Inequity in Applying Midwifery Standards of Practice by Midwives on Early Detection and Management of Maternal Neonatal Emergency in Denpasar City and Fakfak District, Papua Indonesia

Inequity n the application of health service standards is still a major issue in the community. The inequity is affected by the inequality of availability of the resources. The purpose of this study is to explore the main factors of gap in the implementation of midwifery services in terms of midwife�s ability to detect early conditions of pathology and emergency at the health center and in other health facilities using critical thinking analysis. The type of research is quantitative and qualtative research (mixed method). The study sample is all midwife of mother and child health service and family planning fulfilling inclusion criteria in area of Health Care Center (Puskesmas) II Denapasar Barat, Puskesmas I Denpasar Timur in Denpasar City and Puskesmas Distrik Fakfak, Puskesmas Distrik FakFak Tengah, Fakfak Regency. We found that a big gap between human resources especialy about competency of midwifes in Puskesmas of Fakfak Regency and Denpasar City. The main obstacle in referring clients to the hospital is that no pick up drivers are available. There is a significant difference in the knowledge, attitude, motivation and skills of midwives in Puskesmas of Fakfak Regency and those in Puskesmas of Denpasar City regarding the competence of early detection and management of pathology, emergencies and critical thinking (p