Maternal and neonatal referral system in rural North Lampung: a qualitative study of referral system readiness

Submitted: 24 July 2024
Accepted: 19 August 2024
Published: 4 September 2024
Abstract Views: 156
PDF: 59
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A reliable referral system is the key to handling emergency cases, for this reason, it is necessary to conduct an in-depth study of the description of the referral system that is in force and implemented in North Lampung, considering that most maternal deaths are caused by cases that require fast and integrated treatment. The aim of the research is to provide an overview of the readiness of the maternal neonatal referral system in terms of four aspects: i) infrastructure, ii) human resources readiness, iii) community readiness, and iv) policy readiness. The research is using qualitative analysis. Data collection uses in-depth interviews, documentation studies, observations, and Focus Group Discussions (FGDs). The Maternal Mortality Rate (MMR) is impacted by the quality of maternal and neonatal services, including handling pregnancy complications. The percentage of rural North Lampung who gained coverage for focusing on pregnancy issues throughout 2021 was a miserable 52.66%. Rural North Lampung's pregnancy-related issues procedures do not adhere to the operational guidelines for maternal-neonatal referral procedures. The fundamental reference, Educate Basic Emergency Neonatal Obstetric (BEmONC), is no longer in operation, as is Comprehensive Emergency Neonatal Obstetric Services (CEmONC). The readiness of all stakeholders for the neonatal and maternal referral system needs to be improved, including the readiness of infrastructure, human resources, and family-community readiness, and needs to be supported by regional government policies.

