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Indonesia Struggles with High Maternal Death Rate

  • Sara Schonhardt

Participants at the Women Deliver conference in Kuala Lumpur, Malaysia. (Photo: Women Deliver)

Participants at the Women Deliver conference in Kuala Lumpur, Malaysia. (Photo: Women Deliver)

Despite political and economic progress over the past decade, Indonesia still struggles with one of the highest rates of maternal death in the developing world. This is largely due to a lack of access to health and family planning services - something the country's health minister is working hard to improve. She believes giving women more control over their reproductive health is crucial.

On Wednesday, Indonesia’s Health Minister, Nafsiah Mboi, will address thousands of activists and policymakers attending a global conference on women’s health in Kuala Lumpur.

The discussion will focus on ways countries can accomplish one of the United Nations’ Millennium Development Goals by improving women’s access to family planning services.

Mboi says improving women’s access to family planning services in Indonesia is difficult because of its geography. More than 17,000 islands comprise the archipelago, only 6,000 of which are inhabited. Another difficulty, she says, is political. Health services are controlled by local governments.

But, Mboi said, she is committed to meeting the needs of each region.

“We have added health facilities, puskasmas, and the puskasmas have been equipped with much better equipment, have better trained midwives, but still a lot needs to be done because Indonesia is so big,” she explained.

Family planning

Mboi said family planning is a top priority where women's health is disadvantaged by too many births. In others, she says the priority should be toward prevention and health promotion.

She also said improving access to services is necessary to reduce cases of excess bleeding, hypertension and infection during child birth, the main causes of maternal death in Indonesia.

“I believe family planning is inter-related with reproductive health and rights,” Mboi said.

Not everyone agrees. In the Philippines, for instance, opposition from leaders of the Catholic Church has delayed the implementation of a controversial law that would provide free access to contraception and family planning services.

Criticism

In Indonesia, Mboi has received harsh criticism from conservative officials and religious leaders for her efforts to increase condom use among at-risk groups. Since taking over the health ministry last year, she has softened her advocacy of certain types of contraception and focused more on family planning generally as a means of ensuring safe, healthy and wanted pregnancies.

Despite the challenges, she says Indonesia needs to take a more participatory approach to family planning that will involve local governments and religious leaders. It also needs to ensure family planning is included as part of a national health insurance scheme to be rolled out in 2014.

A recent report by Save the Children on the situation facing the world’s mothers ranked Indonesia 106 out of 130 developing countries, below China and Vietnam, but above the Philippines and East Timor.
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