Cash vouchers help improve maternal health in post-disaster areas – Indonesia

When Semeru volcanic eruption On December 4, 2021, hitting the village of Sumber and Loh where she lives, Safa Aten Ridu, 26, was forced to flee with her husband to her husband’s home in Jember, about 89 kilometers east of Sumber and Luo, Lumagang Regency, East Java. She was three months pregnant. “We stayed in Jember for two weeks, then moved to my aunt’s house in Lumajang for a week. I came home after three weeks,” Safa recalled. “Although the situation was stable back then, I was afraid because Sumber and Luo were still a red zone.”

Women and girls are particularly vulnerable in emergency situations. In addition to physical and mental health risks, pregnant and postpartum women often face barriers to the maternal and reproductive health services they need to ensure a healthy pregnancy and safe delivery. When disaster strikes amid the COVID-19 pandemic, women face multiple layers of risks and burdens.

The United Nations Population Fund (UNFPA) works with Yayasan Kirti Praga, provincial and district health offices to provide cash voucher assistance to 300 pregnant women in urgent need of life-saving reproductive health assistance in three post-disaster districts, Solomon (Yogyakarta), Lumagang (East Java), Basaman and West Basaman Barat (West) Sumatra). Cash assistance is part ofPaulé Bersama: Rapid Response to COVID-19 and UNFPA Emergency Fund(C-Surge Pulih Bersama) with support from the Australian Department of Foreign Affairs and Trade (DFAT).

Through cash transfers, pregnant women are empowered to access life-saving health interventions to prevent maternal deaths. After each appointment they attend, they will receive cash through bank transfers. Each woman will receive a maximum of IDR 700,000 (about US$46) to cover transportation to access antenatal care (ANC), delivery services, postpartum care (PNC) services, and purchase hygiene items and nutritious complementary foods for mothers or newborns or cover any other additional costs related to obtaining health services. Nutrition packages and maternal health classes are also part of the intervention.

Impact of disasters on maternal health

Fortunately for Safa, one of her husband’s relatives in Jember is a midwife. Therefore, in the event of displacement, she can still consult a health worker about her pregnancy. “I was worried at the time because I had to run during the eruption. I didn’t even remember I was still early in pregnancy (when I was running). So I had to make sure he was ok,” she said. She was also visited by a midwife at her aunt’s house in Lumagang.

However, the disaster still affected her and her pregnancy. Her waters broke early, so she had to have a caesarean section to deliver. “The midwife took me to the community health center (puskesmas)…when I almost ran out of water but the baby hadn’t come out yet, I was referred to the hospital,” Safa recalls. “Thank God, everything went well.”

Safaa believed that the stress of the volcanic eruption contributed to the complications she experienced during labour. “Even now I still get scared when it’s dark or when it’s raining… In the hospital, the doctor and midwife warned me not to get too nervous,” she said.

Her three-month-old is feeling the effect, too. “I still can’t breastfeed my baby. I tried many methods but nothing worked because of the stress. Safa explained that I had to feed the baby with formula.

Safa used the cash assistance to buy milk for her baby. “Once I got the cash, I bought the milk. I used all the money to buy the milk,” she said. “The cash help really helped.”

After her husband lost her job at a local lumber mill after the Semeru eruption, Safa and her family relied on selling iced drinks at home to make a living.

“The cash voucher assistance came at the right time, when all humanitarian assistance was stopped,” said Ernie Iriuni, midwife coordinator at the Penangal Community Health Center (puskesmas), about 4 kilometers from Sumber and Luo. “It really helped us because we really need comprehensive post-disaster assistance,” she continued.

Reproductive health education saves lives

As part of the overall response, C-SURGE Pulih Bersama provided maternal health classes to cash voucher assistance recipients. From these classes, Safa gained critical knowledge about sexual and reproductive health that you need as a new mom.

I learned a lot about family planning. I didn’t know much about family planning. Through the classes I’ve attended, I’ve learned that there are many ways to plan a family…and there’s no need to be afraid of side effects. With all the information she received, Safaa now knows what is the best method of contraception for her. “I think an IUD would be best for me because it’s simple and can last for years.”

People say that first breast milk should be discarded. But I learned from the classes that first breast milk is really good.”

Additionally, Safa has gained a new support system through classes. “I have never participated in gatherings with other pregnant women in the village before,” she said. “Now I can increase my knowledge and share it with my colleagues.” Safaa said she will continue to go to such classes after the program ends. “These classes are important for pregnant women, especially since it was my first pregnancy,” she said.

“I am really grateful for the help as it has really benefited me and my family… I hope this program will continue so that more people can benefit from it,” Safa concluded.

Midwife Ernie echoed Safa’s hopes. “The cash voucher has really helped the women and health workers here,” she said. “I hope the program will be extended into a comprehensive program that not only assists post-disaster pregnant women but also other reproductive health sub-cluster goals.”

Rahmi Diane Agostino

Communications Analyst, UNFPA Indonesia

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