Why do we need

ALARM course ?
Objectives :
1. Qualification
2. Standard of care
3. Reduction of MMR&PMR through EmOC

Political Statement
SMI

(1989) Indonesia to reduce

MMR 450 half (in 2000)
MPS (2001)
Every pregnancy should be wanted
Every complication should have
proper care
90% of delivery by skilled attendants

Reasons
High

MMR & PMR

Standard
Guidelines
Training

FACTS

MMR 396/100.000
CBR = 2.6
5.2 million
deliveries/year
57% CPR
Unmet need 9%
63% delivery by
Skilled attendants

75% of Hospitals have OG

60.000 midwives
deployed in villages

PMR

30%o
150.000 Perinatal
deaths/year
QUALITY

OF
ATTENDANTS ?
POVERTY (50%)
7000 HC+bed
underutilized

Deaths could be prevented

Pregnancy

- Labour
Complications mild
Complications severe deaths
Target

: Skilled attendants that

competence in dealing with
complication (EmOC)
TRAINING

MMR
Indonesia
Subang
Bali

396 (2000)

district 110

88
Lombok 120
East Java (selected) 55

Technology
Postpartum

hemorrhage AM3
+Misoprostol
Eclampsia MgSO4 + Nifedipine
Sepsis antibiotic
Unwanted pregnancy safe abortion
+ PAC
Prolonged labour partogram,
CS,vacuum ext.

Healthy Indonesia 2010

MMR

125
IMR 15
ANC 1 =95%, ANC 4 =80%
Skilled attendant cov. 90%
80% Complications should be
properly cared

Colaboration of Ob-Gyn &

Midwives
Improve

quality

of care
Standard of
training program
Extension of
training to every
districts (400+)
Monitoring &
evaluation

Cooperation
POGI

1500

JNPK

Midwifery Association
70.000 members

ALARM
Course

Ob-Gyn

EmOC
(BEONC)
Midwives
Figure: ALARM certified Spesialist will be involved in the
training of EmOC for Health centres nurses, doctors and
midwives

Organization
Headquarter
5

centres
Medan, Jakarta,
Semarang,
Surabaya &
Makassar

Quality

control
3-4 training
program/centre/ye
ar
Trainers

: ALARM
certified faculty for
EmOC (Beonc)