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ndonesia could fail its Millenium Development Goal (MDG) of reducing maternal mortality by 75 percent by 2015, due to the slow progress in improving the country’s family-planning program, a senior health official says.

Slamet Riyadi Yuwono, director general of nutrition and child and maternal health at the Health Ministry, said the maternal mortality rate in Indonesia remained too high and the government ought to do more work to improve community-based maternal care as well as providing access to contraception.

“Our target is still off-track. We may be able to reduce the number of post-natal deaths to 162 per 100,000 live births by 2015, but that is far higher than the 102 per 100,000 live births targeted in the MDG,” he told journalists on the sidelines of a coordination meeting between the National Demography and Family Planning Agency (BKKBN) and the Indonesian Military (TNI).

About 30 percent of maternal deaths are caused by obstetric hemorrhaging, making it the most common cause of maternal mortality.

“Women who give birth too often, bear children too young or have pregnancies too close together are at a higher risk of suffering from such obstetric problems,” said Slamet.

He said improved family planning could decrease maternal mortality rates, as delayed childbearing, longer intervals between births and limited childbirth could protect women against any obstetric dangers.

“This is why we require all pregnant women who seek Jampersal coverage to partake of family planning, particularly long-term contraceptive care for those who already have two children because many obstetric problems are faced by women who already have two or more children,” he said.

The government-funded Jampersal childbirth plan provides coverage for women who seek services at community health centers or use third-class facilities at hospitals during childbirth.

As of this year, the government requires Jampersal holders to join family-planning programs if they already have two children.

According to the Indonesian Demographic and Health Survey (SDKI) in 2007, there were 228 maternal deaths per 100,000 live births, making Indonesia the country with the highest maternal death rate in Southeast Asia.

“Reducing the maternal death rate to 102 per 100,000 live births is the most urgent consideration,” said BKKBN chairman Sugiri Syarief.

To revitalize the stagnant family-planning program, the BKKBN has gone into partnership with the TNI to ensure that contraceptive care is available nationwide, including even the remotest parts of the country, such as cross-border provinces and the outermost islands.

Sonny Harry B. Harmadhi, head of the Institute of Demography at the University of Indonesia’s School of Economics, said family planning had succeeded in reducing the average number of children born to a woman during her reproductive life to 2.5 in 2010, from between 5.5 and 6 in the early 1960s.

“However, challenges remain for people who want to access reproductive health care, especially the impoverished and those who reside in remote areas,” he told The Jakarta Post.

The 2007 Health and Demographic Survey showed that one in every 10 pregnancies were unwanted or unplanned, caused among others things by poor access to contraceptive health care.

Citing the same survey, Sonny said 98 percent of women who had been married at least once and 99 percent of women who were currently married, as well as 95 percent of married men, had some knowledge of family planning or contraception.

The country’s contraceptive prevalence rate, however, still hovers at around 61.7 percent only, due to a shortage in contraceptive-care services, he said.

Sonny said with only three years remaining for the government to meet its MDGs, it would be better if the government devised a new strategy.

“Looking at current trends, there needs to be more work done to reduce the maternal mortality rate to 102 per 100,000 live births by 2015. The most effective way to reduce it is to get more support from health workers during childbirths and have births conducted at health care facilities,” he said.