Project Background
SurfAid believes that Mother and Child Health can only be improved if basic health structures are in place and adequately equipped; if staff and volunteers are well trained, able and motivated to deliver appropriate health services; if mothers and caregivers understand and practice healthy behaviours and there is a positive environment to support these improved health behaviours.
The natural entry point for the project is the community health post (Posyandu) and the community health volunteers (kaders) that work in them. Each sub-district has a basic public health centre (Puskesmas) that employs medically trained health professionals. Staff travel monthly to communities to deliver Posyandu services and are assisted by the kaders.
With your support, we have been able to significantly improve the quality of the community health post services!
Training of the kaders encompasses a wide range of topics, including providing information on suitable nutrition to (expecting) mothers and young children, and recognising indicators for problematic pregnancies and malnourished children that function as an early warning. The kaders are provided with basic tools to conduct data collection (scales, measuring tapes, etc.). Additionally, the project provides training of health staff on methodologies for training the kaders, and also works closely with Puskesmas health staff to closely coordinate activities in the project’s target area.
Key Project Outcomes
- Improved quality of 15 community health posts (Posyandu)
- Trained 75 Health Volunteers (kaders)
- Established 45 support groups within the community
- Established hand-washing campaigns in 12 schools
- 1,120 community members reached with creative health promotion campaigns
Project Overview
Better access to quality community health services (Posyandu)
The quality of Posyandu services has significantly improved, leading to better visiting rates and better health monitoring of pregnant women and children. Before the project, the Posyandu was only attended once in a while, and mainly for immunisation. Most of the kaders did not know not know how to measure children’s weight and height; how to record and monitor the information, and provide appropriate support to families.
Through Footprints funding, SurfAid together with the community health centre trained 75 kaders from 4 villages in Laboya Barat, West Sumba on facilitating basic health services in the Posyandu; how to conduct anthropometry, to plot the children’s nutritional status in the important growth monitoring chart and manage the Posyandu services. To improve the skills of kaders, SurfAid also coached them before and after the Posyandu services.
An average of 936 mothers of children under-five are now able to access the improved Posyandu services every month and enjoy the health promotion sessions from the kaders.
Every other month after the Posyandu service, the kaders also facilitate a cooking class to promote a healthy diet using local foods such as cassava, pumpkin, coconut and mung-bean. It is a fun way for mothers and caregivers to learn nutritious and delicious recipes, while practicing proper hand-washing and how to prepare foods. Given that an average traditional meal is a bowl of rice with some sugar or salt, the children really love the new recipes! With the cooking classes we are slowly changing the perception on what healthy food is, that it doesn’t have to be expensive if you use vegetables from your garden, and that vegetables are tasty!
To create a positive environment to support the new knowledge and behaviour of the mothers, 45 support groups were established. These 420 parents and grandparents of children under-five are helping to change the community perception about child-caretaking so it becomes a family and community responsibility.
Health campaigns for the whole community
Next to the intensive coaching and sessions for mothers and care takers, SurfAid also delivered health campaigns through very popular movie sessions to more than 1,120 people. Mainstream movies were cut up and inserted with ‘commercial breaks’. The ‘commercial breaks’ are messages from community members themselves or short clips, on hand-washing, hygiene practices, early and exclusive breast feeding, and malaria prevention using insecticide treated malaria nets.
The simple act of hand washing with soap can reduce the number of sanitation related deaths by over 40 percent.
Campaigning and capacity building on hand-washing with soap are therefore important components of SurfAid’s health promotion activities. Basic activities included practicing hand washing with soap using buckets with a simple tap (as made available by SurfAid), or using tippy taps that can be easily be made by community members. The tippy tap is a hands free way to wash your hands that is especially appropriate for rural areas where there is no running water. It is operated by a foot lever, which reduces the chance for transmission of bacteria as the user touches only the soap. It is simple and efficient to create, requiring only sticks, rope and a container; and ensures a family has a hand-washing facility.
The hand-washing campaigns were delivered in 12 elementary schools reaching 600 students. Students are an effective agent of change to improve the hand-washing behaviour of family members at home. Complementary to practicing with the tippy taps or jerry cans, games and comic books were used to get the children engaged and enthusiastic.
Can I visit this project?
Not at this time.
Project Background
SurfAid’s Mother and Child Health Project in Sumba aims to improve the health and well-being of children under five, pregnant women and the whole community through initiatives conducted by health volunteers. The focus is on improving healthy practices to address diarrhoea, malnutrition and malaria in Lamboya Barat, a remote subdistrict in west Sumba, Indonesia.
Sumba is the Indonesian island closest to northern Australia but remote from Indonesian centres. Infant and maternal mortality are well above national figures. The people are almost all poor subsistence farmers and the local culture remains very strong.
