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r
e
ess
en
tial
to
p
r
ev
en
t
m
ater
n
a
l
m
o
r
tality
,
esp
ec
ially
f
o
r
th
o
s
e
at
h
ig
h
r
is
k
.
T
o
ac
ce
ler
ate
th
e
r
ed
u
ctio
n
o
f
m
ater
n
al
m
o
r
tality
an
d
i
m
p
r
o
v
e
th
e
h
ea
lth
s
tatu
s
o
f
wo
m
en
,
th
e
I
n
d
o
n
esian
g
o
v
er
n
m
e
n
t
h
as
f
o
cu
s
ed
o
n
h
ea
lth
p
r
o
g
r
am
s
s
tar
tin
g
at
th
e
v
illag
e
lev
el.
B
y
e
m
p
o
wer
in
g
v
illa
g
es
as
th
e
lo
west
lev
el
o
f
g
o
v
er
n
m
en
t
r
e
p
r
esen
tatio
n
th
at
d
ir
ec
t
ly
in
ter
ac
ts
with
th
e
c
o
m
m
u
n
i
ty
,
h
ea
lth
in
itiativ
es
ca
n
p
r
ev
en
t
m
ater
n
al
m
o
r
tality
r
is
k
s
ev
e
n
f
r
o
m
th
e
p
r
e
-
p
r
eg
n
an
cy
p
er
i
o
d
[
5
]
.
Ho
w
ev
er
,
s
o
m
e
h
ea
lth
in
itiativ
es
at
th
e
v
illag
e
lev
el,
p
ar
ticu
l
ar
ly
in
r
u
r
al
ar
ea
s
,
ar
e
n
o
t
y
et
o
p
tim
al
in
f
u
lf
illi
n
g
th
eir
p
r
ev
en
tiv
e
an
d
cu
r
ativ
e
r
o
les d
u
e
to
a
lac
k
o
f
h
ea
lth
wo
r
k
e
r
s
an
d
in
a
d
eq
u
ate
h
ea
lth
ca
r
e
f
ac
ilit
ies.
R
esear
ch
b
y
T
italey
et
a
l.
[
6
]
in
d
icate
s
th
at
co
s
t
an
d
d
i
s
tan
ce
ar
e
p
r
im
ar
y
f
ac
to
r
s
in
f
lu
en
cin
g
wo
m
en
'
s
d
ec
is
io
n
to
ac
ce
s
s
m
ater
n
al
h
ea
lth
ca
r
e.
Ad
d
iti
o
n
ally
,
th
is
d
ec
is
io
n
ca
n
n
o
t
b
e
s
ep
ar
ated
f
r
o
m
p
er
s
o
n
al
p
r
e
f
er
en
ce
s
.
T
h
e
b
e
h
av
io
r
o
f
u
tili
zin
g
h
ea
lth
ca
r
e
is
in
f
lu
en
ce
d
n
o
t
o
n
ly
b
y
m
o
t
iv
atio
n
b
u
t
also
b
y
ad
eq
u
ate
k
n
o
wled
g
e,
t
h
e
p
r
esen
ce
o
f
b
a
r
r
ier
s
,
a
n
d
h
o
w
t
h
is
b
eh
av
io
r
is
p
er
c
eiv
ed
as
im
p
o
r
tan
t
an
d
b
ec
o
m
es a
h
ab
it
[
7
]
.
Kar
k
ee
et
a
l.
[
8
]
em
p
h
asize
th
e
im
p
o
r
tan
ce
o
f
s
tu
d
y
in
g
w
o
m
en
'
s
awa
r
en
ess
o
f
m
ater
n
al
h
ea
lth
ca
r
e
an
d
th
eir
p
er
ce
p
tio
n
s
o
f
its
q
u
ality
in
in
cr
ea
s
in
g
u
tili
za
tio
n
.
T
h
er
ef
o
r
e,
wh
ile
ad
d
r
es
s
in
g
is
s
u
es
r
elate
d
to
ad
eq
u
ate
a
v
ailab
ilit
y
o
f
m
ater
n
al
h
ea
lth
ca
r
e
is
a
p
r
io
r
ity
,
th
er
e
also
n
ee
d
s
to
b
e
a
f
o
cu
s
o
n
th
e
n
ec
ess
ity
o
f
u
tili
zin
g
m
ater
n
al
h
ea
lth
ca
r
e
,
p
ar
ticu
lar
ly
i
n
en
h
an
cin
g
k
n
o
wled
g
e
an
d
awa
r
en
ess
o
f
wo
m
en
an
d
th
e
b
r
o
ad
er
co
m
m
u
n
ity
.
R
ed
u
c
in
g
m
ater
n
al
m
o
r
tality
is
a
p
r
io
r
ity
.
Stra
teg
ies
f
o
r
r
ed
u
cin
g
m
ater
n
al
m
o
r
tality
n
ee
d
to
b
e
ex
am
in
ed
b
o
th
f
r
o
m
th
e
p
er
s
p
ec
tiv
e
o
f
p
r
o
v
id
in
g
ad
e
q
u
ate
m
ater
n
al
h
ea
lth
ca
r
e
an
d
u
tili
zin
g
m
ater
n
al
h
ea
lth
ca
r
e.
C
o
n
s
id
er
in
g
th
e
p
o
ten
tial
d
if
f
er
en
ce
s
in
MM
R
ac
r
o
s
s
r
eg
io
n
s
an
d
v
illag
es,
wh
ich
ar
e
cr
u
cial
f
o
r
d
ev
elo
p
m
e
n
t,
it
is
in
ter
esti
n
g
t
o
an
aly
ze
th
e
ac
ce
s
s
ib
ilit
y
an
d
q
u
ality
o
f
m
ater
n
al
h
ea
lth
ca
r
e
ac
r
o
s
s
v
illag
es
in
B
ali
f
u
r
th
er
.
T
h
is
s
tu
d
y
aim
s
to
co
m
p
r
eh
e
n
s
iv
ely
in
v
esti
g
ate
m
ater
n
al
h
ea
lth
ca
r
e
s
er
v
ices
at
th
e
v
illag
e
lev
e
l
in
B
ali.
T
h
r
ee
p
r
im
ar
y
o
b
jecti
v
es
g
u
id
e
th
e
r
esear
c
h
:
f
ir
s
t,
to
m
ap
an
d
an
aly
ze
th
e
in
ter
-
v
illag
e
d
is
p
ar
ities
in
ac
ce
s
s
to
m
ater
n
al
h
ea
lth
ca
r
e;
s
ec
o
n
d
,
t
o
ass
ess
th
e
q
u
ality
o
f
v
illag
e
-
lev
el
m
ater
n
al
h
ea
lth
ca
r
e
s
er
v
ices
b
y
ex
am
in
in
g
th
e
p
er
ce
p
tio
n
s
a
n
d
e
x
p
ec
tatio
n
s
o
f
u
s
er
s
;
an
d
th
ir
d
,
t
o
d
e
v
elo
p
ev
id
e
n
ce
-
in
f
o
r
m
e
d
s
tr
ateg
ic
r
ec
o
m
m
en
d
atio
n
s
f
o
r
en
h
an
ci
n
g
b
o
th
th
e
ac
ce
s
s
ib
ilit
y
an
d
q
u
ality
o
f
m
ater
n
al
h
ea
lth
ca
r
e
d
eliv
er
y
at
th
e
v
illag
e
lev
el.
