Long-term contraceptive: A young married woman in East Lombok gets an implant, a long-acting contraception method, as part of family planning services provided by trained midwives at a community health center (Puskesmas)
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Every day, Rokhliana has to provide basic health care and maternal health services including pre-and post-natal care and family planning services at a community health center in East Lombok as well as in her own private home.
'A midwife must be able to do everything from delivering babies, treating their mothers to offering family planning services. Not to mention, when we have to deal with ordinary patients with illnesses, only a doctor is licensed to cure them,' said Rokhliana, chairperson of the East Lombok chapter of the Indonesian Midwives Association (IBI).
In villages, a midwife has always been regarded as a 'super woman' or perhaps a super 'doctor'. In Indonesia's family planning program, midwives are at the forefront of delivering services.
Midwives were responsible for delivering 80 percent of knowledge, information and family planning services, all over Indonesia, one study has concluded.
'But since decentralization was enacted, many of us became confused and faced an uncertain future. We once worked under the coordination of the National Population and Family Planning Board (BKKBN), now we are attached to regional health agencies,' added Sri Arnani, chairperson of IBI in Kediri, East Java.
At the same time, Utun Supria, head of East Lombok Health Agency, was overwhelmed by the new job responsibilities that he and his staff had to handle.
In 2001, Indonesian enacted a decentralization policy, delegating more authority from the central government to provincial and district governments. This also applied to BKKBN, once the linchpin for family planning programs in Indonesia.
'Only 22 out of 500 regencies have independent BKKBDs or Regional offices of the National Population and Family Planning Board,' said Surya Chandra Surapaty, chairman of BKKBN.
However, Hari Fitri Putjuk, country representative from Johns Hopkins's Bloomberg School of Public Health's Communication Program (CCP) Indonesia, said that it was a good thing that some provinces and regencies had shown their commitment to continuing family planning programs.
Johns Hopkins has been in partnership with the Indonesian government in the promotion of family planning in the country since 1986.
The joint programs include: 'Condoms 25' or 'Dua Lima' contraception, Lingkaran Biru (Blue Circle), the Bidan Delima midwife program, Desa Siaga (Alert Program) and Suami Siaga (Alert husband).
To revitalize and strengthen the country's stagnant family programming, the Indonesian government has signed a memorandum of understanding that included fresh financial and technical assistance valued at around US$40 million from the university, alongside support from the Bill and Melinda Gates Institutes for Population and Reproductive Health. The assistance will be bundled into a four-year program starting in 2014.
To accelerate family planning program at the district level, a District Working Group (DWG) was established in every regency, whose members comprised officials from local governments, including those in local BKKBN offices, health agencies, professional organizations such as the Indonesian Doctors Association (IDI), Midwives' Association (IBI), Chief Villages, Field Officers, members of PKK village's women's empowerment groups and community and religious leaders.
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