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Presentation

Session: Posters
Room: TBA
Time: Fri 13:00-14:30

Presenter: Rahmi Sofiarini (PAF Project of GTZ-Indonesia. GTZ Indonesia)

Presenter: Goeman Lieve (PAF Project of GTZ-Indonesia. GTZ Indonesia)

Abstract

Community mobilisation is strongly recognized as an effective strategy that can contribute to improving MNH. This paper will describe economic of community mobilization effort, called Desa Siaga, in reducing maternal death. The model is underpinned by the existing traditions of helping one and other that exist across ethnic societies in NTB Province of Indonesia. Assistance is given to communities in facilitatory activities to enable participatory organization in the development of consensus amongst members in helping each other to address responses to health emergency situations by establishing “Community-based Alert System “, which aimed to increase community alertness and readiness to recognize dangers and take non-clinical action quickly to respond to maternal and neonatal emergencies. The Alert System incorporates notification in the community in times of urgent health issues, provision of means of transportation and communication to access the local health facility, provision of financial support, and voluntary blood donation.
To enable the cost analysis, a tool in excel has been developed, which describes all Desa Siaga activities in six steps and in terms of cost categories. For each cost category, physical unit costs are determined with intervals to cover all variations encountered in the data and to deal with the uncertainty this creates for the results. Breakdowns of the total unit costs for one village for one year are done enabling policy relevant information. A societal perspective is chosen and the boundaries of the cost analysis are set so that a clear decision could be made on which costs to include or to exclude for the final unit cost calculation. The cost total costs to implement Desa Siaga in one village for one year averaged Rp. 53,414,400 (4,109 €), with 80% of this establishment of the system and 20% for operations.
Quantitative and qualitative information from routine data and specific evaluation demonstrate that reproductive health service indicators significant improvement since the model was introduced. Significant changes occur as well in terms of husbands accompanying their wives for antenatal care and childbirth. Both first and fourth antenatal care visits improved. Delivery assisted by skilled birth attendants increased as did delivery at a health facility. Family planning knowledge and proportion of current users increased in comparison the baseline data as well client satisfaction with village level health services. Similar trends of improvement were seen in the routine (secondary data) reports from health centre examined that reflect these reproductive health service indicators. The alert systems have triggered community members to help each other to save lives. Therefore, through establishment of alert system the community has contributed to the utilization of health services, access to health facilities, and to a reduction in maternal and infant deaths by improving behavior, recognizing risks, and taking prompt action to reduce delays at the community level.
Looking at these impact and to link to the cost, it is worth the investment of the funds and effort. Thus, by allocating more resources to prevention, the population's health can be substantially improved.

Key Terms

community mobilization, alert system, unit cost, reproductive health indicators

Authors:

Rahmi Sofiarini (PAF Project. GTZ-Indonesia) and Lieve Goeman (PAF Proejct. GTZ-Indonesia)

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