Abstract

Dalam beberapa dekade terakhir telah terlihat penurunan angka kematian anak di bawah umur lima tahun. Tetapi, penurunan pada angka kematian neonatal tidak menunjukkan penurunan yang bermakna. Kematian neonatal merupakan komponen penting jika ingin menurunkan angka kematian anak di bawah umur lima tahun. Kematian anak di bawah umur lima tahun merupakan tujuan ke-4 dari Pembangunan Milenium. Pada tahun 2000 sebanyak 130 juta kelahiran, sebanyak 4 juta mati pada masa neonatal, yang ini merupakan 2/3 dari kematian bayi. Dua pertiga kematian neonatal terjadi pada minggu pertama setelah kelahirannya. Dan 99%-nya terjadi di negara berkembang. Konsentrasi waktu terjadinya kematian neonatal mirip dengan waktu terjadinya kematian maternal. Kematian maternal terbesar terjadi saat trimester ke-3 masa kehamilan, masa persalinan dan seminggu setelah persalinan. Maka, intervensi untuk kematian maternal dan kematian neonatal harus dilakukan secara bersama. Bukti telah menunjukkan dengan upaya yang sederhana dengan berbasis masyarakat dapat menurunkan angka kematian maternal dan neonatal secara bermakna. WHO dan UNICEF pada tahun 2009 telah membuat pernyataan bersama, dengan judul: kunjungan rumah pada bayi baru lahir, sebuah strategi untuk meningkatkan kelangsungan hidup neonatal. Ada 7 butir rekomendasi yang perlu diperhatikan oleh negara yang ingin menurunkan angka kematian neonatal. Setiap negara harus mengevaluasi program yang sedang berjalan dan melakukan penyesuaian.

The declining of children under five of age mortality has been seen over several decades. But the rate of neonatal death remains stagnant. Neonatal death is crucial if one want to decrease the under five mortality as it has been stated as the fourth goal of the Millennium Development Goals. At year 2000 there were 130 million births, among whom 4 million was died during neonatal period, which was 2/3 from the infant death. Two third of the neonatal death occurred at the first week of life and 99% happen in developing countries. The timing of maternal death mostly occurred at the end of pregnancy, at birth and within one week after delivery. Intervention of maternal and neonatal death should be done simultaneously. Evidence have showed that simple measures on community based approach are able to reduce neonatal and maternal mortality significantly. WHO and UNICEF in 2009 have made joint statement: “Home visits for the newborn child: a strategy to improve survival”. There were 7 points of recommendation that need to be addressed by countries who want to reduce neonatal mortality. Each country should look at the existing program and make necessary changes accordingly.

References

  1. Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? where? why? Lancet. 2005; 365(9462): 891-900.
  2. WHO and UNICEF. Home visits for the newborn child, a strategy to improve survival. New York, USA: WHO, Department of Child and Adolescent Health and Development, Geneva. UNICEF, Health Section, Programme Division; 2009.
  3. Ronsmans C, Graham WJ. Maternal mortality: who, when, where, and why. Lancet: 2006.
  4. Sines E, Syed U, Wall S, Worley H. Postnatal care: a critical opportunity to save mothers and newborns. In: Population_Reference_Bureau, ed. January 2007 ed: Save the Children 2007.
  5. Baqui AH. Projahnmo Study Group. Effect of community-based newborn-care intervention package implemented through two service delivery strategies in Sylhet district, Bangladesh: a cluster-randomised controlled trial. Lancet. 2008; 371(9628):1936–44.
  6. Kumar V. Saksham Study Group. Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: a cluster-randomised controlled trial. Lancet. 2008; 372(9644): 1151–62.
  7. Bhutta ZA. Implementing communitybased perinatal care: results from a pilot study in rural Pakistan. Bull World Health Organ. 2008; 86(6): 452–9.
  8. Hannula L, Kaunonen M, Tarkka MT. Helsinki Polytechnic Stadia, health care and social services a systematic review of professional support interventions for breastfeeding. J Clin Nurs. 2008; 17(9): 1132–43.

Download

Share

COinS