Women’s Reproductive Health Rights Still Not Ensured

KOMPAS/P RADITYA MAHENDRA YASA

A health worker weighs a toddler at an integrated health services (Posyandu) post routinely opened in Dukusari village, Ngampel district, Kendal regency, Central Java, Thursday (20/6/2019). The post plays an important role in providing services for and information on maternal and child health, family planning and nutrition. The Posyandu is at the forefront of health service provision in remote areas.

JAKARTA, KOMPAS— Indonesia has been gaining great results from its family planning development in the past few decades. However, women and teenage girls’ rights are not yet ensured. If these rights are unfulfilled, it will be difficult for the country to achieve its Sustainable Development Goals (SDGs).

Access to reproductive health care remains difficult for around 5 million Indonesian women. Every hour, one to two women die from complications in pregnancy and childbirth. Meanwhile, one out of three women suffer from violence at least once in their lives. Child marriage and circumcision practices also put women in danger.

National Population and Family Planning Board (BKKBN) chairman Hasto Wardoyo said at the Indonesia ICPD25 Workshop in Jakarta on Monday (21/10/2019) that the government was focused on achieving the Three Zero targets to resolve this issue.

The Three Zero targets are zero unmet needs for women wanting to use contraception, zero women dying from childbirth and zero gender-based violence and dangerous practices toward women.

Indonesia aims to meet these targets by 2030. “It is impossible to achieve the SDGs without accommodating the ICPD action programs, especially the Three Zeros,” United Nations Population Fund (UNFPA) Indonesia country representative Anjali Sen said.

The International Conference on Population and Development (ICPD) in Cairo, Egypt, in 1994 was a historical milestone in the paradigm shift of population development. If humans had been seen as merely numbers before, now humans are seen as the focus of development, whose rights must be fulfilled.

KOMPAS/P RADITYA MAHENDRA YASA

An officer checks health data of a toddler at an integrated health services (Posyandu) post routinely opened in Dukusari village, Ngampel district, Kendal regency, Central Java, Thursday (20/6/2019). The post plays an important role in providing services for and information on maternal and child health, family planning and nutrition. The Posyandu is at the forefront of health service provision in remote areas.

Unachieved

This year, the ICPD is 25 years old. Many targets remain unachieved, which has led to the emergence of the Three Zero campaign.

Hasto said decreasing the maternal mortality rate from 305 out of 1,000 would be challenging, as it was a complex issue involving health, culture, healthcare worker management and infrastructure.

Despite these challenges, pregnancy monitoring by midwives will be able to reduce the rate. “Reducing the maternal mortality rate is easier than reducing the stunting rate,” Hasto said.

The solution can only be implemented in regions without significant geographical challenges, like on Java. For eastern Indonesia, a special approach would be necessary as the challenges are different.

Health Ministry public health directorate general secretary Eni Gustina said a third of maternal mortalities were caused by pregnancies at a young or old age, or mothers with more than three children.

Increasing the marriage age can reduce the maternal mortality rate. Today, almost 47 percent of women are married at less than 20 years old. Distance between births must also be made longer from two years to 4.5-5 years.

To reduce unmet needs, Hasto said he proposed combining contraception and childbirth services. The 2018 Basic Health Research showed that 79 percent of childbirth takes place at healthcare facilities. If contraception service is combined with childbirth, unmet needs can be reduced.

Unmet needs must be resolved as lack of contraception contributes to unwanted pregnancies, maternal deaths and disrupted child development.

On gender-based violence, child marriage remains a dangerous practice toward women. “The recent law amendment that includes a minimum marriage age of 19 years old must be followed by an extension of the rule of marriage dispensation,” the Women Empowerment and Child Protection Ministry’s deputy of public participation Indra Gunawan said. (FRD/MZW)