Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia

Abstract

BACKGROUND: Maternal mortality is a sentinel event used globally to monitor maternal health and the overall quality of reproductive health care. Globally, maternal mortality is mostly due to direct causes; apparently, it is not limited by the setting or geographic region. However, Indonesia has failed to achieve the Millenium Development Goals (MDGs) target for maternal mortality.
 AIM: This study aims to explore health workers' and stakeholders' expectations in maternal health services to reduce maternal mortality in urban areas.
 METHODS: It is qualitative research through naturalistic, conducted in one of the regencies in Indonesia, the urban area with the highest Maternal Mortality Rate (MMR) in one province by 2019. Data were obtained in the form of information from Focus Group Discussions (FGDs). FGDs were carried out with stakeholders at the Health Service level (n=3), first-level health facilities or public health centres (n=3), and advanced health facilities or hospitals (n=7). Data analysis in this study employed software (Nvivo Release 1.0) to utilise transcripts in coding and categorising.
 RESULTS: The expectations that emerged from health workers' perspectives in the field were an integrated system of collaboration between health facilities, affordability of Hospital with Comprehensive Emergency Obstetric Care (CEmOC) in action for maternal-neonatal referral urgency, and the skilled health workers as a golden opportunity.
 CONCLUSION: Health workers’ expectations can improve the quality of maternal health services in urban areas, thereby reducing the MMR with a system of collaboration between health facilities, the affordability of maternal-neonatal emergency referral facilities, and the availability of Obstetricians who standby.

Community health worker empowerment through collaborative models with community midwifery

“…Maternal mortality can be reduced if health care providers meet patients needs without undue deleys using a deley prevention strategy, wichh is consistent with workers expectations [9]. Indonesia has made a lot of effort to prevent MMR by providing adequate maternal and child health care since 1989 through the midwives program.…”