Maternal Mortality Evaluation: A Case Study in Bantul, Yogyakarta

Arlina Dewi, Nikma Kurnianingtyas Bekti, Supriyatiningsih Supriyatiningsih


Background: Maternal mortality rate is one of the indicators to measure the level of a woman's health. The maternal mortality rate in Indonesia is still high, it's about 190/100.000 live birth. The objective of the present study is to evaluate the cause of maternal death in Bantul at 2016 which related to the health services including human resources.

Subjects and Method: This was a mixed method with case study design on maternal mortality in Bantul District. The qualitative data collected through Focus Group Discussion (FGD) and the quantitative data from the questionnaire were filled by a senior midwife throughout the hospital in Bantul. The number of hospitals in Bantul District was 11 consisting of 1 government hospital and 10 private hospitals.

Results: The number of obstetricians who could be available 24 hours in hospitals was still limited. The skills of midwives were still considered to be limited in handling a number of obstetric emergency conditions due to the lack of regular training. The primary health care services which had been provided to support and handle obstetric emergencies, but the infrastructure and human resources were still considered inadequate. Thus, there was also a condition where the utilization of integrated ANC facilities in the primary health center (Puskesmas) was still low, soan early detection of complications of pregnancy was less optimal.

Conclusion: There are three main topics causing the maternal mortality at Bantul, and those are 1)Maternal mortality related to hospital facilities, 2) Maternal mortality related to human resources at the hospital, 3) Maternal mortality related to health center facility.

Keywords: maternal, obstetrician stand-by, hospital

Correspondence: Arlina Dewi. Masters Program in Hospital Management, Universitas Muhammadiyah Yogyakarta. Jl. Brawijaya, Bantul 55183, Yogyakarta, Indonesia. Email: Mobile: +6281­22972576

Journal of Maternal and Child Health (2019), 4(5): 342-350


Full Text:



Arulita F (2007). Faktor-Faktor Risiko yang Mempengaruhi Kematian Maternal (Studi Kasus di Kabupaten Cilacap) (PhD Thesis). Tesis, Program Studi Magister Epidemiologi, Program Pas-ca Sarjana Universitas Diponegoro, Semarang.

Bossert T, Soebekti R, Rai NK (1991). Bottom-up’ planning in Indonesia: decentralization in the ministry of health. Health Policy Plan. 6: 55–63.

Campbell OM, Graham WJ (2006). Strategies for reducing maternal mortality: getting on with what works. The Lancet. 368: 1284–1299.

Dinkes Bantul (2017). Profil Kesehatan Kabupaten Bantul 2016.

Dinkes DIY (2015). Narasi Profil Daerah Istimewa Yogyakarta.

Efendi F (2012). Health Worker Recruitment and Deployment in Remote Areas of Indonesia (SSRN Scholarly Paper No. ID 2884694). Social Science Research Network, Rochester, NY.

Emelumadu OF, Onyeonoro UU, Ukegbu AU, Ezeama NN, Ifeadike CO, Okezie OK (2014). Perception of quality of maternal healthcare services among women utilizing antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria. Niger. Med. J. J. Niger. Med. Assoc. 55, 148.

Ferrinho P, Van Lerberghe W, da Cruz Gomes A (1999). Public and private practice: a balancing act for health staff. Bull. World Health Organ.

Hutchinson PL, Do M, Agha S (2011). Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya, and Ghana. BMC Health Serv. Res. 11, 203.

Kemenkes (2015). Data Dasar Puskesmas DIY 2015.

Kirigia JM, Gbary AR, Muthuri LK, Nyoni J, Seddoh A (2006). The cost of health professionals’ brain drain in Kenya. BMC Health Serv. Res. 6, 89.

Lehmann U, Dieleman M, Martineau T, (2008). Staffing remote rural areas in middle and low-income countries: A literature review of attraction and retention. BMC Health Serv. Res. 8, 19.

Mashalla YJ, Sepako E, Setlhare V, Chuma M, Bulang M, Massele AY (2016). Availability of guidelines and policy documents for enhancing the performance of practitioners at the Primary Health Care (PHC) facilities in Gaborone, Tlokweng, and Mogoditshane, Republic of Botswana. J. Public Health Epidemiol. 8, 127–135.

Noerdin E, Aripurnami S, Anindhita F, Elison NK, Pelangi B, Susanti LR, (2015). Pemenuhan Fasilitas Kesehatan Ibu Melahirkan Era Jaminan Kesehatan Nasional.

Osubor KM, Fatusi AO, Chiwuzie JC (2006). Maternal health-seeking behavior and associated factors in a rural Nigerian community. Matern. Child Health J. 10, 159–169.

Powell-Jackson T, Gao Y, Ronsmans C, Zhou H, Wang Y, Fang H (2015). Health-system determinants of declines in maternal mortality in China between 1996 and 2013: a provincial econometric analysis. The Lancet, The Lancet-CAMS Health Summit Abstracts booklet 386, S15.

Ramani S, Rao KD, Ryan M, Vujicic M, Berman P (2013). For more than love or money: attitudes of student and in-service health workers towards rural service in India. Hum Resour Health. 11: 58. doi: 10.1186/1478-4491-11-58.

Saleh N (2014). Audit Kematian Ibu.

Say L, Chou D, Gemmill A, Tunçalp Ö, Mol-ler AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L (2014). Global causes of maternal death: a WHO systematic analysis. Lancet Glob. Health 2: e323–e333.

Sousa A, Tandon A, Dal Poz MR, Prasad A (2006). Measuring the efficiency of human resources for health for attaining health outcomes across subnational units in Brazil. World Health Organization.

Speybroeck N, Paraje G, Prasad A, Goovaerts P, Ebener S, Evans DB (2012). Inequality in Human Resources for Health: Measurement Issues. Geogr. Anal. 44, 151–161.

Uzochukwu BSC, Onwujekwe OE, Akpala CO (2004). Community satisfaction with the quality of maternal and child health services in southeast Nigeria. East Afr. Med. J. 81: 293–299.

WHO, UNICEF, UNFPA, World Bank Group (2015). Trends in maternal mortality: 1990-2015: estimates from WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division.

Wilson A, Gallos ID, Plana N, Lissauer D, Khan KS, Zamora J, MacArthur C, Coomarasamy A (2011). The effectiveness of strategies incorporating training and support of traditional birth attendants on perinatal and maternal mortality: a meta-analysis. BMJ. 343: d7102.

Yego F, D’Este C, Byles J, Williams JS, Nyongesa P (2014). Risk factors for maternal mortality in a Tertiary Hospital in Kenya: a case-control study. BMC Pregnancy Childbirth 14: 38.


  • There are currently no refbacks.