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Alkema L, Chou D, Hogan D, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet 2016;387:462-74. DOI: https://doi.org/10.1016/S0140-6736(15)00838-7
GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385:117-71. DOI: https://doi.org/10.1016/S0140-6736(14)61682-2
United Nations. The Millennium Development Goals Report 2014. 2014. Available from: https://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf
Word Health Organizations (WHO). Maternal mortality by 2030. 2015. Available from: https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicator-group-details/GHO/maternal-mortality
Tarmizi SN. Turunkan Angka Kematian Ibu melalui Deteksi Dini dengan Pemenuhan USG di Puskesmas. 2023. Available from: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20230115/4842206/turunkan-angka-kematian-ibu-melalui-deteksi-dini-dengan-pemenuhan-usg-di-puskesmas/
Bapeda Provinsi Lampung. Perubahan Rencana Pembangunan Jangka Menengah Daerah (RPJMD) Provinsi Lampung Tahun 2019-2024. 2016. Available from: https://dinaspsda.lampungprov.go.id/detail-post/perubahan-rencana-jangka-menengah-daerah-rpjmd-provinsi-lampung-tahun-2019-2024
Ministry of Health. Buku Saku Pelayanan Kesehatan Ibu di Fasilitas Kesehatan Dasar dan Rujukan, Pedoman Bagi tenaga Kesehatan. 2013. Available from: https://library.stikesbup.ac.id/index.php?p=show_detail&id=2476&keywords=
Murray S.F, Pearson SC. Maternity referral systems in developing countries: current knowledge and future research needs. Soc Sci Med 2006;62:2205-15. DOI: https://doi.org/10.1016/j.socscimed.2005.10.025
Raj SS, Manthri S, Sahoo PK. Emergency referral transport for maternal complication: lessons from the community based maternal death audits in Unnao district, Uttar Pradesh, India. Int J Health Policy Manag 2015;4:99-106. DOI: https://doi.org/10.15171/ijhpm.2015.14
Hyre A, Caiola N, Amelia D, et al. Expanding maternal and neonatal survival in Indonesia: a program overview. Int J Gynecol Obstetr 2019;144:7-12. DOI: https://doi.org/10.1002/ijgo.12730
Pranajaya R, Suarni L, Kodri. Mortality determinants in the handling of maternal emergencies. 2020. Available from: https://www.ijicc.net/images/vol_13/Iss_2/Part_2/SC31_Pranajaya_2020_E_R1.pdf
Aday JS, Heifets BD, Pratscher SD, et al. Great Expectations: recommendations for improving the methodological rigor of psychedelic clinical trials. Psychopharmacology 2022;239:1989-2010. DOI: https://doi.org/10.1007/s00213-022-06123-7
Whitehead M. The concepts and principles of equity and health. Int J Health Serv 1992;22:429-45. DOI: https://doi.org/10.2190/986L-LHQ6-2VTE-YRRN
Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Global Health 2014;2:e323-33. DOI: https://doi.org/10.1016/S2214-109X(14)70227-X
Madise N, Nandi A, Wong B, Razvi S. Achieving maternal and neonatal mortality development goals effectively: a cost-benefit analysis. J Benefit-Cost Analysis 2023;14:1-29. DOI: https://doi.org/10.1017/bca.2023.24
Hapsari Y. Analisis Implementasi Program Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) di RSU Adhyaksa Tahun 2020. 2020. Available from: https://lib.fkm.ui.ac.id/detail?id=134349&lokasi=lokal
Mia VAF, Suparwati A, Suryoputro A. Analisis pelaksanaan sistem pelayanan obstetri dan neonatal emergensi dasar (poned) di puskesmas sitanggal kabupaten brebes. 2016. Available from: https://ejournal3.undip.ac.id/index.php/jkm/article/view/13953
D’Ambruoso L, Byass P, Qomariyah SN, Ouédraogo M. A lost cause? Extending verbal autopsy to investigate biomedical and socio-cultural causes of maternal death in Burkina Faso and Indonesia. Soc Sci Med 2010;71:1728-38. DOI: https://doi.org/10.1016/j.socscimed.2010.05.023
Lee H, Perosky J, Horton M, et al. Verbal autopsy analysis of maternal mortality in Bong County, Liberia: a retrospective mixed methods study. BMJ Open Quality 2023;12:e002147. DOI: https://doi.org/10.1136/bmjoq-2022-002147
Direktorat Gizi Kesehatan Ibu dan Anak. Laporan Akuntabilitas Kinerja Instansi Pemerintah (LAKIP) Direktorat Tahun Anggaran 2022. 2023. Available from: https://kesmas.kemkes.go.id/kategori_konten/a8baa56554f96369ab93e4f3bb068c22/laporan-akuntabilitas-kinerja-instansi-pemerintah-lakip
Word Health Organization (WHO). Hari Kesehatan Sedunia 2023. 2023. Available from: https://www.who.int/indonesia/news/events/hari-kesehatan-sedunia-2023/milestone#year-1948
Kaselitz E, James KH, Aborigo RA, et al. Understanding the gap in emergency obstetric and neonatal care in Ghana through the PREventing Maternal and Neonatal Deaths (PREMAND) study. Int J Gynecol Obstetrics 2019;145:343-9. DOI: https://doi.org/10.1002/ijgo.12803
Kadia RS, Kadia BM, Dimala CA, et al. Evaluation of emergency obstetric and neonatal care services in Kumba Health District, Southwest Region, Cameroon (2011–2014): a before-after study. BMC Pregnancy Childbirth 2020;20:95. DOI: https://doi.org/10.1186/s12884-020-2774-9
Bintabara D, Ernest A, Mpondo B. Health facility service availability and readiness to provide basic emergency obstetric and newborn care in a low-resource setting: evidence from a Tanzania National Survey. BMJ Open 2019;9:e020608. DOI: https://doi.org/10.1136/bmjopen-2017-020608
Bhatta DN. Involvement of males in antenatal care, birth preparedness, exclusive breast feeding and immunizations for children in Kathmandu, Nepal. BMC Pregnancy Childbirth 2013;13:14. DOI: https://doi.org/10.1186/1471-2393-13-14
Moshi FV, Ernest A, Fabian F, Kibusi SM. Knowledge on birth preparedness and complication readiness among expecting couples in rural Tanzania: differences by sex cross-sectional study. PLoS One 12018;3:e0209070. DOI: https://doi.org/10.1371/journal.pone.0209070
Elmusharaf K, Byrne E, AbuAgla A, et al. Patterns and determinants of pathways to reach comprehensive emergency obstetric and neonatal care (CEmONC) in South Sudan: qualitative diagrammatic pathway analysis. BMC Pregnancy Childbirth 2017;17:278. DOI: https://doi.org/10.1186/s12884-017-1463-9

How to Cite

Suarni, L., Rahmayati, E., & Kodri, K. (2024). Maternal and neonatal referral system in rural North Lampung: a qualitative study of referral system readiness. Healthcare in Low-Resource Settings. https://doi.org/10.4081/hls.2024.12845