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Maternal deaths in eastern Indonesia: 20 years and still walking: an ethnographic study

Belton, Suzanne, Myers, Bronwyn and Ngana, Frederika Rambu (2014). Maternal deaths in eastern Indonesia: 20 years and still walking: an ethnographic study. BMC Pregnancy and Childbirth,14(Article No. 39).

Document type: Journal Article
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IRMA ID 11436xPUB49
Title Maternal deaths in eastern Indonesia: 20 years and still walking: an ethnographic study
Author Belton, Suzanne
Myers, Bronwyn
Ngana, Frederika Rambu
Journal Name BMC Pregnancy and Childbirth
Publication Date 2014
Volume Number 14
Issue Number Article No. 39
ISSN 1471-2393   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84892637433
Total Pages 10
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
The delays in receiving adequate emergency maternal care described by Thaddeus and Maine twenty years ago are still occurring, as exemplified in this study of cases of maternal deaths in a subdistrict in rural eastern Indonesia.

Methods

An ethnographic design was conducted, recruiting eleven families who reported on cases of maternal deaths in one sub-district of Indonesia, as well as assessing the geographical and cultural context of the villages. Traditional birth attendants and village leaders provided information to the research team which was thematically and contextually analysed.

Results

Two stages to the first and second delays have been differentiated in this study. First, delays in the decision to seek care comprised time taken to recognise (if at all) that an emergency situation existed, followed by time taken to reach a decision to request care. The decision to request care resided variously with the family or cadre. Second, delays in reaching care comprised time taken to deliver the request for help and then time for help to arrive. A phone was not available to request care in many cases and so the request was delivered by walking or motorbike. In two cases where the decision to seek care and the delivery of the request happened in a timely way, help was delayed because the midwife and ambulance respectively were unavailable.

Conclusions

This study, although a small sample, confirmed that either a single delay or a sequence of delays can prove fatal. Delays were determined by both social and geographic factors, any of which alone could be limiting. Initiatives to improve maternal health outcomes need to address multiple factors: increased awareness of equitable access to maternal health care, village preparedness for emergency response, improved access to telecommunications and geographic access.
Keywords Maternal mortality
Indonesia
Stigma
Health-seeking
Fatalism
Geo information systems
DOI http://dx.doi.org/10.1186/1471-2393-14-39   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 2.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 2.0 License
URL https://creativecommons.org/licenses/by/2.0/au


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