FOLLOW UP OF THE 7TH HIGH LEVEL MEETING

“ To Wards an Inclusive Society”

1

DEVELOPING AN INTEGRATION SERVICES

TO CHILDREN WITH DISABILITIES (CWDs)

Collaboration between MOSA & MOH

Republic of Indonesia

Tokyo, Japan, 30 August-2 September 2010

Several activities had been done :

1. Coordination meeting : recommended Plan ofAction that have to be done by each sectors

2. MOSA (Demand Side) :

Building Centre of Integration

Services for CWDs (2010 – 2011)

Developing guideline book with SOP

Empowering CWDs Forum at the

district level

3. MOH (Supply Side) :

Strengthening Health Centre to deliver health

services for CWDs through School Health Program

Drafting CWDs guidelines hand book for parents

who has CWDs. It is going to discuss with JICA and

it will be developed as MCH-Hand Books

Providing Community Health Insurance

(Jamkesmas) for CWDs of poor people

CHALLENGE and GAP

1. MOH and MOSA have different programpriority

2. Decentralization aspects related to humanresources

3. Indicator of CWDs in The PresidentInstruction No.3 in 2010 that its will beevaluated regularly by President Team.

POVERTY ALLEVIATION

WITH A FOCUS ON VULNERABLE PEOPLE-

THROUGH STRENGTHENING COLLABORATION

BETWEEN

THE SOCIAL WELFARE AND HEALTH SERVICES

Presented to

The 8th ASEAN & Japan High Level officials Meeting on Caring Sociieties:

30 August-2 September 2010, Tokyo, Japan

Ministry of Social Affairs Indonesia

5

BACKGROUND

Macro Statistics After the monetary crisis hit Indonesia in 1997, the

country still struggles to fight poverty.

In 2008 the total number of poor people (very poor, poorand near poor) were 19,1 million households or 76,4million people

Currently, it is believed that as the impacts of pro- poor,pro-growth, and pro-job programmes initiated by theGovernment, the number of poor people in 2009decreases to 18,5 million households or 74 Millionpeople

There are 22 Disadvantage People (PMKS)

6

Micro StatisticsBased on Demographic Health Survey

in 2007, are :

Prevalence of Under-Five Children malnourishment :5.4% (BW/aged)

Under-Five Mortality Rate : 44/1000 life births

Infant Mortality Rate : 34/1000 life births

Maternal Mortality Rate: 228/100,000 motherdelivery)

7

24

35

44

51

73

23

36

43

65

67

Secondary +

Some

secondary

Primary

Some primary

No education

26

29

33

47

56

17

36

44

50

61

Highest

Upper middle

Middle

Lower middle

Lowest

IMR* DIFFERENTIALS

EDUCATION WEALTH INDEX QUINTILE

* IMR refers to 0-9 yrs preceding the survey

31

45

32

52

Urban

Rural

RESIDENCE

IMR (per 1000 live births)

IDHS 2002-3

IDHS 2007

68

57

46

35 34

91

81

58

46 44

32 3026

20 19 26

32

23

0

30

60

90

120

1991 1994 1997 2000 2003 2006 2009 2012 2015

DE

ATH

S P

ER

1000 L

IVE

BIR

TH

S

MDG

2015

INDICATOR MORTALITY RATE

Per year Per day Per hour

Neonatal Mortality (0-28 days) 19/1000 Live Births 86.000 236 10

Infant Mortality (0-12 months) 34/1000 Live Births 146.000 401 17

Under five mortality (0-60 bulan) 44/1000 Live

Births

193.000 531 22

GOAL 4: REDUCING CHILD MORTALITY RATE

?

