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