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INTERNATIONAL COUNCIL ON MANAGEMENT OF POPULATION PROGRAMMES

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ANNUAL REPORT

2016

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International Council on Management of Population ProgrammesNo. 534 Jalan Ampang Utama, Taman Ampang Utama, 68000 Ampang, Selangor, Malaysia

ICOMPPublications

A Theory of Change for Tackling Young People’s

Sexual and Reproductive Health36 pages;

AGEING Thailand, Malaysia, Indonesia and Cambodia:

Demographic Transition, Policy and Programmatic Responses

112 pages; ISBN 978-983-3017-18-8

Consultation on Policy and Programmatic Responses to

Population Ageing70 pages; ISBN 978-983-3017-17-1

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2016


ANNUAL REPORT 2016


ANNUAL REPORT 2016

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Foreword

I. Introduction

II. ICOMP’s Executive Committee and General Assembly

1. ICOMP’s Executive Committee Meeting

2. 21st General Assembly (GA) Meeting

III. Programmes and Activities

1. Universal Access to Family Planning and SRHR

a. Policy and Technical Support Unit

b. Activities

i. The 14th FP2020 Country Committee Meeting ii. Family Planning in Universal Health Coverage (UHC) iii. Supply Chain Management (SCM) iv. FP2020 Country Committee Report v. Policy Dialogues and Advocacy

2. Population Dynamics

a. Indonesia’s Population Dynamics and Demographic Dividend

b. Ageing Across the Region

i. Case Studies on Ageing in Thailand, Malaysia, Indonesia and Cambodiaii. Six-Country Consultation on Ageing

IV. Adolescent Sexuality and Reproductive Health and Rights

1. Strengthening Leadership of Young People towards Adolescent, Sexuality, Reproductive Health and Rights in Indonesia

2. National Meeting and Roundtable Discussion

3. Independent Evaluation of the Youth Leadership Program

4. 2016 International Conference on Family Planning, Nusa Dua, Bali, Indonesia

5. 8th APCRSHR Satellite Meeting

6. Mentoring

V. South – South Collaboration

Financial Report

Policy Briefs

Highlights of the Adolescent Sexual and Reproductive Health Policies and Programs in Indonesia

Highlights of the Policy Brief on Universal Health Coverage

Highlights of the Policy Brief on Demographic Dividend

Executive Committee / ICOMP Members

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CONTENTS

Living its mission in 2016, the International Council on Management of Population Programmes rolled out a series of activities focusing on leadership and management, and capacity building for our partners. We would like to express our deepest thanks to those who made it possible for us to do our mandate. Our gratitude goes to the donor member countries particularly Indonesia, China and India, and to our Executive Board for their support and guidance. Special mention to Ford Foundation Indonesia and India for their steadfast support to ICOMP and its vision. It is always great to work with UNFPA Indonesia, IPPF – ESEAOR and our other partners.

We encourage you to read our Annual Report 2016 for it accounts what we did, but more because of what we have done together with the government line ministries, civil society organizations and the people to introduce changes and make the difference in the communities. No matter how arduous the tasks may be, it is the spirit of working together to reach shared goals that matter. Indeed, by collaborating, we have gone further.

Highlighted in this report the high-level technical guidance of ICOMP to the Government of Indonesia in partnership with UNFPA Indonesia and National Population and Family Planning Board (BKKBN) through the Policy and Technical Support Unit (PTSU). The PTSU, managed by ICOMP, has completed the in-depth studies and analyses in the major areas of the Universal Health Coverage as it relates to Family Planning, Supply Chain Management, Population Dynamics and Youth Development. These studies were made as the basis to formulate policy where it is non-existent or to review and make it adapt to or deal with unexpected issues.

ICOMP continues to get inspired by the young people for steering our project, Young Visionary Leaders, and, in so doing, they reached out to more disadvantaged young people. We always think that young people are out to enjoy. But true to their being, they are out to enjoy but also to mark the difference on the issues of teenage pregnancy, HIV/AIDS, domestic violence, and maternal death to name a few. What we’ve learned is that we need to trust them, and to provide support as they steer their future. What ICOMP simply did is to provide the avenue to learn, mentor them, and provide the seed grants to undertake serious work to address the concerns of young people in their respective communities.

While the young people enthuse us, we also deeply care for the elderly, and the seeming neglect of this population for lack of clear understanding of their situation. ICOMP has commission four experts to study the ageing population in Thailand, Indonesia, Malaysia, and Cambodia. The south-south meeting on ageing, which ICOMP organized indeed provided the altitude to guide countries.

