Indonesia

South East Asia Region

Maternal and Perinatal Health Profile

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

Demographics and Information System Health status indicators - Maternal and Perinatal mortality
Total population (2012) [1] 246,864,191 Maternal mortality ratio (2010) [3] 220
Total women aged 15-49 years (2012) [1] 66,144,422 Annual number of maternal deaths (2010) [3] 9,600
Annual number of births (2012) [1] 4,504,569 Perinatal moratlity rate (2012)[4] 26
Sex ratio at births (2005-10) [1] 1.05 Stillbirth rate (2009)[3] 15
Birth registration coverage [2] 53 Neonatal mortality rate per 1000 live births (2012) [5] 15
Total fertility rate (2012) [1] 2.4 Annual number of neonatal deaths (2012) [5] 72,437
Adolescent fertility rate [per 1000 woman] (2005-2010) [1] 52
Under five population [1] 24,622,394
Coverage of vital registration of deaths [2] -

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

% change in MMR between 1990-2010 63 800

Average annual % change in MMR 1990-2010 4.9
Per 100 000 LB

Range of uncertainly on annual % change in MMR 600

5.9
(lower estimate) 400No Data
600 Available MDG5
Range of uncertainly on annual % change in MMR Target, 150
4.0
420
(upper estimate) 200 340
270 220
Making 0
Progress towards improving maternal health
progress
1990 1995 2000 2005 2010 2015
MDG 5 target by 2015 150

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 rate (PMR): Trend Perinatal mortality by background characteristics

30 80

Per inatal mortality rate

26.0 60 45
25 25.0 35 35 35
Per inatal mortality rate

24.0 40 30
26 No Data Available
No Data Available 20 15 15 15
20 20

15.6 0
15 14.7

Total

<15

Rural

lowest
39+

highest
Urban

No education

Secondary
14.5

First pregnancy
10 9.6 10.4 10.6

5 Previous pregnancy Place of Mother's Wealth

interval in months residence education quintile
0
2002-03 2007 2012

Stillbirth rate 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.

Perinatal mortality by region

60 51
Perinatal mortality rate

46 45
50 41
38
40 31 34 32 31
29 30 29 28 30
30 No
26 Data
23 Available
24 24
28
24 27 26 24 26
18 19 20 21 20 22 19 17
21 21 19
20 15 15

10
0
..DI Yogyakarta

..South Kalimantan
..DI Aceh

..West Nusa Tenggara

..East Nusa Tenggara

..West Sulawesi
..Lampung
Total

..Central Java

Outer Java-Bali I

..South Sumatera

..South Sulawesi

..Jambi

..Central Sulawesi
..West Java

..East Java

..Bali

..Bangka Belitung

..Riau

..Central Kalimantan
..Gorontalo

..Papua
..Bengkulu

..West Papua
Java-Bali
..DKI Jakarta

..Banten

..North Sumatera
..West Sumatera

..Riau Islands

..Southeast Sulawesi

..Maluku
..North Maluku
..West Kalimantan

..North Sulawesi

..East Kalimantan
Outer Java-Bali II

Source: Demographic Health Survey (2012)

Maternal and perinatal country profile

 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
hours 24-48
33% hours
Early neonatal 25%
deaths
85% Day 6
1% Day 5
3% 48-72hours
Day 3 9%
Day 4 9%
Source: Demographic and Health Survey 5%

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 % of women % women who IPT during ANC visit Place of delivery - % of births delivered % of women who
currently using received ANC (at received ANC 4 times Any health facility by C-section had PNC within 2
modern least once) or more days
contraceptives

1987 1991 1994 1997 2002-03 2007 2012

Source: Demographic and Health Survey

Maternal and perinatal country profile

 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?

Not known Others Non-

No Data Available
0.6% 0.2% No Data Available
trained
providers
Public 2.1%
hospital Qualified
17.3% doctor
Private 18.0%
hospital
45.9%
No Nurse/mid
checkup wife/auxill
Home 19.9% ary nurse
36.0%
60.0%

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

Intervention coverage across continuum of care by geographical areas

100%

80%

60%
No Data Available
40%

20%

0%
..Bengkulu

..West Sulawesi
Java-Bali
..DKI Jakarta

..Central Java

..Bali

..West Sumatera

..Jambi
..South Sumatera
..West Java

..East Java

Outer Java-Bali I
..DI Aceh

..Lampung

..North Sulawesi
..Banten

..South Sulawesi
..Riau Islands
Outer Java-Bali II
..Riau
..Gorontalo

..Central Kalimantan

..Central Sulawesi

..Maluku
..Southeast Sulawesi
..North Sumatera

..Bangka Belitung

..West Nusa Tenggara

..East Nusa Tenggara

..Papua
..West Papua
..DI Yogyakarta

..North Maluku
..West Kalimantan
..South Kalimantan

..East Kalimantan

% 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 99.4

97 96.6
93.3 91.8 91.1
86.9 88 86
83.1
80 79.8 80.1
No Data Available 74.6 74.3

63.2
60 57.5 59.3
Percent

57.9 58.7
57 55.4
53 46.5
40
23.1 29.4

20 16.8
12.3
7.9
3.7
0
% of women % women who % births assisted by % of births by C- % births in health % of births
currently using received any ANC skilled personnel section facilities received postnatal
modern by skilled provider care
contraceptive
Poorest Richest Urban Rural 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

100 100
90 Equity gap
90 Equity gap
% of births assisted by skilled

80 80
% of birth in health facility

70 No Data Available 70 No Data Available

60 60
personnel

50 50
40 40
30 30
20 20
10 10
0 0
Lowest Second Middle Fourth Highest Lowest Second Middle Fourth Highest
Wealth quintile Wealth quintile

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

Maternal and perinatal country profile

 Indonesia

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

100 100
Equity gap Equity gap

% of birthts received post-natal care

% of births delivered by C-section

90 90
80 80
No
70 Data Available No70Data Available
60 60
50 50
40 40
30 30
20
20
10
10
0
0
Lowest Second Middle Fourth Highest
Lowest Second Middle Fourth Highest
Wealth quintile Wealth quintile

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 Many barriers can prevent women from seeking medical
accessing the quality of ANC services that pregnant care in general when needed. Understanding these
women receive in order to be prepared for factors is critical to improve the accessibility and
complications and any danger signs associated with utilization of medical care during pregnancy and childbirth.
pregnancy and childbirth.

Signs of Getting
pregnancy permission to
complicatio go for
ns treatment
No Data 100 Available No Data Available
100
80
80 Weight 60
60 measured Any of the
specified 40 Getting money
40 problems 20 for treatment
20 0
Blood
0
Height
sample
measured
taken
Not wanting to Distance to
go alone health facility
Urine Blood
sample pressure
taken measured
Total
Richest Poorest 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 Obstetricians 870
Other health professionals with some midwifery competencies 2 - Community health workers with some midwifery
-
General practitioners with some midwifery competencies - 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? Yes

If yes, how many visits 4

Is there a national policy or policy statement on the right of every woman to have access to skilled care at
Yes
childbirth?
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 Yes
Source: WHO: Maternal newborn, child and adolescent health policy database based on key informant surveys in 2009-10 & 2011

Maternal and perinatal country profile