Presence of doctors and obstetrician/gynecologists for patients with maternal complications in hospitals in six provinces of Indonesia

Alisa Pedrana, Maya Tholandi, Siti Nurul Qomariyah, Reena Sethi, Anne Hyre, Dwirani Amelia, Stephanie Suhowatsky, Saifuddin Ahmed

Research output: Contribution to journalArticle

Abstract

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 (CEmONC) 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 CEmONC hospitals during obstetric emergencies undermines Indonesia's efforts to reduce high maternal mortality rates.

Original languageEnglish (US)
Pages (from-to)42-50
Number of pages9
JournalInternational Journal of Gynecology and Obstetrics
Volume144
DOIs
StatePublished - Feb 2019

Keywords

  • Health facility delivery
  • Indonesia
  • Maternal health
  • Obstetrician/gynecologist
  • Provider availability

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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