Fewer maternal and child deaths but too many Indonesian women and children still dying
Jakarta, 14 June 2012. Since 1990, annual mortality amongst Indonesian women and children has declined by more than half, according to global estimates in ‘Building a Future for Women and Children’, published overnight by the Countdown to 2015 initiative (www.countdown2015mnch.org).
Indonesia’s progress towards reaching the 2015 Millennium Development Goals for child and maternal mortality – referred to as MDGs 4 and 5 respectively – mirror global progress ten years after world leaders committed to a World Fit for Children at the UN Special Session on Children in 2001.
Some of the world's poorest countries have achieved spectacular progress in reducing child deaths. Rates of child mortality in many African countries have been dropping twice as fast in recent years as during the 1990s. In Botswana, Egypt, Liberia, Madagascar, Malawi, Rwanda and the United Republic of Tanzania, the rate of decline was on average more than 5 per cent a year between 2000 and 2010.
Similar progress has been seen in reducing maternal deaths, although in fewer developing countries: Equatorial Guinea, Nepal, and Vietnam have each cut maternal deaths by 75 per cent.
In Indonesia, improved health policy and legislation, a renewed focus on reducing malnutrition, improved coverage of key maternal and child health services such as ante-natal care and control of common childhood illnesses are all contributing to reductions in overall mortality.
But globally, all the news is not good. Every two minutes, somewhere in the world, a woman dies from complications of pregnancy and her newborn baby’s chances of survival are very poor. For every woman who dies, an additional 20-30 suffer significant and sometimes lifelong problems, as a result of their pregnancy. Indonesia is amongst 15 countries not expected to achieve the MDG 5 of reducing maternal deaths by three-quarters from 1990 levels.
“Indonesia has made important progress to improve the health of its mothers and children, since making its own commitment to a World Fit for Children,” said Dr. Robin Nandy, UNICEF’s chief of child survival and development in Indonesia. “But even today, it is estimated that 150,000 children die in Indonesia every year before they reach their fifth birthday, and nearly 10,000 women lose their lives annually to problems in pregnancy and childbirth. We must look closely at the barriers that are slowing progress towards preventing these deaths, especially in relation to maternal health, in order to build on previous achievements.”
Disparities between communities and socio-economic groups in Indonesia are clearly apparent in the health sector, says UNICEF. Under-5 mortality rates amongst poorer families are more than three times those in the wealthiest households. Amongst mothers with no education, only 15 per cent give birth in a health facility – a proportion that increases through the levels of education to 71 per cent of mothers with secondary or higher level education. The percentage of births attended by a skilled worker also increases with a mother’s income or educational status.
In 2010, UN Secretary General Ban Ki-moon launched a Global Strategy for Women's and Children's Health, an effort that has generated US$40 billion in commitments to meet key goals supporting women’s and children’s health. These goals include more trained midwives, greater access to contraceptives and skilled delivery care, better nutrition, prevention of infectious diseases and stronger community education. Indonesia has committed to the Strategy, and President Susilo Bambang Yudhoyono has played a leading role in the Every Women, Every Child Initiative to mobilize and intensify global action to improve the health of women and children around the world, stating in 2010 that “The health-related MDGs, particularly MDGs 4 and 5, are cornerstones for achieving all others.”
Here in Indonesia, says UNICEF, more focus must be placed on system-wide approaches that address all components – human resources, health and nutrition education, access to care, quality of services, regulation and standardisation of services, governance and adequate levels and targeting of financing. These efforts, along with health insurance and other social protection mechanisms, will build a more responsive and equitable public health system.
“Investing in a more equitable health sector, and strengthening the safety nets for the most vulnerable, will deliver long-term benefits to Indonesia,” says Dr Nandy. “Healthier mothers deliver healthier children. Healthier children stay in school, have fewer but healthier children themselves in later life, and are more productive members of society. Together, this provides a solid foundation for eliminating poverty, reducing social exclusion and sustaining economic growth and stability.”
About the Countdown Report
Building a Future for Women and Children is authored by a global collaboration of academics and professionals from Johns Hopkins University, the Aga Khan University, the University of Pelotas in Brazil, Harvard University, London School of Hygiene and Tropical Medicine, UNICEF, the World Health Organization, Family Care International, and Save the Children. The secretariat of the Countdown to 2015 initiative is based at The Partnership for Maternal, New-born & Child Health.
The Countdown report shows the who, what, where — and most importantly the why — of maternal, new-born, and child survival. It offers a clear, consistent report card that countries, advocates, and donors can use to hold each other — and themselves — accountable for real, measurable progress.
The report assesses the progress that the 75 highest-burden countries are making towards achieving UN Millennium Development Goals 4 & 5 (MDGs). These MDGs call for reducing maternal deaths by three-quarters and the deaths of children under 5 by two-thirds, both by 2015 compared to 1990 levels.
Countdown to 2015 reports were first published in 2005 to track the progress in the highest-burden countries, to identify knowledge gaps, and to promote accountability at global and national levels for improving maternal and child survival.
The Countdown reports help to hold governments and donors accountable for fulfilling their commitments to the Global Strategy, and will be a key input to the first report to the UN Secretary General in September 2012 from the independent Expert Review Group, set up following the launch of the report of the Commission on Information and Accountability for Women’s and Children’s Health, ‘Keeping Promises, Measuring Results’.
To continue the focus on the MDGs, the release of the Countdown 2012 Report coincides with a two-day forum to chart a course toward the end of preventable child deaths, taking place June 14-15 in Washington, DC. The governments of the United States, India, and Ethiopia, in collaboration with UNICEF, will convene this Child Survival Call to Action. Indonesia will be represented by Mrs. Nina Sardjunani, Deputy Minister for National Development Planning.
In September, UN Secretary-General, Ban Ki-moon, will issue an update on the impact of his Every Woman Every Child effort.
About UNICEF Indonesia
UNICEF works with the Government of Indonesia and other partners to improve the lives of the most vulnerable children through support for programmes in the areas of nutrition, health, water and sanitation, education and child protection.