SDKI 2002-2003 & SDKI 2007

Challenge and Gaps

prepregnancy birth postnatalpregnancy childhood

Continuum of care Indicator Achievement:

DEMAND SIDECommunity utilize available MCH

facility (knowledge, health care

seeking, compliance, satisfaction)

BEHAVIOUR-

CHANGED SIDEImproving women, family and

community role

SUPPLY SIDE

Improving access and quality

of MCH services in basic and

referral levels

Improving

Surveillance System

Monitoring dan MCH

information (PWS-KIA)

FINANCIAL SIDEImproving proportional

budgeting allocation

PARTNER

SHIPBuilding effective

partnership

Implementation of

IMCI, Management of

Asphyxia, LBW &

ESDIGD in all PHC

ACCELERATION STRATEGY

Utilization of

deconsentration

budget, Jamkesmas,

NGO cooperation

Village

Midwives

and Nurses

12

Distance

18%

High Transport Cost

16%

No Idea Where

to Go

6%

Afraid to Go By Self

12%

Usually No Staff

8%

No Money

34%

Not Permitted

(by Spouse)

6%

674.7

8.7

2.6

0.4

2.3

3.8

1.29.6 No money (67,0%)

Do not like/ashamed (4,7%)

Work (8,7%)

Married, take care of family (2,6%)

Not accepted/rejected by school (0,4%)

School is far (2,3%)

Feels his/her education is enough (3,8%)

Invalid (1,2%)

Others (9,6%)

Reasons of Children

7-18 Years Old Not to Pursue

Studies, 2003

Problems of Poor People to

Access Health Services

(Survey 2002-2003)

13

No DISADVANTAGED PEOPLE Total

1 NEGLECTED CHILDREN UNDER FIVE (TODDLERS) 1.186.941 PERSONS

2 NEGLECTED CHILDREN 3.176.462 PERSONS

3 NAUGHTY CHILDREN/CHILDREN CONFLICT WITH THE LAW 155.444 PERSONS

4 STREET CHILDREN 85.013 PERSONS

5 SOCIO ECONOMIC VULNERABLE WOMEN 1.263.449 PERSONS

6 VICTIMS OF VIOLENCE 123.738 PERSONS

7 NEGLECTED ELDERLY 2.994.330 PERSONS

8 PEOPLE WITH DISABILITY 1.541.942 PERSONS

9 PROSTITUTION 71.657 PERSONS

10 BEGGARS 33.041 PERSONS

11 HOMELESS 55.740 PERSONS

12 EX PRISONERS 135.140 PERSONS

13 EX DRUG ABUSE VICTIMS 49.989 PERSONS

14 POOR FAMILIES

14. A VERY POOR 2.930.005 HOUSEHOLDS

14. B POOR 6.842.947 HOUSEHOLDS

14. C NEAR POOR 7.518.496 HOUSEHOLDS

15 FAMILIES LIVING IN INAPPROPRIATE HOUSE 5.880.449 FAMILIES

16 FAMILIES WITH SOCIAL PSYCHOLOGICAL PROBLEMS 453.542 FAMILIES

17 REMOTE INDIGENOUS COMMUNITIES 518.906 PERSONS

18 VICTIMS OF NATURAL DISASTER 1.917.308 PERSONS

19 VICTIMS OF SOCIAL DISASTER 335.992 PERSONS

20 NEGLECTED MIGRANT WORKERS 118.526 PERSONS

21 PEOPLE LIVING WITH HIV/ AIDS 19.834 PERSONS

22 VULNERABLE FAMILIES 1.247.110 FAMILIES

Stages of Poverty Alleviation through Empowerment Program of Very Poor People by Ministry of Social Affairs, the Republic of

Indonesia

Preconditions throughDeconcentration fund

Target: Communityat a whole and very

poor people

KUBE formation(growth) throughDeconcentration fundTarget: very poor peoplein accordance withthe criteria

KUBE Development through Central budget and Local Budget

Target: Productive KUBE/Advanced according to the criteria

MFI through central fundand Local BudgetTarget: Independent KUBE according to the criteria

Borrowingthrough BANK

ACTIVITY1. Proposals submission2. Checking the BANK3.Utilising loan4.Facilitated by Independent Maskot5. Evaluation

ACTIVITY1. MFI formation 2. Implementation of

business in MFI3. Facilitation of

Independent Maskot 4. Evaluation

ACTIVITY1. Socialization2. Selection and recruitment of TKSK3. Training for Facilitators 4.Veri & pene productive KUBE

