Abstract
Maternal and child health (MCH) situation in three southernmost provinces has been in a critical stage. MMR was about three times higher than country’s targets and almost two times in MDGs Plus target, lower than the performance in almost all indicators. Most deaths due to causes that can be prevented in the context of modern obstetrics. There is only a small detail that seems to be absent. Prenatal care to pregnant women with traditional midwives. The way of life, religion and cultural norms determine the practice of pregnant women. But it is not seen as important as surveillance and health complications. Key factors which affect the success of maternal and child in three southernmost provinces are
1. Manpower : Turnover rates are frequent, because it is a difficult task, required high skills and experience. More tools and indicators and some indicators are not consistent with the context in three southernmost provinces.
2. Belief : Two believes persists that determines the norms and practices of pregnant women are 1) do not eat more and do not take the medicine 2) seek female personnel’s service for delivery. Including lifestyle, religious values are very high in regard to procreation, and that the death is natural. The attitude that contraception is wrong, against the principles of Islam.
3. Traditional Birth Attendants (TBA) : TBA is the strength of maternal and child health in the southernmost provinces. Pregnant women are faithful and believe in TBA. While Islam still had limited access to medical services.
Suggestion and Policy Brief
1. Urgent measures : Cooperation with TBA to reduce MMR (Maternal Mortality Rate) in three southernmost provinces. Development competency TBA to learn assessment of high risk pregnancy, refer and delivery of emergency cases safely. Appropriate Incentive measures are important. We should also encourage Muslim husbands to have proper attitude and to help woman during pregnancy and childbirth.
2. Medium and long term measures : Department of Health and related agencies should review policy, strategy and tools that is flexible, affordable and possible. Provides analysis and support capacity in maternal and child health. We should put more obstetricians in the three southernmost t provinces and enhance them and their MCH team to understand the way of truly Muslim.
