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Making Maternal Health a Shared Responsibility in Factories and Farming Villages in Indonesia

Posted By: Kristina Gryboski, Ph.D. on June 17, 2015

Labels: Indonesia , Women’s and Children’s Health, Health Systems Strengthening

During my week visiting HOPE's Women's and Children's health programs in Indonesia, I have written about new efforts in both factories and villages for healthy pregnancies and childbirth. A healthy childbirth depends so much on what happens during pregnancy. Women can’t do it all by themselves. Project HOPE’s programs reach women where they are - in villages and in factories - to ensure they and key decision makers have the right information and systems to make safe delivery possible.

Traditional Birth Attendants and midwives work together to provide healthier births in Indonesia.

I met with one of those decision makers whose support can save mothers’ lives while visiting a village in the Serang District, where Project HOPE is implementing a program funded by Johnson & Johnson. The project is strengthening the capacity of health services to handle obstetric emergencies and is also working with communities to make sure they have systems in place for women to reach care in time. I met with Village Chief, Mr. Hasan, who has implemented a Safe Birth Preparedness System (DesaSiaga). The system has a pooled fund for maternal emergency needs, a vehicle for use as an ambulance, walking blood donors (people available to give blood when necessary), and an identification system of all pregnant women. The program also ensures family knowledge, providing education on the danger signs during pregnancy and delivery, and where to seek help. While this village-level system has been a national policy for several years, in this district most of the villages were not fully implementing it when the project started. Mr. Hasan has initiated an association of neighboring village chiefs to form health teams for better coordination and to create further commitments among other chiefs to ensure this system is active. Another decision maker is the Traditional Birth Attendant (TBA), who the community respects. The village TBA is now encouraging women to deliver with a midwife, with whom she partners at childbirth.

This grandmother is now taking care of her daughter's twins. Without proper emergecny services, her daughter died durign childbirth.

Factories are also part of shared responsibility for safe motherhood. Earlier in the week, I visited two of the five factories in Subang, Indonesia, where Project HOPE works to improve maternal health, funded by MSD Merck for Mothers. Project HOPE has helped the factory clinics introduce ongoing anemia screening of women. Anemic women are more likely to die from post-partum hemorrhage, which is one of the top causes of maternal death. Anemia was detected in 40% of the women. Pregnant women are now provided iron tablets by the factories, and all women are offered counseling and referral to the free government supply of iron tablets for women of reproductive age. Over 85% of the women are under 34 years of age and in prime childbearing years. Preventing anemia prior to pregnancy gives them a better chance for a healthy birth outcome and also improves their well-being and productivity. The factory management is now making it part of their business practice to provide the screening and treatment.

It’s clear that when maternal health matters to decision makers -whether they are factory managers or village chiefs, women can get the support they need and deserve for a healthy pregnancy and motherhood. Project HOPE is committed to ensuring that decision makers have the information and systems in place to do the right thing to prevent maternal deaths.

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