Saving the Lives of Mothers in Indonesia

By Presha Rajbhandari

In Indonesia, more than 400 women in 100,000 live births die as a result of complications during childbirth, compared to 13 in the United States. To prevent these tragic deaths, Jhpiego has worked with communities in Indonesia to create a referral system called Desa SIAGA (“ALERT village”).

Based on the results of a USAID-funded pilot program in Indonesia, Jhpiego developed the Desa SIAGA system to assist communities to identify resources for pregnant women and improve the quality of health services. The system has four major elements:

• Identify and track all pregnant women in the community,


• Assure that transportation is available to move mothers to the next higher level of the health care system should complications arise – in a timely and responsive manner,


• Assure a blood supply is available for women experiencing complications that require blood transfusion, and


• Participate through in-kind or cash donations to sponsoring the three elements of Desa SIAGA listed above

The program uses community volunteers called Kaders to work with the community leaders to raise the profile of maternal health and organize the community to address the needs of pregnant women. Neighbors, relatives or family members inform the Kader of all pregnancies.  The Kader then informs a local bidan (village midwife). 

Kaders also register cars and vehicle owners to assist families if childbirth complications should occur and the mother would need to be taken to a health facility or hospital. A funding system to pay for health care expenses is established in each village with contributions from community individuals. The funds are provided to families in need without the expectation of reimbursement. Blood types are identified for people in the community who could serve as blood donors in cases such as surgery and postpartum hemorrhage. In addition, the Kaders set up routine schedules for blood donations in collaboration with the Indonesia Red Cross.

In partnership with private donors such as Chevron, ExxonMobil, BP and Rio Tinto, Jhpiego has been able to establish 166 models of Desa SIAGA with 306 community volunteers and 928 health workers serving more than 85,000 women in Indonesia.

Based on the success of Desa SIAGA, the Indonesia Ministry of Health adopted it in 2005 as part of its approach to reduce maternal and child deaths nationwide. Today, it is part of a government strategy set for a national level expansion. In addition to maternal and newborn health, the Desa SIAGA system will also be used for other health emergencies such as dengue fever outbreaks, avian flu and natural disasters.

Desa SIAGA represents a collaborative effort to save lives of new mothers and their children. Desa SIAGA has also emerged as an excellent platform for pubic-private partnership that allows private entities to contribute to government strategy and make a visible impact in the community.