-  Women’s Health and “Health Mobile”  -

Astuti bus 2

Improving infant and mother’s healthcare in rural Indonesia

Tag’s grass-roots maternal and infant mortality reduction project operates across rural villages in Central Java, Indonesia with its local partner YAKKUM. Vital training is provided for local healthcare workers and traditional birth attendants, providing them with valuable lifesaving skills. A large health mobile visits the villages to raise awareness, disseminate knowledge and provide health education. Professionals in the van will also provide vital women’s healthcare services.

To live in rural Indonesia typically means to be cut off from proper healthcare.  Maternal and infant mortality rates are a challenge, despite huge progress. Our project aims to improve mother and baby healthcare in remote locations that do not have ready access to a hospital. In April 2013, Tag co-hosted a 3-day seminar of women’s health as part of the collaborative project with our local partner organisation YAKKUM aimed at reducing Infant and maternal rural mortality rates. This project builds on several pilots in the country to support local partners in acquiring expertise in disaster preparedness and women and infant health. 

Indonesia is a dynamically growing country, a member of the G20 group of major economies, but its infant and maternal mortality rates are depressingly high. Although the number of babies and infants that die has halved in the last twenty years, approximately 40 children out of every 1,000 do not make it to age 5. Maternal mortality rates are also a challenge, despite huge progress. In 1991, 390 of every 100,000 women died during childbirth, and this has nearly halved to ‘only’ 220 deaths per 100,000. In rural areas, 70 percent of births still take place at home there were 5,118 maternal deaths in 2011.

While substantial resources and efforts have been dedicated to improving maternal and infant health, bringing down the number of deaths and improving the health of mothers and babies has proven challenging. This project contributes towards improved health outcomes through introducing innovative teaching methods to raise awareness, increase capacity and bolster involvement in rural areas as well as increasing the capabilities of hospital-based personnel to reach out to the villages.

The project incorporates three elements:

  1. Piloting innovative solutions at community level in rural villages in Central Java
  2. Enhancing cooperation and integration of hospital and community based healthcare provision
  3. Through evaluation and research create policy recommendation and best practice guidelines for healthcare professionals at all levels.

Our project is providing extensive training designed to generate awareness, understanding and implementation of practices that will result in significant health benefits for mothers and babies. The intervention works with midwifes and traditional birth attendants to introduce creative teaching and problem solving models focused on the main levers for improving health outcomes, such as:

  • Promoting healthy nutrition based upon triple AAA: availability, accessibility and affordability of the nutrients
  • Improving the quality of ante-natal care through improved skills of local health care providers.
  • Educating about basic hygiene, including dental hygiene
  • Prenatal neonatal care, including safe delivery methods

Health Mobile

The project includes  a mobile health unit that travels among rural areas Professionals in the van disseminate knowledge, train village health professionals and volunteers, provide vital equipment, upgrade women’s skills to improve their capacity to earn a livelihood, and collect health data in an organized manner.

The health mobile encourages women who might have been reluctant to do so in the past, to come forward with medical complaints, as confidentiality will be assured, since the on-board staff will not be members of the communities they visit. Our goal now is to upgrade the health mobile with much-needed equipment and facilities to provide a better range of educational and clinical services.

Background

Led by Dr. Diana Flescher, a specialist in Women’s Health and Internal Medicine, Tag conducted a comprehensive needs assessment of the status of women’s health in Java, which found that women in general and in the rural areas in particular are the most neglected and underserved and at greatest risk, with a far-reaching negative impact on the community at large.

Focus groups were held by Tag professionals with posyandus, minimally-trained community health workers, nurses and other medical staff. The Tag team also met with the directors of various local charities and health organisations, including the head of the Society of Surgeons. Seminars were provided for posyandus, health field workers, and nurses, in which Dr. Flescher introduced the field of women’s health, reviewed concepts in gender medicine and presented the skills doctors need to care properly for female patients.

Since January 2013, fourth year medical student Thomas Betjeman has been fulfilling a three-month medical internship in Indonesia to assist in the implementation of the project. In March 2013, a group of senior Tag professionals, including Dr. Flescher, visited Indonesia to help:

  • Set policy, standards, procedures, and guidelines for team development in local hospitals with a focus on reducing Infant and Maternal Mortality Rates, and improving treatment for HIV and TB.
  • Enhance the competency of the hospital teams through module development and by delivering workshops
  • Develop strategic and operational plans, including an outreach program through the health
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