Health and Sanitation
Japanese assistance promotes health of mother and child
Improving the health of pregnant women and reducing the infant mortality rate are important goals incorporated into the Millennium Development Goals (MDGs). Although the maternal and infant mortality rates in Indonesia are on the decline in recent years, the levels are still high at 307 cases against 100,000 births for maternal mortality and 35 cases against 1,000 births for infant mortality. The situation in Japan was much like that of a developing country many years ago. But the maternal and infant mortality rates was reduced drastically by educating the mothers on health in general through the maternal and child health handbook and by strengthening the regional health care system. Today, the maternal mortality rate is 5.7 cases against 100,000 births and the infant mortality rate is 1.3 cases against 1,000 births in Japan.
Based on such an experience, Japan has worked to raise the quality of health and sanitation for pregnant women and infants and to strengthen health services in Central Java Province as a model district since 1989 through the "family planning and mother and child health project" (1994) implemented by JICA. During the prosess of this project, the Japanese maternal and child health handbook came to the attention of an official in charge of the provincial health bureau (an Indonesian doctor) who was in Japan as a trainee of JICA. In Japan, the maternal and child health handbook is provided to pregnant women so that they can give birth and rear their child with confidence. The handbook keeps records of medical examinations of the mother, vaccinations and the growth of the child and teaches mothers what to keep in mind in everyday life with regard to pregnancy and childbirth together with the health and nutrition necessary for the child. In short, it gives information and keeps the record of childbirth and child rearing. This handbook is uniquely to Japan. The universalization of the handbook contributed significantly to the improvement of maternal and child health in Japan by reducing the maternal and infant mortality rates. The trainee who came from the provincial health bureau thought that Indonesian mothers and their babies could have a safe and healthy life with this handbook, used succesfully in Japan. This promoted the development of an Indonesian version of the maternal and child health handbook.
The handbook, which was produced and distributed experimentally in Central Java, was received very well by the local people and then spread to many other parts of Indonesia. Responding to this developement, Japan launched the "maternal and child health handbook project" in 1998 (-2003) which aims at improving maternal and child health service through the use of the maternal and child health handbook. At present, the handbook has spread to as many as 26 provinces out of the 30 some provinces in Indonesia. So far, approximately 2,220,000 handbooks have been distributed through the Ministry of Health. The handbooks are modified to suit the different local culture and customs in each province. For example, cover illustration is changed. Difficult technical terms are avoided as much as possible and pictures are used extensively so that the mothers who cannot read can understand easily. In addition, a health ministerial decree (2004) was issued to encourage the use of the handbook by pregnant women. International organizations and other donor countries supported their printing cost. This assistance which utilizes Japanse experience and knowledge is appreciated by Indonesians and donor agencies.
At the background of the successful spread of the maternal and child health handbook throughout Indonesia lie the steady efforts of many Japanese experts and Japan Overseas Cooperation Volunteers working together with Indonesians in the field. Japan will assist Indonesia so that it can distribute the handbook on its own and improve maternal and child health.