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There is a saying in humanitarian NGOs that the “aid stops where the road stops”, but that’s where SurfAid’s work begins.
Many people living in remote areas in Indonesia do not have access to basic public services, resulting in avoidable death and disease, especially among pregnant women and children under five. Geographical barriers also contribute to unacceptably high levels of malnutrition, diarrhoea and acute respiratory infections in children under five, which all have long term impacts on cognitive ability and economic productivity.
Indonesia is one of ten countries with the highest number of under-five deaths, and one of seven countries that account for over half of all maternal deaths worldwide. It is estimated that 70% of these deaths are preventable and that basic resources, including rudimentary health care, access to clean water, and improved nutrition, improve overall health.
SurfAid believes that mother and child health (MCH) can only be improved if basic health structures are in place and adequately equipped; that staff and volunteers are well trained, able and motivated to deliver appropriate health services; that mothers and caregivers understand and practice healthy behaviours and there is a positive environment to support and foster improved health behaviours.
The natural entry point for improving MCH in Indonesian communities is through the community health post (posyandu) and its community health volunteers (kaders). SurfAid supports 25 community health posts in 3 sub-districts in remote islands in Indonesia.
Each of the 3 sub districts have a public health centre that employs medically trained health professionals. The staff from these facilities are meant to visit remote communities monthly to deliver community health services, assisted by local community health volunteers. The community health posts focus on health issues relating to mothers, children and pregnant women.
There is a direct correlation between poor health post services and high levels of isolation and poverty. SurfAid aims to remedy this negative trend by working to improve community health posts so that they provide the highest quality of services. In Indonesia, the government calls these high quality health posts mandiri (in English: ‘Independent’).
To reach Mandiri level, local community health volunteers need to be well-trained, the clinic must run monthly, meet quality standards, generate operational funds and provide ancillary services, such as feeding programs for undernourished children.
Monthly training and coaching on mother and child health issues
Training was conducted for 336 community health volunteers and 40 groups for pregnant women & lactating mothers and husbands & mothers-in-law.
Many of life’s important lessons and skills are learned outside the classroom, and we know that workshops alone are not enough. Community members and local staff need a foundation on which to build increasingly complex skills. That is why continuous coaching and capacity-building over time are so important.
SurfAid Indonesia uses ‘accompaniment’ to ensure important issues are continuously addressed, and communities can learn, make mistakes and learn from mistakes at their own pace. We enable local people to apply their own good ideas, rather than simply delivering our own. Our local staff live and work alongside people in remote communities to facilitate this slow but highly effective change.
Sessions and materials developed on the most important health behaviours
Including antenatal care and giving birth with the help of a health professional, visiting the health posts for weighing & monitoring of infants, using clean water for drinking and consumption and washing hands with clean water and soap.
Managing small businesses
30 groups are now actively managing small businesses; Chicken farms, catfish farms, corn cultivation and banana and sweet potato chips production. In the long run, these small income generating activities will fund additional caring programs of the community health posts. 7 are already able to contribute to the community health posts. 42 groups improved their quality level. 30 community health posts are now mandiri.
SurfAid is implementing an overarching mother and child health program across remote villages in Indonesia, where simultaneous projects are targeting access to clean water and improved food security.
This project is one of many smaller projects that all contribute to supporting communities to become more independent.