Nadya Natahadibrata, Jakarta – Indonesia has been ranked 100th out of 176 countries worldwide in terms of health equality for children, according to a report released by humanitarian organization World Vision (WV).

The report, released on Tuesday, "The Killer Gap: A Global Index of Health Inequality for Children" ranked 176 countries around the world according to the size of the gap between those who have access to good healthcare and those who do not. A large gap in a country means its most vulnerable children have less chance of accessing much-needed treatment and health facilities, despite national progress, the report said.

The study used four indicators: life expectancy, out-of-pocket expenses for using health services, adolescent fertility rate and coverage of health services.

The top five countries with the most equal access to healthcare are France, Denmark, Norway, Luxembourg and Finland, while countries ranked among the bottom five in the global health gap index are Chad, Sierra Leone, Guinea, Mali and Equatorial Guinea.

World Vision Indonesia spokesperson Teresia Prahesti said that the wide gap would hamper the Indonesian government's attempt to meet the Millennium Development Goals (MDGs) to reduce the number of post-natal deaths to 102 per 100,000 live births by 2015.

"We collected data in all regencies in the country and compared the situation between cities such as Jakarta, where access to healthcare for pregnant women and children is more evenly distributed, and remote areas such as East Nusa Tenggara, for instance," Teresia told The Jakarta Post on Wednesday.

"People who live in cities tend to be more aware that the government has programs such as Jampersal for pregnant women, while people living in rural areas are unaware about such programs and have no access to them," she continued, citing the government-funded Jampersal childbirth plan that provides coverage for women who seek services at community health centers or use third-class facilities at hospitals to give birth.

The report says that the main causes of the gap include a lack of equal investment in the early years of life, as well as policies and practices that prioritize urban growth, leaving rural communities to suffer the effects of chronic underinvestment in infrastructure and amenities.

"Should the government really aim to meet the MDGs, it should have the political will to improve services for those in remote areas. Otherwise it will fail," she said.

Separately, Health Ministry spokesperson Murti Utami said she was unsure about the indicators used by the organization to measure the gap, saying that the ministry would study the report.