Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia

Alisa Pedrana, Siti Nurul Qomariyah, Maya Tholandi, Bambang Wijayanto, Trisnawaty Gandawidjaja, Dwirani Amelia, Mandri Apriatni, Sudirman Sudirman, Ali Zazri, Reena Sethi, Mark Ross Emerson, Saifuddin Ahmed

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)30-41
Number of pages12
JournalInternational Journal of Gynecology and Obstetrics
Volume144
DOIs
StatePublished - Feb 1 2019

Fingerprint

Indonesia
Referral and Consultation
Mothers
Newborn Infant
Survival
Emergencies
Communication
Confidence Intervals
Eclampsia
Incidence
Pre-Eclampsia
Obstetrics
Infection

Keywords

  • Health facility delivery
  • Indonesia
  • Maternal health
  • Monitoring and surveillance
  • Referral

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia. / Pedrana, Alisa; Qomariyah, Siti Nurul; Tholandi, Maya; Wijayanto, Bambang; Gandawidjaja, Trisnawaty; Amelia, Dwirani; Apriatni, Mandri; Sudirman, Sudirman; Zazri, Ali; Sethi, Reena; Emerson, Mark Ross; Ahmed, Saifuddin.

In: International Journal of Gynecology and Obstetrics, Vol. 144, 01.02.2019, p. 30-41.

Research output: Contribution to journalArticle

Pedrana, Alisa ; Qomariyah, Siti Nurul ; Tholandi, Maya ; Wijayanto, Bambang ; Gandawidjaja, Trisnawaty ; Amelia, Dwirani ; Apriatni, Mandri ; Sudirman, Sudirman ; Zazri, Ali ; Sethi, Reena ; Emerson, Mark Ross ; Ahmed, Saifuddin. / Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia. In: International Journal of Gynecology and Obstetrics. 2019 ; Vol. 144. pp. 30-41.
@article{f949fd19f16c4a04a5dc218098c9f109,
title = "Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia",
abstract = "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.",
keywords = "Health facility delivery, Indonesia, Maternal health, Monitoring and surveillance, Referral",
author = "Alisa Pedrana and Qomariyah, {Siti Nurul} and Maya Tholandi and Bambang Wijayanto and Trisnawaty Gandawidjaja and Dwirani Amelia and Mandri Apriatni and Sudirman Sudirman and Ali Zazri and Reena Sethi and Emerson, {Mark Ross} and Saifuddin Ahmed",
year = "2019",
month = "2",
day = "1",
doi = "10.1002/ijgo.12733",
language = "English (US)",
volume = "144",
pages = "30--41",
journal = "International Journal of Gynecology and Obstetrics",
issn = "0020-7292",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Assessing the effect of the Expanding Maternal and Neonatal Survival program on improving stabilization and referral for maternal and newborn complications in Indonesia

AU - Pedrana, Alisa

AU - Qomariyah, Siti Nurul

AU - Tholandi, Maya

AU - Wijayanto, Bambang

AU - Gandawidjaja, Trisnawaty

AU - Amelia, Dwirani

AU - Apriatni, Mandri

AU - Sudirman, Sudirman

AU - Zazri, Ali

AU - Sethi, Reena

AU - Emerson, Mark Ross

AU - Ahmed, Saifuddin

PY - 2019/2/1

Y1 - 2019/2/1

N2 - 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.

AB - 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.

KW - Health facility delivery

KW - Indonesia

KW - Maternal health

KW - Monitoring and surveillance

KW - Referral

UR - http://www.scopus.com/inward/record.url?scp=85062158295&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062158295&partnerID=8YFLogxK

U2 - 10.1002/ijgo.12733

DO - 10.1002/ijgo.12733

M3 - Article

C2 - 30815868

AN - SCOPUS:85062158295

VL - 144

SP - 30

EP - 41

JO - International Journal of Gynecology and Obstetrics

JF - International Journal of Gynecology and Obstetrics

SN - 0020-7292

ER -