Project Background
In Nias, a beautiful holiday and surfing destination, infant and maternal mortality are significantly above national figures. It is SurfAid's mission to improve the health, well being and self-reliance of people living in isolated areas like Nias, using our "a hand up, not a hand out" philosophy.
Surprisingly, you actually don’t have to look very far to find remote communities in our ever-connected world. Just behind the palms of one of the world’s top surfing destinations are villages that are so off the beaten track that basic government services don’t reach them. No clean water, health services, education or electricity.
With the support of Footprints, SurfAid has been able the increase the quality of the local community health posts, the knowledge on healthy behavior and mother and child health, the health seeking behavior of community members, increase exclusive breastfeeding for babies, and establish nutrition gardens for remote communities.
All these different elements have contributed to a decrease in underweight of children under five, from 23% to 3%!
Key Project Outcomes
- Rate of underweight children reduced from 23% to 3%
- Improved community health posts
- 40 household nutrition gardens established
- Community knowledge of positive 'Mother and Child Health' behaviours increased from 63% to 91%
- Mothers practicing breastfeeding increased from 47% to 55% and providing colostrum from 35% to 71%
- Family practicing planning on safe delivery is 93%, a huge increase from the initial 2.5%
- 1374 people reached, including 393 children under 5 and 105 pregnant women
Project Activities
In this project, groups of community health volunteers 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 front line, receiving ongoing training and support from SurfAid staff. These health volunteers are the bridge between their own community and the community health services.
Monthly, a health service is run by the volunteers, where children under five and pregnant mothers receive basic health services. These include monitoring, weighing, immunisation and provision of health information. To help the volunteers give clear and correct health messages to families, it is very important that they have training and educational materials.
Increasing the quality of basic health services (community health posts)
The basic monthly health service for pregnant women, mothers and children under five is run by health volunteers. Health and growth monitoring, immunisation and provision of health information are the main tasks. At the start of the project, the health posts didn’t have the most basic equipment to perform these tasks; weighing scales, measurement tapes and baby length boards, growth charts, tables etc. Therefore, the first step was to provide the health posts with these basic materials and to teach the health volunteers (kader posyandu) how to correctly use them and record the results. (see also “Increase coaching skills of health volunteers to support the parents in their communities”)
With the training and equipment available, the kader posyandu drastically increased their commitments and availability, from 11% of the health volunteers playing an active role in the health service, to 100%! This had an immediate impact in the service level. When assessed by the health department, all 6 health posts increased their quality level from level 0, the second highest level (as defined by the national government). The village midwives also received a midwife kit and the District Health Office ensured that the midwives and health staff are providing vaccine and medication during the monthly health service. With equipment in place, trained health staff available and knowledgeable active health volunteers ready to support, the visiting rate increased from 10% to 62%!
The visiting rate is important, as the health post provides the important monitoring service and health information. Higher visiting rates means that more women and children receive a health check and a bigger audience for health promotion.
Increasing the coaching skills of health volunteers to support parents in their community
The health volunteers are the front line workers. This project trained 42 health volunteers across 6 communities on mother and child health and specific coaching techniques by SurfAid staff and midwives. In remote areas the mode of delivery is usual very teacher driven, with very little room for creativity. The trining explored different ways of sharing knowledge, coaching and health promotion.
As a result, the confidence of the health volunteers drastically increased, as demonstrated through their ability to involve of all community leaders in the villages to support community health post activities, and to access budget from the villages! 4 out of 6 community health posts currently get supports from the village budget. This contributes to the sustainability of the quality of the health posts.
With the confident health volunteers in place, the quality of the health post increased, and the health promotion sessions for the community achieved remarkable successes.