Ultim
ately
,
th
is
r
esear
ch
s
ee
k
s
to
p
r
o
v
id
e
a
n
u
an
ce
d
u
n
d
er
s
tan
d
i
n
g
o
f
t
h
e
cu
r
r
en
t
m
ater
n
al
h
ea
lth
ca
r
e
lan
d
s
ca
p
e
a
n
d
co
n
tr
ib
u
te
ac
tio
n
ab
le
in
s
ig
h
ts
to
ass
is
t
p
o
licy
m
ak
er
s
an
d
h
ea
lt
h
ca
r
e
p
r
o
v
id
er
s
in
ad
d
r
ess
in
g
g
eo
g
r
ap
h
ical
in
eq
u
ities
an
d
im
p
r
o
v
i
n
g
m
ater
n
al
h
ea
lth
o
u
tco
m
es a
cr
o
s
s
B
ali.
Fig
u
r
e
1
.
Ma
ter
n
al
m
o
r
tality
r
atio
a
ch
iev
em
en
t a
n
d
t
ar
g
ets
in
B
ali
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Op
timiz
a
tio
n
o
f m
a
tern
a
l h
ea
lth
ca
r
e
a
t th
e
villa
g
e
leve
l in
…
(
P
a
n
ca
Dw
i P
r
a
b
a
w
a
)
1767
2.
L
I
T
E
R
AT
U
RE
R
E
VI
E
W
2
.
1
.
Acc
ess
t
o
hea
lt
hca
re
a
nd
m
a
t
er
na
l
m
o
rt
a
lit
y
T
h
e
co
n
d
itio
n
o
f
m
ater
n
al
m
o
r
tality
r
ef
lects
n
o
t
o
n
ly
th
e
wo
m
en
’
s
h
ea
lth
s
tatu
s
d
u
r
in
g
p
r
eg
n
a
n
cy
an
d
c
h
ild
b
ir
th
b
u
t
also
ac
ce
s
s
to
a
n
d
q
u
ality
o
f
h
ea
lth
ca
r
e,
b
eh
a
v
io
r
s
in
u
tili
zin
g
h
ea
lth
ca
r
e,
as
well
as
th
e
s
o
cio
-
ec
o
n
o
m
ic
s
tatu
s
o
f
wo
m
en
,
h
o
u
s
eh
o
ld
s
,
an
d
co
m
m
u
n
ities
in
th
e
ar
ea
[
4
]
.
So
cio
-
ec
o
n
o
m
ic
s
tatu
s
in
f
lu
en
ce
s
th
e
in
ci
d
en
ce
o
f
m
ater
n
al
m
o
r
tality
b
u
t
o
n
ly
ex
p
lain
s
a
s
lig
h
t
d
i
f
f
e
r
en
ce
ac
r
o
s
s
p
r
o
v
in
ce
s
in
I
n
d
o
n
esia.
Acc
ess
to
m
ater
n
al
h
ea
lth
ca
r
e
is
th
e
lead
in
g
ca
u
s
e
o
f
d
is
p
ar
ities
in
MM
R
[
9
]
an
d
s
h
o
u
l
d
b
e
co
n
s
id
er
ed
in
ef
f
o
r
ts
to
r
ed
u
ce
m
ater
n
al
m
o
r
tality
[
1
0
]
.
E
asil
y
ac
ce
s
s
ib
le
an
d
q
u
ality
h
ea
lth
ca
r
e
d
u
r
in
g
p
r
eg
n
a
n
cy
an
d
ch
ild
b
ir
th
r
e
d
u
ce
s
th
e
r
is
k
o
f
m
ater
n
al
m
o
r
tal
ity
an
d
m
o
r
b
id
ity
[
1
1
]
.
Acc
o
r
d
in
g
to
T
h
a
d
d
eu
s
a
n
d
Ma
in
e
[
3
]
,
th
e
c
o
n
d
itio
n
o
f
h
ea
lth
ca
r
e
f
ac
ilit
ies
b
ein
g
f
ar
awa
y
an
d
lim
ited
h
as
th
e
p
o
ten
tial
to
d
elay
wo
m
en
f
r
o
m
r
ea
c
h
in
g
th
em
an
d
o
b
tain
in
g
ad
eq
u
ate
h
ea
lth
ca
r
e.
Dela
y
s
in
r
ea
ch
in
g
h
ea
lth
f
ac
ilit
ies
ar
e
p
r
im
ar
ily
ca
u
s
ed
b
y
l
o
n
g
d
is
tan
ce
s
r
esu
ltin
g
f
r
o
m
th
e
u
n
e
v
en
d
is
tr
ib
u
tio
n
o
f
lo
ca
tio
n
s
,
p
ar
ticu
lar
ly
th
e
ten
d
en
cy
f
o
r
f
ac
ilit
ies
to
b
e
co
n
ce
n
tr
ated
in
u
r
b
an
ar
ea
s
[
1
2
]
,
[
1
3
]
.
On
t
h
e
o
th
er
h
an
d
,
d
elay
s
in
r
ec
eiv
i
n
g
a
d
eq
u
ate
h
ea
lth
ca
r
e
ar
e
m
ain
l
y
ca
u
s
ed
b
y
lim
ited
r
eso
u
r
ce
s
at
h
ea
lth
f
ac
ilit
ies,
wh
ich
ar
e
u
n
a
b
le
to
h
an
d
le
c
o
m
p
lex
p
r
eg
n
a
n
cy
an
d
ch
ild
b
ir
th
co
m
p
licatio
n
s
.
I
n
ad
d
itio
n
to
lo
n
g
d
is
tan
ce
s
an
d
lim
ited
s
er
v
ices,
co
n
d
itio
n
s
in
r
u
r
al
a
r
ea
s
ar
e
e
x
ac
er
b
ated
b
y
a
lac
k
o
f
awa
r
e
n
ess
o
f
m
ater
n
al
h
ea
lth
,
lead
in
g
to
d
elay
s
in
d
ec
id
i
n
g
t
o
s
ee
k
h
ea
lth
ca
r
e.
2
.
2
.
Wo
m
en's
perc
ept
io
n o
f
hea
lt
hca
re
qu
a
lity
T
h
e
q
u
ality
o
f
h
ea
lt
h
ca
r
e
is
a
cr
u
cial
co
n
s
id
er
atio
n
wh
en
d
e
cid
in
g
wh
eth
er
to
s
ee
k
ca
r
e
.
Fin
d
in
g
s
b
y
[
3
]
s
h
o
w
th
at
wh
en
wo
m
en
h
a
v
e
ac
ce
s
s
to
h
ea
lth
ca
r
e
f
ac
ilit
i
es,
th
eir
p
er
ce
p
tio
n
o
f
h
ea
lth
c
ar
e
q
u
ality
ten
d
s
to
b
e
p
r
io
r
iti
ze
d
o
v
er
d
is
tan
ce
.
