Angka kematian ibu (AKI) di Indonesia masih tergolong tinggi (373 per 100.000 kelahiran hidup, SKRT 1995). Setelah melalui penelusuran oleh WHO melalui Prevention of Maternal Mortality Network diketahui ada 3 keterlambatan yang terjadi. Pertama terlambat membuat keputusan di tempat tinggal pasien, kedua terlambat merujuk ketempat yang lebih mampu untuk menangani dan ketiga terlambat memberi pertolongan setelah berada di rumah sakit. Dalam sebuah penelitian di Afrika didapati waktu tunggu penanganan kasus gawat darurat berkisar antara 2,6 jam hingga 15,5 jam. Untuk mengetahui keadaan di Pontianak dibuat sebuah penelitian mengenai waktu tunggu kasus gawat darurat kebidanan yang dirujuk atau datang sendiri ke rumah sakit. Penelitian dilangsungkan selama 8 minggu sejak 15 September hingga 15 Nopember 2000. Sampel diambil secara purposif sejumlah 35 kasus. Faktor-faktor yang diduga mempengaruhi waktu tunggu persiapan operasi kasus gawat darurat kebidanan diteliti antara lain karakteristik pasien (pendidikan pasien, kadar Hb pasien, pendidikan suami, kehadiran suami, penghasilan keluarga) karakteristik sumber daya rumah sakit (kesibukan dokter jaga, bidan, dokter operator, staf kamar operasi) karakteristik fasilitas (kesibukan kamar operasi, waktu persiapan alat operasi) karakteristik administrasi (mendapatkan ijin operasi) dan karakteristik penunjang (tersedianya darah). Hasil penelitian memperlihatkan rerata waktu tunggu 8 jam 16 menit dengan nilai median 5 jam 45 menit. Waktu terpendek 30 menit dan terpanjang 25 jam 36 menit. Panjangnya waktu tunggu disebabkan oleh kondisi pasien. Sebagian variabel yang diteliti tidak ada hubungan bermakna kecuali kadar Hb dan waktu persiapan kamar operasi. Variabel waktu persiapan kamar operasi ternyata merupakan faktor paling dominan. Disarankan untuk meningkatkan mutu pelayanan secara keseluruhan dan memperpendek waktu tunggu agar menempatkan bank darah didalam rumah sakit dan persiapan kamar operasi lebih baik lagi. Bagi pasien yang akan dirujuk diupayakan agar tetap berada dalam kondisi terbaiknya. Selain itu juga dianjurkan membuat dan membina jaringan kerjasama antara rumah sakit dan Puskesmas serta mencoba mendapatkan cut off point waktu tunggu melalui organisasi profesi (POGI).

Waiting Time Analysis of Preparation Operation for Obstetric Emergency Cases in Hospitals in Pontianak in the Year 2000The Maternal Mortality Rate in Indonesia is still high with 373 deaths per 100.000 live birth(SK.RT 1995). WHO through Prevention of Maternal Mortality Network had found that there were 3 categories of late in helping the patients. The first is "late to decide" by the family, second is "late to refer" to the hospital and the third is "late to take care the patient inside the hospital by the health personnel". Former study in Africa for waiting time was found that it need between 2,6 to 15,5 hours for a patient to wait until she got a help. This study was trying to know the waiting time for an emergency case in obstetric begins when she arrived until she got medical interventions such as cesarean section or laparotomy. The study was carried out for about 8 weeks, from 15th of September until 15th of November 2000. The samples were taken by purposive method and a total of 35 cases were achieved during this study period. Many factors were correlated to the waiting time such as characteristics of the patients (education, hemoglobin value, education of her husband, husband present in the hospital) characteristics of personnel of the hospital (level of occupancy of the doctor in charge, the midwife, the obgyn and the staff of the operation room)characteristics of the facility of the operation room (readiness of the operation room, readiness of the equipment) characteristic of getting the letter of inform consent (time to get the agreement) characteristic of the other (readiness of the blood). The result of this study found that the waiting time's mean was 8 hours 16 minutes. The median was 5 hours 45 minutes and the range was 30 minutes to 25 hours 36 minutes. The causes of the length of the waiting time were patients? condition. There were no significant variables except hemoglobin value and preparation of the operation room's time. With the backward method of linear regression the time for preparation of the operation room was the most dominant variable. To improve the quality in health services and make the waiting time shorter, it is suggested to make preparation time faster, organized a blood bank inside the hospital and referred patient in her best condition. Also suggested to build and maintain good networking between hospital and health center and try to find the cut off point of waiting time through the Indonesian Society of Obstetric and Gynecologist (ISOG).

