Detail Cantuman

Abstract
Maternal Mortality Rate (MMR) is an unresolved issue. Three major causes of it are the lateness
to decide, to service place, and to get help. The National Healthcare Period implements a tiered
referral system that requires midwives to refer to primary health care. Before the validity of the JKN
era, midwives can make direct referrals to tertiary health care. The midwife assumes that claims can
be made if the referral is tiered as a primary health care network. The purpose of this study was to
analyze the effectiveness of midwife referral in the era of JKN on emergency cases (et causa Preeclampsia
& Eclampsia). The design of this research was qualitative with case study approach. The
data were collected by using deep interview method, document study, and observation. Secondary
data taken from medical record of dr. Saiful Anwar Malang, primary data was taken from the
interview with independent midwives practice. This research gave results regarding midwife referral
model in JKN era. Result of this study are 5 pregnant women with PreEclamsia and Eclamsia came
with a referral from midwives to Public Hospital dr. Saiful Anwar Malang. Midwives have conducted
referrals in accordance with tiered referral guidelines.
Keyword : Referral, Midwife, Tiered, Pre-eclampsia, JKN