Evaluation of a comprehensive home-based midwifery programme in South Kalimantan, Indonesia


Ronsmans, C; Endang, A; Gunawan, S; Zazri, A; McDermott, J; Koblinsky, M; Marshall, T; (2001) Evaluation of a comprehensive home-based midwifery programme in South Kalimantan, Indonesia. Tropical medicine & international health, 6 (10). pp. 799-810. ISSN 1360-2276

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Abstract

: We report the findings of an evaluation of a programme in three districts in South Kalimantan, Indonesia, which consisted of the training, deployment and supervision of a large number of professional midwives in villages, an information, education and communication (IEC) strategy to increase use of village midwives for birth, and a district-based maternal and perinatal audit (MPA). Before the programme, the midwives had limited ability to manage obstetric complications, and 90% of births took place at home. Only 37% were attended by a skilled attendant. By 1998-99, 510 midwives were posted in the districts and skilled attendance at delivery had increased to 59%. Through in-service training, continuous supervision and participation in the audit system midwives also gained confidence and skills in the management of obstetric complications. Despite this, the proportion admitted to hospital for a caesarean section declined from 1.7 to 1.4% and the proportion admitted to hospital with a complication requiring a life-saving intervention declined from 1.1% to 0.7%. The strategy of a midwife in every village has dramatically increased skilled birth attendance, but does not yet provide specialized obstetric care for all women needing it. The high cost of emergency obstetric interventions may well be the most important obstacle to the use of hospital care.<br/>

Item Type: Article
Keywords: Delivery of Health Care/*standards, Female, Home Care Services/*standards, Human, Indonesia, Maternal Health Services/*standards, Midwifery/*standards, Pregnancy, *Program Evaluation, Support, Non-U.S. Gov't, Support, U.S. Gov't, Non-P.H.S., Delivery of Health Care, standards, Female, Home Care Services, standards, Human, Indonesia, Maternal Health Services, standards, Midwifery, standards, Pregnancy, Program Evaluation, Support, Non-U.S. Gov't, Support, U.S. Gov't, Non-P.H.S.
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Maternal Health Group
PubMed ID: 11679128
Web of Science ID: 171475600009
URI: http://researchonline.lshtm.ac.uk/id/eprint/16595

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