KINERJA 6592f5fd f0ea 4b5b a345 425c1b49f3cb
Summary: Governance in Safe Delivery and Immediate Exclusive Breastfeeding
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Health Sector Initiatives
Maternal and child health is one of the main mid- and long-term health priorities of the Indonesian national government. As such, KINERJA supports the government through two programs: 1 Safe Delivery, and
2 Immediate and Exclusive Breastfeeding IEBF. The national government aims to see improvements in these areas through the achievement of minimum service standards MSS. KINERJA’s hypothesis is that strong
relationships between the supply and demand sides will lead to sustainable and systematic improvement of health care delivery.
KINERJA’s support focuses on improving four areas: laws and regulations, management, multi-stakeholder forums, and health promotion strategies.
Through its implementing organizations IOs, KINERJA worked to initiate the development of district head regulations on safe delivery and immediate exclusive breastfeeding. These regulations were developed with
the involvement of many different stakeholders throughout the entire process – from situational analysis through
to the formal legalization of the regulations. KINERJA’s approach to strengthening health center management encompasses three different types of
management: institutional management, program management, and service management. Institutional management improves planning and budgeting at the health center level. Program management supports
the safe delivery program through developing midwife-traditional birth attendant partnerships, pregnancy classes, and pregnancy information systems. For IEBF, program management focuses on ensuring
breastfeeding groups and ambassadors are active, and that breastfeeding rooms are available. Service management includes developing service charters, standard operating procedures SOPs, and creating
complaint management mechanisms. Multi-stakeholder forums MSFs in the health sector act as the in-between for the supply and demand sides.
With members consisting of all parts of society – citizen journalists, local media, districtcity health office staff,
health center staff, legislative members, community figures, religious leaders, and others – the MSFs are able to
play an active role as supervisors, advocators, and motivators for improvement in service delivery. KINERJA supports the community, health sector and other government sectors to engage in promoting safe
delivery and IEBF. KINERJA strongly encourages health service providers to allocate funds from their budgets for promotional activities, such as awareness raising programs. The community can then become
actively involved in promoting safe delivery and IEBF – for example, KINERJA has supported service
providers to carry out education programs for religious figures, bridal make-up artists, and vegetable sellers so that they can use their knowledge to encourage others to breastfeed. Another success is that other
sectors such as the District Education Offices and Religious Affairs Offices now include time for health promotion when conducting their routine activities. For instance, some district offices now run reproductive
health education programs for students, and provide maternal health information during mandatory pre- wedding consultations to brides and grooms. In fact
, in some districts, the district’s highest officeholders District Head and Mayor have even become breastfeeding ambassadors.
Ringkasan Tata Kelola Persalinan Aman, Inisiasi Menyusu Dini dan ASI Eksklusif
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KINERJA ’s support for safe delivery and immediate and exclusive breastfeeding aligns with the five
strategies of the Indonesian Ministry of Health and the World Health Organization: 1.
Improving access and quality. 2.
Encouraging service providers to develop standard operating procedures through referring to existing literature or policies and by including the community. KINERJA goes one step further and
encourages health centers to not just develop SOPs but to display them on walls and doors. This ensures the community is better aware of their healthcare rights. SOPs thus become tools of
accountability and transparency in health care delivery. 3.
Enhancing partnerships and empowering families and the community. KINERJA primarily achieved this through establishing MSFs and supporting their involvement in supervision and advocacy for
improvements in services. KINERJA also assisted health centers in increasing the number of pregnancy classes for women at the village level, and in developing participatory and accountable
partnerships between midwives and traditional birth attendants. 4.
Improving supervision and health information systems. KINERJA here focuses on the revitalization of pregnancy information systems which list all pregnant women in the surrounding area. The systems
are created in such a way that health center management knows the whereabouts of pregnant women, what their risk level is, and when they will give birth. This ensures that management can
instruct midwives to stand by and be ready. The non-medical parts of this information is also shared with the MSFs and village heads so that they can be prepared to provide help the mother in question
if required, such as through assisting with arranging transport or blood donation. 5.
Increasing health funding. KINERJA here works to improve budgeting and planning, and to ensure that adequate funding is provided and used for safe delivery and IEBF. MSF members are
supported to act as community representatives during budget development, and are encouraged to actively supervise its implementation.
Based on the above strategies, KINERJA designed activities to work with both the supply and demand sides. Some principles that characterize KINERJA
’s program are:
1. Not developing new innovations, but adopting models that have already been tested by the
government, universities, development partnersdonor institutions, and others. 2.
Technical assistance conducted by Implementing Organizations IOs with an emphasis on using and building local resources.
3. Enriching public services by applying aspects of good governance, comprising the elements of
participation, transparency, responsiveness and accountability of service providers. 4.
Promoting replication by regional governments in both partner and non-partner regions. 5.
KINERJA supports programs that are synchronous with the National Medium Term Development Plan RPJMN, Regional Medium Term Development Plan RPJMD and Regional Sector Strategic
Plan Renstra, as well as achievement of Minimum Service Standard MSS in health.
Summary: Governance in Safe Delivery and Immediate Exclusive Breastfeeding
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6. At national level, KINERJA coordinates with relevant ministries: the National Planning Body
BAPPENAS, the Directorate General for Regional Autonomy, and the Directorate General of General Government. A Coordinating Team was established based on need, involving the National
Planning Body Bappenas, Ministry of Health, Ministry of Internal Affairs, Ministry of Education, Ministry of State Administrative and Bureaucratic Reform, and others.
Ringkasan Tata Kelola Persalinan Aman, Inisiasi Menyusu Dini dan ASI Eksklusif
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www.kinerja.or.id