The early years
Indonesia has made considerable progress in reducing the rate of infant mortality in recent years; between 1991 and 2009, the number of deaths amongst children under the age of one fell from 68 to 34 for every 1,000 live births. Under-five mortality rates have also fallen - from 79 deaths for every 1,000 live births in 1991 to 44 in 2009. There remain serious challenges to infant and young children's health. Stunting – being below average height for one’s age – affects 37 per cent of children under five while 18 per cent of children below the age of five are underweight. More than one-third of under-five deaths are those that occur in the first month after birth, and can be attributed to complications resulting from premature birth, still births, and severe infections including pneumonia, meningitis and septicaemia. Other major causes of death amongst children who survive the first month but die before the age of five are diarrhoeal disease and pneumonia. Many infants are left unprotected against disease because of low levels of breastfeeding – less than one-third of Indonesian children are exclusively breasted for the first six months of life. Moreover, only 41 per cent of children aged between 6 and 23 months are fed according to recommended practices. This leaves children exposed to the risks of malnutrition and diarrhoeal disease; the latter accounts for 18 per cent of all child deaths in Indonesia. Inequity in early child health and development While national statistics point to progress in protecting children's survival and development, there are clear disparities behind those figures. For example, the infant mortality rate in East Nusa Tenggara province is 57 deaths for every 1,000 live births, three times that of Yogyakarta province and much higher than the national rate of 34 deaths. Under-five and infant mortality rates amongst the poorest households are generally more than twice those in the highest income familiesmortality remains a serious problem in Indonesia. Reducing rates further will necessitate improving access to health care; improving the quality of delivery care and the management of childhood disease; improving environmental health, including the provision of clean water and sanitation; controlling communicable diseases; improving maternal nutrition; and creating a protective environment from children against risks of violence, abuse and exploitation.
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