Peranan Dokter Umum dalam Pelayanan KIA RISKESDAS
2010
2013
Cakupan Ibu Hamil yang memperoleh pelayanan AN
92,7 %
95,2 %
Cakupan Persalinan Persali nan oleh Tenaga Kesehatan Kesehata n
79,0 %
86,9 %
Tantangan RAN PP AKI 2013 Kualitas Pelayanan Kesehatan belum optimal Ketersediaan sumberdaya strategis untuk Kesehatan Ibu dan Bayi masih terbatas Pengetahuan dan kesadaran masyarakat tentang kesehatan ibu masih cukup rendah. 60
515,000 KEMA KEMATIAN TIAN IBU setiap setia p tahun
Human Development Network Health, Nutrition, and Population Series © 2003 The International Bank for Reconstruction and Development / The World Bank 8
Investasi pada Kesehatan Perempuan, Ibu dan Anak 1.
Women’s Women’s and children’s children’s health is valuable in itself. its elf.
Saving a
pregnant woman’s life means saving her newborn 2. Ther There e are are proven & affordable ways of saving the lives of mother & newborn 3. Investing in maternal, maternal, newborn newborn and child child health health makes economic sense 4. Investing in maternal, maternal, newborn newborn and child child health health has political benefits, benefits, including social stability and human security 5. Investing in maternal, newborn and child health makes health system work better
the
Dampak Komplikasi dan Kematian Ibu
Causes
serious ill-health of infants and older children.
Risk
of death children <5 years is doubled if doubled if their mothers die in childbirth.
Highly
correlated with maternal mortality ratios: every year, million newborns die before first months of life, life , additional 4 million are stillborn
At
least 20% of the burden of disease among children less than the age of 5 years is attributable to conditions directly associated with poor maternal and reproductive health, nutrition, quality of obstetric and newborn care
Puncak Kematian Ibu dan Bayi
Kaitan Penyebab Kematian Ibu dan Bayi
12
Asuhan Persalinan menentukan masa depan Bayi
Behavior
Bukti Penelitian Success of reduction maternal & neonatal death is depend on the health
in place
system
rather than maternal and child
health program.
Lancet 2011: 2011: 377; 516 – –25 Published Online January25, 2011 DOI:10.1016/S0140-6736(10)62049-1
Tersedianya Bukti-bukti Ilmiah
Lancet 2011: 377; 516 –25 Published Online January 25, 2011 2011 DOI:10.1016/S0140-6736(10)62049-1
Malaysia has reduced its maternal mortality rate by 45 per cent – from 53 per 100,000 in 1990 to 29 per 100,000 live births in 2010 Women Deliver Congress 2013 17
TANTANGANNYA is to implement these interventions in environments where political commitment, policies, and institutions and health systems have been weak.
18
Target 4.A. Menurun Menurunkan kan angka Kematian Balita hingga
2/3 dalam kurun waktu 1990 - 2015
INDIKATOR 4.1.
Angka Kematian Balita per 1000 kelahiran hidup
4.2.
Angka Kematian Bayi (AKB) per 1000 kelahiran hidup
4.3
Persentase anak usia 1 tahun yang diimunisasi campak
Data Saat Dasar ini (1990 (2010 ) ) 97
44
68
34
44,5% Meni (1991 ngkat ) 20
Target (2015)
32
Status
●
23
●
74,5% (2010)
On Track
Arah Kelangsungan Hidup Balita, Bayi dan Neonatus, 1991 -2015
Peny enyebab ebab kemati ematian an Neona Neonatus tus Penyebab Kematian 0-6 hari
Penyebab Kematian 7-28 hari
BBLR
Save Sav e the Children
Estimasi Jumlah Kematian Bayi setiap Provinsi, 2010 50% kematian (86.111) 25% kematian (42.845) 25% kematian (41.313)
TARGET 5A : MENGURANGI ¾ ANGKA KEMATIAN IBU
(AKI) DALAM KURUN WAKTU 1990 & 2015
INDIKATOR
5.1. Angka Kematian Kematian Ibu (AKI) per 100,000 kelahiran hidup :
5.2. Pertolongan Persalinan oleh Tenaga Kesehatan Terlatih
TARGET TARGET RPJMN MDGs (2014) (2015)
ACUAN DASAR
SAAT INI
390 (1991)
259 (SP 2010), 359 (SDKI 2012)
118
102
40.70% (1992)
83,1% , 63,2% di faskes (SDKI, 2012)
90%
90%
Status
TARGET 5B : AKSES SEMESTA TERHADAP
KESEHATAN REPRODUKSI TAHUN 2015
INDIKATOR
5.3.
5.5.
5.6.
Tingkat Tingkat pemakaian kontrasepsi/ contraceptive prevalence rate (CPR) wanita yang menikah usia 15-49, metode modern:
Cakupan pelayanan Antenatal (kunjungan pertama dan kunjungan minimal 4 kali ANC): • Kunjungan pertama • Kunjungan minimal 4 kali
Unmet need KB :
ACUAN DASAR
47.10% (SDKI 2007)
75.00% 56.00% (SDKI 2007)
12.70% (SDKI 2007)
SAAT INI
TARGET RPJMN (2014)
TARGET MDGs (2015)
57.90% (SDKI 2012)
65%
65%
95,7% 73,5% (SDKI 2012)
100% 95%
95% 90%
8.5% (SDKI 2012)
-
5%
STATUS
PENYEBAB KEMATIAN IBU
Sumber : Data rutin direktorat Bina
Estimasi Jumlah Kematian Ibu di Indonesia, 2013 5 6 7 8 6 2 6 4 6
50% kematian 25% kematian 25% kematian
9 4 6 2 1 2 8 7 2 4 5 5 5 5 5 2 7 8 1 1 1 4 3 2 1 1 2 6 6 3 1 0 1 1 1 1 0 1 9 9 9 9 9 9 7 4 2 8 4 2 2 7 7 7 7 1 0 9 8 6 5 5 5 5 5 5 4 4 4 3 3
I U T O T A I T H R A A G G R H N U R H T N A T A N T A A U H B L U L T N A A U R N A A A T A L A R A R E N U E A A R K U A A U A A A I I R G R R R R R R T C T R M G M R A A A A B U R U T P T G A M A M A T T N U A N I A A A A A A A G T U A A T L N K A T A I I P N L K I B E T U A B L P B K L B G U A E J N B N B U T T G E L E I O A M A A E T A E T A N A T A A B A A N I N A J E S N I S S M S U S Y R E R E E U E A I U K A S R I L R N W A W R A B G B E T S E O P U T K N A A T E A E A A R W A T I O A A L W W T G A L N D T A S A J A J A G N W G T E Y K A U P A A A G W A G T E I J N L G L N P M W U A N A M N A U M N M E L M A D L I I E E U U S K S A M L L U M T M S A S I B S T U L I A A U S L A L A S K U K N A S S A S K A K U U U N N A L U P Jumlah Total Kematian Ibu: 5.019 E K
Tren AKI 1990-2013 dan Proyeksi AKI 2030 di Indonesia
Bab VII
• Kesehatan Ibu, Anak, Remaja, Lanjut Usia dan Penyandang Cacat • Bagian ke satu : Kesehatan ibu, bayi dan anak
•
Upaya pemeliharaan kesehatan bayi & anak harus ditujukan utk mempersiapkan generasi yg akan datang, yg sehat, cerdas & berkualitas serta untuk menurunkan angka kematian kematian bayi bayi & anak
