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Reducing child deaths in Indonesia

Improvements in health care have significantly reduced rates of child mortality in Indonesia, but experts say more deaths could be avoided with better sanitation and wider practice of basic hygiene.

In 2010, over 150,000 children died in Indonesia before reaching the age of five (35 deaths for every 1,000 live births), but deaths were three times higher among poorer households than wealthier ones.

According to the World Health Organization, illnesses such as pneumonia and diarrhoea accounted for over a fifth of deaths among children during 2010. Speaking to the news agency IRIN, one spokesperson for a non-governmental organisation working in Indonesia said that unless there was progress in widening access to “safe drinking water and basic sanitation”, it would be hard to “prevent deaths from diarrhoea or to reduce the burden of diseases”. 

Data published by the Ministry of Health in its ‘2010 Indonesia Health Profile, reveals that four-fifths of Indonesian households now have easy access to clean and safe drinking water. However, only 70% of houses nationally have their own sanitation facility and the proportion varies greatly by area; in five provinces, less than half of households have basic sanitation. And according to the Ministry of Health, fewer than a fifth of children are taught to wash their hands with soap after defecating or before eating.

Studies have shown that cases of diarrhoea are reduced significantly when people have access to proper sanitation and practice basic hygiene. The Indonesian government has therefore adopted a management policy which aims to promote awareness of disease prevention among children. And with the majority of child deaths taking place within the first 28 days of life, since 2008 health authorities have been asked to carry out three neonatal visits (rather than two) within the first 28 days of a child’s life. During these visits, as well as examining newborns, health workers provide counselling about how to reduce the risk of illness by exclusive breastfeeding and guidance on basic newborn care.

However, data from the Ministry suggests that many provinces are failing to provide the target of three visits. And while a number of local health departments trained up volunteers to help with monthly check-ups of mothers and young children, lack of support and a waning of interest have led to a decline in these services. If Indonesia is to meet its Millennium Development Goal of reducing child deaths by two-thirds since 1990, which would mean seven more children surviving for every 1,000 births, more focus must be put on the provision of clean water, sanitation, neonatal check-ups and health education.

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