NGO participants obtain confidence in sustainable RH strategies

At ICPD 1994, stronger coordination and collaboration among NGOs and GOs was recommended in the POA to ensure reproductive health (RH) at the grassroots level. Globally, many NGOs rely on external donors for financial support for activities, which are in many cases not programmed towards sustaining NGO’s efforts to improve RH, and face risks due to weak strategies in activity and organizational sustainability.

In the first of a new series of RH Seminars for Senior NGO Officers, Capacity Building of NGOs toward Sustainability, entrusted to JOICFP by JICA,11 NGO representatives from 9 countries in Asia, Latin America and Middle East participated from 28th August to 19th September.

The training was structured to strengthen the "enduring impact" of NGO’s sustainability working for RH. The course focused on a) program effectiveness, b) organizational viability and c) financial sustainability

In addition to learning from Japan’s experience in the three strategies of community-based RH, GO-NGO partnership, and advocacy to achieve sustainable RH programs, this new cycle of RH seminars, specially focuses on: NGO officials expected to continue for another five years; and has added the Indonesian component of deepening understanding of how the Japanese experience can be adapted based on real situations in developing countries.

Tokyo - learning from Japan’s experience

The first week of the program was in Tokyo, where the participants learned about Japan’s post WW II experiences in community health through lectures fromorganizations such as the Japan Family Planning Association, the Japan Association of Parasite Control, the Tokyo Health Service Association (THSA), the Council for MCH Promotion, and JOICFP.

Themes covered included promotion of community-operated RH programs, advocacy strategies, and the role of maternal and child health (MCH) promoters, which all directly linked to and provided information on sustainability.

Participants also shared experiences of their respective NGOs, exchanging good practices and lessons learned.

Observing preventive health activities at the THSA

Yamaguchi was one of the first prefectures to adopt the MCH promoter system and became a model for others in Japan. The seminar participants observed community-operated sustainable activities in collaboration with local government.

The seminar participants met all levels of health providers in Yamaguchi; prefectural administration, central hospital, city health center, and MCH promoters. They also observed childcare and mother-support program activities at a nursery school and a community-based organization, respectively, in collaboration with the municipal health department, as well as school health activities in a primary school.

These provided the seminar participants with an opportunity to observe practical applications of GO-NGO partnership, sustainable RH promotion, and to have discussions with those planning and carrying out the activities.

The participants realized the importance of establishing a nation-wide voluntary system such as the MCH promotion council. They were also deeply interested to learn what makes MCH promoters motivated to become volunteers, especially as some MCH promoters have been doing it for a long time.

With Yamaguchi municipal MCH promoters and their hand-made health education materials

Yayasan Kusuma Buana (YKB) has been collaborating with JOICFP for over 20 years. YKB deliversprimary health care service integrated with parasite control school health programs, and mother-and-child health services to the middle-lower income population in the community in Jakarta, drawing on lessons learned from the Japanese experience.

For the last week, the seminar moved to Jakarta to meet with YKB and observe its sustainable activities in order to better understand sustainable RH, how Japanese experiences in community RH can be adapted to suit local conditions, and what YKB has learned in applying those experiences as an element to increase the enduring impact of NGOs.

Even though YKB’s Pisanganbaru Clinic charges clients, it is popular as the quality of service is high at a low cost, and it has come to be rooted in the community through the efforts of the clinic staff and its out-reach health services in the community. The clinic’s main service was provided by midwives with technical supervision by doctors when needed. The clinic was the first one of five YKB clinics, all managed on a fee-charging basis.

Interviewing a client at the Pisangbaru Clinic, which provides quality services and operates on a self-sustainable basis

YKB has been carrying out primary school-based parasite control programs since 1987, also on a fee-charging basis, contributing to its sustainability. Through parasite control activities, YKB introduces other health activities such as anemia control for students and Pap smear examinations for teachers, and seminars on health education for parents and teachers. The number of schools covered has increased from 34 in 1987, to 721 in 2006 with more than 200,000 students.

YKB also works with the private sector, providing health check-ups for workers and offering education and training on HIV prevention. One such good practice is with the PT Gajah Tunggal tire factory, the largest integrated tire manufacturer in South-East Asia. YKB approached the management and advocated for an HIV prevention campaign in the factory. As a result, the management of the factory has accomplished AIDS prevention education for all the 10,000 workers with technical support by YKB. Visiting the factory, the seminar participants attendedrefresher education classesin which the workers were learning from each other at peer education sessions.

Working in a "win-win" relationship with companies, YKB now advocates in networking with ILO to initiate HIV /AIDS program in the work place.

Addressing the seminar participants, Dr. Adi Sasongko, Director, YKB, said that it was important to start small and build on that. He explained how clinic activities with school-based parasite control services had expanded to include education for teachersand other types of health activities, which enhanced the sustainability of their comprehensive preventive health program.

Dr. Adi also emphasized that schools serve as an effective entry point to initiate a comprehensive health program because there are many students and teachers readily available in school. It is not necessary to make a big effort to organize the people as in other cases. Furthermore, in general, teachers become good supporters as they understand the importance of health. Students can follow teachers’ advice and instructions for healthier behavior and they disseminate such messages among their families and community members.

Dr. Adi also urged NGOs should not be afraid of making mistakes as in this way learning could take place.

Observing peer education sessions on HIV prevention at the PT Gajah Tunggal tire factory

Finally, the seminar participants developed interim reports (action plans), making use of practical ideas and strategies learned from the seminar.

At JICA Indonesia Office, through JICA Net, the seminar participants presented their interim reports and communicated with JICA in Tokyo for a wrap-up session.

The three-day workshop with YKB gave participants insight into YKB’s integrated sustainable strategy, and how NGOs can revitalize to avoid organizational deterioration.

Comments from the participants regarding the new RH seminar showed they were strongly convinced and encouraged to adapt Japanese experiences to suit their local conditions, especially as YKB had shown concrete examples on how to do this.

In particular, the participants were impressed with the continual efforts of YKB staff over many years towards improving community health, and that their strategies have been identified as extremely effective in achieving sustainability for NGOs working in the field of RH.