International Journal of Indonesian Studies Volume 1, Issue 3 | Page 78

INTERNATIONAL JOURNAL OF INDONESIAN STUDIES
SPRING 2016
Development gaps
This next section discusses three main contextual factors related to the local issues of
maternal and neonatal health: firstly the development gaps within Indonesia, secondly the
environmental health conditions in South Central Timor and thirdly, a deeper investigation
of the traditional use of the ume kbubu.
Within Indonesia there are dramatic development and health service gaps. This
disparity can be found between various cores and peripheries. Commonly highlighted in the
wider literature is a clear urban-rural gap, see studies from Makowiecka K (2008), Erlyana E
(2011). The gap between the rich and poor is widened through vast income disparities
which are seen throughout Indonesia; see Budi Utomo (2011) and Suryadarma D (2006).
Perhaps most troubling is the vast inter-provincial development gap (UNICEF 2012).
Across the 33 provinces of Indonesia the province of NTT generally faces more
difficult public health conditions (UNICEF, 2012): lower government revenues, higher rates
of poverty, and poor health indicators (AIPMNH, 2008). There are also a range of health
system constraints such as dysfunctional referral systems, poor quality and low numbers of
key health workforce, as well as poor governance, weak accountability to clients and
communities and a range of other problems (AIPMNH, 2008). These difficult conditions are
further exacerbated by complicated environmental factors such as droughts, floods and
environmental health degradation. The cumulative impact of these factors further adds to
the prevailing disadvantage, structural inequality and stigma which separate the diverse
provinces of Eastern Indonesia from core Indonesia.
In a context of such diversity and inequality it becomes increasingly difficult to
implement wide-scale government health interventions. Nationwide studies, blanket
policies and interventions are unlikely to be able to pay adequate attention to diverse local
historical, cultural, socio-economic and environmental conditions. In order for programs to
be more effective a clear understanding of the local context is needed.
As a result, this study examines the specific context of Timor Tenggah Selatan (TTS).
Particular focus is given to the district’s unique conditions in terms of geography, local
public health systems, social cultural customs and beliefs, environmental health conditions
and the resulting government programs and interventions.
Environmental health
In essence, environmental health refers to all the physical, chemical and biological factors of
our environment that have the potential to influence health and behavior. According to the
World Health Organisation (WHO), at its broadest, environmental health addresses: all the physical, chemical, and biological factors external to a person, and all the
related factors impacting behaviours. It encompasses the assessment and control of
those environmental factors that can potentially affect health. It is targeted towards
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