GOVT PULLING OUT ALL THE STOPS TO REDUCE MATERNAL DEATH RATE By Fardah

   Jakarta, Nov 14, 2012 (ANTARA) - Indonesia's maternal mortality rate of 228 per 100,000 live births remains the highest in Southeast Asia, but the figure must be reduced to 102 per 100,000 by the year 2015 in order to achieve the United Nations Millennium Development Goals (MDGs).

         According to Indonesian demographic and health survey (SDKI) data, the country's infant mortality rate decreased from 35 per 1,000 live births in 2004 to 34 per 1,000 live births in 2007.

         The maternal mortality rate dropped from 307 per 100,000 live births in 2004 to 228 per 100,000 live births in 2007.

        Despite the progress made in reducing the maternal and infant mortality rates, the government has expressed concern over the speed of the progress. Therefore, it has called on all parties to support it in its efforts to tackle the problem, through the implementation of several programs aimed at reducing the mortality rates across the country.

        Therefore, Health Minister Nafsiah Mboi signed a memorandum of understanding (MoU) with four NGO leaders and six businessmen to support Indonesia's MDG targets. Held on November 12, the signing event coincided with the 48th National Health Day.

        The four NGOs that signed the MoU with the health ministry are Dewan Masjid Indonesia (the Indonesian Mosque Council), Yayasan Jaringan Pesantren Nusantara (the foundation of Indonesian Islamic Boarding School Network - Jannur), Yayasan Amal Bakti Ibu Indonesia (the foundation of Mothers' Devotion - YABII) and Himpunan Mahasiswa Islam (the Indonesian Muslim Student Association).

         The six business entities that were signatories to the MoU are PT Bank Negara Indonesia Tbk (BNI), PT Novo Nordisk Indonesia, PT Express Trasindo Utama Tbk, PT Cisarua Mountain Dairy, the Ikatan Wanita Pengusaha Indonesia (the Indonesian businesswomen's association), and PT Johnson and Johnson.

          All signatories expressed their commitment to support the government in health development activities in order to help achieve the MDG targets.

        "The initial orientation of the development was 'working for the people'; it has now been changed to `working together with the people," the minister said.

        Therefore, the government must work in cooperation with the private sector, businessmen, NGOs and other stakeholders, Mboi explained.

       The government will speed up the implementation of the `Actively Alert for Rural and Neighbourhood Development' program, which encourages people to take care of their health issues independently,¿ she added.

       Mboi expressed hope that the program would help the government tackle health problems such as high infant and maternal mortality rates and inadequate sanitation facilities among communities across the nation.

        Meanwhile, Deputy Health Minister Ali Ghufron Mukti stated that the government had made some breakthroughs in its efforts to reduce infant and maternal mortality rates by, among other things, providing free birthing services and implementing an integrated emergency management system.

         "We now have a 'Sister Hospital' program, wherein big hospitals from cities send their personnel to remote areas where the maternal and infant mortality rates are still high," he said.

         The program has been implemented by a number of hospitals in Jakarta, Yogyakarta, Medan and Makassar.

        The government has also set itself a target of providing health insurance to all Indonesians by 2019.

         In order to help accelerate the reduction of infant and maternal mortality rates, the government has provided Rp75 million to Rp250 million in funds for each community health centre (Puskesmas) annually, Mboi said.

         The funds are used to support the operational activities of community health centres and integrated health posts (posyandu), as well as to help reduce infant and maternal mortality rates and provide children with proper nutrition, she added.

         The coverage of immunization against measles rose from 67 percent in 2007 to 93.3 percent in 2011.

         The prevalence of malnutrition among infants reduced to 17.9 percent in 2010 (from much higher figures in previous years) and it is expected to decrease to 15 percent by 2015.  
     This year's National Health Day focused on maternal health services, because that is the area in which the nation's MDG target is yet to be achieved.

        "The theme of the National Health Day is 'Indonesia Loves Heath' and the sub-theme is 'Mothers Are Safe, Children Are Healthy" which is a priority for national health development," she said at a function observing the National Health Day.

         In providing health services for mothers and children, the coverage has increased from 61.4 percent in 2007 to 87.4 percent in 2011, Mboi noted.

         Citing an official report, the minister said 71 percent of under-five children were being taken to integrated health posts ("posyandu") for medical check-up every month.

         "It means that 14 million infants receive medical services from the integrated health posts," she explained.

        The decline in maternal mortality rate, infant mortality rate and malnutrition prevalence rate, along with an increase in life expectancy, indicates that Indonesia has made progress in the health sector, Mboi pointed out.

         Despite the progress, however, Indonesia has a long way to go in order to meet its MDG targets by 2015, she said.

         The MDG targets that must be met by 2015 are 24 per 1,000 live births for infant mortality rate, and 102 per 100,000 live births for the maternal mortality rate, Mboi added.

          The Presidential Special Envoy on the MDGs, Prof Nila Moeloek, during a seminar on MDGs, held in Jakarta in May 2012, said: "The fifth MDG (on maternal health improvement) and the sixth MDG (on infectious diseases such as HIV/AIDs) are indeed huge challenges that the nation should address in order to meet all the MDG targets by 2015."
      She, however, expressed optimism that the country would be able to meet the fifth MDG despite the country's current maternal mortality ratio being high. The fifth goal of the MDGs is to reduce maternal mortality ratio by three quarters by 2015.

         "Although Indonesia's maternal mortality ratio is the highest in Southeast Asia, we are optimistic that the fifth MDG target will be achieved, because many people are currently working on reproduction-related issues across the nation," Nila stated.

        She said there was a positive correlation between school dropout rates and early marriages.

        "One of the main reasons why mothers die during childbirth is because they are too young and their bodies are not properly developed for childbirth," she said at a seminar on reproductive health rights.

         About 42 percent of Indonesian women get married between the age of 15 and 19, whereas the ideal age for having a child is 20 to 30, Nila pointed out.

        The average amount of schooling that children receive is 5.8 years, which is far off the government's target of nine years, she continued.

         "Those who drop out are at high risk of having unplanned pregnancies. This often prompts them to get unsafe abortions, which are factors of maternal mortality that don¿t get counted," Nila said.

        Therefore, she noted that the country's high maternal mortality rate was not only a health issue, but also an education and economic issue.

        Nila also identified poor sanitation and hygiene as major threats to young mothers.

        "Forty-four percent of homes here don't have proper sanitation, which puts pregnant women in these families at high risk during childbirth," she said. ***3***
(f001/INE/A/S012)