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Presence of doctors and obstetrician/gynecologists for patients with maternal complications in hospitals in six provinces of Indonesia
Author(s) -
Pedrana Alisa,
Tholandi Maya,
Qomariyah Siti Nurul,
Sethi Reena,
Hyre Anne,
Amelia Dwirani,
Suhowatsky Stephanie,
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.12734
Subject(s) - medicine , eclampsia , referral , obstetrics and gynaecology , maternal morbidity , family medicine , obstetrics , medical emergency , pregnancy , emergency medicine , genetics , biology
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 ( CE m ONC ) 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 CE m ONC hospitals during obstetric emergencies undermines Indonesia's efforts to reduce high maternal mortality rates.