Improving Maternal Health.pdf

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Status and trends

Maternal mortality ratio. Maternal mortality ratio.

Indonesia does not have the vital statistics systems

to directly collect information on this indicator. Di-

rect age-specific estimates of maternal mortality

from the reported survivorship of sisters were ob-

tained from the series of Indonesia Demographic

and Health Surveys (IDHS). While the data indicate

some reduction in maternal mortality—down to 307

per 100,000 live births for the period 1998–2002 —

the IDHS caution that, given the technique, it may

be premature to judge a substantial decline in the maternal mortality ratio (MMR). Among the five mil-lion deliveries in Indonesia annually, an estimated 20,000 women die due to complications related to pregnancy and delivery. With the current trends, the Millennium Development Goal (MDG) target is unlikely to be achieved unless extra efforts are made to reduce the MMR. Disparities. Like other health indicators, there are variations in the MMR between regions. Using estimates of the proportion of maternal deaths in females of reproductive age (PMDF) in 1995 for five provinces, calculations showed that the MMR of Central Java (248) was much lower than that in Ma 2 luku (796), Papua (1,025), West Java (686) and East Nusa Tenggara (NTT; 554).3Other countries. Indonesia has a relatively high MMR when compared with some other Southeast Asian countries. The lifetime risk of a mother dying related to childbirth in Indonesia is timated to be 1 in 65, compared with 1 in 1,100 in Thailand.4 Major medical causes. Haemorrhage, eclampsia or

convulsions resulting from hypertensive disorders of pregnancy, abortion complications, obstructed labour and infections are the main medical causes of maternal death. Haemorrhage, responsible for 28 per cent of all maternal deaths, is usually unpredict able and sudden in onset. Most haemorrhages hap pen in the post-partum period, reported as due toretained placenta and atonia uteri. This indicates inadequate management of the third stage of labourand the failure to provide timely emergency obstetric and neonatal care in the health system. Eclampsia is the second major cause of maternal mortalityin Indonesia (13 per cent of deaths, compared with12 per cent globally). Deaths from eclampsia can beprevented by careful monitoring during pregnancyand ensuring access to simple and low-cost treat-ment.

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Socioemotional Selectivity Theory, Aging, and Health.pdf

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Socioemotional Selectivity Theory, Aging, and Health: The Increasingly Delicate Balance Between Regulating Emotions and Making Tough Choices

ABSTRACT After providing an introductory overview of socioemotional selectivity theory, we review empirical evidence for its basic postulates and consider the implications of the predicted cognitive and behavioral changes for physical health. The main assertion of socioemotional selectivity theory is that when boundaries on time are perceived,present-oriented goals related to emotional meaning are prioritized overfuture-oriented goals aimed at acquiring information and expanding horizons.Such motivational changes, which are strongly correlated with chronological age, systematically influence social preferences, social network composition, emotion regulation, and cognitive processing. On the

one hand, there is considerable reason to believe that such changes are good for well-being and social adjustment. On the other hand, the very same motivational changes may limit health-related information-seeking and influence attention, memory, and decision-making such that positive material is favored over negative information. Grounding our arguments in socioemotional selectivity theory, we consider possible ways to tailor contexts such that disadvantages are avoided.

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