Sat, 13 Nov 2004

Govt to improve effort on health

Sari P. Setiogi, The Jakarta Post, Jakarta

Indonesia must improve its health services and reduce maternal deaths if it hopes to achieve the Millennium Development Goals, a report released by the World Bank says.

The report says that every hour at least two women in the country die during childbirth, or about 20,000 mothers each year from about five million deliveries.

According to the report, which was released recently, the country's maternal mortality rate has been reduced to 307 per 100,000 live births from 450 in 1986. However, the country may not meet the millennium development goal of 125 maternal deaths per 100,000 births by 2010.

Hemorrhaging, eclampsia, complications from abortion, obstructed labor and infections are still the main causes of maternal deaths here.

However, more women are being attended by professional health workers during birth, from only 43.2 percent in 1997 to 66.2 percent last year.

"More effort is needed. Some women still prefer to go to a traditional midwife because they are cheaper and also offer to do the housework after the mother gives birth," said the chairwoman of the National Family Planning Coordinating Board, Sumarjati Arjoso.

In comparison, fellow members of the Association of Southeast Asian Nations (ASEAN) have much lower maternal mortality rates. Thailand records 24 deaths per 100,000 live births, Vietnam 100 and the Philippines 172.

Indonesia has halved its infant mortality rate from 91 per 1,000 live births in 1990 to just 45 in 2002.

Compare that to Cambodia, where one in every seven children does not reach his fifth birthday.

One of the main factors in the lower infant mortality rate here is a comprehensive measles immunization program. The number of children aged between 12 months and 23 months immunized against measles increased from 57.5 percent in 1992 to 71.6 percent in 2002.

However, at least 26 children below the age of five in Alor, East Nusa Tenggara province, died recently in an outbreak of measles.

The World Bank report also found Indonesia has been reducing malnutrition by some 5 percent annually.

That figure is impressive when compared to fellow ASEAN countries. Malnutrition has been falling 1.1 percent annually in Myanmar and Cambodia, 0.9 percent in Laos and 0.6 percent in the Philippines.

World Bank president James D. Wolfensohn said during the release of the report, Rising to the Challenges: The Millennium Development Goals for Health, that countries needed to look at measures such as committing increased resources to meeting the health-related Millennium Development Goals.

The World Bank said increasing health spending was necessary to get poor people the effective treatment they need.

Indonesia has allocated some Rp 7.4 trillion (US$820 million) for health spending in 2005, or about 16 percent of the total Rp 123 trillion state budget.

Eight Millennium Development Goals were set at the United Nations Millennium Summit in September 2000, where 189 countries committed to ambitious targets for improving the health and well- being of hundreds of millions of people in the developing world by 2015.

Four of the goals relate directly to health. They are to reduce the maternal mortality rate by three-quarters and the child mortality rate by two-thirds, to halve the proportion of people suffering from hunger, combat HIV/AIDS, malaria and other diseases, and to improve access to safe drinking water and essential drugs.