Increasing parents' awareness and knowledge of child health, nutrition, hygiene and sanitation
6 village midwives were trained in a whole series of mother and child health topics so they could train the health volunteers in six remote villages. The volunteers and midwives then trained community groups; mothers and pregnant women, husbands and mothers-in-law. Approximately 180-200 people joined these groups every month. We cannot stress enough how important this is. People in remote areas have less formal education, and have very little access to information. Things that are so normal to us, like using a toilet, washing your hands after toilet use, are sometimes mind bowing concepts for a community. After one of the sanitation sessions, one community member spoke up and said that she never, ever thought about what could possibly be wrong with going to the river or garden to defecate. With the new knowledge on sanitation, bacteria transmission and the link to diarrhea she was immediately triggered into action, and build a toilet for her family…
Next to all sort of education sessions, SurfAid also supported community health volunteers and the village midwives to run monthly cooking classes. The cooking classes are a fun and very practical way translate knowledge on nutrition and child development into good practice. This helps parents or caregivers to prepare a varied menu of simple to prepare nutritious food with cheap, local available ingredients.
Project Background
SurfAid believes that mother and child health 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.
In order to achieve this, SurfAid creates interventions for all these different people and institutions, and aims to reduce barriers to change. Barriers to change include a lack of access to basic health services and clean water, limited access to nutritious foods, a lack of knowledge on basic hygiene and child health, and a lack of a supporting environment.
This project will focus on improving basic health services, specifically the community health posts and the health volunteers and staff who work in them, as well as increasing the healthy behaviour of community members.
Project Overview
In Nias, a beautiful holiday and surfing destination, infant and maternal mortality are significantly above national figures. It is SurfAid's mission to improve the health, well being and self-reliance of people living in isolated areas like Nias, using our "a hand up, not a hand out" philosophy.
Surprisingly, you actually don’t have to look very far to find remote communities in our ever-connected world. Just behind the palms of one of the world’s top surfing destinations are villages that are so off the beaten track that basic government services don’t reach them. No clean water, health services, education or electricity.
One example is Sisobahili -- a remote and extremely isolated village in Gido, Nias. To reach it is a journey unto itself. It begins by car with a four-wheel drive to a small dirt path. From there, it’s a 2 -hour hike, or a hair raising dirt bike ride, through the woods, crossing a river and a stream. During the dry season, it is quite a trek to get there, but easy enough compared to the wet season when the road becomes a sea of mud, and the rivers and streams completely flood. And did we mention there is no bridge?
SurfAid recently added this village to our outreach program. This project will support 6 villages like Sisobahili.
The inhabitants of Sisobahili Gido are mainly subsistence farmers, growing rubber and cacao. Their homes are scattered over a large area, and closer to their agricultural lands, rather than centralized around a main traditional chief house, as is more typical in Nias. Basic services, such as health care, clean water, and education are either of poor quality or non-existent. There is no midwife available to deliver mother and child health services. Two out of nine children are malnourished and the number of women dying in childbirth is unacceptably high.
Key Project Objectives & Activities
Donations to this project will ultimately benefit 6 isolated communities of Gido, Indonesia. These communities are comprised of 1,374 individual family members, including 515 children under five.
Objectives:
- Increase knowledge on child health, nutrition, hygiene and sanitation for the parents of Gido
- Increase quality of basic health services (community health posts)
- Increase coaching skills of health volunteers to support the parents in their communities
Activities:
- 42 volunteers across 6 communities will be empowered and inspired through dynamic training on mother and child health and coaching techniques
- 6 community health posts will receive basic health materials to monitor the health of toddlers, pregnant women and mothers.
Community Volunteer Driven
All of SurfAid’s programs employ a philosophy of a “hand up, not a hand out”.
To achieve this, we work to empower communities through training and behaviour change. In this project, groups of community health volunteers 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 front line, receiving ongoing training and support from SurfAid staff. These volunteers are the bridge between their own community and the community health services.
Monthly, a health service is run by the volunteers, where children under five and pregnant mothers receive basic health services. These include monitoring, weighing, immunisation and provision of health information. To help the volunteers give clear and correct health messages to families, it is very important that they have training and educational materials.