We work together with communities and local government to prevent mother and child suffering and death. The latest Indonesian statistics show that every three hours a mother dies in childbirth, while every hour 20 babies die. Half of these babies are less than one month old. In remote areas these figures are worse. We provide a mix of practical support, education and health promotion that aims to change poor health behaviours into positive behaviours. Simple basic stuff, really, but with huge effects!
Project Objectives
- Locally adapted education materials on mother and child health for 7,765 people in 15 communities. Sumba has very strong local traditions, which will be acknowledged and incorporated into health messaging, prepared in the local language.
- Village level coaching of 75 health volunteers (kader) in 15 communities.
- Village level coaching of mothers, caregivers and support groups on mother and child health. Including; pregnancy and birthing support, nutrition and hygiene.
Project Activities
- All the villages in Lamboya Barat will receive vibrant health materials, posters and videos in their local dialect, and equipment such as weighing scales. This will cover 8604 people, with 1344 children under five.
- 75 volunteers across 15 hamlets will be empowered and inspired through dynamic training on mother and child health
- 15 midwives will receive support in the villages and supplementary training including in community engagement
Though the wider program, of which this project is cornerstone, mother and child mortality will be reduced through lifting local skills, mutual support and self-belief.
Volunteer driven
Groups of community health volunteers (kader) work together with the local health department to deliver health messages on nutrition, hygiene and sanitation to their neighbours, focusing on at-risk households. They are our frontline, receiving ongoing training and support from SurfAid staff. These kader are the lynchpin between their own community and the community health services (Posyandu). Posyandu is a monthly health activity run by the kaders, where children under five and pregnant mothers receive basic health services. These include monitoring, weighing, immunisation and provision of health information. To help the kaders give clear and correct health messages to families, it is very important that they have training and educational materials.
Story of Marcelinus Talugoro – Water Committee, Patiala Dete
What’s important in your life? Your family, your job, your friends, your health, your future? To Marcelinus, the leader of the water and sanitation committee of West Sumba, the answer is something most of us take for granted: access to clean water and basic health care.
When I met Marcelinus on a rainy Friday, he was walking down the dirt road from Patiala Dete village. A bright smile lit up his face as I introduced myself and my companion from SurfAid. He kindly invited us into his house to wait for the rain to pass. His wife and brother welcomed us. A tikar — traditional woven mat — was quickly laid out on the veranda, a gesture from the home owner that we are welcome.
Marcelinus told us that his community is very happy with the community water program from SurfAid Sumba. He said, “It has changed our lives, made it better in a lot of ways, our mothers and daughters don’t have to walk for 3km twice a day to provide water for our family. Now our children are healthier; now we can dedicate the time to do other things, such as planting vegetables near our house, to make sure we have some nutritious vegetables for our family. But we can do more to ensure our community health”.
Very passionately, Marcelinus explained his daily tasks as leader of the committee for water & sanitation: from checking the water availability in the tank to ensuring there is fair distribution and trouble shooting problems. SurfAid ensures its water projects have appropriate low cost, low-tech materials so that the community can maintain them. This means that the equipment, tools and spare parts can be replaced locally with minimum cost and time. Marcelinus explained: “One day, we had a leak in one of the connectors, so we tried to find a quick solution. We were able to fix the problem by changing the broken pipe with a piece of garden hose. No extra cost needed to fix the problem! One of our community happily gave up the hose from his own house because we all have the same vision; the water is for our communal needs and that’s our priority”.
The hamlet in which Marcelinus lives has around 60 houses, and close to 400 people. So there’s 6–7 people per house. The bare minimum daily needs for clean water (drinking, cooking, basic hygiene) is around 3 litres per person. So, each house needs a minimum of 18 litres per day. So far, only 10 litres per house can be provided. This means even with the amazing effort, at this point in time, we can only provide half of what people really need.
The community is trying to help each other, and as Marcelinus says, “to make the community better, it’s important to own the issue as yours or mine, it’s OUR challenge”.
In addition to his voluntary work as head of the water committee, is a self-subsistence farmer. He mostly plants vegetables and corn to feed his family. Only a few times in a year can he sell some of the surplus of his harvest. Currently, he can sell some of his green beans, earning only 4000 IDR (32 cents USD) per kilo. Three months farming on 10000m2 land will yield around 240 USD. This income will be spent on basic necessities, including his children’s education.
“I wasn’t able to continue my education, I was in school until 9th grade only, I don’t know what God’s plan for me, but I hope we can provide education for the kids. It is so important for us all that they will reach as high as they can, and one of the kids would be able to become nurse or teacher, we need them very much here”.
The rain has stopped, or at least, slowed down a bit. It is time for us to say goodbye. As I leave the embrace of Pak Marcelinus’s hospitality, I feel encouraged by the dedication and efforts of Marcelinus and his community. I know there is still a long way to go, before one of the children becomes that teacher or nurse. I also know that Marcelinus will be a driving force in the new SurfAid Sumba program to support healthier, independent and resilient communities. The sun peeks out of the clouds. It is going to be a brighter tomorrow here in Sumba.
-- Nana Sohan --