Description:
Maternal health remains one of the top
priorities of the Government of Indonesia (GoI) and the
Ministry of Health (MoH) because reductions in maternal
mortality have been slows. The current Maternal Mortality
Ratio (MMR) for Indonesia is 228 but with existing programs
and interventions the government does not believe it will be
able to achieve its stated millennium development goal of
102 maternal deaths per 100,000 live births by 2015. There
are positive trends in an increased use of skilled birth
attendants, almost universal access to some level of
antenatal care and continued use of family planning but
these are not enough to stem the tide of maternal death.
Interventions by the skilled birth attendants in many cases
are not in line with existing standards and prove to be
ineffective in trying to address the emergence of
complications. Antenatal care is important, but it is not
where gains in decreased mortality will be obtained. The
continued use of traditional birth attendants (TBA) and
delivering at home are contributory factors to maternal
mortality in Indonesia. In collecting data from verbal
autopsies in three districts, (a widely used government
initiative to determine the causes of maternal death) 63 out
of 76 deaths occurred in home births that had been assisted
by a TBA. In order to improve the access of the poor and the
near poor to health services, the government is implementing
the social insurance scheme, Jamkesmas. Approximately 104
million people should qualify for assistance but there are
presently only 76.4 million people covered by this social
health insurance (SHI) plan. Even those who are covered are
not always able to afford care because of external expenses
such as transportation charges which must be paid up front.