Supporting Indonesia’s efforts to improve maternal and neonatal health services and reduce deaths due to pregnancy complications or poor postnatal care.
Situation
Indonesia has the highest maternal mortality rate in South East Asia. In 2007 there were approximately 228 women deaths for every 100,000 live births. In poor provinces in eastern Indonesia, the rates are worse. Nusa Tenggara Timur (NTT) Province has one of the highest rates of maternal deaths with a death rate (in 2007) of 306 women per 100,000 live births. Neonatal mortality in NTT was also high with 57 neonatal deaths per 1,000 live births.
A key challenge in NTT is its geography. The province is spread out over many islands with limited and inadequate transport infrastructure, and it is difficult for communities to access health services, including maternal and child health services. As a result, more than 75 per cent of births are conducted at home, with 40 per cent of these deliveries assisted by traditional birth attendants.
Solution
The Australia Indonesia Partnership for Maternal and Neonatal Health (AIPMNH) was a partnership between the Governments of Australia and Indonesia that aimed to make pregnancy and childbirth safer in Nusa Tenggara Timur Province (NTT).
We managed AIPMNH on behalf of the Australian Government and worked in partnership with communities to raise awareness and encourage behaviours that would help save the lives of mothers and babies in NTT. AIPMNH also worked with local, district and provincial governments to improve services related to pregnancy and childbirth, strengthen the health system, and improve accountability and performance to ensure long-term sustainability of the program.
AIPMNH established behaviour change communication teams from local government, leaders and non-government organisations across districts. The teams conducted research into the barriers facing women when attending Puskesmas, the community health clinic, to give birth. The program increased communication with rural and urban populations in NTT using innovative communications approaches such as radio shows, community drama, mobile phone campaigns in order to reach mothers and non-traditional influencers, such as birth attendants, husbands, in-laws and others in the health system and the community.
The program improved delivery of basic maternity and neonatal care at the community level, with more than 5000 health workers and volunteers trained to support childbirth activities, around half of the total number of health workers and volunteers in the NTT province. Birthing wards were renovated in East Nusa Tenggara, allowing twice the number of births to take place at those clinics where data was collected.
Result
AIPMNH finished in 2015 achieving its main goal of a reduction in maternal and neonatal mortality with successes including:
- 40% reduction in maternal mortality
- 7% reduction in maternal mortality
- 31% increase in birth deliveries in health facilities
- 30% increase in management of maternal and neonatal complications
- 11 district hospitals licensed and accredited.
Client
Australian Department of Foreign Affairs and Trade (DFAT)
Location
Nusa Tenggara Timur, Indonesia
Duration
2009 – 2015
