ 500 billion Rps

All Provinces and Districts


16/19

SIMPUL KEGIATAN

PADA SIKLUSKEHAMILAN

PUSPASANGAN USIA SUBUR

KEHAMILAN

PERSALINAN

NIFAS

Pre Pregnancy Package : STATUS KESEHATAN

PENYAKIT YANG DIDERITA

PERILAKU REPRODUKSI SEHAT (KB)

PERSIAPAN KEHAMILAN

Ante Natal Care : PERENCANAAN PERSALINAN

INFO PERILAKU SEHAT (BUKU KIA)

FREKUENSI KONTAK DENGAN PETUGAS

STATUS KESEHATAN & KEHAMILAN

( GIZI, IMMUNISASI, PENYAKIT)

Pertolongan Persalinan:

KOMPETENSI (Tenaga & Sarana)

KOMPLIKASI (Notifikasi-Siaga)

SISTEM RUJUKAN (PONED-PONEK)

Kunjungan Nifas FREKUENSI KONTAK DENGAN PETUGAS

KOMPLIKASI IBU & NEONATUS

YAN KB PASCA SALIN


17/19

DI RUMAH

DI PERJALANAN

DI PUSKESMAS

1. KEPUTUSAN KELUARGA

PENGETAHUAN

KETERSEDIAAN BIAYA

KESIBUKAN KELUARGA

SOSIAL BUDAYA

2. KETERSEDIAAN TRANSPORTASI

1. SARANA TRANSPORTASI

2. TINGKAT KESULITAN

3. WAKTU TEMPUH

1. KESIAPAN PETUGAS

2. KETERSEDIAAN BAHAN & ALAT

3. SIKAP PETUGAS

KEMUNGKINAN TERJADINYA

KEMATIAN IBU

DALAM PERSALINAN

DI RUMAH SAKIT

1. KESIAPAN PETUGAS

2. KETERSEDIAAN BAHAN & ALAT

3. SIKAP PETUGAS

4. BIAYA ??


18/19

Jalan Menuju Keselamatan

Tdk Hamil

Kemungkinanhidup >

DO

PPGDON

PONED

PONEK

K1

K4

Pn

CFR < 1%


19/19

Sekian

Terima Kasih

mch mainstream

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