Author : Suhartono Hermanus*
Over the past 15 years, the maternal mortality rate in Indonesia has not shown a significant decline, which should have been 225 / 100,000 live births in 2000. The challenge we face is to reduce Maternal Mortality Rate to 102 / 100,000 live births and Mortality Rate Infants (IMR) to 15/1000 live births by 2015 as achieved in the Millennium Development Goals (MDGs). Although many parties are skeptical about the role of Community Health Centers, not only in the handling of obstetric and neonatal emergency cases but also basic or normal delivery but still need to be empowered primary care services at primary level is the provision of PONED puskesmas. Basic Emergency Services is a must for primary reference services. The reason is that, in the difficult terrain of access to a limited referral center, geography and transportation, the PONED PHC is the only facility most likely to be reached. In addition, although it is close to the referral hospital, but if the emergency cases are unrecognized and stabilized and referred to in optimal and timely circumstances then the chances of saving mothers and babies will be better than cases that are not managed properly. In certain circumstances, even complications will be avoided and blood transfusions, not necessary. The 24-hour PONEK organization strategy in each referral hospital is obliged to foster Puskesmas in their work areas, through training of health officer performance improvement to be able to handle and refer optimally and timely the various obstetric and neonatal emergency cases at the basic service level.
Dr. Arend L Mapanawang, Sp.PD, FINASIM, PhD