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)