Crisis threatens motherhood programs

Crisis threatens motherhood programs

JAKARTA (JP): Every month, Martina, who is seven months
pregnant, goes to a community health center for a checkup.

She does not have to worry about the cost as she has a
maternity care (ANC) card which entitles her to professional
medical treatment during pregnancy, childbirth and postnatal
care.

To get the card, Martina, 25, paid Rp 2,500 and she will only
have to pay Rp 50,000 in hospital fees for the birth. Her husband
has saved enough money to provide her with healthy food and other
necessities when their first child is born.

The couple lives in a village, in Central Java, which is quite
far away from a provincial hospital. But they do not have to
worry about transportation because one of their neighbors has
offered to help. He has a car which usually functions as the
village ambulance.

The couple does not have to fork out transportation fees
because the car owner can be reimbursed at the nearest bank or
village cooperative.

The village chief has also built a transit home near the
hospital to accommodate pregnant women from remote areas who are
nearing the end of their pregnancy.

This sounds too good to be true but it is real. This is all
part of the Safe Motherhood schemes and mother-friendly movements
currently underway in Indonesia's 27 provinces.

The implementation of these programs is mainly aimed at
providing social, financial and health security for pregnant and
breast-feeding mothers.

Stephen J. Woodhouse, Unicef's area representative for
Indonesia and Malaysia, said that the scheme was carried out in
Central Java with Salatiga being the first city to apply it.

"I was very impressed with the program and it seems to work
quite well," he said referring to the province's Safe Motherhood
program supported by the government and the Japanese
International Cooperation Agency.

Unicef, he said, is planning to carry out similar programs
in Maluku, Irian Jaya and West Java provinces with the assistance
of the Australian Agency for International Development.

"Ideally, all community members are involved in Safe
Motherhood programs. In some provinces, such as in Yogyakarta,
the programs work very well," Woodhouse said.

Yogyakarta has the lowest maternal mortality rate in Indonesia
with only 100 deaths in 100,000 live births compared to
the national average of 400.

Most maternal deaths, he said, are due to poor nutrition,
inadequate medical facilities, delay in transporting pregnant
women in need of emergency obstetric care because they live in
poor and remote villages.

The current financial crisis in Indonesia makes the future
stability of any government program unclear, and the ability of
the government to fund health care is likely to diminish.

The ongoing socioeconomic-political upheavals have greatly
affected national health programs.

Meiwita B. Iskandar, resident advisor of Resident Population
Council Jakarta, revealed in her most recent study on the impact
of the present crisis on women's health and nutritional status
that many improvement programs for women's health would unlikely
achieve their target.

The Ministry of Health has an ambitious target to reduce the
maternal mortality rate of 400 in 100,000 live births by half by
2,000.

"The spiraling prices of basic commodities, drugs and medical
equipment have been devastating to the life of Indonesian people,
particularly the most vulnerable members including pregnant
women, breast-feeding mothers and children under five," Meiwita
wrote.

The purchasing power of the people has been declining so
sharply due to a high inflation rate and mass layoffs. In rural
areas, the drought has destroyed harvests and compounded the
difficulties facing poor farmers, Meiwita revealed.

A lot of people would be unable to buy nutritious food for
their families. Pregnant women, breast-feeding mothers and
children under five are threatened with malnutrition because they
cannot afford healthy food and necessary vitamins such as
supplements of Vitamin A, iodine, folic acid, iron tablets and
other minerals.

This also results in a growing number of families who fail to
take their sick children to health centers.

A number of pregnant women will likely stop prenatal care and
choose to give birth at home without proper medical assistance.
Medical staff will likely go to big cities to open their own
medical practices rather than work in villages.

The future of maternal and child health programs depends
heavily on the way the government deals with the present crisis,
she said.

"It is predicted that childbirth risks will increase, and thus
maternal and infant mortality rates, unless the government
is quick to resolve the current social, economic and political
crisis," Meiwita recommended. (raw)