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Boosting access to voluntary long-term contraceptive through community partnership
Women and children first: A woman undergoes a check-up at Muhammadiyah Hospital in Karanganyar, Central Java
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span class="inline inline-center">Women and children first: A woman undergoes a check-up at Muhammadiyah Hospital in Karanganyar, Central Java. It was part of a mobile family planning campaign organized by Aisyah community service.
The Cipta Cara Padu Foundation (YCCP) through Advanced Family Planning (AFP) global initiative brings together various stakeholders in a partnership program at the district level to make voluntary family planning program successful through access to long-term contraception.
Curbing rapid population growth is one of the pressing issues facing many developing nations, including Indonesia.
Studies have shown that overpopulation can cause social problems, such as poverty, lack of adequate access to education and health services and a poor overall quality of life.
Family planning is one of the ways to contain rapid population growth.
In Indonesia, the promotion of family planning by using contraceptive methods remains a challenge as many people, including leaders and uneducated couples, are not aware of the importance of family planning.
Several decades ago when Indonesia was under authoritative Soeharto administration, the family planning program have worked really well despite criticism from activists and scholars for using a method of coercion. The country's fertility rate or the average number of children born dropped from 5.6 per woman in the early 1960s to 3.4 by 2000.
Since 2003, however, Indonesia's total fertility rate has stagnated at 2.6 per woman, far from the ideal rate of 2.1.
This has prompted a number of organizations to devote themselves to the improvement of the family planning program. The Cipta Cara Padu Foundation (YCCP) is one of them.
The foundation, established in 2008, has its own strategy to ensure successful implementation of the program. Its family planning program is part of a global Advanced Family Planning (AFP) initiative, which covers nine focus countries, namely Burkina Faso, Democratic Republic of the Congo, India, Indonesia, Kenya, Nigeria, Senegal, Tanzania and Uganda.
AFP aims to increase the financial investment and political commitment needed to ensure access to quality family planning through evidence-based advocacy. It seeks to improve family planning by dealing directly with key decision-makers and policy leaders in every community where it operates as it is deemed the most effective way to create social change.
District working group
Driven by this conviction, the organization works at the district level, where regional autonomy has been introduced.
The organization's main target is to increase the budget and political commitment to ensure access to family planning. In order to achieve the goal, partnerships is needed by engaging local stakeholders, including government officers, scholars, midwives, community leaders, as well as private sector, in each respective area, which they call district working groups (DWGs).
The group serves as a mechanism of collective action and partnership that are very important to accelerate the implementation of the foundation's program.
The group works in collecting evidence-based data related to a particular district's population issues and presents them to the district leaders. Through numerous meeting sessions with district leaders, DWG explains the benefit o family planning program to reduce district burden due to overpopulation.
The group also convinces the district leaders that by supporting the family planning program, they will enjoy the long-term benefit from the demographic dividend, where the number of people in the productive age bracket is greater than that from the dependent age.
By using evidence-based data, the DWG hopes that it can prompt them to support the family planning program such as increasing the budget to prioritize long-term contraceptives for community
'A lot of district heads and councilors do not see the family planning program (including contracptive method mix) as a feasible investment, particularly because they do not produce short-term or visible results. It's different when you invest in infrastructure projects where you can see the visible progress of roads and bridges being constructed,' YCCP executive director Inne Silviane said.
Despite not yielding visible results, Inne maintains that the program is very important, since overpopulation could spell so many social problems.
'Infrastructure projects will do no good when you have an issue with overpopulation. Roads, for example, will be damaged if too many people drive their motor vehicles through them. Hospitals will do no good if a lot of poor people can't seek treatment there due to financial constraints. Furthermore, family planning program increases the welfare of citizens in the long run,' she said.
According to M&E officer of AFP, Elfira Nacia, the success of the advocacy effort is indicated by, among other things, the issuance of supporting regulations or policy and the family planning budget increase.
Success story
Despite the challenges the foundation has faced in advocating the family planning program, one district stands out as a success story: Karanganyar district in Central Java.
An area populated by 840,171 people with a population growth rate of 0.70 percent as of 2014, the district has been a beneficiary of AFP program for three years now. During the three-year implementation, the district has shown some significant impacts. It is all thanks to the commitment of its district head, H. Juliatmono.
Unlike the other district leaders, he had a prior knowledge on population including family planning issue he won a speech contest about the issue when he was still a student.
The district head recently issued a circular urging all regional working unit (SKPD) chiefs in the area to support the family planning program. Furthermore, the region has seen a 156 percent increase in budget allocated to the family planning program to Rp 655 million in 2013 from Rp 255.3 million in 2012, the year the foundation started its advocacy program.
This means more people can be subsidized for long-term contraception; data obtained from the district demonstrates that the overall number of a long-acting permanent method acceptors has increased from 32.38 percent in 2012, when the program was first implemented, to 33.75 percent last year.
'The family planning program is an important element to the development of the district as it increases the district's human resources quality through birth control. The program also helps families and individuals create high-quality families,' Juliatmono said.
Meanwhile, Karanganyar resident Ambar Setyowati, 32, who has been using an IUD since 2013, said she became aware of the importance of long-term contraception for the first time when she participated in a familiarization program on the issue.
She said that the family planning program had helped her and her husband to parent their two children adequately, and able to provide her children with adequate health care and education since both were busy working.
Knowledge transfer
In order to enable the community to sustain its family planning program, DWG member who comprises of multi stakeholders works together to continue the program after the partnership program has ended.
'This is why, as has been mentioned before, we appoint people from diverse backgrounds to be members of the DWG, so that they can influence the members of their respective circles to support the family planning program long after we leave the district,' Inne said.
Furthermore, each time a district undergoes a leadership transfer, the DWG for that respective region has to approach the new district leader to advocate the importance of the family planning program endorsed by the previous leader, and transfer knowledge on the mechanisms and lessons learned from the program implementation under the previous leader.
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Partners for Change
This page is produced by The Jakarta Post in cooperation with Company-Community Partnerships for Health in Indonesia (CCPHI). It promotes best practices in community partnerships. For more information, contact the Supplements & Supplemental Products section at supplement@thejakartapost.com.