T
h
is
co
n
d
itio
n
ca
n
n
o
t
b
e
s
ep
ar
a
ted
f
r
o
m
th
e
wo
m
en
'
s
ass
e
s
s
m
en
ts
b
ased
o
n
th
eir
ex
p
er
ien
ce
s
o
r
t
h
e
in
f
o
r
m
ati
o
n
th
e
y
r
ec
eiv
e.
T
h
u
s
,
w
o
m
en
'
s
d
ec
is
io
n
s
to
u
tili
ze
m
at
er
n
al
h
ea
lth
ca
r
e
ar
e
co
n
n
ec
ted
to
h
ea
lth
ca
r
e
q
u
alit
y
.
T
h
is
ca
n
b
e
u
n
d
er
s
to
o
d
as
wo
m
en
ar
e
m
o
r
e
lik
ely
to
h
av
e
a
h
ig
h
in
te
n
tio
n
t
o
r
etu
r
n
if
th
ey
f
ee
l
s
atis
f
ied
with
th
e
q
u
ality
th
ey
r
ec
eiv
e
d
[
1
4
]
.
T
h
er
e
f
o
r
e,
ass
ess
in
g
wo
m
en
'
s
p
er
ce
p
tio
n
s
ca
n
s
er
v
e
as a
n
ev
alu
atio
n
f
o
r
h
ea
l
th
ca
r
e
p
r
o
v
id
er
s
to
im
p
r
o
v
e
an
d
en
h
a
n
ce
th
e
q
u
ality
o
f
t
h
e
ir
h
ea
lth
ca
r
e
[
1
5
]
.
Acc
o
r
d
in
g
to
Do
n
ab
ed
ian
[
1
6
]
,
h
ea
lth
ca
r
e
q
u
ality
ca
n
b
e
ass
es
s
ed
th
r
o
u
g
h
a
m
o
d
el
c
o
n
s
is
tin
g
o
f
th
r
ee
in
ter
co
n
n
ec
ted
ca
teg
o
r
i
es:
s
tr
u
ctu
r
e,
p
r
o
ce
s
s
,
an
d
o
u
tco
m
e.
T
h
e
D
o
n
ab
e
d
ian
m
o
d
el
is
o
n
e
o
f
th
e
r
ec
o
m
m
en
d
ed
m
o
d
els
f
o
r
ass
ess
in
g
h
ea
lth
c
ar
e
q
u
ality
,
as
r
ec
o
m
m
en
d
e
d
b
y
[
1
7
]
,
an
d
s
er
v
es
as
a
s
y
s
tem
atic
an
d
f
lex
ib
le
g
u
id
elin
e
f
o
r
ev
al
u
atin
g
h
ea
lth
ca
r
e
q
u
ality
.
I
n
t
h
e
co
n
tex
t
o
f
h
ea
lth
,
ac
c
o
r
d
in
g
to
th
e
Do
n
a
b
ed
ian
m
o
d
el,
o
u
tco
m
es
en
c
o
m
p
ass
n
o
t
o
n
ly
im
p
r
o
v
em
en
ts
in
p
h
y
s
i
ca
l
h
ea
lth
co
n
d
itio
n
s
b
u
t
also
s
u
b
jectiv
e
asp
ec
ts
,
s
u
ch
as
p
atien
ts
'
p
er
ce
p
tio
n
s
an
d
ex
p
e
r
ien
ce
s
.
T
h
er
ef
o
r
e,
wo
m
en
'
s
s
atis
f
ac
tio
n
with
h
ea
lth
ca
r
e
an
d
th
eir
d
esire
to
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etu
r
n
a
r
e
im
p
o
r
tan
t
f
ac
to
r
s
in
e
v
alu
atin
g
h
ea
lth
c
ar
e
q
u
ality
.
A
p
o
s
itiv
e
p
er
ce
p
tio
n
in
d
icate
s
th
at
h
ea
lth
ca
r
e
m
ee
ts
th
eir
ex
p
e
ctatio
n
s
.
W
o
m
en
'
s
p
er
ce
p
tio
n
s
o
f
h
ea
lth
ca
r
e
q
u
ality
wil
l
af
f
ec
t
h
ea
lth
ca
r
e
u
tili
za
tio
n
in
th
e
f
u
tu
r
e
an
d
in
d
ir
ec
tly
in
f
lu
e
n
ce
th
e
r
e
d
u
ctio
n
o
f
m
ate
r
n
al
m
o
r
tality
.
2
.
3
.
T
he
ro
le
o
f
v
illa
g
es in im
pro
v
ing
ma
t
er
na
l hea
lt
h
Ma
ter
n
al
h
ea
lth
in
itiat
iv
es
aim
to
m
ain
tain
wo
m
e
n
’
s
h
ea
lt
h
s
o
th
ey
ca
n
g
iv
e
b
ir
th
to
h
ea
lth
y
an
d
q
u
ality
g
e
n
er
atio
n
s
wh
ile
r
e
d
u
cin
g
m
ater
n
al
m
o
r
tality
.
T
o
h
elp
ac
ce
ler
ate
th
e
ac
h
i
ev
em
en
t
o
f
o
p
tim
al
m
ater
n
al
h
ea
lth
,
co
m
m
u
n
ity
i
n
v
o
lv
em
e
n
t
is
n
ec
ess
ar
y
,
tailo
r
ed
t
o
th
e
s
p
ec
if
ic
c
o
n
d
itio
n
s
an
d
n
ee
d
s
o
f
th
e
lo
ca
l
p
o
p
u
latio
n
.
On
e
way
to
em
p
o
wer
th
e
co
m
m
u
n
ity
is
th
r
o
u
g
h
ac
tiv
e
p
ar
ticip
atio
n
in
co
m
m
u
n
ity
-
b
ased
h
ea
lth
in
itiativ
es
(
UKBM)
,
wh
ich
s
er
v
e
as
a
p
latf
o
r
m
f
o
r
v
i
llag
er
s
’
em
p
o
wer
m
en
t
estab
lis
h
ed
b
ased
o
n
th
eir
n
ee
d
s
,
m
an
ag
e
d
b
y
,
f
o
r
,
a
n
d
with
th
em
,
p
r
io
r
itizin
g
a
p
r
o
m
o
tiv
e
an
d
p
r
ev
en
tiv
e
a
p
p
r
o
a
ch
(
R
eg
u
latio
n
o
f
th
e
Min
is
tr
y
o
f
Hea
lth
o
f
th
e
R
ep
u
b
lic
o
f
I
n
d
o
n
esia N
u
m
b
er
2
1
o
f
2
0
2
1
)
.
Villag
es
p
lay
a
c
r
u
cial
r
o
l
e
in
p
r
o
v
id
in
g
h
ea
lth
ca
r
e
,
wh
ich
ca
n
b
e
f
ac
ilit
ated
th
r
o
u
g
h
th
e
m
an
ag
em
en
t
o
f
UKBM.
