International Journal of Public Health Science (IJPHS) Vol.5, No.1, March 2016, pp. 84 ~ 93 ISSN: 2252-8806  84 Journal homepage: http://iaesjournal.com/online/index.php/IJPHS The Effort to Decrease Maternal and Child Mortality Rates through Cultural Transformation Atik Triratnawati, Rani Ditya Kristianti, Aldo Pandega Putra, Pandu Bagas Setyaji Dept. of Anthropology, Faculty of Cultural Sciences, Universitas Gadjah Mada, Yogyakarta, Indonesia Article Info ABSTRACT Article history: Received Nov 26, 2015 Revised Dec 22, 2015 Accepted Feb 26, 2016 Maternal and infant mortality in Ende is still high, but research related a social science is rare. The cultural aspect and medical factors such as the lack of primary health care services are also play a role. This study aims are to identifying and formulate the local cultural transformation as a way to solve maternal and infant mortality. This ethnographic research was conducted in 2013. The study carried not only interviews, but also observation towards reproductive-age women, heads of family, traditional birth attendants, doctors, midwives, local leaders, adat leaders, pastors and sisters, local government officials, and head of health district at Ende. Data is analysed phenomenologically. The strong belief to adat and local tradition has implication to people’s attitude towards traditional birth attendants. Traditional birth attendants hold superior position in the community. They also have strong influence due to their ability to massage, correctly guess infant’s sex, reposition infant in the womb, and stop bleeding during labor. Maternal and/or infant mortality has nothing to do with traditional birth attendants because local people believe that such case happens as a result of hex or black magic called ru’u. Anemia, bleeding, food taboo, and incorrect diet pattern worsen the overall condition of pregnant women. Cultural transformation is done by alternating TBAs practices in massaging pregnant women. TBAs are encouraged to massage pregnant women’s back instead of stomach since pregnant women often have to deal with low back pain during pregnancy. Keyword: Cultural transformation Ende Massage Maternal and infant Mortality Nutrition Copyright © 2016 Institute of Advanced Engineering and Science. All rights reserved. Corresponding Author: Atik Triratnawati, Dept. of Anthropology, Faculty of Cultural Sciences, Universitas Gadjah Mada, Yogyakarta, Indonesia, Sosio Humaniora 1, Bulaksumur, Sleman, D.I. Yogyakarta. Email: atik_triratnawati@yahoo.co.id 1. INTRODUCTION Maternal and infant mortality is still one of the main public health problems in Indonesia, including in East Nusa Tenggara (ENT). Total fertility rate in ENT of 4.2 is the highest in Indonesia, while infant mortality rate in every 1000 birth is 57 – second in the country after West Nusa Tenggara 1, 2. Both local and central government have attempted various ways to decrease this maternal and infant mortality rate with no significant impact. Since 2009, the local government has implemented a program called Revolution of Maternal and Infant Health with its jargon: “if one person comes, two or more persons return. It is not acceptable if only one person return.” This illustrates the importance of going back from giving birth with one or two babies (twin), and avoiding the death of either mother or child or even both. In this program, it is not acceptable to have dukun bayi (Traditional Birth Attendants) helping the birthing process. Every pregnant woman must only go to health facilities such as Puskesmas or PHC (Primary Health Center) 3. However, the implementation of this program is challenged by the limited number of health personnal such as specialist. In