Interview:

POGI Vice President/President Elect

dr. Poedjo Hartono, SpOG (K)

1. Based on the above statement, what are your views about the maternal
healthcare situation in Indonesia?
I think it is true that Indonesia is currently overloaded with midwives, to the
extent that those better qualified ones are exported abroad. Most midwives
are posted to maternity hospitals which directly reach out to the public, only a
few are in central hospitals. In some ways it has helped reducing the rate of
infant mortality, however there are other factors that are important as well, and
fetal monitor is only one of them.

2. How are fetal monitors used in Indonesia?
Fetal monitors are standard facility that hopitals are required to have in order
to perform early fetal checking, ICU monitoring, as well as uterine
contractions. It is vital in helping us doctors to decide on what action and
medical procedures we have to carry out later on.

3. Do you think equipping hospitals with fetal monitors are important?
Why?
Of course since it is a standard exercise to use fetal monitors to identify the
condition and situation of the child.

4. Do you think hospitals in Indonesia are sufficiently equipped with fetal
monitors? Why?
Based on my observation, hospitals are already sufficiently equipped with
various maternal healthcare facilities including fetal monitor. There are even
hospitals and clinics that provide continuous fetal monitoring should the need
arises.


5. If hospitals are short of fetal monitors, can you elaborate on this
shortage? Like for example how many fetal monitors should be installed vs
current situation.
I think we do not have a shortage of fetal monitors. As I have mentioned
earlier, it may be true that fetal monitor decreases the rate of fetal mortality,
however it is only a small factor. The rate of fetal mortality is actually mostly
due to premature birth and infections. We rarely see a case of neonatal death
during delivery. Furthermore, in my opinion the true challenge for maternal
healthcare is peoples mindset and cultural lag that prevent us to provide the
best service for them. For example, many middle to low income families still
choose to use witch doctors for delivering babies. There is also a problem
when we refer a patient to another better equipped hospital, the patient
usually does not want to be referred to more expensive hospitals. Therefore,
although we have sufficient maternal healthcare facilities, imperfect
information on the patients part becomes an obstacle for us to provide
maternal health services.

6. What brands of fetal monitors are present in Indonesia?
7. What are the top 5 most popular brands that you know of?
As doctors, we are less aware of the brands of fetal monitors as they are
operated by midwaves. We are more brand concious for USG and other
equipments since we operate those machines by ourselves. But for fetal
monitors, we only evaluate the data passed on by midwives.

8. We estimated that the number of fetal monitors in Indonesia now is ~
2800 units. It has grown 11.8% per year from 2008. Do you agree with what
we see? Why?

It is true that the number of fetal monitors have increased significantly during
that period.

9. What do you think is the cause of such growth? We believe that is the
influx of Korean and Chinese Chinese brands, what do you think?
In the market we usually see Sony and Samsung which are Chinese,
Japanese and Korean brands.

11. Moving forward, we believe that the Chinese and Korean brands will be
popular than the international brands as there are cheaper. Do you think this
is true?

For hospitals, of course we should prioritise on quality over the price of
products so as to maintain the quality service standard of our hospitals.
However, in my opinion it is also important to have cheaper brands so as to
minimise cost, and this does not necessarily means that the quality of our
services will also decline since I see the trend that the quality of Chinese and
Korean products have levelled with those of other established brands.
However, in terms of endurance, Chinese and Korean brands are pretty weak.
10. The uptake of fetal monitors will slow down and they will not be as fast
growing as the period between 2008 to 2012 as we think that growth will be
mainly driven by natural replacement and purchases by new hospitals and not
so much of existing hospitals buying more units. Do you agree with our
statement? Why or why not?
12. What do you think will be the future trends for the uptake of fetal
monitors?
I believe it may decline since fetal monitors are not equipments that we have
to replace often, one installment would last for a long time. However, this may
depend on the change in insurance policy in Indonesia, which I see will occur
next year. The insurance policies are planned to cover more on various
healthcare, and hence the changes will affect how we provide the equipments.
If insurance companies decide to have more profit, which is very likely, they
will cut off the use of high-end equipments such as fetal monitors, and we will
see further decline on the market of these equipments. Yet, we cant tell for
sure since this is still a much anticipated change, but very likely there will be a
change in the pattern of healthcare provision in Indonesia next year.

13. When do you think Indonesia will try to adopt OBIT? Do you think OBIT
will be useful to Indonesia? Why or why not?
Our maternal healthcare services are already centralised to a data centre in
Indonesia, like those in Singapore and Australia.