T
h
e
im
p
lem
en
tatio
n
o
f
UKBM
in
th
e
v
illag
e
s
u
p
p
o
r
ts
en
h
a
n
ci
n
g
m
ater
n
al
h
ea
lth
d
u
r
in
g
p
r
e
-
p
r
eg
n
an
cy
,
p
r
eg
n
an
cy
,
ch
ild
b
ir
th
,
an
d
p
o
s
tp
ar
tu
m
p
er
io
d
s
th
r
o
u
g
h
in
te
g
r
ated
s
er
v
ices
p
o
s
t
(
p
o
s
ya
n
d
u
)
a
n
d
v
illag
e
h
ea
lth
p
o
s
t
(
p
o
s
ke
s
d
es
)
.
At
th
e
v
ill
ag
e
lev
el,
th
er
e
is
also
a
v
ill
ag
e
-
b
ased
m
id
wif
e
(
b
id
a
n
d
esa
)
p
r
o
g
r
a
m
,
wh
ich
aim
s
to
en
s
u
r
e
ev
er
y
v
illag
e
h
as
a
m
id
wif
e
ass
ig
n
ed
to
p
r
ac
tice
m
id
wif
er
y
as
p
ar
t o
f
t
h
e
n
etwo
r
k
co
n
n
ec
ted
to
th
e
co
m
m
u
n
ity
h
ea
lth
ce
n
te
r
(
p
u
s
ke
s
ma
s
)
.
O
n
t
h
e
o
t
h
e
r
h
a
n
d
,
t
h
e
I
n
d
o
n
e
s
i
a
n
g
o
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e
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n
m
e
n
t
h
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s
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o
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m
i
tt
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t
o
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v
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m
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n
t
a
t
t
h
e
v
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l
l
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g
e
l
e
v
e
l
.
A
c
c
o
r
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g
t
o
L
a
w
o
f
t
h
e
R
e
p
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o
f
I
n
d
o
n
e
s
i
a
N
u
m
b
er
6
o
f
2
0
1
4
,
v
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l
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a
g
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r
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d
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3.
M
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H
O
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3
.
1
.
O
pera
t
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l f
ra
m
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k
T
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1
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1
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[
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4
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f
ails
to
m
ee
t
p
atien
ts
'
ex
p
ec
tatio
n
s
.
T
h
er
ef
o
r
e,
asp
ec
ts
d
em
o
n
s
tr
atin
g
th
e
m
o
s
t
s
ig
n
i
f
ican
t
g
ap
s
s
h
o
u
ld
b
e
p
r
i
o
r
itized
f
o
r
im
p
r
o
v
em
en
t
t
o
en
h
a
n
ce
o
v
er
all
s
er
v
ice
q
u
ality
.
Ad
d
itio
n
ally
,
test
s
wer
e
p
er
f
o
r
m
e
d
to
ex
am
i
n
e
th
e
s
ig
n
if
ican
ce
o
f
t
h
e
r
elatio
n
s
h
ip
b
et
wee
n
p
er
ce
iv
ed
h
ea
lth
ca
r
e
q
u
ality
a
n
d
o
u
t
p
u
t
o
f
th
e
h
ea
lth
ca
r
e
r
ec
eiv
ed
(
m
ed
ical
o
u
t
p
u
t)
u
s
in
g
th
e
Pear
s
o
n
c
o
r
r
elatio
n
test
,
id
en
tify
in
g
wh
ich
asp
ec
ts
o
f
m
ater
n
al
h
ea
lth
ca
r
e
q
u
ality
a
r
e
m
o
s
t
clo
s
ely
ass
o
ciate
d
wi
th
m
ater
n
al
h
ea
lth
o
u
tco
m
es a
n
d
p
atien
t sati
s
f
ac
tio
n
.
4.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
4
.
1
.
Acc
ess
ibi
lity
lev
el
o
f
m
a
t
er
na
l hea
lt
hca
re
a
t
t
he
v
illa
g
e
lev
el
Am
o
n
g
th
e
ele
v
en
cr
iter
ia,
m
ater
n
al
h
ea
lth
in
s
u
r
a
n
ce
f
o
r
lo
w
-
in
co
m
e
h
o
u
s
eh
o
ld
s
r
e
ce
iv
ed
th
e
h
ig
h
est
s
co
r
e,
in
d
icatin
g
it
is
th
e
to
p
p
r
io
r
ity
in
ass
ess
in
g
th
e
ac
ce
s
s
ib
ilit
y
o
f
m
ater
n
al
h
ea
lth
ca
r
e
in
B
ali.
Pro
v
id
in
g
h
ea
lth
in
s
u
r
a
n
ce
n
o
t
o
n
ly
i
n
cr
ea
s
es
th
e
u
t
ilizatio
n
o
f
h
ea
lth
ca
r
e
f
ac
ilit
ies
b
u
t
also
im
p
r
o
v
es
th
e
q
u
ality
o
f
ca
r
e
p
r
o
v
id
ed
[
2
8
]
.
Hea
lth
in
s
u
r
an
ce
r
ed
u
ce
s
th
e
f
in
a
n
cial
b
u
r
d
en
o
f
ac
ce
s
s
in
g
h
ea
lth
ca
r
e,
p
ar
ticu
lar
ly
f
o
r
in
d
iv
i
d
u
als
with
lim
ited
in
co
m
es
[
2
9
]
,
[
3
0
]
.
I
n
ad
d
itio
n
,
it
en
co
u
r
ag
es
h
ea
l
th
ca
r
e
f
ac
ilit
ies
to
im
p
lem
en
t
s
p
ec
if
ic
m
in
im
u
m
s
er
v
ice
s
tan
d
ar
d
s
,
w
h
ich
in
tu
r
n
en
h
an
ce
s
s
er
v
ice
u
tili
za
tio
n
.
A
s
tu
d
y
b
y
[
3
1
]
f
o
u
n
d
th
at
m
ater
n
al
h
ea
lth
in
s
u
r
an
ce
o
wn
e
r
s
h
ip
p
o
s
itiv
ely
in
f
lu
en
ce
s
th
e
u
s
e
o
f
m
ater
n
al
h
ea
lth
ca
r
e
.
Ho
wev
er
,
s
o
m
e
v
illag
es
m
ay
n
o
t
p
r
o
v
i
d
e
m
ater
n
al
h
ea
lth
in
s
u
r
an
ce
f
o
r
lo
w
-
in
co
m
e
h
o
u
s
e
h
o
ld
s
b
ec
a
u
s
e
th
ey
ar
e
alr
ea
d
y
c
o
v
er
e
d
u
n
d
er
th
e
Natio
n
al
Hea
lth
I
n
s
u
r
an
ce
–
Hea
lth
y
I
n
d
o
n
esia Car
d
(
J
KN
-
KI
S)
p
r
o
g
r
am
.
T
h
e
s
ec
o
n
d
p
r
i
o
r
ity
v
ar
iab
le
i
s
th
e
av
ailab
ilit
y
o
f
m
id
wif
er
y
p
r
ac
tice
in
th
e
v
illag
e.
