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] 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 risks
Prevalence 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 1990-2010
Average 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)
53
1.05
4,504,569
66,144,422
246,864,191
15
15
9,600
220
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
P
e
r

1
0
0

0
0
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
Source: Demographic Health Survey (2012)
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
P
e
r

i
n
a
t
a
l

m
o
r
t
a
l
i
t
y

r
a
t
e

Stillbirth rate Early neonatal deaths rate PMR
26
30
45
20
35
15
35
15
35
15
0
20
40
60
80
T
o
t
a
l
F
i
r
s
t

p
r
e
g
n
a
n
c
y
<
1
5
3
9
+
U
r
b
a
n
R
u
r
a
l
N
o

e
d
u
c
a
t
i
o
n

S
e
c
o
n
d
a
r
y

l
o
w
e
s
t
h
i
g
h
e
s
t
Previous pregnancy
interval in months
Place of
residence
Mother's
education
Wealth
quintile
P
e
r

i
n
a
t
a
l

m
o
r
t
a
l
i
t
y

r
a
t
e

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
0
10
20
30
40
50
60
T
o
t
a
l

J
a
v
a
-
B
a
l
i

.
.
D
K
I

J
a
k
a
r
t
a

.
.
W
e
s
t

J
a
v
a

.
.
C
e
n
t
r
a
l

J
a
v
a

.
.
D
I

Y
o
g
y
a
k
a
r
t
a

.
.
E
a
s
t

J
a
v
a

.
.
B
a
n
t
e
n

.
.
B
a
l
i

O
u
t
e
r

J
a
v
a
-
B
a
l
i

I

.
.
D
I

A
c
e
h

.
.
N
o
r
t
h

S
u
m
a
t
e
r
a

.
.
W
e
s
t

S
u
m
a
t
e
r
a

.
.
S
o
u
t
h

S
u
m
a
t
e
r
a

.
.
B
a
n
g
k
a

B
e
l
i
t
u
n
g

.
.
L
a
m
p
u
n
g

.
.
W
e
s
t

N
u
s
a

T
e
n
g
g
a
r
a

.
.
W
e
s
t

K
a
l
i
m
a
n
t
a
n

.
.
S
o
u
t
h

K
a
l
i
m
a
n
t
a
n

.
.
N
o
r
t
h

S
u
l
a
w
e
s
i

.
.
G
o
r
o
n
t
a
l
o

.
.
S
o
u
t
h

S
u
l
a
w
e
s
i

.
.
R
i
a
u

I
s
l
a
n
d
s

O
u
t
e
r

J
a
v
a
-
B
a
l
i

I
I

.
.
R
i
a
u

.
.
J
a
m
b
i

.
.
B
e
n
g
k
u
l
u

.
.
E
a
s
t

N
u
s
a

T
e
n
g
g
a
r
a

.
.
C
e
n
t
r
a
l

K
a
l
i
m
a
n
t
a
n

.
.
E
a
s
t

K
a
l
i
m
a
n
t
a
n

.
.
C
e
n
t
r
a
l

S
u
l
a
w
e
s
i

.
.
S
o
u
t
h
e
a
s
t

S
u
l
a
w
e
s
i

.
.
W
e
s
t

S
u
l
a
w
e
s
i

.
.
M
a
l
u
k
u

.
.
N
o
r
t
h

M
a
l
u
k
u

.
.
P
a
p
u
a

.
.
W
e
s
t

P
a
p
u
a
P
e
r
i
n
a
t
a
l

m
o
r
t
a
l
i
t
y

r
a
t
e

Maternal and perinatal country profile
Indonesia
Early and late neonatal deaths (proportion of death by timing)
No Data Available
Source: Demographic and Health Survey
Source: Demographic Health Survey (2012)
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 women
currently using
modern
contraceptives
% of women
received ANC (at
least once)
% women who
received ANC 4 times
or more
IPT during ANC visit Place of delivery -
Any health facility
% of births delivered
by C-section
% of women who
had PNC within 2
days
1987 1991 1994 1997 2002-03 2007 2012
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?
No Data Available No Data Available
Source: Demographic Health Survey (2012) Source: Demographic Health Survey (2012)
Intervention coverage across continuum of care by geographical areas
No Data Available
Source: Demographic Health Survey (2012)
Private
hospital
45.9%
Home
36.0%
Public
hospital
17.3%
Not known
0.6%
Others
0.2%
Nurse/mid
wife/auxill
ary nurse
60.0%
No
checkup
19.9%
Qualified
doctor
18.0%
Non-
trained
providers
2.1%
0%
20%
40%
60%
80%
100%

