Jurnal Manajemen Pelayanan Kesehatan
Vol 11, No 03 (2008)


D.Irasanty, Gufria (Unknown)

Article Info

Publish Date
16 Dec 2013


Background: The geography, distances and infrastructuresfactors are highly affecting community accessibility to moderntransportation. In general, obstetric emergency cases failed tobe managed because of the low accuracy in routine pregnancyfollow up and delay in referral. One limiting factor in obstetricreferral is the unavailability of an effective mode of moderntransportation to reach remote residential area. Autonomy ofthe clinics and willingness of health staff are the key factors inmedical referral system. Unfortunately, the transportation whichconnects between community and health facilities and amongfacilities has not become parts of a professional integratedreferral system. This research studies the strategies toovercome delay in delivery assistance in remote areas whichare far from health facilities. It tries to prove that referralmanagement should become a focus and a part of governmentagenda.Method: This research uses case study design. Data wereobtained from village midwives, important public figures, headsof community health service, the head of health department,the director of public hospital, the head of hospital emergencyunit, the local head of Indonesia Red Cross Organization, localfield coordinator of Red Cross Organization and the patientsof obstetric emergency units in Kabupaten Majene. Thisresearch was conducted from August to December 2007.Result: The patients and their family play the main role inmanaging the emergency of obstetric problems. Family financialcapability and distances are some of the problems in managingthe obstetric emergency for patients who live far from healthfacilities. The efforts to overcome those problems are still inthe hand of service providers and health service units. Theyheavily depend on the patient and family financial capability.The patients who can afford to pay the services will be able toovercome their problems. Most of the families who live in ruralarea which are far from health facilities will face unsecureddif ficult situation. Every ambulance which is owned bycommunity health services, hospital and Red CrossOrganization are managed by the head of their units. Thehospital itself has a special ambulance service unit which isseparated from its emergency unit.Conclusion: Even though the management of transportationmode has already become a part of health department andgovernment agenda, it is still hand over informal sectors.Community is helping in providing transportation servicespontaneously. The management of transportation mode is stillsimple and undertaken by each health facility.Suggestion: The initiatives to manage ambulance in integratedway become a must to develop local health system. Theseefforts could be supported by all available ambulance in everyhealth service. The presence of units which manage thecooperation between every available obstetric service in oneregional integrated system should become the main agenda.Keywords: maternal referral delay, traditional referral, serviceregionalization

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