Mid
wiv
es
p
lay
a
v
ital
r
o
le
in
m
ater
n
al
h
ea
lth
c
ar
e,
p
ar
ticu
lar
ly
in
p
r
o
v
id
i
n
g
an
ten
atal
ca
r
e,
f
ir
s
t
aid
,
an
d
ea
r
ly
d
etec
tio
n
o
f
co
m
p
licatio
n
s
d
u
r
in
g
p
r
eg
n
an
cy
,
ch
ild
b
ir
th
,
a
n
d
th
e
p
o
s
tp
ar
tu
m
p
er
io
d
.
Fu
r
t
h
er
m
o
r
e,
m
id
wiv
es
au
th
o
r
ized
to
p
r
ac
tice
in
d
ep
e
n
d
en
tl
y
a
r
e
g
r
ad
u
ates
o
f
p
r
o
f
ess
io
n
al
ed
u
ca
tio
n
p
r
o
g
r
am
s
,
eq
u
ip
p
in
g
th
em
with
m
o
r
e
ad
v
an
ce
d
co
m
p
eten
cies
(
L
aw
o
f
th
e
R
ep
u
b
lic
o
f
I
n
d
o
n
esia N
u
m
b
er
4
o
f
2
0
1
9
)
.
Ach
iev
in
g
u
n
iv
er
s
al
co
v
er
ag
e
o
f
m
id
wif
er
y
s
er
v
ices
h
as
th
e
p
o
ten
tial
to
p
r
ev
en
t
u
p
to
6
7
p
er
ce
n
t
o
f
m
ate
r
n
al
m
o
r
tality
in
lo
w
-
an
d
m
id
d
le
-
in
co
m
e
c
o
u
n
tr
ies
[
3
2
]
an
d
is
also
ass
o
ciate
d
with
r
ed
u
ce
d
r
ef
er
r
al
r
ates
an
d
f
ewe
r
ca
s
es
r
eq
u
i
r
in
g
co
m
p
le
x
in
ter
v
en
tio
n
s
[
3
3
]
.
Ho
wev
er
,
th
is
m
u
s
t
b
e
s
u
p
p
o
r
ted
b
y
co
m
p
lian
ce
with
co
m
p
eten
c
y
s
tan
d
ar
d
s
an
d
th
e
av
ailab
ilit
y
o
f
an
en
ab
lin
g
p
r
a
ctice
en
v
ir
o
n
m
en
t.
Ad
d
itio
n
al
ly
,
m
id
wiv
es
ar
e
o
f
ten
th
e
p
r
e
f
er
r
ed
p
r
o
v
id
er
s
o
f
m
ater
n
al
h
ea
lth
ca
r
e
ac
r
o
s
s
s
o
cio
-
ec
o
n
o
m
ic
g
r
o
u
p
s
d
u
e
to
th
eir
ac
ce
s
s
ib
ilit
y
in
te
r
m
s
o
f
d
is
tan
ce
an
d
af
f
o
r
d
a
b
ilit
y
[
3
4
]
.
T
h
e
im
p
lem
en
tatio
n
o
f
p
r
e
n
a
tal
g
r
o
u
p
cla
s
s
es
an
d
s
u
p
p
le
m
en
tar
y
f
ee
d
i
n
g
p
r
o
g
r
a
m
s
f
o
r
p
r
eg
n
a
n
t
wo
m
en
with
ch
r
o
n
ic
en
er
g
y
d
ef
icien
cy
(
C
E
D)
is
am
o
n
g
th
e
cr
iter
ia
with
r
elativ
ely
h
ig
h
p
r
io
r
ity
in
im
p
r
o
v
in
g
m
ater
n
al
h
ea
lth
.
Par
ticip
atio
n
in
p
r
en
atal
g
r
o
u
p
class
es
is
p
o
s
itiv
ely
ass
o
ciate
d
with
in
cr
ea
s
e
d
u
tili
za
tio
n
o
f
ad
eq
u
ate
an
ten
atal
ca
r
e
an
d
d
eliv
er
y
ass
is
tan
ce
b
y
tr
ain
ed
h
ea
lth
p
r
o
f
ess
io
n
als
at
h
ea
lth
ca
r
e
f
ac
ilit
ies
[
3
5
]
.
Me
an
wh
ile,
s
u
p
p
lem
e
n
tar
y
f
ee
d
in
g
p
r
o
g
r
am
s
co
n
tr
ib
u
te
to
im
p
r
o
v
ed
n
u
tr
itio
n
al
in
tak
e
an
d
r
e
d
u
ce
d
m
o
r
b
id
ity
am
o
n
g
p
r
eg
n
a
n
t
wo
m
en
,
th
er
eb
y
lo
wer
in
g
th
e
r
is
k
o
f
co
m
p
licatio
n
s
d
u
r
i
n
g
p
r
eg
n
an
cy
a
n
d
ch
ild
b
ir
th
[
3
6
]
-
[
3
8
]
.
T
h
ese
f
i
n
d
in
g
s
h
ig
h
lig
h
t
th
at
m
ater
n
al
h
ea
lth
in
itiativ
es
a
t
th
e
v
illa
g
e
lev
el
r
ep
r
esen
t
a
k
ey
p
r
i
o
r
ity
in
e
n
h
an
ci
n
g
ac
ce
s
s
to
m
ater
n
al
h
ea
lth
ca
r
e.
B
ased
o
n
th
e
p
r
io
r
ity
s
co
r
es
s
h
o
wn
in
Fig
u
r
e
4
,
th
e
ac
ce
s
s
ib
ilit
y
lev
el
o
f
m
ater
n
al
h
ea
lth
ca
r
e
ca
n
b
e
ca
lcu
lated
f
o
r
ea
ch
v
illag
e.
A
h
ig
h
er
ac
ce
s
s
ib
ilit
y
s
co
r
e
in
d
icate
s
th
at
m
ater
n
al
h
ea
lth
ca
r
e
is
m
o
r
e
ac
ce
s
s
ib
le
in
ea
ch
a
r
ea
.
Mo
s
t
v
illag
es
in
B
ali
Pro
v
in
ce
e
x
h
ib
it
r
elativ
ely
h
ig
h
ac
ce
s
s
ib
ilit
y
.
T
h
is
i
s
illu
s
tr
ated
b
y
th
e
th
em
atic
m
ap
in
Fig
u
r
e
5
,
wh
ich
s
h
o
ws
th
at
2
1
.
3
%
o
f
v
illag
es
f
all
in
to
th
e
ca
teg
o
r
y
with
th
e
h
ig
h
est
ac
ce
s
s
ib
ilit
y
lev
el
(
in
d
icate
d
i
n
b
lu
e)
.
T
h
ese
v
illag
es
ar
e
p
r
ed
o
m
in
an
tly
lo
ca
ted
in
th
e
s
o
u
th
er
n
p
ar
t
o
f
B
a
li,
p
ar
ticu
lar
ly
in
Gian
y
ar
R
eg
en
cy
,
a
n
d
ar
o
u
n
d
th
e
ca
p
itals
o
f
J
em
b
r
an
a
an
d
B
u
lelen
g
R
eg
en
cies.
I
n
co
n
tr
ast,
o
n
ly
1
0
.
