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Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia.

Pedrana A, Qomariyah SN, Tholandi M, Wijayanto B, Gandawidjaja T, Amelia D, Apriatni M, Sudirman S, Zazri A, Sethi R, Emerson M, Ahmed S

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  • Journal International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

  • Published 10 Apr 2019

  • Volume 144 Suppl 1

  • Pagination 30-41

  • DOI 10.1002/ijgo.12733

Abstract

To determine if the Expanding Maternal and Neonatal Survival (EMAS) program was associated with improved effectiveness of the referral system in Indonesia to facilitate timely and effective management of complications experienced by women and newborns.

analysis.

Monitoring data demonstrated improvements in intervention areas for stabilization of pre-eclampsia/eclampsia (24% vs 61%, incidence rate ratio [IRR] 2.4; 95% confidence interval [CI], 2.3-2.6) and treatment of newborns with suspected severe infection (30% vs 54%, IRR 2.0; 95% CI, 1.6-2.4) prior to referral. The EMAS program was associated with significantly higher levels of communication, advanced notification, back referral, and hospital emergency readiness and staff preparedness compared with the comparison arm.

The EMAS program contributed to improvements in the management of obstetric and newborn complications, including communication, transportation, and preparation of pregnant mothers in need of referral and hospital emergency readiness and staff preparedness.