Kerusuhan sosial berbau etnis yang terjadi di Kabupaten Sambas Kalimantan Barat, awal 1999 di Kecamatan Jawai, Kabupaten Sambas memberikan dampak pada berbagai sektor dan kehidupan masyarakat yang sampai saat ini belum dapat kembali pada keadaan semula. Arus pengungsi dievakuasi ke berbagai tempat yang aman dan ditampung pada barak-barak penampungan dan fasilitas pemerintah. Di tempat pengungsian, sarana dan prasarana tidak tersedia untuk hidup layak, sebagai konsekuensinya banyak masalah yang dihadapi termasuk masalah kesehatan dan gizi. Hasil survei oleh Palang Merah Internasional menunjukkan 17,5% anak balita pengungsi gizi buruk, menurut UNHCR berada pada keadaan gizi yang kritis (>15%), dan perlu penanganan segera, Dinas Kesehatan Propinsi Kalimantan Barat dan Kantor Wilayah Departemen Kesehatan Propinsi Kalimantan Barat bekerja sama dengan World Vision Indonesia membentuk Therapeutic Feeding Center (TFC) untuk menangani.masalah balita gizi buruk oleh karena ini merupakan pengalaman pertama, namun hasilnya cukup memuaskan, dimana tidak ada yang meninggal di TFC. Penelitian ini bertujuan untuk mendapatkan informasi yang mendalam, tentang bagaimana pelaksanaan dan hambatan-hambatan kegiatan pemulihan status gizi balita gizi buruk, yang untuk selanjutnya dapat digunakan oleh pengelola program gizi sebagai masukan dalam memperbaiki pelaksanaannya. Penelitian ini menggunakan metode kualitatif dengan rancangan penelitian menggunakan pendekatan deskriptif yang bersifat studi kasus retrospektif sedangkan pengumpulan data dilaksanakan dengan menggunakan teknik wawancara mendalam (in-depth interview) observasi dan telaah dokumen. Analisis data yang terkumpul menunjukkan bahwa tim kesehatan TFC telah memenuhi standar yang telah ditentukan. Studi ini menyimpulkan bahwa ketersediaan dana, sarana parasarana, serta berjalannya fungsi manajemen, merupakan salah penyebab rendahnya kegagalan dalam perawatan balita gizi buruk di TFC.

Analysis of the Implementation of Sambas Refugee Children Malnutrition Status Recovering at Therapeutic Feeding Center, Dokter Soedarso District General Hospital, Pontianak, Kalimantan Barat in the Year 2000Racial unrest in Kecamatan Jawai, Kabupaten Sambas, Kalimantan Barat in the early of 1999 has influenced many sectors and public life there, which has not recovered yet to the normal condition. Refugees have been evacuated to other safer places, emergency refugee barracks, or to other governmental service facilities. At those places, the facilities and infrastructures are not provided adequately to support proper daily living, so that it induces many social problems, including the health and nutrition problems. The survey result by International Red Cross Committee has shown that 17.5% of the children have suffered from malnutrition. While according to the UNHCR, 15% of the children suffer from critical nutrition condition and need immediate treatment. The Health Service and Health Ministry Regional Office of Kalimantan Barat Province in cooperation with The World Vision Indonesia have established the Therapeutic Feeding Center (TFC) in order to treat the children malnutrition. Even though this is an initial experience, it has brought satisfying enough result, whereas no patient has died in TFC. The purpose of this research is to obtain comprehensive information regarding the implementation and hindrance of the nutrition status recovering for the malnourished children. This result shall be useful input for the nutrition program official in order to enhance the program implementation. This type of research used qualitative method, accompanied by research plan using descriptive approach as a retrospective case study. Data was obtained from in-depth interviews, observation and documents analysis. While the result from the research shows that the TFC health service team has carried out the requirement standards. This research summarizes that the availability of fund, facilities, infrastructures, and managerial functions are factors of high success in malnutrition children treatment at TFC.