Publications & Reports

Presence of doctors and obstetrician/gynecologists for patients with maternal complications in hospitals in six provinces of Indonesia.

Pedrana A, Tholandi M, Qomariyah SN, Sethi R, Hyre A, Amelia D, Suhowatsky S, Ahmed S
Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia.

Abstract

OBJECTIVE: To describe doctors' and specialist physicians' availability to manage obstetric complications in hospitals in six provinces of Indonesia. METHODS: Data from a nonrandomized, quasi-experimental pre-post evaluation study were used to describe the distribution of providers by each cadre of worker and assess the availability of doctors and obstetrician/gynecologists (ob/gyns) for consultations for women experiencing postpartum hemorrhage or pre-eclampsia/eclampsia, disaggregated by hospital type, province, referral status, and by time of day of provider consultation. RESULTS: Among hospitals that should have comprehensive emergency obstetric and newborn care (CEmONC) services available 24 hours a day, 7 days a week, many did not have a doctor available to manage obstetric complications as they presented, despite there being an average of seven ob/gyns and four doctors registered for service across all facilities. Slightly over 50% of obstetric emergency cases admitted with postpartum hemorrhage and severe pre-eclampsia/eclampsia did not receive a consultation from an ob/gyn. Among the patients who received consultations, about 70% received consultations by phone or SMS. CONCLUSION: Findings from this study indicate that persistent issues of maldistribution of maternal and newborn specialists and high absence rates of both doctors and ob/gyns at CEmONC hospitals during obstetric emergencies undermines Indonesia’s efforts to reduce high maternal mortality rates.

Link to publisher’s web site

Publication

  • Journal: International Journal of Gynaecology and Obstetrics
  • Published: 01/02/2019
  • Volume: 144 Suppl 1
  • Pagination: 42-50

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