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A MATERNAL AND CHILD COMMUNITY-BASED HEALTH PROGRAM IN ENDE DISTRICT, INDONESIAMartha Mabiala
INTRODUCTION
Source:
INDONESIA1,2The world’s 4thmost populous country17,000 islands ; 33 provincesLower middle-income country1997 financial crisis65.9% of the population can be categorized in the lowest wealth quintile10.4% (8.0%) of women have no education; 21% only completed primary education
INDONESIA1-3Indonesia at the bottom of several health indicators:Maternal mortality rate: 126 per 100,000 birthsU5M: 167 per 1,000; Infant mortality: 138 per 1,000; Neonatal deaths: 83 per 1,00032% of infants exclusively breastfed for the first 6 monthsPrevalence of anemia in under-fives: 36%Shortage of health professionals and healthcare facilities:Health post density: 9.2 per 100,000; health district density: 0.4 per 100,000Hospital beds density: 6 beds per 100,000 (for 8 consecutive years)
MATERNAL AND CHILD HEALTH ASSESSMENT
ENDE, NUSA TENGGARA TIMUR4,5Nusa Tenggara Timur (NTT)One of the poorest provincesUnder-5 mortality: 80 per 1,000 live births80% (59% for Indonesia) of women give birth at home55% (32% for Indonesia) have birth assisted by a TBAEnde, a rural, mountainous district in Nusa Tenggara Timur (NTT)Population: 250,000; 214 villagesLower life expectancy at birth for both sexes than NTT95% of the population lives in rural areasHigh prevalence of diarrhea, ARI, pneumonia and skin diseases among under-fives
THE ENDE CHILD MORTALITY SURVEY (ECMS)4,5Cross-sectional household surveyMeasured MCH service utilization, early age mortality, socioeconomic factorsResults: Low utilization of skilled birth assistance and obstetric services50% of deliveries attended by a SBA in a hospitalHigher infant mortality and risk of infant death associated with the use of TBAs compared to SBAsHigher risk of child mortality in areas where health centers were more than 1 hour away
PROPOSAL
Community Health Worker programCHWs can provide health services affordable even to the poorest members of the communityMore likely to be well-receivedObjectivesImproving provision of maternal, neonatal and child health services at household and community levelsIncreasing knowledge of and practices related to maternal, neonatal and child health.
PROJECT IMPLEMENTATIONPHASE 1- Community engagement and community planCommunity engagementFocus groups, key informant interviews, community dialogues

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Term
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Tags
Demography, Health care provider, CHWs

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