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Why do we need ALARM course ?
Objectives :
1. Qualification
2. Standard of care
3. Reduction of MMR&PMR through EmOC
Political Statement
SMI (1989) Indonesia to reduce MMR 450 half (in 2000)MPS (2001) Every pregnancy should be wantedEvery complication should have proper care90% of delivery by skilled attendantsReasons
High MMR & PMRStandard GuidelinesTrainingFACTS
MMR 396/100.000CBR = 2.65.2 million deliveries/year57% CPRUnmet need 9%63% delivery by Skilled attendants75% of Hospitals have OG60.000 midwives deployed in villagesPMR 30%o150.000 Perinatal deaths/yearQUALITY OF ATTENDANTS ?POVERTY (50%)7000 HC+bed underutilizedDeaths could be prevented
Pregnancy - Labour Complications mild Complications severe deathsTarget : Skilled attendants that competence in dealing with complication (EmOC)TRAININGMMR
Indonesia 396 (2000)Subang district 110Bali 88Lombok 120East Java (selected) 55Technology
Postpartum hemorrhage AM3 +MisoprostolEclampsia MgSO4 + NifedipineSepsis antibioticUnwanted pregnancy safe abortion + PACProlonged labour partogram, CS,vacuum ext.Healthy Indonesia 2010
MMR 125IMR 15ANC 1 =95%, ANC 4 =80%Skilled attendant cov. 90%80% Complications should be properly caredColaboration of Ob-Gyn & Midwives
Improve quality of careStandard of training programExtension of training to every districts (400+)Monitoring & evaluationCooperation
POGI 1500Midwifery Association
70.000 members
JNPK
Figure: ALARM certified Spesialist will be involved in the training of EmOC for Health centres nurses, doctors and midwives
EmOC
(BEONC)
Midwives
ALARM
Course
Ob-Gyn
Organization
Headquarter5 centresMedan, Jakarta, Semarang, Surabaya & MakassarQuality control3-4 training program/centre/yearTrainers : ALARM certified faculty for EmOC (Beonc)