Indonesia to Pay Bills for All Citizens' Births

Jakarta Globe, Dessy Sagita | August 19, 2010

Jakarta. The government on Thursday announced a plan to provide free birth care to all, helping to prevent cases of mothers selling their babies to pay for the deliveries and hospitals holding the infants ransom until the medical bills are paid.

In the next year, the state will start a pilot program to pay for all births in community health centers (Puskesmas) and state hospitals nationwide.

Although the benefit is aimed at low-income mothers, even the wealthy qualify, so long as “they are willing to give birth to their babies in third-class wards in hospitals,” Health Minister Endang Rahayu Sedyaningsih said.

But the scheme comes with a caveat, she said. After the project’s first year, free delivery benefits will be limited to a mother’s first two children.

“This is expected to boost our stagnant family planning program,” Endang said, adding that the country was at risk of a population explosion.

President Susilo Bambang Yudhoyono stressed on Monday that the latest census put the population at 237.6 million people, a 32.5 million increase in a decade.

The rapid rise showed that the nation’s family-planning program, remarkable for reining in a population boom during the three decades under President Suharto, was no longer effective, Home Affairs Minister Gamawan Fauzi has said.

Health Ministry officials said the free delivery program was also expected to reduce the country’s extremely high maternal and infant mortality rates.

The latest maternal mortality figure for Indonesia is 228 deaths per 100,000 births, one of the highest in Southeast Asia, while 34 out of every 1,000 infants born die within their first year.

Budiharja, the Ministry of Health’s director general for community health and education, said the program should bring maternal deaths down to 102 per 100,000 births and reduce the infant mortality rate to 24 out of 1,000 births by 2015.

The progress would meet UN Millennium Development Goal targets.

“We hope that the number of births handled by the professional medical workers will increase to 100 percent,” Budiharja said.

A normal delivery at a Puskesmas or state hospital costs from Rp 300,000 to Rp 500,000 ($34 to $56).

However, recent cases of women selling their newborns in order to pay for their medical bills have highlighted the fact that many low-income mothers still can’t afford deliveries.

Others who can’t afford care opt to give birth at home, contributing to the high mortality rate.

Budiharja said the free care was intended for all birth procedures, including those requiring Caesarian sections or postpartum complication treatments.

The government is developing Puskesmas capable of providing basic obstetric, neonatal and emergency services, Budihara said.

“Out of 7,000 Puskesmas in Indonesia, more than 2,500 of them have been able to provide those three services, but only 1,600 of them provide the services 24 hours,” he said adding that all regional hospitals in Indonesia were expected to be able to provide more comprehensive care.

The 2011 draft state budget revealed on Monday included Rp 26.2 trillion, an almost 26 percent increase, in funding for the Ministry of Health.

Additional reporting from Antara

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