Skip to main content

Reducing Maternal and Neonatal Mortality in Indonesia Saving Lives, Saving the Future (2013) / Chapter Skim
Currently Skimming:

Chapter 4 The Indonesian Health Care System
Pages 39-52

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 39...
... . The Indonesian National Health Development Program is based on a primary health care concept: the community health center is the basic health care facility, supported by hospitals and other communitybased health care facilities.
Read the entire page →
From page 40...
... -- a measure intended to facilitate outreach to the community and mobilization to promote the utilization of health care services. Since the establishment of integrated health services, several initiatives have been adopted in attempts to enhance this core system of community health care centers, village health posts, village midwives and birth facilities, community health extension posts, and community health volunteers.
Read the entire page →
From page 41...
... team of specialists. NOTE: BEmONC = basic emergency obstetric and newborn care; CEmONC = comprehensive emergency obstetric and newborn care, which includes cesarean section and blood transfusion.
Read the entire page →
From page 42...
... Antenatal care at the puskesmas typically includes pregnancy testing, counseling, monitoring of weight gain and fetal development via palpation and a Pinard stethoscope, assessments of maternal hemoglobin levels, blood pressure monitoring, and biochemical tests for proteinuria, although the latter is not consistently available. Birthing facilities include a clean delivery room and basic equipment and supplies such as oxytocin, but they do not fulfill the requirements for basic emergency obstetric and newborn care (BEmONC)
Read the entire page →
From page 43...
... . TABLE 4-3 Readiness of Public Hospitals to Provide Comprehensive Emergency Obstetric and Newborn Care (CEmONC)
Read the entire page →
From page 44...
... Midwives employed in the public sector would be contracted by central, provincial, or district governments, or directly by health facilities. Most midwives work in hospitals, health centers, and village birth centers.
Read the entire page →
From page 45...
... The Ministry of Health does not regularly supervise the operational activities of hospitals or the quality of care offered by hospitals. In general, the private hospitals are profit-based medical institutions and are usually not considered agents for carrying out community health programs, including those aimed at reducing maternal and neonatal mortality.
Read the entire page →
From page 46...
... This change places greater pressure on local budgets, especially since decentralization when the recruitment and placement of doctors in community health centers became the responsibility of local governments with limited revenue. The village midwives program (Bidan di Desa)
Read the entire page →
From page 47...
... The Indonesian Health Care System 47 TABLE 4-4 Number of Health Providers and Facilities per 100,000 Population and per 1,000 Square Kilometers, Indonesia Number of Health Providers and Facilities Per 100,000 Population Per 1,000 square kilometers Province MS N&M CHC MS N&M CHC MS N&M CHC Aceh 1,600 16,000 310 38 370 7 29 280 5 North Sumatra 4,400 16,000 500 33 120 4 60 220 7 West Sumatra 1,700 9,300 240 36 190 5 41 220 6 Riau 1,600 9,600 180 30 180 3 18 110 2 Riau Islands 770 4,900 61 51 320 4 94 600 7 Jambi 780 5,800 160 27 200 6 16 120 3 South Sumatra 370 4,900 280 5 68 4 4 53 3 Bangka-Belitung 300 2,500 55 26 220 5 18 150 3 Bengkulu 500 4,700 170 30 280 10 25 240 8 Lampung 1,200 5,200 260 16 70 4 35 150 8 Sumatra 13,300 79,400 2,200 27 160 4 28 160 5 Jakarta 3,600 8,000 340 39 87 4 5,400 12,100 510 West Java 5,100 24,600 1,000 12 59 2 140 700 28 Banten 840 9,600 200 9 98 2 87 990 20 Central Java 6,200 35,400 850 19 100 3 190 1,100 26 Yogyakarta 2,400 6,400 120 68 180 3 7603 2,0008 38 East Java 8,200 33,800 940 22 91 3 170 700 20 Java 26,400 117,900 3,500 20 88 3 200 910 27 Bali 2,000 8,900 110 56 250 3 340 1,500 20 West Nusa Tenggara 710 4,500 140 16 100 3 38 240 8 East Nusa Tenggara 710 8,900 290 15 190 6 15 180 6 Bali + Nusa Tenggara 3,400 22,200 550 27 180 4 47 300 7 West Kalimantan 900 6,500 230 21 150 5 6 44 2 Central Kalimantan 600 4,800 170 29 230 8 4 31 1 South Kalimantan 820 6,100 210 24 170 6 21 160 5 East Kalimantan 1,400 7,000 200 44 220 7 7 34 1 Kalimantan 3,700 24,500 820 29 190 6 7 45 2 North Sulawesi 740 5,200 160 33 230 7 53 370 11 Gorontalo 230 1,60 75 24 160 8 21 140 7 Central Sulawesi 500 3,000 160 20 120 7 8 49 3 South Sulawesi 1,500 5,000 400 20 64 5 33 100 8 West Sulawesi 270 1,300 77 26 120 7 16 75 5 Southeast Sulawesi 320 4,300 220 15 200 11 8 110 6 Sulawesi 3,600 20,400 1,100 22 120 7 19 110 6 Maluku 480 3,900 130 36 290 10 10 83 3 North Maluku 280 2,900 96 29 290 10 9 90 3 Papua 300 4,100 270 14 190 13 1 13 1 West Papua 270 3,000 100 32 350 12 3 31 1 Maluku + Papua 1,300 13,900 600 25 260 11 3 28 1 Indonesia 51,800 278,000 8,700 22 120 4 27 150 5 NOTE: MS = medical staff; N&M = nurses and midwives; CHC = community health center. SOURCES: Badan Pusat Statistik (2011)
Read the entire page →
From page 48...
... (2009) using pooled IDHS data between 1991 and 2002 concluded that they could find no measurable relationship between overall declines in neonatal mortality and the increased availability of health personnel, notably through the village midwife program that got under way in 1989 and in theory provided for replacements for less trained birth attendants for deliveries in the home elsewhere in the village.
Read the entire page →
From page 49...
... Some recent initiatives designed to increase the use of health institutions include the maternity insurance scheme, Jampersal. It is specifically designed to ameliorate the cost implications of institutional deliveries as well as encourage an increase in the number of community health centers with a capacity for basic emergency services in neonatal obstetrics (BEmONC)
Read the entire page →
From page 50...
... Factsheet: Direktorat Bina Kesehatan Ibu, Ditjen Bina Gizi dan 2 The 2012 IDHS noted, for example, that while nearly all women who undertook antenatal check-ups received basic checks such as weight, blood pressure, stomach exam and consultation, only about half said they had received any specific information on symptoms of pregnancy complications or about the dangers of childbirth outside of surroundings where basic emergency services are not available (Badan Pusat Statistik et al., 2012)
Read the entire page →
From page 51...
... 2010. Why do some women still prefer traditional birth attendants and home delivery?
Read the entire page →

Key Terms

  • community health
  • public hospitals
  • newborn care
  • traditional birth
  • badan pusat

  • emergency obstetric
  • neonatal mortality
  • reducing maternal
  • pusat statistik
  • private hospitals

  • birth attendants
  • health facilities
  • antenatal care
  • family planning
  • primary health

  • integrated health
  • child health
  • health facility
  • health survey
  • health posts

  • basic emergency
  • comprehensive emergency
  • daily office
  • midwifery school
  • square kilometers

  • office hours
  • school graduates
  • maternal health
  • health personnel
  • health providers


    • This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
    More information on Chapter Skim is available.