6
%
o
f
v
illag
es
a
r
e
cl
ass
if
ied
as
h
av
in
g
th
e
lo
west
ac
ce
s
s
ib
ilit
y
lev
el
(
in
d
icate
d
in
r
ed
)
,
p
r
im
ar
ily
f
o
u
n
d
in
B
an
g
li,
T
ab
a
n
an
,
an
d
Kar
an
g
a
s
em
R
eg
en
cies.
Villag
es
in
th
is
lo
west
-
ac
ce
s
s
ib
ilit
y
g
r
o
u
p
a
r
e
ty
p
ically
ch
ar
ac
ter
ized
b
y
th
e
ab
s
en
ce
o
f
m
id
wif
er
y
s
er
v
ic
es
an
d
th
e
lack
o
f
m
ater
n
al
h
ea
lth
in
s
u
r
an
ce
f
o
r
lo
w
-
in
co
m
e
h
o
u
s
eh
o
l
d
s
.
T
h
e
ac
ce
s
s
ib
ilit
y
o
f
m
ater
n
a
l
h
ea
lth
ca
r
e
ac
r
o
s
s
v
illag
es
is
n
eg
ativ
ely
c
o
r
r
elate
d
with
m
ater
n
al
m
o
r
tality
.
As
illu
s
tr
ated
in
F
ig
u
r
e
6
,
v
illag
es
with
lo
wer
lev
els
o
f
ac
ce
s
s
ib
il
ity
,
s
u
ch
as
th
o
s
e
in
B
an
g
li,
T
ab
an
an
,
an
d
Kar
an
g
asem
R
e
g
en
cies
,
ten
d
t
o
h
a
v
e
h
ig
h
er
MM
R
.
I
n
co
n
tr
ast,
ar
ea
s
with
h
ig
h
er
ac
ce
s
s
ib
ilit
y
,
s
u
ch
as
Den
p
asar
C
ity
,
B
ad
u
n
g
R
eg
en
cy
,
an
d
Gian
y
a
r
R
eg
e
n
cy
,
g
en
er
ally
ex
h
i
b
it
lo
wer
MM
R
.
T
h
e
co
n
ce
p
t
o
f
ac
ce
s
s
ib
ilit
y
ex
ten
d
s
b
ey
o
n
d
g
eo
g
r
ap
h
ic
d
is
tan
ce
;
it
also
en
co
m
p
ass
es
th
e
ea
s
e
wit
h
wh
ich
p
r
eg
n
a
n
t
wo
m
en
ca
n
o
b
tain
ad
eq
u
ate
a
n
d
tim
ely
h
ea
lth
ca
r
e
[
4
]
.
I
m
p
r
o
v
ed
ac
ce
s
s
en
ab
les
p
r
eg
n
an
t
wo
m
en
to
r
ec
eiv
e
ap
p
r
o
p
r
iate
ca
r
e
th
r
o
u
g
h
o
u
t
p
r
eg
n
an
cy
,
r
ed
u
ce
s
th
e
r
is
k
o
f
c
o
m
p
licatio
n
s
,
an
d
u
ltima
tely
c
o
n
tr
ib
u
tes
to
lo
wer
MM
R
.
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I
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8
8
0
6
Op
timiz
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1771
Villag
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r
io
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ity
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o
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im
p
r
o
v
in
g
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al
h
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lth
ca
r
e
ac
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ess
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e
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n
f
u
r
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e
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s
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Fig
u
r
e
7
,
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al
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ea
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ex
h
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it
r
elativ
ely
lo
w
ac
ce
s
s
ib
ilit
y
lev
els
d
esp
ite
h
av
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g
h
ig
h
p
o
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u
latio
n
d
e
n
s
ities
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h
ese
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illag
es
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e
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ab
an
an
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eg
en
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am
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ir
i,
an
d
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r
g
a
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icts
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an
g
li
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en
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s
u
t,
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an
g
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d
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em
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u
k
u
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icts
)
,
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eg
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n
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ict)
.
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h
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u
g
g
ests
a
h
ig
h
p
o
ten
tial n
ee
d
f
o
r
m
ater
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al
h
e
alth
ca
r
e
in
th
ese
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s
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g
iv
en
t
h
e
lar
g
e
n
u
m
b
e
r
o
f
f
em
ale
r
esid
en
ts
,
y
et
s
ig
n
if
ican
t
b
ar
r
ier
s
r
em
ain
in
ac
c
ess
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g
m
ater
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h
ea
lth
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r
e.
E
f
f
o
r
ts
to
im
p
r
o
v
e
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ce
s
s
ib
ilit
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s
h
o
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ld
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e
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ir
ec
ted
to
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d
v
illag
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with
lo
w
ac
ce
s
s
ib
ilit
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lev
els;
h
o
wev
er
,
p
r
io
r
ity
s
h
o
u
ld
b
e
g
iv
en
to
th
o
s
e
with
h
ig
h
er
p
o
p
u
latio
n
d
en
s
ities
,
as
in
ter
v
en
tio
n
s
in
th
ese
ar
ea
s
ar
e
lik
ely
to
h
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g
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ter
im
p
ac
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n
r
e
d
u
cin
g
m
ater
n
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m
o
r
tality
.
Fig
u
r
e
4
.
Prio
r
ity
s
co
r
es o
f
ac
ce
s
s
ib
ilit
y
cr
iter
ia
f
o
r
m
ater
n
a
l h
ea
lth
ca
r
e
ac
r
o
s
s
v
illag
es
Fig
u
r
e
5
.
Villag
e
-
lev
el
s
p
atial
d
is
tr
ib
u
tio
n
o
f
m
ater
n
al
h
ea
lth
ca
r
e
ac
ce
s
s
ib
ilit
y
in
B
ali
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I
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u
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am
o
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a
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ater
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ag
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ted
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R
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y
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eg
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ali
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i
g
u
r
e
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u
a
d
r
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h
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t
o
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v
er
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g
e
m
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2
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Wo
m
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perc
ept
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n o
f
m
a
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er
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lt
hca
re
qu
a
lity
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t
t
he
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g
e
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el
Ov
er
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e
q
u
ality
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er
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ce
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at
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o
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wn
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2
.
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a
s
ca
le
o
f
1
to
7
,
th
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ag
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p
er
ce
p
tio
n
s
co
r
e
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1
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we
v
er
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th
e
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r
r
esp
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g
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p
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tatio
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r
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h
ig
h
er
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at
6
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8
0
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,
in
d
ica
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a
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o
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o
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im
p
r
o
v
e
d
m
ater
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al
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lth
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e
q
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ality
at
th
e
v
illag
e
lev
el
(
p
o
s
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/p
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h
e
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tical
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m
p
ar
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g
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e
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ce
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t
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e
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er
ag
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ap
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r
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r
e
v
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d
if
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er
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,
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n
d
er
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in
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g
ap
b
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m
ater
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h
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lth
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r
en
tly
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ec
eiv
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at
th
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y
ex
p
ec
t.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
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N:
2252
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8
8
0
6
Op
timiz
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tio
n
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tern
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b
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w
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)
1773
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ab
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2
.
