Premium
Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia
Author(s) -
Pedrana Alisa,
Qomariyah Siti Nurul,
Tholandi Maya,
Wijayanto Bambang,
Gandawidjaja Trisnawaty,
Amelia Dwirani,
Apriatni Mandri,
Sudirman Sudirman,
Zazri Ali,
Sethi Reena,
Emerson Mark,
Ahmed Saifuddin
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12733
Subject(s) - referral , medicine , poisson regression , preparedness , incidence (geometry) , confidence interval , emergency medicine , program evaluation , medical emergency , family medicine , environmental health , population , physics , optics , political science , law , public administration
Objective 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. Methods Poisson regression using longitudinal monitoring data was used to assess the impact of the EMAS program on stabilization practices prior to referral. Data from a nonrandomized quasi‐experimental pre‐post evaluation study were used to assess the impact of the EMAS program along the referral pathway using χ 2 analysis. Results 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. Conclusion 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.