Midwifery Added to Health Scheme, but More Still Needed
Jakarta. Indonesian mothers who give birth assisted by a midwife will soon be covered by the universal health insurance scheme BPJS Kesehatan, after the state insurer signed an agreement with the Indonesian Midwife Association.
The deal is crucial, BPJS Kesehatan president director Fachmi Idris said on Thursday, to combat the maternal and infant mortality rates, given that many women in rural Indonesia depend on midwives, particularly in remote areas without adequate health care facilities.
Fachmi also said the deal would allow mothers to register their unborn children with the BPJS scheme. Currently, parents can only apply for their children after they are born, meaning any congenital ailments are not covered.
Midwives — trained only to handle the natural childbirth process — will also be able to quickly transfer their patients to clinics and hospitals under the scheme.
Midwives association chairwoman Emi Nurjasmi said there were currently 300,000 midwives in the organization, 47,000 of whom worked individually.
“In terms of quantity it’s enough. However, they’re not well distributed,” she said. The majority of midwives are concentrated in Java, Indonesia’s most populous and developed island.
“Meanwhile, in other islands we don’t have enough. Approximately 20 percent of villages [in Indonesia] do not have access to midwives,” Emi said.
She added midwives working in remote areas were usually contract workers.
“Once their contracts are over, they leave. So [these midwives] should be made permanent staff or public officials,” she said.
Emi said midwives were often neglected by the government and considered outside the regular health system, despite aiding some 87 percent of all pregnancies and 65 percent of all natural childbirths.
“Many clinics refuse to create a network with midwives. They see us as competition. But clinics must realize it’s about providing better services,” she said.
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