Child Survival Revolution

1
Child Survival Revolution

• Some Illustrations from Indonesia

2
The Development Context

• Continuing interest in problems of poverty and
  inequitable income distribution
• Clearly absolute poverty is closely linked to
  ill-health and premature mortality
• Persistent problem in the Third World is high
  infant and child mortality
• Indonesian IMR in 1960 was 120 and in 2004 stands
  at 46 per 1,000 live births
• How has this been accomplished?
• Yet striking contrast with Malaysias IMR of
  11/1,000 live births

3
Indonesian Infant Mortality Rates
4
Population Density in Indonesia
5
Roots of the Problem

• Survival and development of children in Indonesia
  and elsewhere dominated by two major problem
  areas
• Nutritional deficiency- especially protein energy
  malnutrition (PEM)
• Infectious diseases acute respiratory (influenza
  and pneumonia), diarrhea and measles
• Major causes of deaths is dehydration due to
  diarrhea and neo-natal tetanus

6
Child Survival Revolution

• Attempt by United Nations to address the growing
  concern worldwide for infant and child mortality
  levels
• Aid has focused on a set of four factors defined
  by GOBI
• 1. Growth monitoring- weighing children regularly
  to detect weight loss
• 2. Oral rehydration- replenishing body fluids
• 3. Breast feeding- more nutritious and important
  where water is non-potable
• 4. Immunization- immunizing against preventable
  diseases through four vaccines (measles, polio,
  diphtheria, tetanus)

7
Child Health in Rural Indonesia

• Growth monitoring is done in posyandu
  one-stop small health posts in rural areas
• Goal all children have access to health center
  no more than 5 kilometers away
• Goal Immunization regime to cover major diseases
• Health care system deepened through use of
  midwives

8
Breast feeding birthing room rural Java
Sarmani, 65-years-old, has been a Dukun
(traditional birth attendant) for 50 years. She
is bathing a one-day-old baby girl from the
village of Deket Kulon posyandu.
9
Family Planning in Indonesia

• Natural increase rate currently 1.6 (22/6)
• But Indonesian family planning program very
  successful
• 60 percent of 15-49 women use some form of
  contraception
• Health care practices emphasized as part of the
  family planning program