By Johnson Tobing and Christine Panjaitan

"My name is Sri Wahyuni. I live in one slum area in Jakarta. My husband, Slamet Waluyo, works as a milk delivery man. He earns around two to three U.S. dollars a day. To help him earning enough for our daily needs, I opened a small stall in front of our house.

We have been married for five years and now I am carrying our second child... I am so happy and scared at the same time to wait for the delivery…… What should I do to stay healthy, and how to make sure my baby in the womb also stays healthy?

Then, if I give birth, what food I should give to my baby so that this child can grow well. Oh....so many questions in my head that I am curious to know, but I just get a headache thinking of it. I'm so scared....."

The struggle that Sri is facing is a common struggle faced by millions of mothers dwelling in pockets of poverty in sprawling cities like Jakarta. They are simple families. Some work as food vendors, some as daily labors, some work as drivers, and some as scavengers.

The high risk of death in mothers who are giving birth, along with so many cases of children born with abnormalities or low birth weight, are among the indications that knowledge of maternal and child health is still lacking in urban areas.

Community groups share the right information

As part of World Vision's Food Security and Nutrition strategy in Indonesia, Pos Bumil, or community support groups for pregnant and lactating mothers, began in September 2006 specifically to reach young mothers living in urban poverty.

Every Pos Bumil serves 10 to 15 pregnant mothers, facilitated with one midwife. Every month five meetings are conducted, with three of these allocated for health education and discussion, one day for pregnancy exercise, and one day for pregnancy check up.

At the meetings, young mothers learn about the development of fetus inside the womb, as well as what kind of nutritious foods are needed for mothers during pregnancy and lactation periods. They are provided with menus based on healthy, affordable, easy to find ingredients.

The pregnancy exercise is provided especially for mothers who are pregnant seven months and above, and whose pregnancies are progressing normally. They learn safe and comfortable positions for givingg birth and how to breathe correctly during labor.

Pos Bumil also promotes early initiation of breastfeeding and exclusive breastfeeding. The exclusive breastfeeding is recommended for six months, followed by introduction of various complementary foods to fulfill the baby's needs to grow and develop well.

After the five-day meeting at the Pos Bumil ends, support continues with home visits by the Midwife and the Village Health Volunteer or Cadres. They help to monitor the health of mother and child as the pregnancy develops, and motivate them to eat and live healthily.

Once the baby is born, more home visits help the mother to breastfeed correctly and understand the importance of good nutrition in the future.

In the 15 months Pos Bumil operated, around 1200 pregnant mothers have felt the benefits, through 30 separate groups in nine urban areas.

Measurable results for healthier children

One measurable impact of the programme is the increase in the number of mothers delivering in healthier and safer environment with health personnel instead of with the Traditional Birth Attendants.

Just as important is the improved awareness of mothers in these communities about the importance of breastfeeding for the growth of their babies.

When Mrs Yurlina, one of the Pos Bumil participants, delivered her second child, Nino, the Midwife who assisted the delivery offered Yurlina to give infant formula to her newborn.

With the knowledge she gained from the programme, this young mother had the courage to refuse the offer because she was determined to  give only breastmilk to her second child up to six months.

"After  learning from the Pos Bumil, I know how to breastfeed correctly, how I should position the baby, what are the benefits of breastmilk, knowledge that the first milk is very very important and should not be thrown away," says Yurlina. "I want to give my child only breast milk, as I was told by the facilitator from World Vision."

In the end, Mrs Yurlina was successful in giving exclusive breastfeeding to Nino and she also felt the benefits.

"Since he was born up to now, Nino never catches a disease. He's very healthy and very active. I can save money as well from not having to buy milk, and it's so practical because I don't have to prepare the milk, the bottle and the hot water," she explains proudly.