Strengthening Emergency Maternal and Neonatal Care A Provincial Initiative to Improve PONED Capacity in Central Sulawesi, Indonesia
DOI:
https://doi.org/10.62012/junic.vi.31Keywords:
Maternal health, neonatal emergency, PONED, capacity building, health systems strengtheningAbstract
Maternal and neonatal mortality remain major public health concerns in Indonesia, particularly in rural and under-resourced regions. Despite national policies promoting emergency obstetric and neonatal care (PONED), disparities persist due to limited human resource capacity, inadequate facility preparedness, and weak referral coordination. This study describes the design, implementation, and outcomes of the GADAR PONED 2025 initiative, a provincial-level program aimed at improving the quality and responsiveness of emergency maternal and neonatal services in Central Sulawesi, Indonesia. Using a descriptive and participatory approach, the program integrated structured training, simulation-based learning, and inter-facility coordination across 15 district-level puskesmas. The intervention involved multidisciplinary teams of doctors, midwives, and nurses, emphasizing clinical skills, communication, and decision-making in emergency scenarios. Data were drawn from training evaluations, supervision reports, and stakeholder feedback. Findings showed a significant improvement in participants’ clinical competency, teamwork, and confidence in managing obstetric and neonatal emergencies. Facility assessments indicated enhanced preparedness through better resource allocation and referral response times. The establishment of communication networks among PONED teams and hospitals further reduced delays in emergency handling. The GADAR PONED 2025 initiative demonstrates that integrating human resource training with system preparedness and referral coordination can effectively strengthen maternal and neonatal emergency care. This provincial model provides a practical framework for scaling up sustainable, decentralized health interventions aligned with Indonesia’s efforts to achieve the Sustainable Development Goals (SDG 3.1 and 3.2).
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References
S. Suparji, H. Nugroho, S. Sunarto, A. Latif, and A. S. Prayogi, “Impact, Implications, Challenges of Accelerating Maternal Mortality Rates in Indonesia,” Health Dynamics, p., 2024, doi: 10.33846/hd10306.
N. A. Mulyadi, “The Role of Nutritional Supplements in Supporting Elderly Health Care A Multidisciplinary Perspective”, Junic, vol. 1, no. 1, pp. 18–23, Mar. 2024.
S. Suparji, H. Nugroho, S. Sunarto, and A. S. Prayogi, “The high maternal mortality rate in Indonesia is a challenge that must be addressed immediately,” PAMJ - One Health, p., 2024, doi: 10.11604/pamj-oh.2024.14.13.44464.
P. Priyono and I. Cahyaningrum, “Implementasi Program Puskesmas Pelayanan Obstetri Neonatal Emergensi Dasar (PONED) di Kabupaten Lebak,” Jurnal Akademika Baiturrahim Jambi, p., 2022, doi: 10.36565/jab.v11i1.446.
C. P. Kismoyo, M. Hasanbasri, and M. Hakimi, “Benarkah puskesmas poned efektif,” vol. 1, pp. 93–102, 2012, doi: 10.22146/jkki.v1i2.26235.
H. Perry, B. Rassekh, S. Gupta, and P. Freeman, “Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 7. shared characteristics of projects with evidence of long–term mortality impact,” J Glob Health, vol. 7, p., 2017, doi: 10.7189/jogh.07.010907.
A. Nuris, A. Munawir, and D. Rokhmah, “Analisis Pelayanan Obstetri Neonatal Emergensi Dasar Berdasarkan Program QA di Puskesmas PONED X Kabupaten Bondowoso,” Multidisciplinary Journal, p., 2020, doi: 10.19184/multijournal.v3i2.24048.
A. A. Putra, H. Hasibuan, R. Tambunan, and L. Lautetu, “Integration of the Sustainable Development Goals into a Regional Development Plan in Indonesia,” Sustainability, p., 2024, doi: 10.3390/su162310235.
A. Z. A. S. Ashar, “Literature Review: Nutritional Therapy for Patients in the Intensive Care Unit (ICU)”, Junic, vol. 1, no. 2, pp. 41–47, Sep. 2024.
Rulinawati, L. Samboteng, A. Wijaya, M. H. Tahili, and R. Halim, “Enhancing Trust-Based Governance And Collaborative Innovation Based On Routine Dynamics In Central Sulawesi Province,” Public Policy Adm, p., 2023, doi: 10.13165/vpa-24-23-2-11.
K. Karinda, E. Nursin, M. Sawir, and T. Sriyakul, “Potential and Challenges of Digital Governance at the Local Level in Central Sulawesi, Indonesia,” Journal of Contemporary Governance and Public Policy, p., 2024, doi: 10.46507/jcgpp.v5i2.246.
A. C. Amorim, M. Silva, R. Pereira, and M. Gonçalves, “Using agile methodologies for adopting COBIT,” Inf. Syst., vol. 101, p. 101496, 2020, doi: 10.1016/j.is.2020.101496.
R. Agustina et al., “Universal health coverage in Indonesia: concept, progress, and challenges,” The Lancet, vol. 393, pp. 75–102, 2019, doi: 10.1016/s0140-6736(18)31647-7.
P. Feng et al., “Effect evaluation of competency-based education (CBE) combined with multi-disciplinary team (MDT) teaching mode in respiratory rehabilitation nursing teaching:A randomized controlled trial.,” Nurse Educ Pract, vol. 76, p. 103896, 2024, doi: 10.1016/j.nepr.2024.103896.
F. Luo, J. Cai, Haixia, X. Wu, and Y. Xia, “Application of a training program system centered on job competency in the standardized training of new nurses,” BMC Nurs, vol. 24, p., 2025, doi: 10.1186/s12912-025-02970-9.
N. Kaeley et al., “Impact of capacity building training on emergency medical services for chardham yatra: a pre-test post-test study in a hilly region of North India,” Int J Emerg Med, vol. 18, p., 2025, doi: 10.1186/s12245-025-00858-8.
Y. Khan et al., “Public health emergency preparedness: a framework to promote resilience,” BMC Public Health, vol. 18, p., 2018, doi: 10.1186/s12889-018-6250-7.
R. Khatri et al., “Preparedness, impacts, and responses of public health emergencies towards health security: qualitative synthesis of evidence,” Archives of Public Health, vol. 81, p., 2023, doi: 10.1186/s13690-023-01223-y.
J. Ruducha et al., “Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis,” BMJ Open, vol. 9, p., 2019, doi: 10.1136/bmjopen-2019-028943.
I. Vargas et al., “Outcomes and conditions for sustaining changes of Participatory Action Research interventions,” Eur J Public Health, vol. 30, p., 2020, doi: 10.1093/eurpub/ckaa166.503.
I. Vargas et al., “Can care coordination across levels be improved through the implementation of participatory action research interventions? Outcomes and conditions for sustaining changes in five Latin American countries,” BMC Health Serv Res, vol. 20, p., 2020, doi: 10.1186/s12913-020-05781-7.
S. Susanti, M. Y. Setiani, T. Yuniningsih, and B. Sastrawan, “The Evaluation Of Indonesia’s Basic Emergency Obstetric Care Program,” Jurnal Sosial Humaniora, p., 2024, doi: 10.30997/jsh.v15i1.11040.
S. Basu, S. Patel, and S. Berkowitz, “Projected Health System and Economic Impacts of 2025 Medicaid Policy Proposals,” JAMA Health Forum, vol. 6, p., 2025, doi: 10.1001/jamahealthforum.2025.3187.

