PENDEKATAN NEAR MISS DALAM PERBAIKAN KUALITAS PELAYANAN KESEHATAN MATERNAL DI SISTER HOSPITAL PROVINSI NUSA TENGGARA TIMUR
| Main Authors: | , Yeanne Seviani Sarimin, , Prof. dr. Mohammad Hakimi, Sp.OG(K), Ph.D |
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| Format: | Thesis NonPeerReviewed |
| Terbitan: |
[Yogyakarta] : Universitas Gadjah Mada
, 2014
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| Subjects: | |
| Online Access: |
https://repository.ugm.ac.id/128973/ http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=69348 |
Daftar Isi:
- Background: NTT provincial implement its sister hospital program in 2010, as part of the revolution KIA. Maternal deaths move to inadequate health facilities (Poskesdes and polindes), health centers basic emergency obstetric neonatal care, and hospitals, by 9% in 2011 compared to 2010 (46% to 55%). Maternal effective audit should be improving the quality of maternal health services. Nevertheless, although the maternal audit has been introduced in Indonesia since 1994, has yet to bring a significant change. Near miss approach is a strategy to reduce maternal mortality and improve understanding of protective risk factors for survival. Objectives: The main purpose of this study is to determine the effect of sister hospital program to the improvement of maternal health services in the province. This is done by comparing the complication management, and severe maternal outcome measure at its sister hospital. This study also identifies the main cause and that contribute to severe maternal outcome. Methods: The study design using interrupted time series (ITS) quasi-experiments, with switching replications (sequential intervention). Selected hospitals consisting of sister hospital 1 and sisters hospital 2, with each represented by one hospital. Data analysis using a quantitative approach, where the series were analyzed with statistical tests for the data series, using ARIMA models (1,1,1) for TTS hospital and (0,0,0) for TTU hospital. Results: The main cause of severe maternal outcomes were found in 2010-2012 was PEB/Eclampsia (53.27 %), and severe postpartum hemorrhage (35.51 %). Severe maternal complications are life -threatening, severe anemia exacerbated by the presence of 5.92%. Other things that contribute to that near miss had experienced mothers before reaching the hospital at 88.41%. Management and prevention of complications according to WHO recommendations, once implemented sister hospital program, improved (50.92 % in TTS and TTU 5.83%), with a tendency to decrease over time (estimate TTS hospital ) and a tendency to improved estimates TTU hospital. Mortality index after the sister hospital program has decreased in TTS ( 10 % to 2.69 % ) and in TTU increased (1.8 % to 5.5 %). This program prevents 70 % of maternal deaths in TTS (RR 0.3), but after the intervention sister hospital program in TTU hospital, maternal mortality increased 3 times higher than before the program is implemented (RR 3.1). Hospital Mortality index with sister hospital program higher (MI 5.71 %), compared to control hospitals (MI=2.15 %). Women with severe maternal complications were arriving and being treated in hospital with this program, nearly 3 times the risk of death (RR 2.66) greater than control hospitals . Conclusion: The quality of maternal health services, demonstrated by indicators CFR, MI and MNMMR. All three indicators were found in this study, suggests that it is very important to prepare the components of hospital in terms of resources, implementation of management and managerial complications, so that interventions implemented will provide maximum results.