Issues in training for essential maternal health care in Indonesia

Abstract

The Maternal Mortality Ratio (MMR) in Indonesia remains high, i.e. approximately 390 per 100,000 live births. The estimated MMR obtained from the studies from 1978 to 1994 suggests a slow reduction, although it has been determined that by the end of Five Year Plan VI, the MMR is expected to be reduced to 225 per 100,000 live births. The efforts to reduce the MMR in Indonesia have been reasonably made. The conceptual frame work from McCarthy and Maine, consisting of distant determinants, intermediate determinants, and outcome will be outlined. The outcome includes the process of pregnancy, complication of pregnancy and labor, and mortality/disability. The intermediate determinants include health status, reproductive status, access to health services, health care behavior, and unknown/unpredicted factors. The distant determinants encompasses women’s status, family's status in community, and community’s status. The last section of this paper reviews the role of the trainings in safe motherhood movement, covering the education of health personnel and the subsequent continuing education. The role of the National Clinical Training Network initiated by POGI, which introduces the Competency Based Training in Family Planning and Reproductive Health is very significant.