In relation to the development of the curricula and training plan, Health Services Program (HSP) and Women Research Institute (WRI) during the next six-month period (July 13 – August 31, 2007) will organized 14 workshops in districts namely: (1) Serang; (2) Tangerang; (3) Jakarta Barat; (4) Jember; (5) Malang; (6) Aceh Barat; (7) Aceh Besar; (8) Banda Aceh; (9) Deli Serdang; (10) Medan; (11) Sumedang; (12) Kota Bandung; (13) Bogor; (14) Aceh Jaya and (15) Kediri. HSP and WRI had conducted several workshops on July – August 2007. This report attempts to picture on the implementation of four workshops that already took place in (1) Kediri (August 21 – 23, 2007), (2) Aceh Besar (August 21 – 23, 2007), (3) Sumedang (August, 29 – 31, 2007) and (4) Deli Serdang, conducted in Medan (August, 29 – 31, 2007).

 

Achievements

 

This program is a capacity building program in strengthening skills of advocacy aims to assist the Ministry of Health in accelerating the reduction of maternal, newborn, and child (MNC) mortality. One of the strategies is to conduct advocacy at the national, provincial, and district levels, as well as ensure that there will be sufficient resources allocated to reduce MNC mortality. Along with decentralization regulations, this program emphasizes advocacy work at district levels by strengthening District Health Office capacities in advocacy.

 

In relation to the facilitation of the process in the two workshops in Kediri, Aceh Besar, Sumedang and Deli Serdang, it can be said that to some extend the advocacy skills of the participants is strengthened. The participants, who represent people from the parliaments, civil servants, and NGOs, had gained experiences and knowledge in conducting advocacy activities. The Sumedang experience was interesting, due to the strong role of the coordinator of the District Ad-Hoc Team. Although, in the beginning some reluctance were in the air, particularly from the executive, the responds from the Local Parliament and the Head of Budget Committee turned out to be very positive. The Local Parliament agree to discuss further the draft of the local regulation to improve local health services, including handling maternal & child mortality as well as increasing the budget for the aforementioned issues.

 

Compared to the workshop in Sumedang, the lobby to the Local Parliament in Kediri to some extent can be concluded as quite good. The participants learned a lot from the real setting with the Local Parliament in Kediri. They had to wait almost 2 hours and at the end the Deputy of the Local Parliament sent the D Commission to accept the participants. The process of lobbying was quite tough and took more than one hour of negotiation. However, at the end the D Commission promised the participants to make adjustment to the Local Budget regarding allocation for programs on Maternal and Child Health Care in Kediri.

 

The workshop in Aceh Besar also can be concluded successful. The approach of engaging multi stake holders, help participants in developing advocacy messages. The advocacy to the Local Parliament had made the Local Parliament promised that they will increase the budget for improving Maternal and Child Health in 2008.

 

The training in Deli Serdang showed that it is indeed important to link the calculation of the need of MNCH budget with the economic lost calculation. This linking may help to convince the budget advocacy process to the decision makers at the district level.

 

In all of the four districts, the existing data of MNCH condition and local budget allocation for MNCH are still lacking. Some of the local district health offices even do not have current data on MNCH, particularly that related with the maternal and child mortality. The participants who then formed an ad hoc advocacy team, i.e. in Kediri, Aceh Besar, Sumedang and Deli Serdang, will do the follow up in order to get these data as well as commitment from the District Parliament (DPRD) in each of the above districts and Head of districts. Some districts, even still do not open their access to the public regarding the budget allocation for current fiscal year.

 

Lessons Learned

The four workshops revealed that there were areas that need to be improved for the implementation of the next workshops.

 

Participants

 

The workshop was design to enhance the advocacy skills of the participants. Thus, the participants of the workshop should be people who already have knowledge on issues of maternal and child mortality as well as advocacy. With regards to this aspect, the selection criteria of the participants are people who have knowledge on the issues of maternal and child mortality as well as experience in advocacy. The district of Sumedang is a good example of a strong role of the Head of the Ad Hoc Team. The result of the advocacy activity is a direct one. The advocacy is quite successful in influencing the program planning and budget allocation to reduce maternal and child mortality in the four districts. The success story of Sumedang district also links with the selection of participants which consist of people who have knowledge on the issues and advocacy, as well as have influence to the decision makers at the district level, particularly from the Local Parliament.

 

The workshops were planned to be implemented in the period of six months, yet most of the PC office only have limited time to prepare for the workshop. In Kediri for example, the participants stated that they were not informed well in advanced regarding the objectives and term of reference of the workshop. In the workshop in Kediri, therefore the participants did not bring the data to the workshop.

