Mortality in Central Java: results from the indonesian mortality registration system strengthening project

Background. Mortality statistics from death registration systems are essential for health policy and development. Indonesia has recently mandated compulsory death registration across the entire country in December 2006. This article describes the methods and results from activities to ascertain causes of registered deaths in two pilot registration areas in Central Java during 2006-2007. The methods involved several steps, starting with adaptation of international standards for reporting causes of registered deaths for implementation in two sites, Surakarta (urban) and Pekalongan (rural). Causes for hospital deaths were certified by attending physicians. Verbal autopsies were used for home deaths. Underlying causes were coded using ICD-10. Completeness of registration was assessed in a sample of villages and urban wards by triangulating data from the health sector, the civil registration system, and an independent household survey. Finally, summary mortality indicators and cause of death rankings were developed for each site. Findings. A total of 10,038 deaths were registered in the two sites during 2006-2007; yielding annual crude death rates of 5.9 to 6.8 per 1000. Data completeness was higher in rural areas (72.5%) as compared to urban areas (52%). Adjusted life expectancies at birth were higher for both males and females in the urban population as compared to the rural population. Stroke, ischaemic heart disease and chronic respiratory disease are prominent causes in both populations. Other important causes are diabetes and cancer in urban areas; and tuberculosis and diarrhoeal diseases in rural areas. Conclusions. Non-communicable diseases cause a significant proportion of premature mortality in Central Java. Implementing cause of death reporting in conjunction with death registration appears feasible in Indonesia. Better collaboration between health and registration sectors is required to improve data quality. These are the first local mortality measures for health policy and monitoring in Indonesia. Strong demand for data from different stakeholders can stimulate further strengthening of mortality registration systems

Kesehatan Anak Dan Bayi Baru Lahir Di Kota Bekasi (Newborn and Child Health in Bekasi Municipality)

Newborn and child health is a main principle issue to be examined due to its close relationship to newborn and child mortality and morbidity, as well as maternal health during pregnancy, labor or puerperal period. The National Household Health Survey 1995 revealed a low prenatal mortality rate in Indonesia(48 per 1000 births). This particular indicator allows in assessing the health status of children and newborn, as well as to assess reproductive health services in relation to the development policies or inhealth service practices. The assessment of reproductive health is important to be conducted, taking into account the coverage of weighted newborn, prevalence of LBW and abortion, as well as the coverage of breastfeeding practices and supplementary food consumption. This study also aims to provide baseline data and considerable inputs for policy makers. Survey was conducted in Bekasi municipality (September 2002), with a cross-sectional study design. Samples are 210 mothers who have been pregnant and delivered within a year before time of interview. The results show that 95% infants were weighed after delivery, 95% mothers had breastfed and 71% of those still breast feed until time of interview. In terms of supplementary food consumption, 44% children consume a combination of rice, vegetables, and fish/meat, while 33% received bottled milk. The prevalence of abortion is 12%. It is found that health services for children and newborn should be improved, by promoting the importance of breastfeeding and supplementary food consumption. Inter sector collaboration across programs should be endorsed, to increase health status of mother and child