PATTIRO: To Reduce the Maternal Mortality Rate, Health Ministry Should Provide Spaces for the People to Monitor Village Midwives
Health Minister Nila Moeloek notes that there are at least 5 targets of Millennium Development Goals (MDGs) in health sector Indonesia failed to achieve, one of which is the target to reduce Maternal Mortality Rate (MMR)[i]. Indonesian Midwives Association (IBI) Secretary General Tuminah Wiratmoko stated one of the reasons that cause the failure is the poor quality of community health center (puskesmas) midwives serving in the villages[ii].
The statements are in line with the research result PATTIRO conducted in 100 villages in South Sulawesi and Banten Provinces. Based on the data PATTIRO collected, there are still many village midwives who neglect their duty to conduct health promotion activities as well as educate the citizens particularly the expectant women and their families about the importance of undergoing Childbirth Planning and Complication Prevention Program (P4K), giving birth in health facilities, and conducting postnatal health care. “There are only 49.4% of the midwives in the 100 villages suggests the pregnant women to undergo P4K, only 49.7% of them disseminate the importance of giving birth in health facilities, and there are only 56% of them educates the women to conduct conducting postnatal health care,” said PATTIRO Researcher Didik Purwondanu.
Therefore, Didik contends, in order to prevent such failure in the effort of achieving the targets of Sustainable Development Goals (SDGs) in health sector, Health Minister should give more space to the citizens or other stakeholders to oversee the work performance of the village midwives.
Actually, Didik explained, the Health Minister has given the space for the public to participate in encouraging the health promotion and disease prevention activities. “In 2014, Health Ministry issued the Health Minister Regulation Number 75 Year 2014 on Community Health Center (Puskesmas)[iii] replacing the Health Minister Decree Number 128/MENKES/SK/II/2004 on Puskesmas Basic Policy[iv],” he added.
However, until now, the role of multi stakeholders in the community to eversee the performance of the health service unit and village midwives has not worked yet. One of the things causing it is that the Health Misitry decided to remove the provision about the role of multi stakeholders in monitoring puskesmas and its health workers including village midwives who are considered as the frontliner in the effort of achieving MDGs and SDGs targets, explained Didik.
Didik described that in the expired Health Minister Decree on Puskesmas Basic Policy, it is stated that citizens have the role as puskesmas’ partner in health development. This role is fulfilled by a forum named Puskesmas Committee (BPP) or Subdistrict Health Committee (K3) whose members consist of multi stakeholders such as civil society organizations, citizens, public figures, and other related stakeholders. “On the contrary, the role of BPP/K3 is no longer exist in the new regulation. Therefore, this regulation cannot be categorized as a breakthrough, but a deterioration,” he emphasized.
Understanding the great importance of civic engagement in encouraging SDGs target achievement, Health Minister Nila Moeloek invited all stakeholders, starting from private sector, academics, until civil society to participate actively in accelerating the SDGs target achievement process, particularly in health sector[v].
Responding to the Minister’s statement, Didik said, if they do have the commitment to open up the space for the multi stakeholders, the Health Minister should start it by issuing a policy or a regulation that can strenghten civic participation and roles in encouraggin health development. “Give more space to the society. Re-establish the community organization like BPP/K3 so that the people can involve in the planning, implementation, and monitoring process of health development. And in fact, the multi stakeholders involvement can reduce the government’s workload,” Didik asserted.
The Bahasa Indonesia version of this article is published in:
- Majalah Kartini Online (majalahkartini.co.id) with the title Tekan Angka Kematian Ibu, Kinerja Bidan Desa Perlu Diawasi.
- Tribunnews.com with the title Masyarakat Harus Dilibatkan untuk Tekan Kematian Ibu.
- iBerita.com with the title Masyarakat Harus Dilibatkan untuk Tekan Kematian Ibu.
[i] The statement was said by the Minister in National Workshop on SDGs in Jakarta on December 29, 2015.
[v] The statement was said by the Minister in National Workshop on SDGs in Jakarta on December 29, 2015.