 

Based on the sharing of experiences in the workshop, participants realized that network between communities to exchange information about each other‘s works and experiences, and capacity building on advocacy, are crucial. It was important to exchange information on the success of many groups in forging alliances across stakeholders. It is equally important to exchange information regarding the efforts of multi-stakeholders to educate members of the community to adopt critical way of thinking in analyzing problems of maternal and child mortality. The way the multi-stakeholders educate the community base on reliable data, should also be shared as valuable experience.

 

The experience of the four workshops mentioned above showed that it is important to get hold with reliable data. This is a prerequisite of a good advocacy work. However, with some qualitative data and projection data calculated, the substance of advocacy messages strong enough to convince the Local Parliament of Deli Serdang.

 

The Organizing Committee

 

In the opening session of each of the workshops, always emphasized on the importance of data and advocacy should be evidence based activity. Therefore, back up data it is very important. The past workshop implemented in Kediri, Deli Serdang and Aceh Besar was without strong back up data. Meanwhile, the workshop in Sumedang showed that the participants get hold on the issue of Maternal and Child Mortality. The data and evidence based advocacy are the basis, therefore for the next implementation of workshops in the other districts should supported by strong back up data by the PCs.

 

The core of the workshop is to strengthen the skills of advocacy of the participants. The workshop itself was designed to help participants gained knowledge and experience of advocacy in the real setting, whether in the setting of hearing to the parliament or dealing with the public in a talk-show program in the radio or television. The workshops were prepared in a very limited time, so based on its experiences the next workshops still have enough (longer) time to prepare the real setting. The PCs still have quite enough time to build rapports to the parliament members, the decision makers at the executive level as well as NGOs and women’s groups who have experiences in conducting advocacy on maternal and child mortality. By doing all the arrangements, it is hope that the preparation, i.e. inviting participants, preparing the real setting of hearing/lobby the parliament, experienced resource persons on the issue of maternal and child mortality and budget as well as policy at each districts and the back up data, well planned and may help to meet the objective as planned.

 

The workshops in Kediri, Sumedang and Deli Serdang had succeeded in organizing real setting to do advocacy with the Local Parliament. The results were encouraging, since the legislative members very convince with the presentation made by the participants. In Aceh Besar, the Local Parliament was invited to the site of the workshop to meet the participants. All of the efforts to lobby the decision makers bring to good results to increase the local budget to reduce maternal and child mortality as well as improving local health services. It is now the initiative of the ad hoc team to follow up these promises, so it will become into concrete effort to reduce Maternal and Child Mortality.

 

The Development of the Draft Module

 

On August 16, 2007 HSP and WRI met to prepare the feed back meeting for the module with MoH which will take place on September 20, 2007. Up till now, there were several written inputs from MoH as well as several people i.e. from international organizations who participated as observers in the four workshops mentioned above. At this stage, WRI is preparing the fourth draft of the Module.

 

The comments are very positive and the MOH representative feel that the improvement of the Module very useful for them. Especially, regarding the topic of Budget Analysis and Identifying Local Problems of Maternal and Child Mortality. The MOH also feel that the advocacy tool, i.e. the presentation done by the participants for the substance of their advocacy, is excellent and strong one. The MOH had mentioned that the workshops indeed had equip them to do the lobby and advocacy to reduce Maternal and Child Mortality.

 

The co-Facilitators

 

Based on the inputs from the Ministry of Health (MOH), the implementation of the workshop should encourage the role of co-facilitators; this term is actually referring to the local facilitators. The involvement of local facilitators is seen by both the Ministry of Health and HSP to strengthen the work of the ad hoc team that may be formed as a result after the workshop.

 

In Sumedang, the local facilitator showed that he has strong knowledge on advocacy and particularly on budget tracking. The skills of facilitation are good and able to engage with participants who came from different backgrounds (multi stakeholders). It is seen that the ad hoc team in Sumedang has good facilitator as well as may achieve the objective of their work plan. It is happened that the local facilitator also the head of the Ad Hoc team in Sumedang. In Kediri, Aceh Besar and Deli Serdang the local facilitators were keen to get involve with the processes of the workshop. They are engaged and involve with the dynamic of the workshop. The facilitators engaged actively until the end of the process of the workshop. The facilitator in Deli Serdang was people from the local district health office trainers. This is very encouraging, since trainers from the local district health office may be more involved by the PC. It is hope in the future; the role and capacity of local facilitators become important aspect to be considered by the PC offices in Aceh districts. ***