IMPROVING CONTRACEPTIVE METHOD MIX (ICMM)

Update September 2014

IMPROVING CONTRACEPTIVE METHOD MIX (ICMM)

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

• Advocate PT MAICHA NUSANTARA MPGG for FP at the work place

• Work with PKK, IBI and PLKB to intensify LAPM to potential acceptors

• Advocate APDESI for FP budget allocation in the village budget (ADD)

• Achievements: 1.MOU between DWG, PKK and 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.

Lumajang

• Work with PKK, IBI, PLKB and other partners (APTISI, religious and community leaders) to intensify LAPM to potential acceptors

• Advocate APDESI for FP budget allocation in the village budget (ADD)

• Achievements: 1.MOU between DWG, PKK and IBI to promote LAPM 2.MOU between DWG and 8 universities (members of APTISI) to support FP program

Kediri

• Work with PKK, IBI and PLKB to intensify LAPM to potential acceptors

• Advocate APDESI for FP budget allocation in the village budget (ADD)

• Achievements: 1. MOU between DWG, PKK and IBI to promote LAPM 2. DWG works with DOH, District BKKBN, BPJS, IDI (doctors association) and IBI (midwives association) to maximize the impact of Juniversal Health Coverage (JKN)

West Nusatenggara Current Advocacy Activities

Lombok Timur

• Advocate APDESI for FP budget allocation in the village budget (ADD)

• Advocate religious leaders to promote LAPM

• Achievements: An Endorsement Letter No.411.3/77/BPMPD/2014 to instruct village heads to allocate for 2015 village allocation budget (ADD) from the District Head (Bupati) has been signed. Its worth IDR 500.000/village/year for 254 villages.

Lombok Barat

• Advocate AKAD (local APDESI) for FP budget allocation in the village budget (ADD)

• Advocate religious leaders to promote LAPM

• Achievements: MOU between DWG and religious leaders to promote LAPM

Sumbawa

• Advocate APDESI for FP budget allocation in the village budget (ADD)

• Work with PKK to intensify LAPM to potential acceptors

• Maximize the impact of Universal Healt Coverage (JKN)

• Achievements: MOU between DWG and religious leaders to promote LAPM

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.

• 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.

ICMM 2014-2015 Strategies

IMPROVING CONTRACEPTIVE METHOD MIX (ICMM)

Update September 2014

THANK YOU!