Hubungan Umur Ibu, Paritas dan Penolong Persalinan dengan Kematian Neonatal di Wilayah Kerja Puskesmas Kabupaten Banjarnegara tahun 2013

Background: The neonatal mortality rate is Banjarnegara district is high compared with a target of IMR in Central Java province. In 2012 the neonatal mortality rate in Banjarnegara reached 316 cases, whereas in 2013 there were 115 cases in all health centers working area. The high neonatal mortality rate in Banjarnegara influenced by the persistence of early marriage in woman, birth attendant by non skilled health worker (dukun bayi) and women’s parity more than 4.Objective: The purpose of this study is to analyze the correlation between maternal age, parity and birth attendants with the incidence of neonatal mortality and examine the most dominant factors influencing the incidence neonatal mortality in the Health Center working area in Banjarnegara.Method: This study is a case control study design with retrospective approach. The data consists of perinatal verbal autopsy and medical records as many as 136 respondents consisting of 68 mothers who gave birth to her child and neonatal death and 68 maternal and child alive. Subjects were mothers who gave birth a baby who died aged 0-28 days.Result and Discussion: Statistical analysis using Chi Square, Mann Whitney, and multiple logistic regression. The results showed maternal age and parity variables were not significantly corerelated with neonatal mortality (p> 0.05), the variables significantly corerelated with neonatal mortality was birth attendants with p = 0.001. The results of logistic regression showed the strength of the corerelation from the most dominant variable to the smallest variable were birth attendants with OR: 5.64 (95% CI: 1.81 to 17.4), maternal age OR 3.97 (CI 95%, from 1.54 to 10.22), and parity OR: 0.32 (CI 95% 0.12 to 0.87).Conclusion: In conclusion, there was no relationship between maternal age and parity with neonatal mortality but there was a relationship between birth attendants with neonatal mortality. Based on the results of the multivariable analysis, birth attendants’ effect on the incidence of neonatal deaths was 5 times greater than mother’s age and parity.Keywords: Neonatal mortality, maternal age, parity, birth attendant

FACTORS CONTRIBUTING TO MATERNAL MORTALITY IN TASIKMALAYA CITY

Maternal deaths reflect the risks faced by mothers during pregnancy, childbirth, and postpartum were affected by maternal nutritional status, state of ill health during pregnancy, the incidence of various complications in pregnancy, childbirth, and postpartum. Moreover, the availability and use of healthcare facilities, including prenatal and obstetric services, were also very affecting. So it is necessary to minimize the occurrence of maternal deaths. The government had made various efforts to reduce maternal mortality, but the results were still not optimal yet. If maternal mortality could be prevented as early as possible with appropriate identification, it could significantly reduce maternal mortality. The research aims to analyze the cause of maternal death in Tasikmalaya city in 2015. The research design used a quantitative approach in the form of observation. The population was all maternal deaths in Tasikmalaya City Health department in 2015. The study's affordable population was all maternal mortality data with a precise address and recorded in the OVM as many as 20 cases of death. Factors associated with maternal mortality were the problem relating to patients, health professionals, health infrastructure, and referrals. Moreover recording and reporting of maternal mortality also influenced the determination of proper diagnosis to decrease the number of maternal mortality. Maternal mortality was a problem that has never finished with the complexity of the cause. It requires efforts that involve many parties, not only the health authorities alone, but all stakeholders were supported by government regulation. This study could be the basis for further research on maternal mortality and can be used to enhance the knowledge of researchers, health professionals, and stakeholders about the factors that cause maternal deaths. This study's results are expected to know the causes of maternal mortality and used as guidelines in making policy to reduce maternal mortality.Keywords: Maternal mortality, related factors

The 1992 Indonesia Norplant® Use-Dynamics Diagnostic Study

Although the Indonesian Norplant® program is unique in terms of scale and pace of expansion, it also characterizes many of the operational problems that other developing countries are likely to confront as they expand their Norplant programs. Many of the concerns—such as screening and counseling, use-effectiveness, removal on demand, and tracking and notification systems for five-year removal—can only be answered through research on the Indonesian program. As this report states, operations research on issues related to Norplant within the Indonesian program will be of direct relevance to the growing number of Norplant programs in other developing countries. While the Indonesian program represents the largest and most ambitious Norplant program in the world, much remains unknown about many aspects of service delivery and use-dynamics. This survey provides essential information that the BKKBN and other Indonesian and international family planning organizations can use to improve the quality of Norplant services and to increase the effective use of this method