The Maternal Mortality Ratio (MMR) in Indonesia remains a major challenge in national health development. Based on data from the 2025 Inter-Census Population Survey (SUPAS), the MMR was recorded at 144 per 100,000 live births. Although this shows an improvement over previous years, the figure is still far from the Sustainable Development Goals (SDGs) 2030 target of 70 per 100,000 live births.
A lecturer at the Faculty of Medicine, Public Health, and Nursing UGM (FK-KMK UGM), Dr. Eugenius Phyowai Ganap, stated that achievements should be appreciated, but efforts to reduce maternal mortality must be strengthened. As a developing country, the 2025 MMR data show improvement, with a decline in maternal deaths per 100,000 live births.
“However, looking at the 2030 SDGs target, we still have significant work to do over the next five years to achieve it,” he said on Monday (Jun. 15).
According to Dr. Phyowai, the high maternal mortality rate is multifactorial. Healthcare workers’ availability is important, but must be supported by adequate infrastructure and an effective health system.
“We need a resilient health system. Good human resources will not be optimal if facilities are inadequate or if the referral system does not function properly. In addition, early detection capacity is also a very important factor,” he explained.
Through the Ministry of Health, the government has made efforts to improve the distribution of healthcare workers, including obstetricians. Yet several challenges in practice require stronger supervision and support mechanisms.
“A clear reward and punishment mechanism is needed so that healthcare workers who have received education and assignments can fulfill their responsibilities according to regional needs,” he said.
Dr. Phyowai explained that disparities in maternal mortality rates between regions are not solely determined by rural or urban areas. A more critical issue is the three delays that often arise in maternal emergency cases. The first delay is related to risk recognition and early detection at the family level or primary healthcare facilities. The second occurs during transportation and referral to more advanced healthcare facilities.
“The obstacles vary. In Papua, for example, they are related to geography, while in major cities, they may be caused by traffic congestion. In some cases, the large number of hospital options can also create confusion in determining the appropriate referral facility,” he explained. In obstetric emergencies, there is a golden period crucial to the survival of both mother and baby.
Furthermore, Dr. Phyowai explained that the MMR is calculated based on the number of maternal deaths per 100,000 live births. Therefore, birth control and pregnancy planning are essential in reducing MMR. Contraception plays a significant role in preventing unwanted pregnancies, thereby reducing maternal health risks.
“This is where contraception becomes very important. It helps prevent unplanned pregnancies so that maternal health risks can be minimized,” he said.
Currently, maternal deaths in Indonesia are still dominated by hemorrhage, hypertension in pregnancy or preeclampsia, and infections. However, Dr. Phyowai warned that new trends are emerging, such as an increase in maternal deaths caused by previously undetected comorbidities.
“We are now seeing a rising trend of deaths caused by other conditions, such as congenital heart disease that is only detected during pregnancy,” he noted.
To reduce these risks, Dr. Phyowai emphasized the importance of a preconception care approach. With this approach, women can understand their health before planning a pregnancy.
“Ideally, a woman should undergo a health examination before planning a pregnancy so that various risk factors can be detected and managed from the beginning,” he said.
He hopes increased public awareness of reproductive health, strengthened referral systems, equal access to healthcare services, and the implementation of preconception care will become strategic steps to accelerate the reduction of maternal mortality in Indonesia and help achieve the SDGs 2030 target.
Author: Jelita Agustine
Editor: Gusti Grehenson
Post-editor: Jasmine Ferdian
Photo: Magnific