5. UEP Proposal6. BLPS Fund Withdrawal7. Facilitation of IndependentTKSK

ACTIVITY1 .. Selection of candidate members of KUBE2. Establishment of pre Groups3. Determination of business services4. Training of facilitators5. Skill Training for KUBE members6. Capital aid 7.Facilitation by Maskot

KT, PSM, Orsos8 Evaluation

ACTIVITY1.Orientation and Observation2. Registration &identification3. Planning Program4. General social extension5.Problem Ident.. Guidance6..Motivation Guidance7. Preparation of evaluation

ACTIVITY RESULTSIdentification of prospective site and households of KAT member

ACTIVITY RESULTSKUBE formationand implementation of social activities and UEP andselected Productive andnon productive KUBE

ACTIVITY RESULTSFund distribution for UEP development and Identification of KUBE MFI and KUBE revitalization

ACTIVITY RESULTSMFI formation along withinvestment funds andKUBE membership in MFI

ACTIVITY RESULTSIncreased activity of UEPKUBE (KUBE membersreleased of Poverty)

Year 0 Year I Year II Year III Year IV

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MOH BUDGET ALLOCATION

FOR JAMKESMAS

Program

Budget (Rp trillion)

2005 2006 2007 2008 2009

Community Health Center (Puskesmas) 1,00 0,78 1,05 1,00

Hospitals 1,26 1,63 3,40 3,60

Total 2,26 2,42 4,45 4,60

Target (million population) 60 60 76,4 76,4 76,4

ACCELERATION OF POVERTY REDUCTION

UNDERTAKEN BY THE MOSA, THROUGH:

I. Empowerment of very poor people (PPFM)

II. Empowerment of Remote Indigenous Communities (KAT)

III. Unconditional Cash Transfer (BLT)

IV. Conditional Cash Transfer/Family Hope Program (PKH)

V. Social Security for People with Severe Disability (PJSPC)

VI. Social Services and Security for Neglected Elderly (PJSLUT)

VII. Permanent Social Welfare Assistance (BKSP)

VIII. Social Welfare Insurance (ASKESOS)

17

The Usage of Cash Assistance

(food education health)

18

FREQUENCIES OF BENEFICIARIES VISITING

PRIMARY HEALTH INSTITUTIONS (MONTHLY )

19

Scale 1-4:

1 Never

2 Sometimes

3 Often

4 Always

Beneficiaries’ Commitment to send their

Children to School (Monthly)

THE IMPACT OF HEALTH EFFORTS

IN CCT PROGRAM

Since 2009, all CCT beneficiaries automatically being covered

by Community Health Insurance as known “Jamkesmas”.

It is reported that CCT beneficiaries are more easily accessed to

the basic health care, nutrition care, communicable disease

eradication, etc at the Health Centre (Puskesmas) and certain

referral at the Hospital

20

School Enrollment

of CCT Beneficiaries' Children

Have been enrolled in

school before CCT and regulalry present

(80.47%)

Enrolled in school after

CCT and regularly present (19.05%)

Enrolled in school but not

present(0.47%)

21

Schoool and not working99.18%

School while

working (0.82%)

The Comparison Between

Working & Not Working Students of

CCT Recipients

EDUCATION SIDE Average of monthly school presence of children are more

than 85%

Ministry of National Education has stipulated that Special

Stipend for Poor Children (Beasiswa Miskin) must be

prioritized to CCT beneficiaries.

But:

Some parents still expect their children to work.

In common, some state owned basic schools still maintain passing

grade mechanism for new students. Therefore more children of

poor households are not passed and have to study in private

schools or religious school institutions (e.g. Madrasah (MI/MTs).

PROBLEMSExclusion and inclusion error

Self-targeting

Lack of coordination among stakeholders, at centraland local level

Integrated CCT into National/Local CoordinatingTeam of Poverty Alleviation

Administration problems on reporting and recording

Simplify verification forms

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Thank You

24

Terima kasih