Indonesia

South East Asia Region

Maternal and Perinatal Health Profile

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

Demographics and Information System
Total population (2012) [1]

Health status indicators - Maternal and Perinatal mortality

246,864,191

Total women aged 15-49 years (2012) [1]

Annual number of births (2012) [1]
Sex ratio at births (2005-10) [1]

66,144,422
4,504,569
1.05

Birth registration coverage [2]

53

Total fertility rate (2012) [1]

2.4

Adolescent fertility rate [per 1000 woman] (2005-2010) [1]

Under five population [1]
Coverage of vital registration of deaths [2]

220

Maternal mortality ratio (2010) [3]

9,600

Annual number of maternal deaths (2010) [3]

Perinatal moratlity rate (2012)[4]

26

Stillbirth rate (2009)[3]

15
15
72,437

Neonatal mortality rate per 1000 live births (2012) [5]

Annual number of neonatal deaths (2012) [5]

52
24,622,394
-

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.

Maternal nutrition

Pregnancy involving risks

Prevalence of anaemia among pregnant women

Birth interval <24 months and birth order >3

1.8

Night blindness (adjusted)

Total age <18 and birth interval <24 months

0.1

Iron tablets taken during pregnancy (any tablets)

77.1

Source: Demographic Health Survey (2012)

Maternal mortality
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.

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

Range of uncertainly on annual % change in MMR

(lower estimate)
Range of uncertainly on annual % change in MMR
(upper estimate)
Progress towards improving maternal health
MDG 5 target by 2015

63
4.9
5.9
4.0
Making
progress

150

800
Per 100 000 LB

% change in MMR between 1990-2010

Average annual % change in MMR 1990-2010

600
600 Available
400No Data
420
200
340
0

MDG5
Target, 150

270 220

1990 1995 2000 2005 2010 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.
Source:

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

Indonesia

Perinatal mortality
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).

Perinatal mortality by background characteristics

10.4

10.6

Previous pregnancy
interval in months

Place of
residence

15

Mother's
education

highest

9.6

15
lowest

10

15.6

35

Secondary

14.5

35

No education

14.7

20

Rural

15

40

Urban

20

45
35
30
26 No Data Available
20
15
39+

No Data Available

60

<15

26.0

25.0

24.0

80

First pregnancy

25

Per inatal mortality rate

Per inatal mortality rate

30

Total

Perinatal mortality rate (PMR): Trend

Wealth
quintile

0
2002-03
Stillbirth rate

2007

2012

Early neonatal deaths rate

PMR

Source: Demographic Health Survey

Source: Demographic Health Survey (2012)

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

Maternal and perinatal country profile

21

..West Papua

19

..Papua

..Central Sulawesi

..East Kalimantan

..Central Kalimantan

26

..Maluku

21

17

..East Nusa Tenggara

..Jambi

..Riau

Outer Java-Bali II

Source: Demographic Health Survey (2012)

..Bengkulu

19

15

..North Maluku

30

..Southeast Sulawesi

30 29 28

..Riau Islands

20 22

..Gorontalo

26 24

..North Sulawesi

..Lampung

..West Nusa Tenggara

..South Sumatera

..Bangka Belitung

..West Sumatera

..DI Aceh

..North Sumatera

Outer Java-Bali I

21

..South Sulawesi

31

51

45

..West Sulawesi

38
24 27

15

..Bali

..Banten

..Central Java

..DI Yogyakarta

..West Java

..DKI Jakarta

..East Java

19 20

18

34 32
29

..South Kalimantan

26 Data
No
Available
24
24
23

28

46

41

..West Kalimantan

31

Total

60
50
40
30
20
10
0

Java-Bali

Perinatal mortality rate

Perinatal mortality by region

Indonesia

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

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.

No Data Available
Late neonatal
deaths
15%
within 24
24-48
hours
hours
33%
25%

Early neonatal
deaths
85%

Day 6
1% Day 5
3%
Day 4
5%

Source: Demographic and Health Survey

Day 3
9%

48-72hours
9%

Source: Demographic Health Survey (2012)

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

100

80

No Data Available

60

40

20

0
% of women
currently using
modern
contraceptives

% of women
received ANC (at
least once)

1987

% women who
IPT during ANC visit
received ANC 4 times
or more

1991

1994

1997

Place of delivery - % of births delivered

Any health facility
by C-section

2002-03

2007

Source: Demographic and Health Survey

Maternal and perinatal country profile

2012

% of women who
had PNC within 2
days

Indonesia

Place of birth and type of provider

Type of postnatal care provider

- who provides the postnatal care?

Place of Births - Where are babies born?

