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IndonesiaSouth East Asia Region

Maternal and Perinatal Health ProfileDepartment of Maternal, Newborn, Child and Adolescent Health (MCA/WHO)

Demographics and Information System Health status indicators - Maternal and Perinatal mortality Total population (2012) [1] Maternal mortality ratio (2010) [3]Total women aged 15-49 years (2012) [1] Annual number of maternal deaths (2010) [3]Annual number of births (2012) [1] Perinatal moratlity rate (2012)[4]Sex ratio at births (2005-10) [1] Stillbirth rate (2009)[3]Birth registration coverage [2] Neonatal mortality rate per 1000 live births (2012) [5]Total fertility rate (2012) [1] Annual number of neonatal deaths (2012) [5]Adolescent fertility rate [per 1000 woman] (2005-2010) [1]Under five population [1]

Coverage of vital registration of deaths [2]

Maternal nutrition Pregnancy involving risksPrevalence of anaemia among pregnant women Birth interval <24 months and birth order >3

Night blindness (adjusted) Total age <18 and birth interval <24 months

Iron tablets taken during pregnancy (any tablets)

Source: Demographic Health Survey (2012)

Maternal mortality

Maternal mortality ratio (MMR): maternal mortality per 100 000 live births

% change in MMR between 1990-2010Average annual % change in MMR 1990-2010

No Data Available

MDG 5 target by 2015

Source: WHO, UNICEF, UNFPA and The World Bank estimates. Trends in maternal mortality: 1990 to 2010 .

One of the eight Millennium Development Goals (MDGs) that has made some progress, albeit slow, is MDG 5: Improve maternal health. The two targets for assessing MDG 5 are reducing the maternal mortality ratio (MMR) by three quarters between 1990 and 2015, and achieving universal access to reproductive health by 2015.

Note: Consultations with countries were carried out following the development of the MMR estimates. The purposes of the consultations were primarily: to give countries the opportunity to review the country estimates, data sources and methods; to obtain additional primary data sources that may not have been previously reported or used; and to build mutual understanding of the strengths and weaknesses of available data and ensure broad ownership of the results.

Progress towards improving maternal health

–5.9

–4.9

150

Making

progress

–4.0

–63

Range of uncertainly on annual % change in MMR (lower estimate)Range of uncertainly on annual % change in MMR (upper estimate)

531.05

4,504,569 66,144,422 246,864,191

1515

9,600220

26

72,437

24,622,394

2.4

-

52

Sources: [1] Population Division, Department of Economic and Social Affairs, United Nations, World Population Prospects: The 2012 Revision.

[2] WHO, World Health Statistics 2013 .

[3] WHO, UNICEF, UNFPA and The World Bank estimates. Trends in maternal mortality: 1990 to 2010.

[4] Demographic Health Survey.

[5] UNICEF/WHO/The World Bank/UN Pop Div. Levels and Trends in Child Mortality. Report 201 3.

0.1

1.8

77.1

-

-

600

420 340

270 220

MDG5 Target, 150

0

200

400

600

800

1990 1995 2000 2005 2010 2015

Pe

r 1

00

00

0 L

B

Indonesia

Perinatal mortality

Perinatal mortality rate (PMR): Trend Perinatal mortality by background characteristics

No Data Available No Data Available

Source: Demographic Health Survey Source: Demographic Health Survey (2012)

Perinatal mortality by region

No Data Available


The perinatal mortality rate expressed per 1000 pregnancies of seven or more months' duration, is used as an indicator of the quality of antenatal and perinatal care. Perinatal deaths include pregnancy losses of at least seven months’ gestation (stillbirths) and deaths to live births within the first seven days of life (early neonatal deaths).

Note: information on stillbirths and deaths to infants within the first week of life are highly susceptible to omission and misreporting.

9.6 10.4 10.6

14.7 14.5 15.6

24.0 25.0 26.0

0

5

10

15

20

25

30

2002-03 2007 2012

Pe

r in

atal

mo

rtal

ity

rate

Stillbirth rate Early neonatal deaths rate PMR

26 30

45

20

35

15

35

15

35

15

0

20

40

60

80

Tota

l

Firs

t p

regn

ancy <1

5

39

+

Urb

an

Ru

ral

No

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uca

tio

n

≥ Se

con

dar

y

low

est

hig

hes

t

Previous pregnancyinterval in months

Place ofresidence

Mother'seducation

Wealthquintile

Pe

r in

atal

mo

rtal

ity

rate

26 23 18

24 31

24 19 20

15

28 34 32 29

24 27 31

38

21 26 24

20 22 15

30 29 28

19

41

30

17

46

21 26

21

45

19

51

0102030405060

Tota

l

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Pap

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Pe

rin

atal

mo

rtal

ity

rate

Maternal and perinatal country profile

Indonesia

Early and late neonatal deaths (proportion of death by timing)

No Data Available

Source: Demographic and Health Survey


No Data Available

Source: Demographic and Health Survey

Trend of intervention coverage across continuum of care for maternal and perinatal health

A neonatal death is defined as a death during the first 28 days of life (0-27 days). Early neonatal death refers to a death between 0-6 days after birth. Late neonatal death refer to a death between 7-27 days after birth.

Late neonatal deaths

15% within 24

hours 33%

24-48 hours 25%

48-72hours 9% Day 3

9% Day 4 5%

Day 5 3%

Day 6 1%

Early neonatal deaths

85%

0

20

40

60

80

100

% of womencurrently using

moderncontraceptives

% of womenreceived ANC (at

least once)

% women whoreceived ANC 4 times

or more

IPT during ANC visit Place of delivery -Any health facility

% of births deliveredby C-section

% of women whohad PNC within 2

days

1987 1991 1994 1997 2002-03 2007 2012


Indonesia

Place of birth and type of provider

Place of Births - Where are babies born? Type of postnatal care provider- who provides the postnatal care?


