The Management of Birth Asphyxia by Village Midwives in Cirebon, Indonesia

The Management of Birth Asphyxia by Village Midwives in Cirebon, Indonesia

 

This talk, based on a study by the same name, was given by Iwan Ariawan, of The Program for Appropriate Technology for Health (PATH), Jakarta, Indonesia. It was prepared by Dr. Ariawan, Mardiana Agustini, Yancy Seamans, Vivien Tsu, and M. Sholeh Kosim.

 

Dr. Ariawan began by explaining that in Indonesia the neonatal mortality rate is still high (Figure 7.1), with a high proportion of deaths due to birth asphyxia (Figure 7.2).

 

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Baseline, pre-study data from 1993 are shown in Figure 7.3.

 

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Prior to the study there had been no training of village midwives.  The goal of the study was to measure the impact on the asphyxia-specific neonatal mortality rate of village midwives (VM) managing birth asphyxia (Figure 7.4).

 

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A flow chart used in training VM on newborn resuscitation is shown in Figure 7.5.

 

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A summary of the input, process, output and outcome of intervention training and research studies is shown in Figure 7.6.

 

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Figures 7.7, 7.8, 7.97.10 describe the designs of the research studies.

 

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Four resuscitation devices were tested by the VM and the results are shown in Figures 7.11, 7.127.13. A summary of the laboratory testing of the devices is shown in Figure 7.14.

 

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Figures 7.15 and 7.16 show the knowledge and skill levels of VMs before and after training.

 

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Figure 7.17 shows the steps applied by VMs in managing  414  cases of birth asphyxia.

 

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The effect of the program on cause-specific neonatal mortality is shown in Figure 7.18. The effect on perinatal and neonatal mortality is shown in Figure 7.19.

 

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Dr. Ariwan’s conclusions are shown in Figures 7.20, 7.217.22.


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