Midwife Coordinator, Ibu Yuli, who was very awesome and very maternal.
Posyandu sign in Dukuh Kariya
Our interviews went pretty well, and we were learning a lot about services in this village. I previously talked about jampersal, a governmental program that will pay women to deliver in facilities. There are some challenges around it because the government will only reimburse the midwives 350,000 RP, when they might normally charge 700,000 RP or more. So, I think it’s a good program to get women into facilities, but I think its limiting midwives and creating a situation where they can start to corrupt the system (which we’ve already seen) by telling women that it costs only 100,000 or 150,000 Rp instead of 700,000 Rp and then they’re pocketing the 150,000 and getting the 350,000 Rp reimbursement from the government. Confused? Just read it again. The bottom line is that there are still kinks to work out and since the government hasn’t (and can’t) implement jampersal nationally, it’ll take awhile for the individual districts to work out the problems. That said, Dukuh Kariya took jampersal in a whole new direction. The private midwife who lives and works in the village is a government employee who also works at the puskesmas and earns a monthly government salary. Based on this, it appears that it wasn’t so much her decision to implement jampersal in the village as it was decided for her. We then learned that jampersal is accepted at her private facility as well as for HOME BIRTHS. That’s right, home births. The whole idea of this program is to get women to a safer facility, and now we’re offering them to stay at home and deliver for free. Problematic, for sure, but I had to remind myself – as I have to almost daily – that we’re not here to change things, we’re just here for data. This news was the biggest of the day because it was so odd. Since Indonesia decentralized, which I don’t know much about, the districts have more power than the national government and therefore decide what to use their money on. That’s why we see that Karawang has implemented jampersal and Minas, for example, hasn’t. Apparently the districts use the money for infrastructure instead of health, which isn’t exactly surprising. So, it was good to know that Karawang took the leap and started providing free deliveries for women, but it doesn’t sound like it was executed the best way.
Posyandu, filled to the brim with women and their children
Concerned mother with her newborn, talking to the midwife and village health worker about the progress of her baby's health
As I mentioned, our interviews went well with the exception of one woman who made me lose confidence in this research. She was in her mid-thirties, dressed to a T, wearing a satin dress with gorgeous embroidery and a beautiful hijab. Her features were striking, her skin not too light and not too dark, her eyes dark and seemingly full of life. I had high hopes as she walked into the room and sat down. She was pregnant and told us that her plan was to deliver at a private midwife’s clinic because she thought it was safer for her and her baby. These are the women that make me jump up and down with joy. But, as the interview continued she slipped up and told us that she actually wanted to deliver at home because it was more comfortable, and that she lied to us because she was scared. My frustration comes in that, is this happening often? Are we getting responses because women are scared or are the telling us what they think we want to hear? How many respondents are doing this? And what do I do with this woman’s interview? My initial feeling is to throw it away, which is probably what I’ll do, but it’s frustrating to think that more of our responses might have this problem and we don’t know about it.
The gorgeous landscape and rice fields of Karawang