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management. The next phase involved holding district-level consultations for all KINERJA partner regions. These
consultations were in the form of Focus Group Discussions FGD. Consultations were held at the District Health Offices or District Planning Offices, with participants
consisting of health office staff, heads of community health centers, midwives, community health volunteers, community organizations working on health issues, professional
health workers’ organizations, media, and religious figures, traditional figures, and women.
The meetings explored priority maternal and child health issues, including breastfeeding and safe delivery, and identified the community health centers that would be assisted by KINERJA during the
initial phase. The health centers chosen were based on three indicators: health centers that needed service improvements, that were isolated, or that were providing adequate services.
Informal discussions in KINERJA ’s partner districts were also held. Members of the media,
government, legislature, and professional organizations were invited to attend in order to obtain a true idea of the condition of KINERJA
’s partner districts. This information was analysed alongside secondary data related to social, economic, education, and health conditions in the partner districts.
KINERJA staff and IOs worked as initiators, motivators, and facilitators to approach and gain the support of the legislatures, Local Planning Bodies, and decision-makers at the District Health Offices,
as well as community leaders and professional organizations. The MSFs later emerged from these efforts.
The main indicator that measured the commitment of district governments was their willingness to allocate a portion of the district budget to support KINERJA
’s program. The funds allocated are used for activities that support public participation in health care delivery. This creates feelings of local
ownership over the programs and encourages sustainability.
2. Working Arrangements
The main duty of Kinerja’s local staff – called Local Public Service Specialists – is to coordinate the
program at the district level, and to facilitate IOs to be able to optimally conduct activities with the health office, MSFs, and regional government. LPSS, together with IOs, are responsible for program
achievement at the district level. IOs work at both the district and health center levels, in addition to assisting the community and MSFs in their advocacy and supervision efforts.
KINERJA conducted regular IO capacity building, so as to ensure adequate capability in providing technical assistance for KINERJA
’s partner districts. For strengthening the supply side on safe delivery, KINERJA worked to empower local champions with health backgrounds to support the work of IOs in
Summary: Governance in Safe Delivery and Immediate Exclusive Breastfeeding
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the region.
3. Development of Work Plan
Upon issuance of the District Head’s decision letter, the district technical team developed work plans in
conjunction with IO work plans. This work plan was required to conform to the district planning and budgeting process.
Work Process
1. Role of Partners
Actively involving partners outside of the immediate KINERJA staff is essential to good implementation. The District Health Offices are involved as resource persons, participants and policy makers in implementing
KINERJA ’s program. The technical team that was established became the steering team when field
implementation encountered challenges. The technical teams hold meetings on a regular basis in order to monitor progress and solve implementing issues. Individuals and representatives of religious organizations
and other civil society groups joined together to establish a forum with government representatives, which came to be known as the district-level multi-stakeholder forum MSF. This MSF runs entirely separately to
the health center-level MSFs, and provides more of an oversight role. Legislative members also play a role in monitoring KINERJA
’s program implementation. In several districts, parliamentarians became members or chairpeople of MSFs, and worked as internal advocators to the
legislature and executive branch such as the District Head and the budget committee to facilitate approval for the budget required to support breastfeeding programs. In regions where the district head had higher
commitment than the parliament, their role was to perform budget advocacy to the legislature to push through the budget.
2. Work Plan Implementation
The Immediate Exclusive Breastfeeding IEBF program was implemented through the following phases: 1.
Synchronizing perceptions and building commitment
Kinerja staff assisted IOs in an initial round of awareness raising campigns on IEBF. This process is an important phase, as it has the objective of creating understanding, ensuring
similar perceptions, and building mutual commitment to program implementation. 2.
Establishing and capacity building of MSFs
Kinerja staff, together with IOs, facilitated several meetings to establish MSFs and to develop