Indonesia

APPI Holds National Meeting and Hosts Talk Show- "Your Babies Are What You Eat"

Attended by 100 people from 13 APPI Province Chapters , the meeting opened by Prof. DR. Haryono Suyono, MA, PhD who stated that the Government and the community must work hand in hand to achieve the main MDG targets . The main target should focus on the young families with children aged 0-15 years. APPI chairperson, Dr. Srihartati P Pandi, MPH, stressed the effort to reduce maternal and child mortality rate, and included the importance of increasing male participation.

The First Panel was about how to raise commitment into program by Prof DR Haryono Suyono. He stressed that commitment must be accompanied by programs and networking either from the central, regional, district or village level for advocacy, education, training and quality of services.

The Second Panel included the presentation of Atlas of Birth by Dr. Ratna Tjaya, SKM , and the APPI & Global Maternal Mortality campaign by Dr. Sunitri Widodo .
There were many questions on this Panel from participants eager to replicate the success of Sukabumi District: What kind of Partnership that has been built? Do they have RAPPI? How to synergize program of APPI Sukabumi and the local Government?

The second day was a hard day discussing Bylaws, the Strategic Objectives 2011-2014 and developing Participant Recommendations. The APPI Chairperson election determined Dr. Sunitri Widodo as the new Chairperson.

(Left) Audience member asking questions of the speakers (Right) Health Consultation with a Doctor in Monas

Recommendations

1. APPI could be formed at all provinces, districs and cities in Indonesia in the year 2011.

2. APPI could reinforce and develop networking and partnerships with stakeholders.

3. APPI could carry out advocacy in the central level to the Government

4. Establish the coordination and active communication between APPI National Secretariat and APPI Provincial and District Chapters through media and direct communication.

RAPPI

Selamatkan Ibu was founded in June 2010 as a part of community response on safe motherhood issues focusing on raising awareness and advocacy at the ground level. Maternal mortality rates in Indonesia remain high, and Selamatkan Ibu believes that it is essential to continue to inform the community on the importance of these issues and contribute to reducing maternal death in Indonesia.

The pro-bono program aims to increase awareness through creative social campaigns and counseling. Through social network tools, such as Facebook and Twitter, the program provides live counseling to the community on emerging maternal health issues. On the 22nd of every month, Selamatkan Ibu tweets the slogan "Selamatkan Ibu Selamatkan Bangsa" to highlight the importance of community awareness of safe motherhood.

Selamatkan Ibu also conducts social campaign events that include community education, discussions with experts, and free antenatal checkups. The program is currently reaching the community in Jakarta and expanding to include the rural areas in Sulawesi.

In order to celebrate the mother’s day on December 22, 2010, APPI and Selamatkan Ibu conducted a campaign and talk show about maternal health. Held on December 19 2010 in Monas, Central Jakarta, the campaign disseminated information through brochures and a booth for consultation with an obstetrician.

On December 22, 2010, we held a talk show, "Your Babies Are What You Eat." The speakers were Dr. Aditya Kusuma and Dr. Nurhadi Rahman, and Wilson Siahaan from the United Nations Millenium Campaign. Dr. Rahman spoke about Selamatkan Ibu as a movement in reducing maternal mortality in Indonesia. Dr. Kusuma spoke about nutrition for mothers before, during, and after pregnancy in order to support the health of mothers and their fetuses. Let’s join the movement. Save the mother, save the nation!

APPI Initiates Social Watch on Jamkesmas

In the west side of Banten province and close to Jakarta, there is a high fertility rate, a high level of poverty and a high maternal mortality rate. Aliansi Pita Putih Indonesia (APPI) initiated a social watch in this region to assess and increase the knowl¬edge of community leaders and low-income individuals about the Indonesian National Social Insurance System for poor families — in terms of how to access the system, where to get information and what to expect in the future — with the goal of empowering potential recipients to access their benefits. The social watch involved tracking policy imple¬mentation, verbal autopsies and information, education and communication (IEC), including through broadcast on radio stations in Serang.

(Left) Focusgroup discussions are health to gather and assess knowledge about Jamkesmas. (Right) APPIadvocatesto the Head of the District.

Jamkesmas was developed by the Ministry of Health in 2008 as an advancement of the 2005 Health Care Insurance for Poor People (Askeskin). According to the Indonesian Health System and law no. 40/2004 on National Social Insurance System for poor people, Jamkesmas: "Every poor family gets a Jamkesmas card, which can be used when they need health care services at public health facilities, such as the Community Health Centre (Puskesmas) in the sub¬district and Public Hospital in the respective district."

Results

• KNOWLEDGE: Most of the respondents and the cadres did not know about or understand Jamkesmas and which members of families could use the card. Most respondents incorrectly believed that Jamkesmas only provides free health services at community health centers (but not public hospitals at the district level).
• ATTITUDE: Respondents said information on Jamkesmas is very limited, and they did not care whether they had the card. The cadres expressed that most of the data about poverty in their village was invalid. Some people felt there was discrimination in the distribution of the cards.
• PRACTICES: Only half of participants who have the Jamkesmas card said they use the card if a nurse, midwife or village community cadre accompanied them to a community health center. The others said they did not know how to use it. Since January, the Serang Municipality has developed Jamkesda, but unfortunately the card is only valid for one year, whereas the Jamkesmas card is valid for three years.
• EXPECTATION: Respondents recommended that local government update the baseline data on poverty, and the cadres wanted to know the tech¬nique, method and IEC kits used to explain and promote Jamkesmas. They said that introducing Jamkesmas should not be done at a special event but instead be integrated into religious meetings, teaching or other events. They urged that the media spread awareness and that Jamkesmas be integrated with other programs such as family planning, safe motherhood, gender and nutrition.

(Left)APPIconducts home visits as part of the social watch. (Right) Interviews are conducted to learn more about how people experience Jamkesmas.

APPI presented these data to government officials and through local and national radio to let women’s voices be heard by formal and informal leaders. APPI advocated to three Directorates of the Ministry of Health in a meeting attended by Head of District of Sukabumi Bupati Sukmajaya, APPI National and APPI Banten, and two consultants. The government officials admitted that community health centers usually use Jamkesmas to claim treatment and referrals to the hospital and very rarely use it for preventive activities — perhaps because they are overloaded with treating people. They said that non-governmental organizations concerned with health can participate with reminding the Puskesmas officials of this job and collaborating for health promotion. The three Directorates agreed to increase IEC through RRI and a workshop for media sensitization.
Note: APPI performed this social watch for health care in general, not for full implementation of Jamkesmas on maternal, newborn and child healthpolicies.