Maternal mortality audit based on district maternal health performance in East Java Province, Indonesia

摘要

Background : Maternal mortality rate (MMR) in Indonesia is still high, including in East Java Province. Although the successful decline in MMR has been achieved, more action still needed to maintain and accelerate the process. Several factors that affect the maternal mortality, especially referral factor, and districts maternal health services quality, need to analyze. This study was conducted to analyze the correlation between maternal mortality with labour referral and maternal health service quality in 10 regencies/cities in East Java Province, Indonesia.? Methods : The case-control study among 2 groups of 5 regencies/cities with the highest and lowest MMR in East Java Province in 2015. The indicators used, were maternal referral relay in maternal mortality report, frequencies of antenatal care, labor by health care provider, puerperal health care, obstetric complication management, detection of high-risk pregnancy by community and healthcare personnel, and family planning program. Results : Total number of maternal mortality in East Java province in 2015 was 531, with MMR were 89,6/100.000 living birth. From the comparative study, we found a significant difference in indicators of high-risk pregnancy detection by healthcare personnel (p=0,035) and obstetrics complications management (p=0,006). There were no significant differences in frequencies of antenatal care, labor by health care provider, puerperal health care, detection of high-risk pregnancy by the community, and family planning program in 10 regencies/cities in East Java Province, Indonesia.? Conclusion : High-risk pregnancy detection by healthcare personnel and obstetrics complications management were related with MMR in 10 districts in East Java province, Indonesia.