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p
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ased
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G
a
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p
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t
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t
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h
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m
o
s
t
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ig
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t
g
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b
s
er
v
ed
in
t
h
e
tan
g
i
b
le
d
im
en
s
io
n
(
in
d
icate
d
b
y
th
e
lar
g
est
g
ap
q
u
ality
s
co
r
e
in
T
ab
le
2
,
in
d
icatin
g
t
h
at
wo
m
en
f
ac
e
lim
itatio
n
s
in
th
e
p
h
y
s
ical
asp
ec
ts
o
f
m
ater
n
al
h
ea
lth
ca
r
e.
T
h
e
in
d
icato
r
with
th
e
wid
est
g
a
p
r
elate
s
to
f
ac
ilit
ies
an
d
in
f
r
astru
ctu
r
e,
as
well
as
th
e
a
v
ailab
ilit
y
o
f
h
ea
lth
wo
r
k
er
s
.
T
h
is
s
u
g
g
ests
th
at
in
ad
eq
u
ate
in
f
r
astru
ctu
r
e
an
d
a
s
h
o
r
tag
e
o
f
h
ea
lth
wo
r
k
er
s
ar
e
t
h
e
m
ain
b
ar
r
ie
r
s
to
m
ee
tin
g
wo
m
en
'
s
ex
p
ec
tatio
n
s
.
T
h
e
s
ec
o
n
d
lar
g
est
g
ap
ap
p
ea
r
s
in
th
e
r
esp
o
n
s
iv
en
ess
d
im
en
s
io
n
,
in
d
icatin
g
th
at
h
ea
lth
wo
r
k
er
s
h
av
e
n
o
t
f
u
lly
m
et
ex
p
ec
tatio
n
s
r
e
g
ar
d
in
g
r
ea
d
in
ess
an
d
s
p
ee
d
in
a
d
d
r
ess
in
g
wo
m
en
'
s
n
ee
d
s
.
T
h
e
m
o
s
t
cr
itical
in
d
i
ca
to
r
with
in
th
is
d
im
en
s
io
n
c
o
n
ce
r
n
s
th
e
ab
ilit
y
o
f
h
ea
lth
wo
r
k
er
s
to
p
r
o
v
id
e
s
er
v
ices
p
r
o
m
p
tly
a
n
d
atten
ti
v
ely
,
ev
en
wh
en
o
p
er
atin
g
u
n
d
er
h
ig
h
wo
r
k
l
o
ad
s
.
T
h
is
h
ig
h
lig
h
ts
h
o
w
lim
ited
s
taf
f
in
g
an
d
ex
ce
s
s
iv
e
wo
r
k
lo
ad
s
ca
n
d
ela
y
r
esp
o
n
s
es
to
wo
m
en
'
s
n
ee
d
s
,
r
ed
u
cin
g
th
eir
p
e
r
ce
p
tio
n
o
f
s
er
v
ice
q
u
ality
.
Hu
m
an
r
eso
u
r
ce
s
a
n
d
in
f
r
astru
ctu
r
e
s
h
o
r
tag
es
ca
n
cr
ea
te
d
is
co
m
f
o
r
t
f
o
r
u
s
er
s
wh
en
ac
ce
s
s
in
g
h
ea
lth
ca
r
e
[
3
9
]
.
Mo
r
eo
v
er
,
h
ig
h
wo
r
k
lo
a
d
s
am
o
n
g
co
m
m
u
n
ity
h
ea
lth
wo
r
k
er
s
ca
n
n
e
g
ativ
ely
af
f
ec
t
th
eir
p
r
o
d
u
ctiv
ity
[
4
0
]
.
I
n
a
d
d
itio
n
to
ex
am
in
in
g
t
h
e
q
u
ality
g
ap
s
,
th
is
s
tu
d
y
also
an
aly
ze
s
th
e
r
elatio
n
s
h
ip
b
et
wee
n
ea
ch
m
ater
n
al
h
ea
lth
ca
r
e
q
u
ality
d
im
en
s
io
n
an
d
m
ed
ical
o
u
t
p
u
t
r
eg
ar
d
i
n
g
im
p
r
o
v
em
e
n
ts
in
wo
m
en
'
s
h
ea
lth
co
n
d
itio
n
s
a
n
d
s
atis
f
ac
tio
n
w
ith
th
e
s
er
v
ices
r
ec
ei
v
ed
.
As
s
h
o
wn
in
T
ab
le
3
,
th
e
ass
u
r
an
ce
an
d
em
p
at
h
y
d
im
en
s
io
n
s
ex
h
ib
it
th
e
s
tr
o
n
g
est
ass
o
ciatio
n
s
with
m
ed
ical
o
u
tp
u
t
,
i
n
d
icate
d
b
y
t
h
e
lar
g
est
P
ea
r
s
o
n
co
r
r
elatio
n
co
ef
f
icien
t
in
T
ab
l
e
3
.
T
h
is
s
u
g
g
ests
th
at
wo
m
e
n
'
s
tr
u
s
t
an
d
co
n
f
id
e
n
ce
in
s
er
v
ices
ar
e
p
o
s
itiv
ely
lin
k
ed
t
o
b
etter
h
ea
lth
o
u
tco
m
es.
C
o
n
v
er
s
ely
,
alth
o
u
g
h
th
e
tan
g
ib
le
an
d
r
esp
o
n
s
iv
en
ess
d
im
en
s
io
n
s
d
is
p
lay
lar
g
er
q
u
ality
g
ap
s
,
th
ei
r
r
elat
io
n
s
h
ip
with
m
ed
ical
o
u
tp
u
t
i
s
r
elativ
ely
wea
k
er
.
I
n
o
th
er
wo
r
d
s
,
ev
e
n
wh
e
n
f
ac
ilit
ies,
in
f
r
astru
ctu
r
e,
an
d
th
e
r
esp
o
n
s
iv
en
ess
o
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4
5
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[
4
6
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.
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ess
[
4
7
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,
[
4
8
]
.
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ar
ticu
lar
ly
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n
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em
o
te
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illag
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[
4
9
]
.
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[
5
1
]
,
[
5
2
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.
T
a
b
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4
.
T
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S
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at
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x
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to
i
m
p
r
o
v
e
a
cc
ess
ib
ili
ty
an
d
q
u
a
lit
y
o
f
m
ate
r
n
al
h
e
alt
h
ca
r
e
at
v
ill
a
g
e
le
v
e
l
I
n
t
e
r
n
a
l
f
a
c
t
o
r
s
Ex
t
e
r
n
a
l
f
a
c
t
o
r
s
S
t
r
e
n
g
t
h
s (S
)
W
e
a
k
n
e
sses
(
W
)
O
p
p
o
r
t
u
n
i
t
i
e
s
(
O
)
S
O
st
r
a
t
e
g
i
e
s
:
˗
O
p
t
i
mi
z
e
m
a
t
e
r
n
a
l
h
e
a
l
t
h
p
r
o
m
o
t
i
o
n
t
h
r
o
u
g
h
c
o
mm
u
n
i
c
a
t
i
o
n
,
i
n
f
o
r
m
a
t
i
o
n
,
a
n
d
e
d
u
c
a
t
i
o
n
i
n
i
t
i
a
t
i
v
e
s
.
