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Abstract

Kematian ibu tidak hanya menjadi masalah kesehatan masyarakat, tetapi juga menjadi masalah sosial karena akan berpengaruh besar terhadap keluarga, terutama anak-anak. Di negara maju dengan status sosial ekonomi yang tinggi kematian ibu telah turun mencapai tingkat minimal kurang dari 10 per 100.000 kelahiran hidup. Hal tersebut belum terjadi di negara-negara berkembang, termasuk Indonesia. Di samping pertumbuhan ekonominya yang terus membaik, kematian ibu di Indonesia masih tergolong tinggi, bahkan di antara sesama negara Asia Tenggara. Berdasarkan data SDKI, telah terjadi penurunan angka kematian ibu, tetapi dengan penurunan seperti sekarang target Pembangunan Milenium tidak akan tercapai. Dari aspek demand, supply, maupun kebijakan, penurunan kematian ibu masih mengalami berbagai hambatan. Untuk mempercepat penurunan kematian ibu perlu dikembangkan kebijakan yang dapat mengatasi hambatan utama berupa kelangkaan petugas pelayanan kesehatan yang terampil, infrastuktur pelayanan kesehatan ibu yang belum memadai, kualitas pelayanan yang sub-standar, dan keengganan para ibu untuk menggunakan fasilitas pelayanan kebidanan karena biaya yang sangat tinggi dan pelayanan yang masih buruk atau karena masih lebih menyukai pelayanan dukun dengan berbagai alasan lingkungan yang spesifik. Dalam mempercepat penurunan kematian ibu, kebijakan dan manajemen di tingkat kabupaten berperan sangat menentukan.

Maternal mortality is both public health and social problem. The death of a mother will affect the family, especially the children. In the developed countries, with their high socio-economic status, maternal deaths have declined to its minimal level, less than 10 deaths among 100,000 life births. That is not the case in the developing countries, Indonesia included. Despite its continued economic growth, maternal death in Indonesia is still high, even within Southeast Asian countries. According to IHDS data, maternal mortality eduction happened over time, however, with its current rate of decline the MDGs target on maternal mortality will unlikely be met. Maternal mortality reduction is still facing various demand, supply, and policy constraints. In order to accelerate maternal mortality reduction, policies are required to overcome various barriers, which include shortage of skilled health providers, inadequate maternal health infrastructures, sub-standard service quality, and unwillingness women to use maternity facilities due to its high cost and inadequate services, or their preference towards traditional birth attendant (TBA) services. Role of district policies and management on maternal health is crucial in accelerating maternal death reduction.

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