In order to reduce maternal mortality rate, the government provides a healthcare insurance for both labour and postnatal care through the National Health Insurance (JKN). Following the ratification of Law No. 40/2004, JKN was launched on 1 January 2014, operated by the Social Security Agency (BPJS).
In the effort to support the success of the programme, it is imperative to have competent and adequate health workers (WHO, 2005; UN, 2012; ICM, 2013). In reducing the number of maternal mortality, midwives hold the main role as the spearhead of the national health services.
Indonesia has held the highest rate of Maternal Mortality Rate (MMR) in South East Asia since 2007 (UNFPA, 2012), with 228 deaths per 100,000 live births. In 2012, only five years later, Indonesia’s Demographic and Health Survey shows that the MMR in Indonesia reached 359 deaths per 100,000 live births. This number is still exceedingly far from the 5th target of the Millennium Development Goals, which is to reach a number of 102 deaths per 100,000 live births by 2015.
The Indonesian Government’s effort to reduce the high rate of MMR, among others, is by implementing the National Health Insurance (JKN) programme. With the ratification of Law No. 40/2004 on the National Social Security System (SJSN) and Law No.24/2011 on the Social Security Agency (BPJS), on 1 January 2014 the National Health Insurance programme, or JKN Indonesia, was officially launched.
Women Research Institute (WRI) had conducted a research under the topic “Access and Utilization of Health Facilities and Services for Poor Women”. This research was conducted from April 2007 until April 2009 in 7 research areas namely Indramayu, Sumba Barat, Surakarta, Lombok Tengah, Jembrana, Lebak, and Lampung Utara. This research utilized quantitative method− survey and qualitative.
In general, this research was conducted with the aim of investigating the problems faced by poor women in accessing and utilizing health facilities. These problems were closely related to health facilities and services, family, and other social and cultural factors. This research was also aimed at finding the ways to improve health facilities so that women could utilize and have the access to good health services.
Women mostly become the poorest of the poor. Poverty is the reason underneath difficulties for them to have access for their rights, particularly for good health services. For more than 10 years there has not been a significant decrease for maternal mortality ratio (MMR) towards the target 115 in 2015.
This article is a summary of a case study of an issue in reproductive health services and childbearing mothers. This case study is taken from one of seven Districts in Indramayu, Surakarta, Lampung Utara district, West Sumba district, East Lombok district, Jembrana district, and Lebak district. It is describing the life story of Ponirah who lives in Lebak, Pasir Tanjung Village, Rangkasbitung subdistrict, Lebak regency.
Ponirah and the Story of her Reproductive Health
During her menstruation, Ponirah admitted to often experiencing problems relating to it. She often suffered from convulsion whose pain was like that of what was experienced by childbearing mothers. She felt painful colic’s. Ponirah said that during her girlhood, her menstruation blood was so much. But after getting married the amount of blood decreased.