Herman Genie – With people marrying younger, a generally low quality of life for women, and poor infrastructure, Indonesia is unlikely to achieve its 2015 Millennium Development Goals, a senior official told journalists at his office on Thursday.

"Poor roads result in people finding it hard to reach their nearest health facilities when they need it most, which contributes to the high rate of maternal mortality," said Dr. Tubagus Rachmat Sentika, an expert on the Millennium Development Goals at the Coordinating Ministry for People's Welfare.

Rahmat said Bangka Belitung province was a good example of how improved infrastructure could reduce the number of cases of maternal mortality. The islands set out to link more villages to main roads, allowing residents greater mobility.

"We need to improve the infrastructure immediately, develop temporary shelters and improve services at community health centers [puskesmas] and hospitals that provide facilities to overcome pregnancy-related emergencies as the answer to the problem," Rachmat suggested.

He said the problems to reach hospitals are making it difficult for medical staff to assist patients who are already in a critical condition because of widespread infections, pregnancy seizures, and hemorrhage.

"The three major factors contributing to the maternal mortality are hemorrhage, infection and high blood pressure. The deaths could actually be prevented if the following symptoms, which are danger signs, are detected earlier. This includes hypertension, swelling, excessive weight gain, and flecks of blood during the third trimester," Rachmat said.

"The expectant mother should be brought straight to a health facility as soon as those signs are discovered," he added.

In the third trimester, pregnant women should have blood checks to discover whether they are anemic or possibly have high blood pressure. Having anemia during pregnancy can affect the woman's flow of blood to her brain, while high blood pressure could lead to severe blood loss during birth.

Rahmat said that Indonesia would have difficulties to achieve the 2015 Millennium Development Goal target. Under the plan, Indonesia has to lower postnatal deaths to 102 per 100,000 live births by the end of 2015.

But the rate stood at 359 deaths per 100,000 live births as of 2012, according to last September's Indonesian Demographic and Health Survey (SDKI).

The maternal mortality rate increased from 220 deaths per 100,000 live births in 2010, according to the United Nations Population Fund, while the total fatality rate reached 2.6 percent. "We only have a year and seven months left. Given the latest data, it seems difficult to achieve the target," Rahmat said.

Teenagers' sexual behavior

Rahmat said early marriage and shifting sexual behavior among teenagers were some factors contributing to high maternal mortality rates, adding that girls now get their first periods at the age of 10-11 years from 12-14 years previously.

"Based on an analysis, 82 percent of deaths occurred among people who are aged 20 or under. The dating behavior of teenagers is also worrying because it could lead to pregnancy and abortion," Rahmat said.

He therefore suggested that the National Population and Family Planning Board (BKKBN) should target junior high school students in the campaign to avoid early marriage.

"Marriage at a young age can increase the maternal mortality rate," Rachmat said. "Given teenagers' current pattern of sexual behavior, I think it would be more effective to target junior high school students to encourage them to abstain from getting married at a young age."

Source: http://www.thejakartaglobe.com/news/indonesia-may-achieve-2015-development-goals/