Effort to Decrease MMR

and IMR

8 Focus Priority Health

Development
1.Improving the health of mothers , babies , toddlers and
KB
2.Improvement of the nutritional status of the community
3.Control of infectious diseases , noncommunicable
diseases and environmental sanitation
4.Fulfillment of development of HRH
5.Increasing the availability , affordability , equity , safety,
quality , use of drugs and drug and food control
6.Community Health insurance
7.Community empowerment , disaster management and
health crisis
8.Improvement of primary health care , secondary and
tertiary

9 Program Ministry of Health

1. Program Management and Implementation Support of
Other Technical Task ;
2. Facilities and Infrastructure Improvement Program
Apparatus of the Ministry of Health ;
3. Improvement Program Oversight and Accountability
Apparatus of the Ministry of Health ;

4.
5.
6.
7.
8.
9.

Health Research and Development Program

Program of Nutrition and Maternal and Child Health ;
Health Services Development Program ;
Program of Disease Control and Environmental Health ;
Program Pharmaceutical and Medical Devices ;
Program Development and Empowerment of Health
Human Resources

Priority MoH through the Health

Reform
1. Health Operational Assistance
2. Health -handling Troubled Regions
3. Community Health Insurance (Assurance )
4. Health Care in Underdeveloped Regions Border
and Islands ( DTPK )
5. Availability of Drugs
6.Reforms
7.World Class Hospital
8.Herb Scientification

MILLENIUM DEVELOPMENT GOALS (MDGS)

Consists of 8 goal / goals , 18 targets and 48
indicators for the period 1990-2015

Goal 1 : Eradicate extreme poverty and

hunger
Goal 2 : Achieve universal primary education
Goal 3 : Promote gender equality and female
empower
Goal 4 : Reduce child mortality
Goal 5 : Improve maternal health
Goal 6 : Combat HIV / AIDS , malaria and
infectious diseases
Goal 7 : Ensure Environmental sustainability
Goal 8: Develop a global partnership for
development

MMR in Indonesia
5M pregnancies per year
20,000 pregnancies end in maternal
death
ASEAN highest MMR at 373 / 100,000
live births

Classification of Maternal
Mortality
A. Direct Obstetric Death ( 95% )
B. Indirect Obstetric Death

Causes of Maternal
Mortality
Dirrect
a. Bleeding : 45,2 %
b. Abortion complications : 11.1 %
c. Eclampsia : 12.9 %
d. Parturition Loss : 6.5 %
e. Postpartum sepsis : 9,6 %
f. Anemia : 1.6 %
g. Premature rupture of membranes
h. Cord winding
i. Etc...

 Indirrect
-. 3 Late
1. Too late to recognize the
danger signs
labor and decision-making
2. Late referenced
3. Late handled by health
professionals in
health facilities .

 4 Too
-. Too young pregnant
-. Too old pregnant
-. Too often have children
-. Too tight spacing childbirth

Infant Mortality Rate

In Indonesia :
-. IMR in Indonesia 45.7 per 1,000
live births
-. Newborn death contributes 47 %
to the IMR
-. 50 % of newborn deaths occur in
the first

Factors - Factors Affecting IMR

Health care facilities
Medical personnel
Nutritional intake
Environment

Issues In Attempts Decline MMR

and IMR
changes in goverment system
centralization decentralization
Health service delivery gaps
Gaps in utilization of health services
Gaps in health care financing
Political commitment and policy gaps
Gaps in cooperation and coordination
of government and partners

Step - Step Reduce MMR and

IMR
Provide advocacy to the holders of
power
Gives KIA
Add and train health workers
Provide training to traditional healers
Improved access and health care
facilities
Changing the paradigm of the public
about the importance of maternal
health