By Ester Lucia Hutabarat, Communications Specialist, MOMENTUM Private Healthcare Delivery Indonesia

On a Tuesday morning, Septaris, the head nurse at Sembiring Delitua Hospital in Deli Serdang District, North Sumatera, Indonesia, was working her shift in the Neonatal Intensive Care Unit (NICU). Suddenly an alarm went off from one of the incubators, indicating something was wrong. A one-day- old baby boy was experiencing chest retraction and breathlessness. He was clearly distressed, and his body turned blue.

Septaris took the baby from the incubator, placed him in an infant warmer, and started giving instructions to her team while conducting emergency treatment. The nurses worked swiftly and in harmony, each aware of their role in the process. In about two-and-a-half minutes the team managed to stabilize the baby and his body slowly returned to its normal color.

Ricky Sembiring, the baby’s father, stood close by watching the team as they made efforts to save his son. “He was alright yesterday when he was born, so I was surprised to get the call that my son was having problems breathing,” he said later.

He admitted how terrified he was when receiving the call from the NICU about his son’s condition. “A few years ago, his older sister also experienced the same problem when she was born and could not be saved. That is why I am so relieved and grateful that the nurses and doctor were able to fix the condition and my son is better now,” he said.

Sembiring Delitua Hospital was first established as a maternity hospital in 1954 and began operating as a general hospital in 1987. However, its maternity services are still the leading reason patients come to the hospital. “We have roughly 250 births monthly,” said Sarmana, the Head of Care Unit of the hospital.

In 2021 Sembiring Hospital partnered with MOMENTUM Private Healthcare Delivery as an intervention facility. The hospital received technical assistance from the program such as hospital mentoring and utilization of digital platforms for data and reporting to increase the quality of maternal and newborn health (MNH) services. MOMENTUM works in close partnership with the Indonesian Ministry of Health to reduce maternal and newborn mortality and morbidity through expanded access to and use of quality, evidence-based information, services, and products. One of the project’s key strategies to improve the quality of MNH services is through hospital mentoring.

Through mentoring, hospitals identify and prioritize areas for improvement. Sembiring Hospital developed an action plan which included introducing routine emergency drills for maternal and newborn cases. The drills aim to increase the capability of health workers, especially in maternal and newborn care, to handle emergency cases.

“Handling emergency cases is not new to us. Even before we received mentoring, we were already faced with newborn emergency cases. The difference is that the way we did it used to be disorganized,” noted Septaris. Each emergency team is now divided into three parts, with clear division of tasks.

The mentoring program encouraged the hospital pediatrician to give in-house training on newborn resuscitation to the nurses and midwives. As a result of the mentoring program, the hospital’s clinical capacity in maternal and newborn services has increased by 25% and its referral response capacity by 34%.

“The routine drills improve our skills in handling emergency cases since the more we do it, the more we can remember the right steps and actions we need to do. The activity boosts our self-confidence in our work and enables us to keep calm and composed when handling a real emergency case,” Septaris emphasized.

In addition to routinely conducting emergency drills, Sembiring Delitua Hospital also added critical hospital equipment recommended in the action plan including more baby incubators and a pacifier sterilizing machine.

Sarmana, the Head of the Care Unit at the hospital, explained that the MOMENTUM mentoring program has increased the staff’s skills and use of tools. This includes identifying and prioritizing problems in maternal and newborn services, implementing Point of Care Quality Improvement (a movement towards ending preventable mortality among mothers, newborns, and children) in the hospital, and using digital platforms for data and referrals.

“Even things that are considered trivial, such as the layout of items and furniture in the emergency room, NICU, and delivery room are reorganized to support the staff to do their tasks effectively and efficiently,” said Sarmana.

MOMENTUM continues to work with Sembiring and other selected private hospitals to provide quality maternal and newborn health services and contribute to reduced rates of maternal and newborn deaths in Indonesia. In coordination with the District Health Offices, the program monitors and assists the intervention facilities to maintain and improve their clinical and referral performances.