Not known
0.6%
No Data Available
Public
hospital
17.3%

Others
0.2%

Nontrained
No Data
Available
providers
2.1%

Private
hospital
45.9%

Qualified
doctor
18.0%

No
checkup
19.9%

Home
36.0%

Source: Demographic Health Survey (2012)

Nurse/mid
wife/auxill
ary nurse
60.0%

Source: Demographic Health Survey (2012)

Intervention coverage across continuum of care by geographical areas

100%
80%
60%

No Data Available

40%
20%

Java-Bali
..DKI Jakarta
..West Java
..Central Java
..DI Yogyakarta
..East Java
..Banten
..Bali
Outer Java-Bali I
..DI Aceh
..North Sumatera
..West Sumatera
..South Sumatera
..Bangka Belitung
..Lampung
..West Nusa Tenggara
..West Kalimantan
..South Kalimantan
..North Sulawesi
..Gorontalo
..South Sulawesi
..Riau Islands
Outer Java-Bali II
..Riau
..Jambi
..Bengkulu
..East Nusa Tenggara
..Central Kalimantan
..East Kalimantan
..Central Sulawesi
..Southeast Sulawesi
..West Sulawesi
..Maluku
..North Maluku
..Papua
..West Papua

0%

% 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

Source: Demographic Health Survey (2012)

Maternal and perinatal country profile

Indonesia

Equity across continuum of care

100

98.2
97

99.4
93.3
86.9

96.6
91.8

80

Percent

88

83.1

No Data Available

74.6

60

57.5

79.8

74.3
63.2

57.9
57

58.7
55.4
53

91.1
86
80.1

59.3

46.5

40
23.1

29.4

16.8
12.3
7.9
3.7

20

0
% of women
currently using
modern
contraceptive

% women who % births assisted by % of births by Creceived any ANC skilled personnel
section
by skilled provider

Poorest

Richest

Urban

Rural

% births in health
% of births
facilities
received postnatal
care

Total

Note:
If more than one source of ANC was mentioned, only the provider with highest qualification is conserved in this tabulation.
Source: Demographic Health Survey (2012)

Utilization of services by wealth quintile

% of births in health facility

% of births assisted by skilled personnel

100
Equity gap
% of births assisted by skilled
personnel

% of birth in health facility

90
80
70

No Data Available

60
50
40
30
20
10
0
Lowest

Second
Middle
Fourth
Wealth quintile

Source: Demographic Health Survey (2012)

Highest

100
Equity gap
90
80
No Data Available
70
60
50
40
30
20
10
0
Lowest Second Middle Fourth
Wealth quintile

Source: Demographic Health Survey (2012)

Maternal and perinatal country profile

Highest

Indonesia

100
Equity gap
90
80
70 Data Available
No
60
50
40
30
20
10
0
Lowest Second Middle
Wealth quintile

% of mothers with postnatal checkup in <2 days of delivery

100
Equity gap
90
80
No70Data Available
60
50
40
30
20
10
0
Lowest Second Middle
Wealth quintile

% of birthts received post-natal care

% of births delivered by C-section

% of births delivered by C-section

Fourth

Highest

Fourth

Highest

Source: Demographic Health Survey (2012)

Source: Demographic Health Survey (2012)

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.

Getting
permission to
go for
treatment

Signs of
pregnancy
complicatio
ns
Available

No Data 100

No Data Available
100

80
60
40
20
0

Blood
sample
taken

Weight
measured

Any of the
specified
problems

80
60
40
20
0

Getting money
for treatment

Height
measured
Not wanting to
go alone
Urine
sample
taken

Richest

Blood
pressure
measured

Poorest

Distance to
health facility

Total
Total
Source: Demographic Health Survey (2012)

Source: Demographic Health Survey (2012)

Maternal and perinatal country profile

Indonesia

Midwifery workforce
Midwives (including nurse-midwives) 1

93,889

Other health professionals with some midwifery competencies 2

General practitioners with some midwifery competencies

Obstetricians

870

Community health workers with some midwifery

training

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

Health system and policy indicators

Health system and policy indicators
Does the national policy/policy statement indicate the minimum ANC visits during the normal pregnancy?
If yes, how many visits

Yes
4

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

Yes

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

No

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

Yes

Maternal deaths review

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

Stillbirths
-

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

What year was the policy adopted?

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

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

Neonatal deaths
-

Is there a policy that requires all neonatal deaths (0-28 days) to be reviewed?
What year was the policy adopted?

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

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

Essential drugs list for maternal and newborn health

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

Magnesium Sulphate

Yes

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

Yes

Maternal and perinatal country profile