Implementation of Delivery Planning and Complication Prevention Program by Midwives at Primary Healthcare Center in Ambon

Abstract

Delivery planning and complication prevention program (P4K) was established to accelerate the decrease of maternal mortality rate (AKI), Implementation of this program in Ambon was not optimal. Objective of this study was to explain the implementation and related factors of P4K by midwives in the primary health care centers of Ambon city. This was a descriptive-qualitative study with cross sectional time approach. Data collection was done using in-depth interview technique to 3 P4K executor midwives as main informants. Triangulation informants were three heads of primary healthcare centers, head of family health unit of Ambon district health office (DKK), and three mothers who gave birth in the last 0-42 days. Content analysis method was applied in the data analysis. Results of this study showed that P4K implementation in the form of giving comprehensive counseling was not done by midwives. Antenatal care (ANC) visit was not conducted according to the standard. Delivery assisted by ‘dukun' was still found. Post delivery contraception use did not attain the target. ‘Tabulin' (savings for giving birth time) and blood donor collection was not performed. Program socialization to the community and cross sectors was still insufficient. The number of midwives was still insufficient. Facilities were still insufficient, and no funding allocation for socialization activity was provided. Management control from Ambon city health office and head of puskesmas was inadequate. Communication forum for P4K was not performed by midwives. Commitment and attitude of P4K executor midwives were good. No standard operating procedure (SOP) for P4K implementation was provided. Implementation of P4K by midwives in Ambon city was insufficient. It was caused by no local policy that supported P4K; lack of communication to the community; insufficient number of midwives, facilities, and funding; inadequate management control by Ambon city health office; and no SOP for P4K implementation