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Sumber: Weber2009
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IMR – URBAN/RURAL Closing the gap
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IMR – ISLAND GROUPS Widening the gap
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U5MR – ISLAND GROUPS Widening the gap
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Day-1 39% Day 0-3 >44% 0-7 days 79.4% Source: Baseline Survey & BPS Neonatal Death Situation
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Underlying Cause L B W
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Source: GARUT HEALTH PROFILE 2007 Infant Mortality 336 PROFILE 2007 +/- 1 infant per day
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StudyProvider Home visit to do ENC inContent of Home Visit NMR Red SEARCH (India) Pekerja kesehatan masyarakat/ kader (diberi upah plus insentif kinerja) Prenatal, Persalinan, Hari 1, 2, 3, 5, 7, 14, 21 dan 28 Konseling prenatal Asuhan kelahiran (resusitasi) Kunjungan postnatal (asuhan & konseling) Manajemen infeksi Asuhan bayi BBR (kunjungan ekstra) 57% ANKUR (India) Pekerja kesehatan masyarakat/ kader (diberi upah plus insentif kinerja) Prenatal, Persalinan, Hari 1, 2, 3, 5, 7, 14, 21 dan 28 Konseling prenatal Asuhan kelahiran (resusitasi) Kunjungan postnatal (asuhan & konseling) Manajemen infeksi Asuhan bayi BBR (kunjungan ekstra) 51% Projahnmo (Bangladesh) Pekerja kesehatan masyarakat/ kader (diberi upah ) Prenatal, Hari 1, 3, dan 7Konseling Prenatal Kunjungan Postnatal (asesmen dan konseling BBL) Perawatan infeksi BBL (jika rujukan ditolak) 34% Shivgarh (India) Pekerja kesehatan masyarakat (diberi upah ), diubah menjadi relawan masyarakat/ kader Prenatal, Hari 1 dan 3Konseling Prenatal Kunjungan Postnatal (konseling) 50% Hala (Pakistan) Pekerja/kader kesehatan perempuan (diupah pemerintah) Prenatal, Hari 1, 3, 7, 14 dan 28Konseling Prenatal Kunjungan Postnatal (asesmen, konseling BBL, rujukan jika perlu) 29% GLOBAL EVIDENCES
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Up to 2010 Policy 1. KN-1: 0-7 days 2. KN-2: 8-28 days
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1.Inserting Day-3 home visit a.KN-1: 6-48 hrs b.KN-2: day 3-7 c.KN-3: day 8-28 2.Bring IMCI to newborn via home visits
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Supportive Materials National Guideline of Essential Newborn Care National Action Plan for Child Survival District Action Plan (started by Garut) Riskesdas (2010)
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1. Increasing the coverage of Child Survival essential package Services packageindicatortarget Increasing high- quality delivery services coverage % delivery by SBA90% % delivery in health facilities70% Managing Neonate Health % neonate receiving early initiation of breastfeeding70% % neonate received three post-natal visit: within 48 hours, 3-7 days and 8-28 days (cord care, vit K, topical eyes antibiotic, thermoregulation, hep B) 60% % uncomplicated LBW who recieved thermoregulation40% % neonate with local infection who receive oral antibiotic60% % sick neonate who early recognized and referred20% Managing Infant Health % of infant who exclusively breastfeed50% % of 6-24 months infant who received appropriate and timely complementary feeding?? % of infant who received measles immunization90% Management of Childhood illnesses % U5 child with diarhea who receive oralit and Zinc80% % U5 child with pneumonia who received appropriate AB80% % U5 child with bloody diarhea who receive appropriate antibiotics60% %u5 child with malaria who receive ACT30%
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