Sumber: Weber2009

IMR – URBAN/RURAL

Closing the gap

IMR – ISLAND GROUPS

Widening the

gap

U5MR – ISLAND GROUPS

Widening the

gap

Day-139%

Day 0-3>44%

0-7 days79.4%

Source: Baseline Survey & BPS

Neonatal Death Situation

29%

15%

27%

29%

OthersInfectionAsphyxiaLBW

Underlying Cause

L B W

Source: GARUT HEALTH PROFILE 2007

Infant Mortality

336PROFILE 2007

+/- 1 infant per day

Study Provider Home visit to do ENC in Content of Home Visit NMRRed

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 7 •Konseling 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 3 •Konseling Prenatal •Kunjungan Postnatal (konseling)

50%

Hala (Pakistan)

Pekerja/kader kesehatan perempuan (diupah pemerintah)

Prenatal, Hari 1, 3, 7, 14 dan 28

•Konseling Prenatal •Kunjungan Postnatal (asesmen, konseling BBL, rujukan jika perlu)

29%

GLOBAL EVIDENCES

Up to 2010 Policy

1. KN-1: 0-7 days2. KN-2: 8-28 days

1. Inserting Day-3 home visita. KN-1: 6-48 hrsb. KN-2: day 3-7c. KN-3: day 8-28

2. Bring IMCI to newborn via home visits

Supportive Materials

• National Guideline of Essential Newborn Care

• National Action Plan for Child Survival

• District Action Plan (started by Garut)

• Riskesdas (2010)

1. Increasing the coverage of Child Survival essential package

Services package indicator targetIncreasing high-quality delivery services coverage

% delivery by SBA 90%% delivery in health facilities 70%

Managing Neonate Health

% neonate receiving early initiation of breastfeeding 70%

% 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 thermoregulation 40%

% neonate with local infection who receive oral antibiotic 60%

% sick neonate who early recognized and referred 20%

Managing Infant Health

% of infant who exclusively breastfeed 50%

% of 6-24 months infant who received appropriate and timely complementary feeding ??

% of infant who received measles immunization 90%

Management of Childhood illnesses

% U5 child with diarhea who receive oralit and Zinc 80%

% U5 child with pneumonia who received appropriate AB 80%

% U5 child with bloody diarhea who receive appropriate antibiotics 60%

%u5 child with malaria who receive ACT 30%