Successes in Safe Delivery and Immediate Exclusive Breastfeeding IEBF

Safe Delivery and Immediate exclusive Breastfeeding 9 www.kinerja.or.id 3. Program Continuity Initiatives already implemented by KINERJA in partner districts and health centers can only be sustainable with the full support of district governments. Changes already achieved through KINERJ A’s governance-based approach are being continued through the allocation of district government budgetary funds. This ensures that the changes at the health center level will remain in place, allowing the centers to become stimulants and places of learning for other health centers. 4. Scope of the Document This document consists of 4 chapters. Chapter 1 presents the general approach of KINERJA, KINERJA’s programs in the health sector, and KINERJA ’s governance principles as they relate to safe delivery and IEBF. Chapter 2 describes KINERJA ’s experiences in supporting the inclusion of governance in safe delivery and IEBF, and how KINERJA’s implementation phases occurred, from start to end. Chapter 4 contains recommendations for various stakeholders on how to replicate KINERJA’s programs. 5. Recommendations a For District Heads KINERJA ’s governance approach – that is, supporting both the supply and demand sides – has been proven to improve public service delivery in just two years of assistance. This approach can then be gradually replicated and expanded to all facilities in the health service in line with regional budgets. Expansion and development requires a number of basic elements, including : 1. High level of commitment from District HeadMayor, legislative assembly, and District Health Office ; 2. An assistance period of 2-3 years for establishing and assisting MSFs ; 3. Creative innovations and incentive systems for service providers and recipients ; 4. Strong coordination and monitoring between district health offices and community health centers ; 5. Strong leadership by governments and the private sector in providing breastfeeding rooms, facilities and counselors in workplaces and public places ; 6. Strong contribution by local media, community health ambassadors, and MSFs to consistently and voluntarily oversee campaigns on safe delivery and IEBF. b For Future Implementing Organizations IOs conducting advocacy on public service delivery can play a significant role in improving services and strengthening local policy. Through KINERJA ’s participatory approach, IOs are able to accelerate and enrich the health care improvement process in their region through working closely with district health Ringkasan Tata Kelola Persalinan Aman, Inisiasi Menyusu Dini dan ASI Eksklusif 1 www.kinerja.or.id offices, health centers, and other stakeholders. The adoption and implementation of materials already developed by KINERJA is ane option that has been proven to make positive changes in a period of just 1 to 2 years of assistance. The key to success of the KINERJA’s 2-year implementation was due to 1 strengthening of IO personnel using KINERJA’s governance approach, ensuring sustainability during the implementation process, particularly if reinforced by universities, training institutions, and local champions; and 2 choosing community movements already rooted and active in the community . c For Education and Training Institutions Training institutions and universities are recommended to incorporate KINERJA ’s governance approach into their curricula and training materials, alongside a strong gender perspective, in order to enhance the knowledge and skills of health officers . Safe Delivery and Immediate exclusive Breastfeeding 11 www.kinerja.or.id

CHAPTER 1 KINERJA

’S APPROACH General Approach of the KINERJA Program USAID-KINERJA is a technical assistance program for 24 districts and cities in five provinces of Indonesia: Aceh, West Kalimantan, South Sulawesi, East Java, and Papua. Kinerja focuses on supporting good governance in public service delivery in the health, education and business licensing sectors. KINERJA offers packages in these sectors to regional governments through a comprehensive approach to capacity building, assisting both the service provider side as well as service users. Working with the two different sides, it is hoped that efforts to achieve good governance will be quicker, more sustainable, and more easily replicable. KINERJA supports service providers through internal capacity building on policies, program management, and supporting active public participation. Community members, for example, were educated on their rights to public services such as healthcare and education, and their participation was strongly encouraged through service provider- led activities. In KINERJA’s partner districts, community members are now more frequently and more deeply involved in policy formulation, planning, implementation, and monitoring and evaluation. At the health centre level, community forums were established to allow community members to carry out supervision, advocacy, and monitoring. KINERJA worked with local stakeholders to identify potential participants who possessed high levels of commitment, interest, and influence. Forum members were then trained and assisted by KINERJA staff in carrying out their activities. KINERJA implements its programs in coordination with local organizations that possess the right experience, expertise and skills to provide technical assistance at the districtcity level. These organisations are known as implementing organisations or IOs. KINERJA developed the overall intervention design and formulated programs, while the IOs themselves developed implementation strategies by adpating KINERJA ’s program to the local conditions, as is related in these modules. IO facilitators were trained prior to beginning cooperation with the district governments and health offices in order to ensure they have the ability to provide technical assistance to KINERJA partners. In the future, it is hoped that these IOs will become the partners of district government s following the end of KINERJA’s official implementation period, and will be able to continue to provide technical assistance to the district governments to ensure long-term sustainability and replication. Summary: Governance in Safe Delivery and Immediate Exclusive Breastfeeding 12 www.kinerja.or.id 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