RI trying to cut maternal mortality rate
By Rita A. Widiadana
JAKARTA (JP): Wearing a tight red dress, a singer appears from the back of a glittering stage with a message for husbands to treat their pregnant wives more affectionately.
In a tender voice, the singer expresses her love for her husband with a dangdut song: You are the man I adore. You care for me and our newborn baby. Babe ... I love you more and more.
This is a scene from the Suami Siaga (Caring Husband) television advertisement featuring popular dangdut singer Iis Dahlia. The ad is part of the safe motherhood campaign.
Iis said she was eager to take part in the campaign because she had gone through difficult periods during her pregnancies.
"Husbands' roles in supporting their wives are important," said Iis, whose first two pregnancies ended in miscarriages.
The advertisement is being broadcast on one state-owned and five private television and radio stations for six months. The ad began running in February and will continue to air through July this year.
In addition to TV and radio spots, the campaign also includes other programs, including the television drama Kembang Untuk Nur (Flower for Nur).
The national campaign is jointly supported by the office of the State Minister of Women's Affairs, the United Nations Population Fund (UNFPA) and John Hopkins University's Center for Communications Programs, in collaboration with advertising firm Indo-Ad.
Abdullah Cholil, an assistant to the State Minister of Women's Affairs, said the six-month campaign was intended to reduce the maternal mortality rate in Indonesia, which reaches 450 to 650 deaths per 100,000 childbirths. This rate is the highest among the member countries of the Association of Southeast Asia Nations (ASEAN). The Suami Siaga campaign is hoped to help lower the maternal mortality rate to around 225 deaths per 100,000 childbirths by 2000.
"We hope it can effectively raise people's awareness about the health and welfare of mothers and babies," Cholil stated.
Television ads and entertainment programs have been proven effective in disseminating messages to target audiences, he said.
"We use a dangdut song because many people love that kind of music. A good song can stir people's emotions," he explained.
The campaign is targeting husbands and rural communities to encourage them to pay more attention to their wives and the women in the community, especially when they are expecting babies.
"In many regions in Asia, including Indonesia, people tend to view pregnancy as an ordinary occurrence," he said.
However, pregnant women face serious health risks, including anemia, undernourishment, bleeding, high blood pressure, miscarriages and even death during childbirth.
Data from the Ministry of Health reveals around 51 percent of pregnant women suffer from acute anemia. The data also shows 22,000 women die each year during childbirth.
In traditional and rural societies, women are regarded as second-class citizens and often receive substandard health care.
Safrie Gurrici, project officer of the Suami Siaga campaign, said pregnancy was usually viewed as a woman's private business.
Husbands, especially those living in villages, rarely get involved in helping their pregnant wives obtain the necessary care, including adequate and nutritious food and proper prenatal health examinations.
"Village women, low-income female workers and uneducated women are very vulnerable to any form of abuse or health hazard during their pregnancies," a doctor said.
Many of these mothers-to-be continue to work long hours, while at the same time their access to health services is limited.
Cholil added the campaign was part of a larger safe motherhood program, Gerakan Sayang Ibu (Love For Mother Movement), launched jointly by the Indonesian government and several local and international agencies.
The Ministry of Health, the World Health Organization (WHO) and the United Nations Children Fund (Unicef) are currently carrying out safe motherhood programs in several provinces in Indonesia. The programs provide health care, transportation and food supplements to expectant mothers.
"The Suami Siaga campaign takes a social and cultural approach to changing community behavior. Therefore, communication is used to achieve our goals," Cholil said.
The campaign is focusing on three major causes of maternal deaths in Indonesia. These include the inability to identify and anticipate maternal health risks, thus preventing pregnant women from receiving proper medical care.
Another problem the campaign is addressing is a lack of transportation and health care facilities, especially in remote villages. A lack of facilities has been blamed in a number of maternal deaths. The campaign is attempting to persuade husbands and communities to provide needed facilities.
Fitri Putjuk, a representative of John Hopkins University's Center for Communications Programs in Jakarta, said in rural communities people argue pregnancy and maternal health should be left to individual conscience, religious guidance and personal choice.
Nevertheless, reproduction issues are becoming increasingly prominent on the public health agenda. In the case of the health of mothers and babies, private behavior has public consequences.
"Husbands who do not care about the health and welfare of their pregnant wives will likely contribute to the increasing number of maternal deaths," she said.
Safrie added the campaign would be tailored to fit the culture and tradition of each targeted province.
"We are now approaching husbands, village chiefs, religious leaders and families because they play significant roles in shaping women's lives," Safrie stated.
The campaign also include other activities, including discussions and workshops for health providers and community members. Brochures, leaflets and posters also are being distributed in community health centers and public places.
UNFPA will also provide minigrants for villages involved in the Suami Siaga campaign.
Changing people's attitude about maternal health is a slow process and this campaign is only a starting point.