Maternal mortality rate down, observers say more work needed

Dewi Santoso, The Jakarta Post/Jakarta

While the current trend of maternal mortality rate (MMR) shows a decreasing pattern, it may be difficult for Indonesia to achieve the target of MMR of around 125 per 100,000 births set by the United Nations' Millenium Development Goals, an expert says.

According to the Indonesian Demographic and Health Survey (SDKI), the country's mortality rate decreased from 307 per 100,000 births in 2003, down from 334 per 100,000 births in 1997 and 390 per 100,000 births in 1994.

Head of the University of Indonesia's Center for Family Welfare, Endang L. Achadi, said on Wednesday that it might be difficult for Indonesia to achieve the MMR of 125 per 100,000 births in 2015 as the country lacked qualified community health centers (puskesmas) and health workers.

"It's true that we're on the right track as the maternal mortality rate in the country has decreased in the past 10 years. To reach 125 in 2015, it means that (the MMR) has to be reduced by 182 over the next 10 years, which I find it quite difficult to achieve as we don't have enough midwives and qualified health centers," said Endang.

Data from the National Family Planning Board (BKKBN) shows that there are 80,000 midwives in 2004, of which 86 percent (68,777) are located in villages, while the remaining in cities.

Of the 68,777 midwives, 40 percent are private midwives, 50 percent civil servants and the remaining based on contracts.

According to data from the Central Statistics Agency (BPS), there were 27,428 puskesmas and 1,215 hospitals in 2002.

Endang praised the government's efforts in reducing the country's MMR by recruiting and training 60,000 midwives in villages and upgrading community health centers and hospitals.

However, she said that more efforts were needed to reduce the country's MMR as Indonesia is still ranked below other Southeast Asia countries.

Data from the United Nations Population Funds (UNFPA) show that the MMR in Malaysia stands at 41 per 100,000 births, Thailand 44 per 100,000 births and Vietnam 130 per 100,000 births.

"We're even behind Vietnam. Thus, more efforts by all layers of society, not just the government, are needed," Endang told The Jakarta Post.

She gave out an example that might help reduce the country's mortality rate.

"Free medical services for the poor, just like in Malaysia, may help as many of poor people in our country do not have access to medical services due to the high charges," she said.

She added that improving the quality of the country's medical services and increasing the budget for the health sector might also help in reducing the MMR.

In 2000, representatives of 189 nations gathered at the United Nations for a historic Millennium Summit and adopted an ambitious set of goals called the Millennium Development Goals (MDGs), which set the target to reduce by half the number of people living in extreme poverty, achieve universal primary education, promote gender equality, reduce infant mortality rate and reduce MMR by 2015.