Analysis of Maternal Referral System in Wulur Public Health Center Working Area in Damer Sub-District of Southwest Maluku Regency (Qualitative Study)

Abstract

Referral of pregnant women and high-risk neonatals is an important component of the maternal health
care system. In order for the maternal referral system to run it is necessary to prepare a referral strategy
in accordance with the prevailing health system with the condition of the local community. The purpose
of this study is to analyze the picture of maternal referral system at the level of community analysis on
maternal mortality cases in Damer Sub-district. The type of research used in this study is qualitative research
with phenomenological approaches. The informants in this study had 27 people consisting of 10 husbands/
families of patients accompanying mothers who died in childbirth in 2017 – 2018, 6 village shamans or
integrated healthcare center cadres who know the chronological pregnancy and childbirth of the mother, 5
village chiefs / village staff / village heads from the village where the patient lives and is in place during the
labor process until the death of the patient, 1 nurse in the village, 2 midwives of Wulur health center, 1 doctor
of public health center, 1 head of Wulur public health center, 1 head of Damer Sub-district. The results
showed that at the level of analysis of high-risk pregnancy communities and health services by midwives
have not woken up well. While the perception of complications in pregnancy is good enough. Cultural
factors, still high trust in the village shaman. Transportation costs, tools and communication processes. To
Wulur public health center to further incentiize health promotion, especially related to high-risk pregnancy
and to change the role of village shamans as labor helpers into preventive promotive personnel