Free Delivery Care in Indonesia Fails to Reduce Maternal Mortality Rate

Indonesia’s maternal and child mortality rates are amongst the highest in South East Asia.

The Ministry of Health has introduced a program that provides free delivery care for all pregnant women..... all they need to do is show their national ID card.

But when 29-year-old housemaid Tariyani wanted to deliver her baby, she was faced with difficulties.

When she found out she was pregnant, her boyfriend left her.

Her employer, Titi Rido, then took her to a government hospital in Jombang, East Java.

“After Tariyani had gone in to the labour room, I took care of the administration. But then one of the hospital staff members said that the patient was a single woman and not married. And I asked him, “So she can’t use the Jampersal scheme?”

Jampersal is a government program, launched two years ago. Under the program, any pregnant women.. married or unmarried... can have free birth delivery care, attended by skilled health personnel. All they need is a national ID card.

“We argued for a while about the marital status. And I said to him that I’d take the issue up with the director. After that we were allowed to use the Jampersal scheme for Tariyani,” as Titi recalls the situation.

Tariyani isn’t the only one.

In another city in East Java, a high school student who had been raped, had difficulty accessing the government scheme. Her parents had to file a report to the local government before they were finally admitted to the hospital.

But the government insists that there’s no discrimination against unmarried women.

“We haven’t received any complaints from the public, parliamentary members or NGOs about patients being rejected by hospitals. Every pregnant woman is eligible for the program,” says Achmad Iskandar from the Jombang Health Office.

But, because of a lack of clear information or detailed guidelines... many patients are denied care by hospitals or have to pay some money for using their facilities.

Sunawan had to pay more than 150 US dollars for his wife’s labour...

“I wanted to use Jampersal for my wife. But I only had my old ID card which states that I’m single, not married. And the officer said I’m not eligible for the scheme. I had to renew my ID card first. But when I came back to the hospital, he said that it was already too late and I had to pay for my wife’s labour.”

Aan Anshori, from the local NGO Jombang Civil Society, suggests that the government should set up a complaint hotline for anyone using the scheme.

“There is no Jampersal hotline for people who use the scheme. If there are any problems, who should you complain to? We tried to help by giving out the numbers of some of the hospital directors and health offices. But when they asked directly they were just passed from one person to another.”

The main goal of the Jampersal scheme is to reduce the maternal and child mortality rate. But after two years, critics claim that the scheme isn’t working. 

According to the Indonesian Midwives Association, this is because it isn’t integrated with the family planning program.

Head of local association Sabrina Dwiprihartini sugests that the scheme should only apply to the first and second child.

“We need to evaluate the program because we don’t see any reduction in the maternal mortality rate. There are so many pregnant women today who can access the program... But they can have as many children as they want, and they’re all covered. If you don’t want to see a higher maternal mortality rate, then don’t get pregnant... then you won’t die.”