Potential Cause of Low Coverage of Labor by Health Personnel in Konawe North District Province South Sulawesi Indonesia

Abstract

One of the causes of the high maternal mortality rate is that delivery assistance is not carried out by health workers, so this is still a health problem in Indonesia. In Southeast Sulawesi Province the coverage of childbirth assistance by health workers in 2015 reached 88.91%, not yet reaching the target of the Ministry of Health's Strategic Plan of 90%. There are still 6 districts below the provincial average, namely South Konawe 82.70%, Buton 80.07%, Bau-Bau City 76.76%, North Kolaka 74.26%, Konawe Kepulauan 60.96% and Konawe North 35.83%. The purpose of the study was to identify the low causal factors for childbirth coverage by health workers in North Konawe Regency, Southeast Sulawesi Province. This type of research is qualitative research, with a case study approach. Informants are Maternity and Health workers. Data collection using in-depth interviews, observation and document review. The results showed that the factors that caused the low coverage of childbirth were traditional or belief factors which were used generations of traditional birth attendants as birth attendants as a result of low knowledge, remote access, geographical conditions, transportation facilities and inability to pay transportation to visit health facilities, not the ownership of health insurance, the lack of health workers and the lack of health facilities that support the work of midwives. The strategies for increasing the coverage of labor include: trained midwife contract system policies with placement mechanisms based on the ratio of midwife staff to the number of people, health education by involving stakeholders, facilitating access to health services through the provision of ambulances, and providing infrastructure that supports midwife's work performance. Conclusion; the cause of the low coverage of childbirth by health workers is caused by the presence of health service factors and community characteristics. Suggestion; stakeholders should formulate a policy of increasing contracting in and contracting out capacity to overcome the shortage of limited midwives' labor, provide health facilities, and train traditional birth attendants.