˗
D
e
v
e
l
o
p
t
e
l
e
m
e
d
i
c
i
n
e
f
o
r
p
r
e
g
n
a
n
t
w
o
me
n
t
o
i
m
p
r
o
v
e
a
c
c
e
ss
a
n
d
a
w
a
r
e
n
e
ss.
W
O
st
r
a
t
e
g
i
e
s
:
˗
R
e
f
i
n
e
mat
e
r
n
a
l
h
e
a
l
t
h
i
n
su
r
a
n
c
e
s
c
h
e
mes
t
o
b
e
m
o
r
e
i
n
c
l
u
si
v
e
a
n
d
t
a
r
g
e
t
e
d
,
c
o
n
si
d
e
r
i
n
g
s
o
c
i
o
-
e
c
o
n
o
mi
c
c
o
n
d
i
t
i
o
n
s
a
n
d
h
e
a
l
t
h
c
a
r
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a
c
c
e
ss
i
b
i
l
i
t
y
.
˗
I
mp
l
e
me
n
t
i
n
c
e
n
t
i
v
e
me
c
h
a
n
i
sms
t
o
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n
c
o
u
r
a
g
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m
i
d
w
i
v
e
s
t
o
serv
e
i
n
u
n
d
e
r
serv
e
d
a
r
e
a
s.
Th
r
e
a
t
s(
T)
S
T
st
r
a
t
e
g
i
e
s:
˗
S
t
r
e
n
g
t
h
e
n
c
o
mm
u
n
i
t
y
-
b
a
se
d
h
e
a
l
t
h
p
r
o
m
o
t
i
o
n
t
a
r
g
e
t
i
n
g
m
i
g
r
a
n
t
p
o
p
u
l
a
t
i
o
n
s
˗
P
r
o
mo
t
e
t
h
e
a
c
t
i
v
e
i
n
v
o
l
v
e
me
n
t
o
f
h
e
a
l
t
h
w
o
r
k
e
r
s
i
n
v
i
l
l
a
g
e
d
e
v
e
l
o
p
me
n
t
p
l
a
n
n
i
n
g
.
W
T
st
r
a
t
e
g
i
e
s:
˗
S
y
st
e
ma
t
i
c
a
l
l
y
r
e
d
i
s
t
r
i
b
u
t
e
h
e
a
l
t
h
w
o
r
k
e
r
s
b
a
s
e
d
o
n
l
e
v
e
l
s
o
f
a
c
c
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ssi
b
i
l
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t
y
a
n
d
ser
v
i
c
e
b
u
r
d
e
n
˗
I
mp
r
o
v
e
a
d
mi
n
i
st
r
a
t
i
v
e
c
o
m
p
l
i
a
n
c
e
mec
h
a
n
i
sms
f
o
r
mi
g
r
a
n
t
p
o
p
u
l
a
t
i
o
n
s
t
o
e
n
h
a
n
c
e
h
e
a
l
t
h
c
a
r
e
a
c
c
e
ss.
On
th
e
o
th
er
h
an
d
,
s
tr
ateg
ies
ad
d
r
ess
in
g
ex
ter
n
al
th
r
ea
ts
f
o
cu
s
o
n
i
n
cr
ea
s
in
g
th
e
u
tili
za
tio
n
o
f
m
ater
n
al
h
ea
lth
ca
r
e,
p
ar
ticu
l
ar
ly
am
o
n
g
m
ig
r
a
n
t
p
o
p
u
la
tio
n
s
.
I
n
th
e
s
tr
en
g
t
h
–
th
r
ea
t
(
ST)
s
tr
ateg
y
,
a
co
m
m
u
n
ity
-
b
ased
ap
p
r
o
ac
h
is
ess
en
tial
to
m
o
b
ilize
m
ig
r
an
ts
to
war
d
im
p
r
o
v
ed
h
e
alth
b
eh
av
io
r
s
an
d
p
ar
ticip
atio
n
in
o
u
tr
ea
ch
p
r
o
g
r
am
s
[
5
3
]
.
T
o
en
s
u
r
e
m
ater
n
al
h
ea
lth
b
ec
o
m
es
a
p
r
io
r
ity
in
v
illag
e
d
ev
elo
p
m
e
n
t,
h
ea
lth
ca
r
e
p
r
o
v
id
er
s
s
h
o
u
ld
ac
tiv
ely
p
ar
ticip
ate
in
v
illag
e
p
lan
n
in
g
p
r
o
ce
s
s
es.
Acc
o
r
d
in
g
to
[
5
4
]
,
r
esp
o
n
s
iv
e
v
illag
e
o
f
f
i
cials,
co
m
b
in
ed
with
ac
tiv
e
co
m
m
u
n
ity
in
v
o
lv
em
en
t
an
d
d
ec
is
io
n
-
m
a
k
in
g
ca
p
ac
ity
,
p
o
s
itiv
ely
in
f
lu
en
ce
t
h
e
ef
f
ec
tiv
en
ess
o
f
d
ev
elo
p
m
e
n
t p
r
o
g
r
am
s
f
u
n
d
ed
b
y
th
e
v
ill
ag
e
f
u
n
d
.
I
n
th
e
wea
k
n
ess
–
th
r
ea
t
(
W
T
)
s
tr
ateg
y
,
th
e
r
ed
is
tr
ib
u
tio
n
o
f
h
ea
lth
wo
r
k
er
s
s
h
o
u
ld
b
e
im
p
lem
en
ted
m
o
r
e
s
y
s
tem
atica
lly
to
en
s
u
r
e
s
er
v
ice
av
aila
b
ilit
y
in
v
illag
es
with
lo
w
ac
ce
s
s
ib
ilit
y
.
A
d
d
itio
n
ally
,
p
o
licies
r
elate
d
to
m
ig
r
an
t
r
eg
is
tr
atio
n
an
d
ad
m
in
is
tr
ativ
e
c
o
m
p
lian
c
e
s
h
o
u
ld
b
e
m
ad
e
m
o
r
e
f
lex
ib
le
an
d
i
n
clu
s
iv
e
t
o
f
ac
ilit
ate
eq
u
itab
le
ac
ce
s
s
to
m
ater
n
al
h
ea
lth
ca
r
e,
p
a
r
ticu
lar
ly
d
u
r
in
g
em
e
r
g
en
cies
[
5
5
]
.
H
ig
h
lig
h
t
th
at
im
p
r
o
v
in
g
h
ea
lth
p
r
o
tectio
n
f
o
r
m
i
g
r
an
t
p
o
p
u
latio
n
s
an
d
r
ed
u
ci
n
g
b
ar
r
ier
s
to
civ
il
r
e
g
is
tr
atio
n
n
o
t
o
n
ly
en
h
an
ce
s
m
ater
n
al
a
n
d
in
f
an
t
h
ea
lth
o
u
tco
m
es
b
u
t
also
s
tr
en
g
th
en
s
th
e
g
o
v
er
n
m
en
t'
s
ca
p
ac
ity
to
m
o
n
ito
r
p
o
p
u
latio
n
h
ea
lth
m
o
r
e
ac
c
u
r
a
tely
an
d
ef
f
ec
tiv
ely
.
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