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Download Article (PDF) Advances in Social Science, Education and Humanities Research, volume 499 2nd International Conference on Law, Governance and Social Justice (ICOLGAS 2020) The Role Of Law In The Improvement Of Maternal Health In Central Sumba Dyah Hapsari Prananingrum1 1Satya Wacana Christian University, Salatiga – Indonesia E-mail: [email protected] Abstract- This research focuses on the issue of how law Motherhood Initiative. This was followed later by should be developed to improve maternal health issues Gerakan Sayang Ibu or Love Mom Movement at the regional level, particularly in Central Sumba Regency, East Nusa Tenggara, Indonesia. Based on the program initiated in 1996 by the President of the presumption that law can be used as a tool to achieve Republic of Indonesia. This program was massive the goals of the community, this study aims to assess the in that its implementation required a wide scope of current policy and regulations concerning maternal health and to prescribe the development of law needed involvement of the health sector as well as the to address this crucial issue. This research adopts other related sectors. empirical approach in which valid data were collected One of the primary programs which has been directly from field assessment. Interview with key informants (including local government officials and devised to overcome maternal mortality issue was traditional leaders) and documentary study are the large-scale deployment of midwives to villages main methods used in collecting data. Techniques to which aims to bring access to mother health service confirm data validity were intensely applied, mostly triangulation (in terms of both source and method) and closer to the community. Another attempt that has source-based cross-checking. This research adopts been carried out is the implementation of Making qualitative analysis which is conducted simultaneously Pregnancy Safer strategy, which was formally along with data collection process. This research found that local regulation needs to be issued to regulate launched in 2000. In 2012, the Health Ministry various aspects needed to improve maternal health launched Expanding Maternal and Neonatal standard in Central Sumba. Survival (EMAS) program for the purpose of Keywords- Function Of Law; Indonesia; Maternal reducing maternal and neonatal mortality rate by Health; Sumba. 25%. The risk of maternal death due to childbirth in I. INTRODUCTION Indonesia is 1 of 65 childbirths which is far higher In Indonesia, since the year of 1990 strategic than 1 of 1,100 childbirths in Thailand. In addition measures have been taken to reduce Maternal to this, disparity of inter-regional (provincial) Mortality Rate (MMR) through Safe Motherhood maternal mortality in Indonesia is still high. To approach, based on the sound assumption that speed up the decrease in MMR a Continuum of every pregnancy carries risks, despite the mother's Care approach may be used in this regard as a way good health condition before and during pregnancy. to tackle the deaths of mothers, babies, and Through this approach, the World Health children. This concept is one of the undertakings in Organization (WHO) developed "Four Pillars of maternal and infant health issue by the Ministry of Safe Motherhood" to describe the different Health. The Continuum of Care Approach, measures to be taken to save mother and her baby particularly in maternal and infant health service, in one single integrated process. The four pillars focuses its attention on health services provided are family planning, antenatal care, clean and safe during the first 1000 days of life. This is in line delivery, and essential obstetric care. These four with the work plan to accelerate the attainment of pillars serve as one Millennium Development Goals (MDGs), where target of health development program is set based of the methods to support maternal and infant on the pertaining life cycle condition. Hence, it's health. targeting pregnant women, women in labour, As part of its effort to reduce MMR in women in postpartum period, and breast-feeding Indonesia, the government through its Health women; and covering as well certain age groups, Ministry since 1990 has launched the Safe such as babies, under-five-year-old children, Copyright © 2020 The Authors. Published by Atlantis Press SARL. This is an open access article distributed under the CC BY-NC 4.0 license -http://creativecommons.org/licenses/by-nc/4.0/. 466 Advances in Social Science, Education and Humanities Research, volume 499 elementary school aged children, and women of regency of Central Sumba. It is expected that the child-bearing age. results of this study could also be implemented in Efforts that have been put in Continuum of Care other regions (municipals or regencies) to address for mothers among others is ensuring that every similar problems. mother can have proper access to qualified health service, such as health service for pregnant women, II. PROBLEMS childbirth care by skilled health personnel in health Based on the previous description, the research care facilities, postpartum care for mothers and issues that will be addressed in this paper are babies, special care and referral when complication specified as follows first, how health care practices occurs, facilitation to obtain pregnancy and were implemented to respond maternal health maternity leave, and family planning service issues in Central Sumba? And second, how could law be utilized to improve maternal health in Figure 1. Thought Flow of Health Development Plan Central Sumba? and National Health System [1] III. RESEARCH METHOD This research adopts empirical approach in which valid data were collected directly from field assessment. Interview with key informants (including logal government officials and traditional leaders) and documentary study are the main methods used in collecting data. It is acknowledged that in such research the validity of data is crucial, so techniques to confirm data validity were intensely applied, mostly To ensure that the goals of health development triangulation (in terms of both source and method) are attained, the National Health System (Sistem and source-based cross-checking. This research Kesehatan Nasional or SKN) was arranged based adopts qualitative analysis which is conducted on Presidential Regulation No. 72 of 2012 on simultaneously with data collection process. National Health System. SKN is a health To approach the second research issue, management system administered by every documentary study on relevant regulations which component in Indonesia, which basically requires are related to the protection and improvement of integrative approach and mutual support from all of maternal health was also performed properly. In the stakeholders to ensure the achievement of the this regards, the regulations studied includes law highest level of health in the community. and regulations at the national level as well as at In reality, the health level of women, including the regional level. maternal health aspects is, in particular, affected predominantly by various factors which most of IV. DISCUSSION them are beyond the scope of health sector control. 1. Implementation of Health Care Practices for Thus, promoting health efforts which exclusively the Improvement of Maternal Health in Central involves only the health sector will less likely be Sumba able to create required health preconditions. The high MMR in East Nusa Tenggara This situation subsequently raises some issues Province was reckoned with data from Cities and such as the implementation of maternal health Regencies; one of them is from the Regency of standards and procedures in a particular social Central Sumba. The number of mortality cases environment where cultural factors play a reported in Central Sumba fluctuates year after substantial role, such as in Central Sumba. From year. In 2012, there were 2 maternal mortality the legal point of view, the relevant issue emerging cases; while in 2013, there was 1 maternal from this situation, which is at the center of this mortality case. Maternal Mortality were 2 cases in study, is how law should be developed to address 2016. To suppress maternal deaths during the problem of maternal and child health in the childbirth, as mentioned above, the following major 467 Advances in Social Science, Education and Humanities Research, volume 499 attempts are made: increasing the pregnancy class outpatient and outreach services (reproductive coverage and the improvement of antenatal service. health, pregnancy care, after childbirth and child Figure 2. Mother and Child Health Care Continuum health services), and one through integrated family Concept and community care throughout the life cycle. Mothers and babies have a high risk in the first days after birth, and the lack of a defined care package after childbirth is an important gap, which also contributes to discontinuity between maternal The concept of a "continuum of care" has and child health programs. emerged as a new paradigm for dealing with Likewise, because family and community maternal, infant and child mortality and is very packages tend not to be considered part of the important for combating maternal, infant and child health system, some countries have made mortality. The first dimension of this continuum is systematic efforts to scale it or integrate it with time - from before pregnancy, through pregnancy, other levels of care. Building a continuum of care childbirth, and the days and years of life. The for maternal,
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