Let us know your thoughts about what we do, and where you think we should also make a big difference. We open our doors to anyone who has a similar vision to empower people and level the opportunities of those disadvantaged. We welcome you to read this report.

Best regards,

Aurelio Camilo B. NaravalExecutive DirectorICOMP

FOREWORD

FO R E W O R D

1ICOMPInternational Council on Management of Population Programmes

2 ICOMP Annual Report 2016

ICOMP came into being in 1973 when the nexus between population and development had just emerged. In response to the 1974 World Population Conference in Bucharest, which underscored the gravity of rapid growth rate and the interdependence between population and development, ICOMP blazed the trail on strengthening the management of population programs in Asia, Africa, and Latin America.

In the subsequent three decades, particularly after the 1994 Cairo Conference, ICOMP collaborated with government agencies and Civil Society Organizations (CSOs) towards community and people-centric interventions guided by universal access, human rights, and civil society participation. Over time it morphed towards addressing the population, development, and Reproductive Health and

Family Planning (RH/FP) in line with the Millennium Development Goals.

As the world moves towards a new international sustainable development order, ICOMP continues to play a unique role in responding to population and development issues by acting as a bridge between national RH and population programs, management institutions, and civil society organizations. It remains focused on leadership

I. INTRODUCTION

I N T R O D U C T I O N


and management, especially in strengthening program capacity and effectiveness with managerial improvement in developing countries, catalyzing policy dialogues and advocacy, and promoting use of best practices and innovative approaches to deliver superior programme results.

In 2015 ICOMP’s Executive Committee and General Assembly approved its three key programs, namely: “Population Dynamics, and National Planning” “Youth

Leadership and Development,” and “Universal Access to SRHR.” And approach these programs through ICOMP’s proven strategies, such as: “strengthening leadership and management capacity and enhancing organizational excellence,” “catalyzing policy dialogues, advocacy and networking,” and “managing knowledge and promoting the use of promising practices” through learning and demonstration. These are discussed separately in this Annual Report.

In 2015 ICOMP’s Executive Committee and General Assembly approved its

three key programs, namely: “Population Dynamics,” “Youth Leadership and

Development,” and “Universal Access to SRHR.” And approach these programs

through ICOMP’s proven strategies, such as: “strengthening leadership and

management capacity and enhancing organizational excellence,” “catalyzing policy

dialogues, advocacy and networking,” and “managing knowledge and promoting

the use of promising practices” through learning and demonstration.

I N T R O D U C T I O N


II. ICOMP’S EXECUTIVE COMMITTEE AND GENERAL ASSEMBLY

ICOMP’s 60th Executive Committee (ExCo) convened in Bali, Indonesia with Dr. Surya Chandra Surapaty, MCH, MD, Ph.D., Head of the National Population and Family Planning Board of Indonesia (BKKBN), and concurrently Chair, ICOMP’s Executive Committee, leading the meeting. In attendance were the Vice-Chair and Treasurer of ICOMP’s ExCo, Mr. Hu Hongtao, Commissioner, National Health and Family Planning Commission of China, and Dato’ Dr.

Siti Norlasiah Bte. Ismail, Director General of the National Population and Family Development Board of Malaysia, respectively. Dr. Aurelio Camilo Naraval being an Ex-Officio member was also present.

In the meeting, the Executive Committee approved the recommendations of the General Assembly with regard ICOMP’s revised Executive Committee membership with representation from key regions (Africa and the Middle East, Asia and the Pacific, Latin America and the Caribbean). It also confirmed ICOMP’s new programs, namely: Population Dynamics and National Planning, Youth Leadership and Development, and Universal Access to FP/SRHR. In the meeting, the ExCo members also confirmed the designation of Dr. Naraval as ICOMP’s Executive Director.

ICOMP’s Executive

Committee Meeting

I C O M P ’ S E X E C U T I V E C O M M I T T E E A N D G E N E R A L A S S E M B LY I C O M P ’ S E X E C U T I V E C O M M I T T E E A N D G E N E R A L A S S E M B LY


21st General Assembly (GA)

Meeting

After Dr. Surya Chandra Surapaty, Head of BKKBN, and concurrent Chair of ICOMP’s Executive Committee gave his welcome remarks, he acknowledged all the participating members of the General Assembly and opened the discussion on the new

programs of ICOMP. A total of 20 GA members attended the meeting from 10 member countries.

Prof. Jay Satia, former Executive Director of ICOMP, moderated the session. Three experts, Dr. Evi Arifin (University of Indonesia), Ms. Hong Ping (China Family Planning Association), and Dr. