This is the first article in a four part series about health in Indonesia
Cynthia Hunter
Medical students learning to be doctorsIT Department, Andalas University |
Health, illness and medicine (both traditional and modern) are never far from people's minds in Indonesia. The country's insular character, large population and varying levels of infrastructure pose particular challenges to those concerned with public health. At the same time, development program rollouts and the wide range of regional health and medical issues mean that many approaches are taken to change and advance the health status of the nation.
One of the biggest challenges faced by doctors and health bureaucrats is knowing precisely what problems they face and how effective particular programs may or may not be. The three articles that follow showcase the kind of painstaking research that underpins efforts to better equip health professionals and Indonesian citizens with the knowledge they need. The first two have been written by Indonesian postgraduate students on scholarships at Australian universities, while the third is the product of a collaboration between Indonesian medical research institutions.
In the first of the articles, Nur Afrainin Syah, an academic from a medical school in Sumatra, explains the steps required to reform medical education so that more and better trained medical doctors are available to meet the nation's burgeoning needs. She makes a strong case for the introduction of more rigorous and robust assessment guidelines for medical students in training, while at the same time outlining some of the resource issues facing Indonesia's medical schools.
The second article, by Susy Sebayang, describes the implementation of a health intervention in a number of Lombok villages, in which pregnant women's diets were supplemented with 15 micronutrients instead of the two recommended by government policy. Part of a global initiative, the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT) introduces the concept of community facilitators, who make regular home visits to support and educate pregnant women about the benefits of micronutrient supplements. The facilitators also assist village midwives by acting as go-betweens, linking women with available maternity services. The success of this intervention has been confirmed by a significant reduction in maternal and infant mortality rates in a region where they have for many decades been the highest in the country.
The third article describes a collaboration between the Burnet Institute in Indonesia and Bali's Udayana University, in which researchers examine the pregnancy-related knowledge, attitudes, beliefs and practices of expectant fathers, pregnant women, young men and women, and older women. The aim of the project is to help expectant fathers become more involved in their wife's pregnancy and in the care of their newborn children. The findings have led to the development of new information materials for policy makers and health officials designed to improve health services and make them more user-friendly for all.
All three articles demonstrate the importance of culturally sensitive research that is clearly located in a particular region but also provides insights and research models that can be transported to other regions of Indonesia. It is this kind of research that makes a difference to the health status of Indonesian citizens and the competence of providers of medicine and health care.
Cynthia L. Hunter (cynthia.hunter@sydney.edu.au) is a medical anthropologist who lectures in International Public Health at the University of Sydney.