Maternal mortality<\/p>\n
\"It's like a jumbo jet full of women crashing down every week,
\nbut nobody hears of it, no one makes a fuss.\"<\/p>\n
This comment was made by Dr. Kumara Rai, the director general
\nof community health, at a luncheon with the theme Businesses who
\ncare. The event was sponsored by the Menteng Rotary Club and the
\nWorld Health Organization (WHO) in commemoration of WHO's 50th
\nanniversary and mother's day.<\/p>\n
Dr. Kumara Rai was referring to the maternal mortality rate
\n(MMR), i.e. deaths caused by pregnancy and childbirth
\ncomplications. In Indonesia, the national MMR is 400 per 100,000
\nlive births -- that is 20,000 mothers dying every year with many
\nmore children becoming motherless.<\/p>\n
This is appalling, you may think.<\/p>\n
Even though Indonesia's rate is not the worst (Papua New
\nGuinea's rate is 700 per 100,000 live births), it is disturbing
\nif compared to neighboring countries: Vietnam's MMR is 60 per
\n100,000 live births, Malaysia's is 80, while Singapore's is 10.<\/p>\n
Why isn't anybody doing something about it? Well, they are.
\nThere are currently various provincial and national health
\nprojects and programs led by the Ministry of Health that are
\naimed at reducing the MMR.<\/p>\n
You may ask \"Why are so many women still dying? Who's to
\nblame?\" Reducing the MMR is not an easy task. As with most
\nthings, it is a very complicated issue.<\/p>\n
If I were a poor, uneducated woman, a farmer's wife, and
\nliving in a remote village, I would have been \"aboard\" one of
\nthose jumbo jets -- ironically, twice! But because I had access
\nto health care facilities, both of my babies were born healthy,
\nthough the deliveries were potentially life-threatening.<\/p>\n
Many other women and their children are not so lucky.<\/p>\n
I recently witnessed a young mother dying in a provincial
\nhospital due to hemorrhaging from giving birth at home to her
\nsixth child two days previously. Hemorrhaging is the most common
\ncause of maternal death in Indonesia. Although she had lived in a
\nvillage only 10 minutes away from the hospital, her family
\nfinally brought her in only when it was too late.<\/p>\n
Access to adequate health facilities and prenatal care is
\nonly one of the determinant factors of MMR. The other three
\nfactors are education of the mothers and the family in
\nrecognizing a life-threatening situation, access to family
\nplanning and obstetricians and new-born care. These factors are
\ncalled the \"four pillars\" of safe motherhood.<\/p>\n
There are also factors that increase the risk of pregnancy
\nrelated complications such as: pregnancy before the age of 20 and
\nafter 30, poor nutrition (anemia), having many children, short
\nintervals between pregnancies and a history of complications.<\/p>\n
Unfortunately the dying woman I witnessed was not identified
\npreviously as having a high-risk pregnancy.<\/p>\n
Any intervention programs aimed at reducing the MMR
\nneed to be comprehensive and must comprise these \"four pillars\".
\nHowever, safe motherhood programs by themselves are not
\nsufficient to reduce MMR. To do that, they must include
\ninterventions to improve the health and welfare of future mothers
\nand fathers starting early in life.<\/p>\n
Thus we need the adoption of a concept of reproductive health
\nwhich encompasses the whole life-cycle, from womb to tomb. Since
\nthe determining factors involve many sectors of society,
\nimprovement of the reproductive health status of our country
\nrequires a concerted effort. Currently, a five-year reproductive
\nhealth project is being prepared with a possible loan from the
\nAsian Development Bank. It is planned to be implemented in West
\nJava, North and Southeast Sulawesi.<\/p>\n
However, each and everyone of us should do something and not
\nbe content to let formal programs do all the work. Factory
\nmanagers can look into improving the reproductive health of their
\nworkers, employers can inform and educate their household staff
\nand parents can inform their children to better avoid unplanned
\npregnancies and to delay marriage.<\/p>\n
We can help change traditional Indonesian perceptions that
\npregnancy is biasa (an ordinary occurrence) to a perception that
\npregnancy is special. Let's make it safe.<\/p>\n
JULIE MARSABAN<\/p>\n
Jakarta<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/maternal-mortality-1447893297", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }