I MPROVING C ONTRACEPTIVE M ETHOD M IX (ICMM) I MPROVING C ONTRACEPTIVE M ETHOD M IX (ICMM) Update September 2014 Update September 2014 Inne Silviane, YCCP Executive Director
ICMM Program Profile The Improving Contraceptive Method Mix (ICMM) Project is investigating the impact of targeted advocacy and knowledge management activities to increase the use of long-acting and permanent contraceptive methods (LAPMs) in two Indonesian provinces: East Java and West Nusatenggara. Project dates: October 2012 – September 2016 Location of ICMM Activities: Being conducted in Jakarta, plus three districts in East Java (Kediri, Tuban, and Lumajang) and three additional districts in West Nusatenggara (Sumbawa, Lombok Timur, and Lombok Barat). There are also six comparison/control districts, three in East Java (Jombang, Bojonegoro, Blitar) and three in West Nusatenggara (Lombok Utara, Lombok Tengah, Bima).
Advocacy Objectives Increase budget for FP program in the 2014 annual district budget (APBD) of each district. Increase LAPM of all modern methods based on districts statistic report. Strengthen public policy support to revitalize FP program as evidenced by commitments from the Mayors, District Legislatures and Policy Makers to support and facilitate FP program activities. Maximize the impact of Universal Health Insurance (UHI) scheme to the increase LAPMs.
Previous Advocacy Activities (2012 – 2013) Hired staff Two Provincial POs – one in West Nusatenggara and one in East Java Six District Independent Consultant s(DICs) – one in each intervention district Conducted courtesy visits Attended by policy makers at the provincial level and in each of the 6 districts Established DWGs in the 6 districts Officiated by respective Bupatis, complemented with issuance of SK Bupati. Conducted trainings Completed Net-Map, AFPSmart (advocacy planning tools) and FP Cost Projection trainings for all DWG members in the 6 districts Created district work plans
East Java Current Advocacy Activities Tuban Lumajang Kediri • Advocate PT MAICHA • Work with PKK, IBI, PLKB and • Work with PKK, IBI and PLKB to NUSANTARA MPGG for FP at the other partners (APTISI, religious intensify LAPM to potential work place and community leaders) to intensify acceptors LAPM to potential acceptors • Advocate APDESI for FP budget allocation in the village budget • Work with PKK, IBI and PLKB to (ADD) intensify LAPM to potential • Advocate APDESI for FP budget acceptors allocation in the village budget (ADD) • Achievements: 1. MOU between DWG, PKK and • Advocate APDESI for FP budget IBI to promote LAPM allocation in the village budget • Achievements: 2. DWG works with DOH, District (ADD) 1.MOU between DWG, PKK and BKKBN, BPJS, IDI (doctors IBI to promote LAPM association) and IBI (midwives 2.MOU between DWG and 8 • Achievements: association) to maximize the impact universities (members of APTISI) to 1.MOU between DWG, PKK and of Juniversal Health Coverage (JKN) support FP program IBI to promote LAPM 2. MOU between DWG and PT MAICHA NUSANTARA MPGG to promote LAPM to their 1.887 female employees 3. Contributed to FP District Budget increased from IDR 2.278.776.000 year 2013 to IDR 2.423.0766.000 year 2014.
West Nusatenggara Current Advocacy Activities Lombok Timur Lombok Barat Sumbawa • Advocate APDESI for FP • Advocate AKAD (local • Advocate APDESI for FP budget allocation in the APDESI) for FP budget budget allocation in the village budget (ADD) allocation in the village village budget (ADD) budget (ADD) • Advocate religious leaders • Work with PKK to intensify to promote LAPM • Advocate religious leaders LAPM to potential to promote LAPM acceptors • Achievements: An Endorsement Letter • Achievements: • Maximize the impact of No.411.3/77/BPMPD/2014 MOU between DWG and Universal Healt Coverage to instruct village heads to religious leaders to promote (JKN) allocate for 2015 village LAPM allocation budget (ADD) • Achievements: from the District Head MOU between DWG and (Bupati) has been signed. Its religious leaders to promote worth IDR LAPM 500.000/village/year for 254 villages.
Advocacy to IBI (Indonesia Midwives Association) Conducted a serial meeting at Jakarta (national), Mataram (West Nusatenggara) and Surabaya (East Java). Recommendation: National level: Advocate MOH and BPJS to improve the networking scheme between First Health Facility - (Fasilitas Kesehatan Tingkat Pertama or FKTP) such as Health Center at sub-district level (Puskesmas) and private midwives should be conducted accordingly. Advocacy to the Ministry of Home Affairs to revise unsupportive local regulations such as - midwives’ fee cuts for local revenue is required to improve midwives role in providing FP services through JKN. Provincial level: Advocate Provincial Health Office and BPJS regarding a contradictive regulation (MOU - between Provincial Health Office and BPJS) on service tariff. Advocacy will be conducted by Provincial Working Group (PWG) with ICMM Secretariat and CWG supports. Advocate Provincial Health Office and BPJS to disseminate JKN regulations to First Health - Facility (Fasilitas Kesehatan Tingkat Pertama or FKTP). Advocacy will be conducted by Provincial Working Group (PWG) with ICMM Secretariat and CWG supports. District level: Advocate DHO, BKKBN district and IBI district to disseminate a current rules related to JKN - scheme. Particularly for midwives and FP services.
Provincial Working Group (PWG) formation East Java PWG is still waiting for East Java Governor Decree. West Nusatenggara is being on process to form PWG.
Monitoring Independent Consultants and Provincial Program Officers monthly reports using forms provided by UI Monthly coordination meeting between YCCP, JHU.CCP Indonesia and CHR-UI Close coordination on data monitoring between YCCP and CHR-UI at the district level
Lessons Learned Data and information availability on FP program (including CHR-UI research) to develop focused advocacy Bridging the district needs by involving provincial stakeholders (Provincial Health Office and BkkbN) Dinkes should lead to ensure access to health centers and midwives. Independent Consultants play important roles to assist DWG. Hence, criteria should be clearly defined and salary should be raised.
ICMM 2014-2015 Strategies Increase budget for FP program in the 2015 annual district budget (APBD) of each • district. • Increase LAPM to all modern methods based on districts statistic report. • Strengthen public policy support to revitalize FP program as evidenced by commitments from the Mayors, District Legislatures and Policy Makers to support and facilitate FP program activities. • Maximize the impact of Universal Health Insurance (UHI) scheme to the increase LAPM through : a. Ensuring that UHI include LAPM in its implementation at each district. b. Advocate BKKBN to continue increasing CTU training for medical doctors and midwives. d. Advocate Health Ministries to insertion midwives to UHI scheme c. Advocate Home Affairs Ministries to allocate village budget regarding Village Law no. 3/2014 for FP activities at village level d. Advocate Home Affairs Ministries to evaluating Districts regulation about reducing midwives fees for Districts income. Continue periodical tracking of service statistics from each district. •
THANK YOU! I MPROVING C ONTRACEPTIVE M ETHOD M IX (ICMM) Update September 2014
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