The Improvement of Primary Care Can Diminish Maternal Health Rate


Maternal health indicator in Indonesia is low. According to data of SKDI (Indonesia Doctor Competence Standard) in 2012, maternal mortality rate when getting pregnant, maternity, and postpartum is 359 per 100,000 live births. Thus, to improve the health care of mothers and children (KIA), primary health care facilities should be enhanced since it functions as a gate keeper focusing on promoting and preventive efforts.

The aforementioned statement was declared by Director General of Health Care, Ministry of Health of Republic of Indonesia dr. Anung Sugihantono, M.Kes in a national seminar ‘Update of Maternal Health in Primary Care’. It was organized by doctors of UMY as one of the event series of the 47th ‘Sumpah Dokter’ (Hippocratic Oat) on Saturday (16/1) at Sportorium of UMY. If the primary care could be carried out well, it could diminish maternal mortality rate. “Besides having managerial function, the primary care is as a gate keeper whose role is to performing public primary care based on the competence and authority,” dr. Agung stated. The gate keeper is also to manage the health care through reference system, advisers, and counselors. The primary care is expected to educate public to create healthy family and to manage human resources.

“Hence, as the gate keeper, the function of doctors is as the first contact of patients, prevention of reference, as well as quality and cost control,” he inserted. If a doctor of primary care could handle patients’ health issues well, it means that 85% primary care issues could be managed. It shows that the mortality rate decreases and alleviate state budget (APBN) for drugs so that it can be cost effective and foster health status as well as patient satisfaction.

dr. Anung also discussed Sustainable Development Goals (SDGs). If Millennium Development Goals (MDGs) possess eight goals and eighteen targets with sixty-three targets, SDGs have seventeen goals, 169 targets with 220 indicators. He explained that one of the huge challenges of the sustainable development goals in Indonesia is reformulating the integrated development concept and put health as a development management process encompassing input, process, output, outcome, and impacts. The other challenge is to make people understand the essence of health development that should be conducted in this decentralization and democracy era.

“In medical field, the proposed program to achieve SDGs is ‘Program Indonesia Sehat’ with three pillars, namely health paradigm, health care, and national health insurance,” dr. Anung mentioned. The health paradigm refers to an approach prioritizing promoting and preventive concepts on the health care, and putting health as an input of a development process. The second pillar, health care, aims at escalating access and care quality, while the primary care is for promoting and preventive care efforts through approach of continuum of care and intervention case health risks on clinical management, program management, management itself. “The third pillar, national health insurance, pointed at insuring health of all citizens and foreigners living in Indonesia,” dr. Anung elucidated.

He also expected that UMY as an educational institution could support the efforts to reducing mothers’ health care in order to create the sustainable development foals. First, UMY may create graduates who possess capability to fulfill health care if mothers and children. Second, UMY may cultivate the students’ professionalism to provide health care of mothers and children as the profession standards and authorities. Last, UMY can reconcile curriculum implementation with the program needs and national standards.

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