The Jakarta Post
Indonesia's child mortality has declined substantially thanks to government and civil society interventions, a new global UNICEF report says. Yet, the country's achievement is still being held back by the high underage marriage rate.
The report 'Promise Renewed: 2015 Progress Report' said that the Indonesian under-5 mortality rate currently stands at 27 deaths per 1,000 live births, compared with 85 deaths per 1,000 live births in 1990.
This drop has saved more than 5 million Indonesian children who would have died if the mortality rate had remained at 1990 levels. In 1990, an estimated 395,000 children died in the country before reaching their fifth birthday. This number has come down to 147,000 in 2015.
'Saving the lives of millions of children is one of Indonesia's great achievements over the past 25 years,' said UNICEF Representative Gunilla Olsson. 'This progress is the result of sustained action by the country's leaders ' to make saving children's lives a policy priority and to scale up coverage of key interventions.'
The report highlighted that Indonesia is among 24 out of 81 low and lower-middle income countries that achieved a two-thirds reduction in under-5 mortality ' the target of Millennium Development Goal Four.
The Health Ministry's director general of mother and child health and nutrition supervision, Anung Sugihartono, said that the achievement could be attributed to the government's vaccination program.
'We are quite advanced in our preventative measures because the immunization program for children is already robust, starting from anti tetanus, polio, diphtheria to measles, we've done it all,' he told The Jakarta Post on Friday.
Simple, high-impact, cost effective solutions coupled with economic growth also likely contributed to this dramatic reduction of young child deaths, including exclusive breastfeeding and the prompt diagnosis and treatment of common childhood illnesses.
'But approximately 150,000 Indonesian children still die every year before celebrating their fifth birthday. This is unacceptable,' Olsson said. 'And we also observe that much of the progress in reducing child mortality in Indonesia occurred during 1990 to 2005 while it has slowed considerably in the last decade.'
Furthermore, the report found that almost half of under-five deaths occurred in the first month after birth and can be attributed to complications from premature birth, asphyxia and severe infections.
'The number of marriages involving people aged 15 to 19 is still high, even though they fall within the category of children. Looking at it from the nutritional aspect, 57.8 percent of these teenagers are anemic. If they suffer from anemia and get pregnant, what happens to their babies? This causes their babies to weigh less than 2,500 grams. These babies have a higher risk of death as their lungs have not developed properly and they are more prone to infections,' Anung said.
Babies who are born with less-than-normal weight also affects their parents' attitudes in raising them, further endangering them.
'If you have a small baby, you would think twice before giving it a vaccine. You would be concerned whether it could withstand the vaccine or not. On the other hand, risks of contamination from germs are everywhere,' said Anung.
He deplored the recent failure to increase the minimum legal age of marriage for girls from 16 to 18 by judicial review at the Constitutional Court.
The plaintiffs, led by the Women's Health Foundation (Yayasan Kesehatan Perempuan), lobbied to raise the minimum marriageable age for girls from 16 to 18 to reduce the number of underage marriages in the country, which has one of the highest rates in the world and the second-highest in ASEAN after Cambodia.
The court comprehensively dismissed the plaintiffs' arguments, saying that there was no guarantee increasing the marriageable age for females would reduce the rate of divorce, domestic violence and other social problems.
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