Nadya Natahadibrata, Jakarta – The Health Ministry said Maluku, North Maluku, Papua and West Papua had the lowest rate of vaccination and births without the assistance of health workers.

"The vaccination rate is under 50 percent in these provinces. We need to work harder to involve local health agencies to increase their vaccination coverage," Health Minister Nafsiah Mboi said.

Nafsiah said that vaccinating children under five years old can prevent communicable disease that can cause disabilities or even death, including tetanus, polio and measles.

Vaccinations reduced the country's infant mortality rate from 46 per 1,000 infants in 1990 to 35 per 1,000 in 2012. The mortality rate of children under five had also decreased from 58 per 1,000 in 1997 to 40 per 1,000 last year.

UNICEF said that Indonesia was on track to reduce its infant mortality rate to 34 per 1,000 live births, which is the number set by the Millennium Development Goals (MDGs).

The Health Ministry, however, said that of the 24 million children in Indonesia, 3 million had not been vaccinated and as a result were at risk.

"In Indonesia, only 86.8 percent of infants received universal child immunization. There are around 13 percent of infants that still haven't been vaccinated," Nafsiah said, explaining that the ministry faced numerous challenges in its drive to reach all recipients, including remote communities and local norms; in urban areas – especially in the slums – most parents are wary of vaccinations.

Beffa Yigibalom, regent of Lani Jaya, Papua, reiterated the ministry's findings and explained that the high mortality rates in his regency were likely caused by the low rate of vaccination coverage and childbirth without the assistance of health workers, however, the regency had yet to collect maternal and infant mortality data.

"A lot of women give birth without any help from health workers, due to the regency's difficult terrain," Beffa said, adding that there were only 10 doctors and 100 midwives for 160,000 residents in the regency.

"Our regency is probably the only one in the country without a family planning program. Apparently the death rate here is higher than the birth rate," he said.