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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Lucy S. Mize, BSN, MPH, Maternal and Neonatal Health Program, JHPIEGO Corporation, Gedung Tifa, 10th Floor, Suite 1002, Jl. Kunigan Barat 26, Jakarta, 12710, Indonesia, 62215201004, lmize@jhpiego.or.id, Djoko H. Soetikno, MD, MPH, Maternal and Neonatal Health Program, JHPIEGO, Gedung Tifa, 10th Floor, Suite 1002, Jl. Kuningan Barat 27, Jakarta, Indonesia, Mardiati Nadjib, DDS, MD, Gedung LPUI, Centre for Health Research, University of Indonesia, Kampus UI, Depok, Indonesia, and Setiatie Soemitro, MD, University of Padjadjaran, WHO Collaborating Center for Health Economics, Gedung Lembaga Penelitian Ekonomi UNPAD, Jl. Cimandari, Bandung, Indonesia.
Increasing political commitment for maternal health under decentralization in Indonesia: A use for information and advocacy
Decentralization in Indonesia has devolved decision-making to the districts, allowing districts to prioritize their health needs and to stop implementing eighteen centrally mandated programs. This has created competition for scarce resources in the social sector. District planners are making efforts to retain funding for maternal health in the era of decentralized planning and resource allocation. They need information, however, on the percentage of resources already being spent on maternal health and with what benefit to the population to ensure appropriate planning. Two studies were done to respond to this need: one analyzed existing budgetary data on percentages of resources allocated for maternal health and the other reviewed the economic impact of decreasing subsidies to village midwives. Key results concluded current budgets are largely used for employee salaries, with only an indirect benefit for maternal health. Shifting resources away from the midwife program will not reduce overall expenditures on health or optimize health outcomes. Improving maternal health outcomes are predicated on the continued existence and support of village midwives, thus planners need to know the impact of reducing local subsidies to the program formerly funded by the central government. The primary recommendation is to create advocacy programs to convince district planners to continue subsidies for village midwives and to allocate greater percentages of budgets for maternal health. Initial advocacy efforts resulted in one district promising to fund clinical training for ten groups of village midwives.
Learning Objectives: Participants will be able to
Keywords: Developing Countries, Maternal Health
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employed by JHPIEGO which has the grant for the MNH Program.