AsianScientist (Mar. 13, 2019) – In a study published in the International Journal of Gynecology & Obstetrics, researchers found that a US-funded initiative to improve quality of care and referrals during pregnancy and childbirth in Indonesia resulted in significant reductions in maternal and newborn mortality at participating hospitals.
About 70 percent of maternal deaths from childbirth complications in Indonesia occur in hospitals or clinics, in part due to poor quality or delayed care. A US$55-million initiative, known as Expanding Maternal and Neonatal Survival (EMAS)and sponsored by the US Agency for International Development from 2011 to 2017 with support from the Indonesian Ministry of Health, was thus enacted to improve the quality of emergency obstetric and newborn care and referrals in Indonesia.
In this study, researchers led by Professor Saifuddin Ahmed at the Bloomberg School’s Department of Population, Family and Reproductive Health, US, analyzed 101 of the largest EMAS-enrolled facilities to assess the outcomes of the initiative.
From 2013 through 2016, the researchers noted that the overall rate of maternal deaths per 1,000 cases of childbirth complications at these facilities fell from 5.4 to 2.6, a drop of about 50 percent. The rate of newborn deaths within 24 hours of birth also fell sharply, from 4.8 to 3.3 per 1,000 live births, while the rate of newborn deaths within seven days of birth fell from 33.6 to 23.9 per 1,000 live births.
The analysis also revealed increases of five percent and 18 percent, respectively, in the appropriate uses of two key interventions: drugs to induce uterine contractions to reduce postpartum bleeding, and magnesium sulfate to treat pre-eclampsia—a condition that can cause seizures and brain hemorrhaging. By the end of the study, the use rates for these interventions, in cases where objective indicators showed they should have been used, were nearly 100 percent.
“These key indicators of the quality of emergency obstetric and newborn care improved significantly at hospitals after EMAS support, suggesting that the program did improve the quality of care,” said Ahmed. “Sustaining and expanding the approaches of the EMAS program in Indonesia remains critically important to save the lives of mothers and children.”
The article can be found at: Tholandi et al. (2019) The Effect of Expanding Maternal and Neonatal Survival Interventions on Improving the Coverage of Labor Monitoring and Complication Prevention Practices in Hospitals in Indonesia: a Difference-in-difference Analysis.
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Source: Johns Hopkins Bloomberg School of Public Health; Photo: Pixabay.
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