J
a
v
a
-
B
a
l
i

.
.
D
K
I

J
a
k
a
r
t
a

.
.
W
e
s
t

J
a
v
a

.
.
C
e
n
t
r
a
l

J
a
v
a

.
.
D
I

Y
o
g
y
a
k
a
r
t
a

.
.
E
a
s
t

J
a
v
a

.
.
B
a
n
t
e
n

.
.
B
a
l
i

O
u
t
e
r

J
a
v
a
-
B
a
l
i

I

.
.
D
I

A
c
e
h

.
.
N
o
r
t
h

S
u
m
a
t
e
r
a

.
.
W
e
s
t

S
u
m
a
t
e
r
a

.
.
S
o
u
t
h

S
u
m
a
t
e
r
a

.
.
B
a
n
g
k
a

B
e
l
i
t
u
n
g

.
.
L
a
m
p
u
n
g

.
.
W
e
s
t

N
u
s
a

T
e
n
g
g
a
r
a

.
.
W
e
s
t

K
a
l
i
m
a
n
t
a
n

.
.
S
o
u
t
h

K
a
l
i
m
a
n
t
a
n

.
.
N
o
r
t
h

S
u
l
a
w
e
s
i

.
.
G
o
r
o
n
t
a
l
o

.
.
S
o
u
t
h

S
u
l
a
w
e
s
i

.
.
R
i
a
u

I
s
l
a
n
d
s

O
u
t
e
r

J
a
v
a
-
B
a
l
i

I
I

.
.
R
i
a
u

.
.
J
a
m
b
i

.
.
B
e
n
g
k
u
l
u

.
.
E
a
s
t

N
u
s
a

T
e
n
g
g
a
r
a

.
.
C
e
n
t
r
a
l

K
a
l
i
m
a
n
t
a
n

.
.
E
a
s
t

K
a
l
i
m
a
n
t
a
n

.
.
C
e
n
t
r
a
l

S
u
l
a
w
e
s
i

.
.
S
o
u
t
h
e
a
s
t

S
u
l
a
w
e
s
i

.
.
W
e
s
t

S
u
l
a
w
e
s
i

.
.
M
a
l
u
k
u

.
.
N
o
r
t
h

M
a
l
u
k
u

.
.
P
a
p
u
a

.
.
W
e
s
t

P
a
p
u
a
% 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
Maternal and perinatal country profile
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.
Source: Demographic Health Survey (2012)
Utilization of services by wealth quintile
% of births in health facility % of births assisted by skilled personnel
No Data Available No Data Available
Source: Demographic Health Survey (2012) Source: Demographic Health Survey (2012)
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 women
currently using
modern
contraceptive
% women who
received any ANC
by skilled provider
% births assisted by
skilled personnel
% of births by C-
section
% births in health
facilities
% of births
received postnatal
care
P
e
r
c
e
n
t

Poorest Richest Urban Rural Total
0
10
20
30
40
50
60
70
80
90
100
Lowest Second Middle Fourth Highest
%

o
f

b
i
r
t
h

i
n

h
e
a
l
t
h

f
a
c
i
l
i
t
y

Wealth quintile
Equity gap
0
10
20
30
40
50
60
70
80
90
100
Lowest Second Middle Fourth Highest
%

o
f

b
i
r
t
h
s

a
s
s
i
s
t
e
d

b
y

s
k
i
l
l
e
d

p
e
r
s
o
n
n
e
l

Wealth quintile
Equity gap
Maternal and perinatal country profile
Indonesia
% of births delivered by C-section % of mothers with postnatal checkup in <2 days of delivery
No Data Available No Data Available
Source: Demographic Health Survey (2012) Source: Demographic Health Survey (2012)
Quality of care indicators
Reasons for not seeking medical care
No Data Available No Data Available
Source: Demographic Health Survey (2012)
Source: Demographic Health Survey (2012)
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
Lowest Second Middle Fourth Highest
%

o
f

b
i
r
t
h
s

d
e
l
i
v
e
r
e
d

b
y

C
-
s
e
c
t
i
o
n

Wealth quintile
Equity gap
0
10
20
30
40
50
60
70
80
90
100
Lowest Second Middle Fourth Highest
%

o
f

b
i
r
t
h
t
s

r
e
c
e
i
v
e
d

p
o
s
t
-
n
a
t
a
l

c
a
r
e

Wealth quintile
Equity gap
0
20
40
60
80
100
Signs of
pregnancy
complicatio
ns
Weight
measured
Height
measured
Blood
pressure
measured
Urine
sample
taken
Blood
sample
taken
Richest Poorest Total
0
20
40
60
80
100
Getting
permission to
go for
treatment
Getting money
for treatment
Distance to
health facility
Not wanting to
go alone
Any of the
specified
problems
Total
Maternal and perinatal country profile
Indonesia
Midwifery workforce
Midwives (including nurse-midwives) 1 Obstetricians
Other health professionals with some midwifery competencies 2
General 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?
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?
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?
Magnesium Sulphate
Oxytocin
Source: WHO: Maternal newborn, child and adolescent health policy database based on key informant surveys in 2009-10 & 2011
Yes
Yes
-
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
Maternal and perinatal country profile