Source: Demographic Health Survey (2012) Source: Demographic Health Survey (2012)

Intervention coverage across continuum of care by geographical areas

No Data Available


Private hospital 45.9%

Home 36.0%

Public hospital 17.3%

Not known 0.6%

Others 0.2%

Nurse/midwife/auxillary nurse

60.0%

No checkup 19.9%

Qualified doctor 18.0%

Non-trained

providers 2.1%

0%

20%

40%

60%

80%

100%

Jav

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Jav

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Pap

ua

% of births assisted by skilled birth attendant % of births received post-natal care within 48 h

% of births delivered by C-section % of births in health facilities


Indonesia

Equity across continuum of care

No Data Available

Note:

If more than one source of ANC was mentioned, only the provider with highest qualification is conserved in this tabulation.


Utilization of services by wealth quintile% of births in health facility % of births assisted by skilled personnel



53

86.9

57.5

3.7

29.4

59.3

55.4

99.4 96.6

23.1

88 91.1

57

98.2

91.8

16.8

79.8

86

58.7

93.3

74.6

7.9

46.5

74.3

57.9

97

83.1

12.3

63.2

80.1

0

20

40

60

80

100

% of womencurrently using

moderncontraceptive

% women whoreceived any ANCby skilled provider

% births assisted byskilled personnel

% of births by C-section

% births in healthfacilities

% of birthsreceived postnatal

care

Pe

rce

nt

Poorest Richest Urban Rural Total

0

10

20

30

40

50

60

70

80

90

100

Lowest Second Middle Fourth Highest

% o

f b

irth

in h

eal

th f

acili

ty

Wealth quintile

Equity gap

0

10

20

30

40

50

60

70

80

90

100


% o

f b

irth

s as

sist

ed

by

skill

ed

p

ers

on

ne

l

Wealth quintile

Equity gap


Indonesia

% of births delivered by C-section % of mothers with postnatal checkup in <2 days of delivery



Quality of care indicators Reasons for not seeking medical care




Contents of ANC can be an important indicator for accessing the quality of ANC services that pregnant women receive in order to be prepared for complications and any danger signs associated with pregnancy and childbirth.

Many barriers can prevent women from seeking medical care in general when needed. Understanding these factors is critical to improve the accessibility and utilization of medical care during pregnancy and childbirth.

0

10

20

30

40

50

60

70

80

90

100


% o

f b

irth

s d

eliv

ere

d b

y C

-se

ctio

n

Wealth quintile

Equity gap

0

10

20

30

40

50

60

70

80

90

100


% o

f b

irth

ts r

ece

ive

d p

ost

-nat

al c

are

Wealth quintile

Equity gap

0

20

40

60

80

100

Signs ofpregnancy

complications

Weightmeasured

Heightmeasured

Bloodpressure

measured

Urinesampletaken

Bloodsampletaken

Richest Poorest Total

020406080

100

Gettingpermission to

go fortreatment

Getting moneyfor treatment

Distance tohealth facility

Not wanting togo alone

Any of thespecifiedproblems

Total


Indonesia

Midwifery workforce Midwives (including nurse-midwives) 1 ObstetriciansOther health professionals with some midwifery competencies 2General practitioners with some midwifery competencies

If yes, how many visits

Is there a national policy on discharge of mother and the baby after normal cildbirth at facility?

What year was the policy adopted?

Does the national policy require all maternal deaths to be reviewed?

If yes, what year was the policy adopted?

Is there a facility maternal death review (audit) process in place?

Is there a community maternal death review (audit) process in place?

Is there a national panel (committee) to review maternal deaths in place?

How often does the panel meet?

Is there a subnational panel (committee) to review maternal deaths in place?

StillbirthsIs there a policy that requires all stillbirths (fresh or macerated) to be reviewed?


Is there a facility stillbirth review (audit) process in place?

Is there a community stillbirths review (audit) process in place?

Is there a policy that requires all neonatal deaths (0-28 days) to be reviewed?


Is there a facility neonatal deaths review (audit) process in place?

Is there a community neonatal death review (audit) process in place?

Magnesium Sulphate

Oxytocin

Source: WHO: Maternal newborn, child and adolescent health policy database based on key informant surveys in 2009-10 & 2011YesYes

- Essential drugs list for maternal and newborn health

-

Does national Essential Drugs List include the following drugs indicated for use during pregnancy, childbirth?

---

Neonatal deaths-

Source: UNFPA, State of the World's Midwifery 2011 report .Notes: 1. Includes midwives, nurse-midwives and nurses with midwifery competencies. These figures do not necessarily reflect the number of practicing midwives or the ICM definition of a midwife. 2. Auxiliary midwives and auxiliary nurse-midwives

Does national policy require all maternal deaths to be notified within 24h to a central authority? Y/N

---

-

-

-----

Yes

Maternal deaths review

Health system and policy indicators

-

-

Is there a national policy or policy statement on the right of every woman to have access to skilled care at

childbirth?

Health system and policy indicators

Does the national policy/policy statement indicate the minimum ANC visits during the normal pregnancy?

Yes

4

Yes

No

Is there a policy recommending postnatal follow up visit/review by a trained provider for mother and newborn?

Community health workers with some midwifery training

870

- - -

93,889


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