HRH2030 Indonesia: Optimizing the Maternal and Newborn Health Workforce

Why Maternal and Newborn Health Needs Special Attention

Indonesia remains one of the largest contributors to global maternal and neonatal mortality. According to the latest Ministry of Health data, the maternal mortality ratio (MMR) stands at about 177 deaths per 100,000 live births, while the neonatal mortality rate (NMR) is roughly 13 per 1,000 live births. These figures reflect gaps in:

• Geographic access to skilled birth attendants, especially in remote islands and mountainous regions.
• Availability of midwives and obstetricians with uptodate clinical competencies.
• Continuity of care from antenatal through postnatal periods.
• Supportive work environments that retain health workers in underserved areas.

A welltrained, motivated, and appropriately deployed workforce is the single most important determinant of safe childbirth. WHO, 2022

HRH2030 Vision for Indonesias MNH Workforce

By 2030, HRH2030 aims to create a resilient MNH workforce that:

• Provides universal access to skilled birth attendance and emergency obstetric care.
• Ensures at least 80% of midwives are competent in evidencebased practices.
• Reduces inequities in workforce distribution between provinces.
• Promotes a supportive policy and financing environment for retention.

Strategic Priorities

1. Strengthening Education and Training

Revise curricula for midwifery and obstetrics to align with WHO/UNICEF standards.
Expand competencybased learning, simulation labs, and elearning platforms.
Institutionalize continuous professional development (CPD) with mandatory recertification every five years.

2. Optimizing Workforce Distribution

Implement a datadriven deployment model using geographic information systems (GIS) to map gaps.
Offer incentive packages (housing, hazard pay, careerpath opportunities) for postings in underserved districts.
Strengthen the Village Midwife program with clear career ladders and remotesupervision tools.

3. Enhancing Quality of Care

Introduce standardised clinical protocols for antenatal, intrapartum, and postnatal care.
Deploy digital decisionsupport tools at primary health centers (Puskesmas).
Establish routine audit cycles (maternal death reviews, newborn case reviews) with feedback loops.

4. Improving Working Conditions and Retention

Ensure safe staffing ratios: at least one skilled birth attendant per 10 deliveries in primary facilities.
Provide mentalhealth support, mentorship, and leadership training for frontline staff.
Introduce performancebased financing that rewards quality outcomes rather than volume alone.

5. Strengthening Governance and Financing

Integrate MNH workforce planning into the national health financing strategy (BPJSKesehatan).
Allocate a dedicated budget line for MNH workforce development (target 1% of total health expenditure).
Foster multisectoral coordination with education ministries, local governments, and professional associations.

Key Interventions under HRH2030

1. National Midwifery Strengthening Initiative (NMSI) a 5year program to train 30,000 new midwives, upgrade 15,000 existing cadres, and embed elearning modules on emergency obstetric care.
2. Mobile Mentorship Units equipped vans travelling to remote districts providing onsite coaching, skills drills, and teleconsultation links to obstetric specialists.
3. Digital Registry & Dashboard a realtime platform tracking workforce distribution, competency certification, and service coverage for rapid policy adjustments.
4. Incentive & Rural Service Bond a tiered incentive package (financial, housing, schooling for children) linked to a 3year service commitment in priority areas.
5. Quality Assurance Networks provincial clusters of hospitals and Puskesmas that share best practices, conduct joint audits, and publish quarterly performance reports.

Monitoring and Evaluation Framework

The HRH2030 MNM (Maternal & Newborn) Monitoring Framework follows a resultsbased approach:

• Input Indicators: number of trained midwives, number of facilities equipped with simulation labs, budget allocated.
• Process Indicators: proportion of facilities using digital protocols, frequency of mentorship visits, CPD completion rates.
• Output Indicators: skilled birth attendance coverage, emergency obstetric care (EmOC) availability, average time to referral.
• Outcome Indicators: maternal mortality ratio, neonatal mortality rate, proportion of births attended by certified midwives.

Data are collected quarterly through the Ministry of Healths Health Information System (SIMRS) and reported to the HRH2030 Steering Committee for midterm adjustments.

Expected Impact by 2030

If fully implemented, the HRH2030 MNH workforce strategy is projected to achieve:

• Increase skilled birth attendance from 84% to 96% nationwide.
• Reduce maternal mortality by 60% (from 177 to <70 per 100k live births).
• Lower neonatal mortality by 30% (from 13 to <10 per 1k live births).
• Achieve equitable workforce distribution, with the underservedprovince gap narrowed from 45% to 12%.
• Improve health worker satisfaction scores by 25% through better working conditions and career pathways.

How Stakeholders Can Contribute

Policy Makers adopt the national workforce plan, allocate sustainable financing, and enact supportive legislation for rural service bonds.
Educators & Training Institutions revise curricula, adopt competencybased assessments, and partner with health facilities for practicum placements.
Health Facility Leaders implement mentorship programs, ensure adequate staffing, and foster a culture of continuous learning.
Community & Civil Society advocate for safe maternal services, participate in local health committees, and monitor service quality.
International Partners provide technical assistance, support scaleup of digital tools, and cofund research on innovative service delivery models.

Further Reading & Resources

• World Health Organization Health Workforce
• Ministry of Health, Republic of Indonesia
• UNICEF Indonesia Maternal & Newborn Health
• Global Health HRH2030 Initiative

Contact

For queries about the HRH2030 maternal and newborn health workforce program, please email hrh2030@kemkes.go.id or call the Ministry of Health hotline at +62211500555.