After quite a long time the publication of the results of the 2012 Indonesian Demographic and Health Survey (IDHS) for the Maternal Mortality Rate (MMR) was delayed by the government, finally the results of the MMR were announced. The results were surprising. Maternal mortality jumped very significantly to 359 per 100.000 live births or returned to conditions in 1997. This means that maternal health actually experienced a decline for 15 years. In 2007, the MMR in Indonesia had actually reached 228 per 100.000 live births.
It is sad that the very high MMR means that Indonesia is even worse off than the poorest countries in Asia, such as Timor Leste, Myanmar, Bangladesh and Cambodia. Indonesia is now considered to be behind in Asia in protecting maternal health. This maternal death emergency must end with serious improvements in policies, budgets and immediate action.
Sad Setback
It is ironic that the development of the health sector in Indonesia at this time. Two decades ago, Indonesia was considered by WHO as one of the successful countries in the Maternal and Child Health (MCH) program. In 1997, the government was able to reduce the MMR to 334 per 100.000 live births from 390 per 100.000 live births in 1994. And lastly in the 2007 IDHS, Indonesia's MMR has reached 228 per 100.000 live births2. For WHO, what Indonesia has achieved in achieving the MDGs targets in terms of maternal and reproductive health is a good achievement.
Indonesia was previously an aggressive country in implementing maternal and child health (MCH) policies. Since WHO launched the Safe Motherhood Initiative in 1987, the Indonesian government has immediately responded to WHO's agenda in MCH development policies. Indonesia also responded quickly to the global population development initiative (International Conference on Population and Development (ICPD) which was first held in Cairo, Egypt in 1994.
One of the points of reference for the Indonesian government is the right of adolescents to obtain reproductive services, including proper counseling services. During the two decades 1980 – 2000 Indonesia was a successful country in managing the MCH program. But now it's the opposite.
Important point:
- There was a significant increase in MMR from 228 (in 2007) to 359 (in 2012) per 100.000 live births
- The soaring MMR shows the weakness of the maternal and reproductive health system, as well as the ineffectiveness of the Population and Family Planning (KKB) program.
The budget for maternal and reproductive health needs to be increased, it is urgent to improve the KKB system and strengthen the role of regions