Community Health Services Experience on the Effort of Mother Health Care : Pilot Project on Several Community Health Services (Pengalaman Puskesmas dalam Upaya Keselamatan Ibu: Pilot Project di Beberapa Puskesmas)

The safe motherhood initiative was launched in 1987 in an International effort to focus on the reduction of maternal mortality and propose strategics to reduce it. By the end of Pelita VI, the Government of Indonesia has committed its policy to reduce the current maternal mortality rate by half. Hence research to reduce define the most appropriate and cost-effective ways to reduce maternal morbidity as well as mortality and improve the availability, accessibility, and quality of health services within specific local culture should be priority of the Safe Motherhood efforts. A review was conducted using analytical framework of maternal mortality as proposed by Mac Carty and Maine. Several theoretical program interventions were briefly discussed such as making family planning services available, improving socio-economic status, providing antenatal services, providing legal and safe abortion services, providing obstetric emergency services, conducting training for traditional birth attendants (TBAS), and providing education and secial mobilization of the community. A combination of recommended strategy was proposed consisting of ensuring availability of obstetric emergency services, decreasing risk of unwanted pregnancy by making available accessible and high quality of family planning services and lastly improving the maternal health services. Field experience in conducting several models of intervention was weakness. It is strongly endorsed making replication of the model in each province in the country which eventually will become a center of training for health personnel in implementing similar programs. It is also suggested to initiate the intervention earlier for the adolescents.