Click here to load reader

Extenal Assessment of Canadian CIDA Supported Safe ... · PDF fileDirektorat Jenderal Pembinaan Kesehatan Masyarakat, Departmen Kesehatan Directorate General of Community Health, Ministry

  • View
    213

  • Download
    0

Embed Size (px)

Text of Extenal Assessment of Canadian CIDA Supported Safe ... · PDF fileDirektorat Jenderal...

Extenal Assessment of Canadian CIDASupported Safe Motherhood Programme

3/2.ooo

TABLE OF CONTENTS

Letter of Transmittal

List of Tables.................................................................................................

List of Figures........................................................................................................................................... (v)

Acronyms and Abbreviations.................................................................................................................(vi)

Executive Summary ..............................................................................................................................(xiii)

1 BACKGROUND TO ASSESSMENT............................................................................................. 1-1

l. l UNICEF COUNTRY PLAN/UNICEF-GOI MASTER PLAN OF OPERATIONS 1995 - 2000... 1-11.2 CIDA-UNICEF CONTRIBUTION AGREEMENT................................................................... 1-2l .3 THE SAFE MOTHERHOOD IN INDONESIA, MARCH-APRIL 1998 EVALUATION REPORT ..... 1-21.4 UNICEF 1998 MID-TERM REVIEW.................................................................................... 1-3

2 TERMS OF REFERENCE, FRAMEWORK AND METHODOLOGY OF ASSESSMENT... 2-1

2.1 TERMS OF REFERENCE........................................................................................................ 2-12.2 FRAMEWORK ...................................................................................................................... 2-2

2.2.1 Difficulties in Doing and Reporting on Safe Motherhood Programmes............... 2-22.3 ASSESSMENT DESIGN ......................................................................................................... 2-4

2.3.7 Assessment Framework......................................................................................... 2-42.3.2 Assessment Activities............................................................................................. 2-42.3.3 Data Collection.....................................................................................................2-52.3.4 Limitations............................................................................................................. 2-5

3 THE CONTEXT OF THE PROJECT............................................................................................ 3-1

3.1 INDONESIAN CONTEXT....................................................................................................... 3-13.1.1 The Government Administrative System................................................................ 3-13.1.2 Village Organization............................................................................................. 3-23.1.3 Socio-Cultural Issues............................................................................................ 3-33.1.4 Political and Economic Development................................................................... 3-3

3.2 UNICEF CONTEXT............................................................................................................. 3-4

External Assessment of CIDA-Supported Safe Motherhood Agriteam Canada Consulting Ltd. andProgramme Within the Cooperation of UNICEF and tuz de Luna InternacionalGovernment of Indonesia in 1995-2000 i April 2000

aoojc\

TABLE OF CONTENTS

4 COMMUNITY CAPACITY-BUILDING COMPONENT........................................................... 4-1

4.1 TERMS OF REFERENCE FOR COMMUNITY CAPACITY-BUILDINX;........................................ 4-14.1.1 Clarification of Concepts and Terms Central to CCB .......................................... 4-34.1.2 Levels of Participation .......................................................................................... 4-4

4.2 COMMUNITY CAPACITY-BUILDING-SOUTH SULAWESI ................................................... 4-54.2.1 Finding Direction: yision..................................................................................... 4-54.2.2 Implementing Programs........................................................................................ 4-5

4.2.2.1 UNICEF-Identified Lessons and Outputs................................................ 4-64.2.3 CCB Assessment Comments.................................................................................. 4-7

4.2.3.1 1996-1998 Safe Motherhood Programming South Sulawesi ...................4-74.2.3.2 1999-2000 Safe Motherhood Programming South Sulawesi................... 4-9

4.3 COMMUNITY CAPACITY-BUILDING--EAST JAVA ........................................................... 4-124.3.1 Finding Direction: Vision................................................................................... 4-124.3.2 Implementing Programs...................................................................................... 4-12

4.3.2.1 Overview of SM Program/Preparations................................................. 4-124.3.2.2 SM-CCB Activities in EJ 1999-2000.....................................................4-134.3.2.3 Pesantren Cooperative Loan Program.................................................... 4-134.3.2.4 Posyandu Revitalization......................................................................... 4-154.3.2.5 Monitoring.............................................................................................. 4-164.3.2.6 UNICEF Self-Critique Comments ......................................................... 4-16

4.3.3 CCB Assessment Comments................................................................................ 4-174.4 COMMUNITY CAPACITY-BUILDING-CENTRAL JAVA..................................................... 4-18

4.4.1 Finding Direction: Vision.................................................................................... 4-184.4.2 Implementing Programs...................................................................................... 4-194.4.3 CCB Assessment Comments................................................................................ 4-26

4.5 MAIN LESSONS LEARNED................................................................................................. 4-304.6 RECOMMENDATIONS ........................................................................................................4-314.7 RECOMMENDATIONS COMMUNITY CAPACITY-BUILDING ............................................... 4-34

5 MATERNAL HEALTH COMPONENT........................................................................................ 5-1

5.1 MATERNAL HEALTH CARE IN INDONESIA-GENERAL ISSUES .......................................... 5-15.1.1 Maternal Health Care Statistics............................................................................ 5-15.1.2 GOIMaternal Health Policy.................................................................................5-2

5.1.2.1 Governmental Sectors Related to Safe Motherhood Initiatives ............... 5-45.7.3 GOI Policy on Privatization.................................................................................. 5-65.1.4 GOI Policy on Decentralization............................................................................ 5-65.1.5 GOI Monitoring of Maternal Health Indicators.................................................... 5-85.1.6 Donors' Roles in Maternal Health Care Service Deliveiy.................................. 5-135.1.7 GOI Maternal Health Care Service Delivery System.......................................... 5-14

5.2 EVALUATION OF MATERNAL HEALTH COMPONENT........................................................ 5-14

External Assessment ofCIDA-Supported Safe Motherhood Agritfam Canada Consulting Ltd. andProgramme Within the Cooperation of UNICEF and Luz de Luna InternacionalGovernment of Indonesia in 1995-2000 ii April 2000

TABLE OF CONTENTS

5.2.1 Theoretical Framework....................................................................................... 5-145.2.2 Issues Common to All Three Project Provinces.................................................. 5-15

5.2.2.1 Institutional Capacity Building.............................................................. 5-175.2.2.2 The Social Safety Net Factor.................................................................. 5-195.2.2.3 Monitoring and Evaluation - Reporting for Results .............................. 5-205.2.2.4 The Maternal-Perinatal Audit (AMP) Process....................................... 5-245.2.2.5 District Hospital Services....................................................................... 5-255.2.2.6 Puskesmas Services................................................................................ 5-265.2.2.7 Training Programmes for Service Providers.......................................... 5-275.2.2.8 Village Midwives (Bidan Di Desa)........................................................ 5-275.2.2.9 The Dukun.............................................................................................. 5-335.2.2.10The Role of the Village Health Volunteer (Kader)................................ 5-33

5.3 FINDINGS SPECIFIC TO EACH PROJECT PROVINCE ........................................................... 5-345.3.1 South Sulawesi..................................................................................................... 5-345.3.2 East Java.............................................................................................................5-385.3.3 Central Java........................................................................................................ 5-41

External Assessment of ClDA-Supported Safe Motherhood Agriteam Canada Consulting Ltd. andProgramme Within the Cooperation of UNICEF a