POLICY AND STRATEGY TO REDUCTION MATERNAL ......2019/11/06  · 2015 SUPAS 2019 TARGET 305 306 INFANT MORTALITY RATE/1.000 KH 24 24 SDKI 2017 2019 TARGET 32.9 24.8 2013 RISKESDAS 2018

POLICY AND STRATEGY TO REDUCTION MATERNAL AND NEONATAL MORTALITY

MoH of Republic of Indonesia

OUTLINE

1. SITUATION ANALYSIS

2. POLICY AND STRATEGY

3. ACTION PLANS

MATERNAL & NEONATAL CHILD HEALTH PROBLEMS

MATERNAL MORTALITY RATE/100.000 KH

2015 SUPAS

2019 TARGET

305 306

INFANT MORTALITY RATE/1.000 KH

24 24SDKI 2017 2019 TARGET

32.9 24.82013 RISKESDAS 2018 RISKESDAS 2019 TARGET*

PREVALENCE OF STUNTING

17.719.6 172013 RISKESDAS 2018 RISKESDAS 2019 TARGET*

PREVALENCE OF

UNDERWEIGHT

TOTAL FERTILITY RATE

PREVALENCE OF LONG TERM CONTRACEPTIVE

METHODE

SDKI 2012 SURVEY 2016

18.3 21.6

SDKI 2012 SDKI 2017

2.6 2.4TARGET 2019

2.28

TARGET 2019

23.5

2024 TARGET

183

16.82024 TARGET

30.82030 TARGET

131

12.32030 TARGET

NUMBER OF MATERNAL MORTALITY

4

CAUSES OF MATERNAL DEATH

infection of pregnancy

6%

other of complication

obstetric12%

non obstetric complication

16%

obstetric hemorrhage

27%

hypertensive disorder

34%

others 5%

Source: Sampling

Registration System

2016

Time of Death

Pregnancy 1 2 3-7 8-42

During delivery & the first 24 hours

post partum 1/3 total death

Post partum,

days 8-42 25%

When and Where Does The Maternal Death Occur?

Banten Study II 2015-2017

THE PLACE and CAUSES OF

NEONATAL & UNDER FIVE

CHILD MORTALITY

THE CAUSES OF NEONATAL

DEATH THE CAUSES OF UNDER FIVE CHILDREN

MORTALITY

Source: Sampling

Registration System

2016

intrapartum complications;

28,3

respiratory and cardiovaskuler disorders; 21,3

low birth weight and

prematurity; 19

congenital malformation;

14,8

infection; 7,3

others; 8,1

tetanus neonatorum;

1,2

perinatal condition; 36

other congenital

malformation; 7

pneumonia; 10

diarrhea; 10

congenital heart

defects; 6

sepsis; 3

others; 21

infection; 7

Protection of Reproductive Health (women and men, every stage of the life cycle)

Elderly

INTEGRATED HOLISTIC CARE

Minimum Service Standards in Health (Permenkes 4/2019)

Adult(premarital,

couple of reproductive

age)

Bumil, Janin

Pregnant & delivery women, newborn

Post natal women,

infant

Under 5, pre school

ageSchool age Adolescent

Conditional Case Transferr

GOVERNANCE STRENGTHENING

REGULATION

PLANNING AND

FUNDING

INFORMATION SYSTEM

HUMAN RESOURCESINFRASTRUCTURE

SERVICES ACCESS

AND QUALITY

REFERAL NETWORK

COMMUNITY EMPOWERMENT

National –Provincial Referral

Hospitals

15

Regional Hospitals

110 120

Locus District Hospitals

Public Health Center

All PHC in

Locus Districts

Increased Role of National - Provincial & Regional Referral

Hospitals as Neonatal Maternal Referral Centers

districtLocus for Reduction

MMR-NMR

ACEH (3):

Pidie,

Bireuen,

Aceh

Utara

SUMUT (4):

Deli Serdang,

Mandailing

Natal,

Asahan, Nias

Selatan

SUMBAR (4):

Kota Padang,

Pasaman

Barat, Pesisir

Selatan, Agam

RIAU (2):

Rokan Hilir,

Pelalawan

KEPRI

(1):

Kota

Batam

JAMBI (1):

Tanjung

Jabung Timur

BENGKULU (2):

Seluma,

Bengkulu UtaraSUMSEL (2):

Banyu Asin,

Musi

Banyuasin

BABEL (2):

Bangka Selatan,

Belitung Timur

LAMPUNG (1):

Kota Bandar

Lampung

BANTEN (7):

Serang, Lebak,

Tangerang,

Pandeglang,

Kota Serang,

Kota Cilegon,

Kota

Tangerang

Selatan

DKI JAKARTA (3):

Kota Jakarta Barat, Kota Jakarta

Timur, Kota Jakarta Utara

JABAR (21):

Indramayu, Bogor, Garut,

Sukabumi, Karawang,

Bandung, Bandung Barat,

Cirebon, Purwakarta, Kota

Bandung, Tasikmalaya,

Bekasi, Subang, Cianjur,

Kuningan, Kota Bekasi,

Kota Depok, Kota

Tasikmalaya, Majalengka,

Sumedang, Ciamis

JATENG (14):

Grobogan, Brebes,

Demak, Cilacap,

Batang, Kota

Semarang,

Banyumas,

Kendal, Pemalang,

Boyolali, Sragen,

Klaten, Blora,

Tegal

JATIM (18):

Jember, Kota Surabaya, Pasuruan,

Bojonegoro, Banyuwangi, Sidoarjo,

Pamekasan, Gresik, Bondowoso,

Mojokerto, Tulungagung,

Jombang, Kediri, Malang,

Lumajang, Sampang, Situbondo,

Magetan

DIY

(1):

Bantul

BALI (2):

Karang

Asem,

Tabanan NTB (2):

Lombok Timur,

Lombok

Tengah

NTT (1):

Timor Tengah

Selatan

KALBAR (1):

Kubu Raya

KALTENG (2):

Kotawaringin

Timur, Kota

Waringin Barat

KALTARA (2):

Nunukan,

Bulungan

KALTIM (1):

Kutai Kertanegara

KALSEL

(1):

Kota Baru

SULUT (2):

Kep. Talaud,

Bolaang

Mongondow Utara

GORONTALO

(2):

Pohuwato,

Boalemo

SULTENG (3):

Banggai

Kepulauan,

Donggala, Sigi

SULBAR (2):

Polewali Mandar,

Mamuju

SULSEL (1):

Gowa

SULTRA (2):

Bombana,

Konawe

Selatan

MALUT (2):

Kepulauan Sula,

Kota Tidore

Kep.MALUKU (3):

Maluku Tengah,

Maluku Tenggara,

Buru

PAPBAR (2):

Manokwari,

Fakfak

PAPUA (3):

Mimika,

Merauke, Asmat

Justification :• Trend Number of MMR And NMR• Number of Health Personal (Obsgyn, Pediatrician,

MD, Midwife), Health Facilities

THANK YOU

No woman should die while giving life

ACTION PLAN FOR MATERNAL AND NEWBORN MORTALITY REDUCTION

03

01

04

02

Establishment of the Committee for the

Acceleration of Maternal and Newborn

Mortality Reduction

Establishment of 120 District / City

Locus for Maternal and Newborn

Mortality Reduction

Role of Hospital for Tiered Assistance

Increased locus area support through

physical and non-physical special

allocation funds (PHC and hospitals)

05Presidential Instruction for Maternal

and Newborn Mortality Reduction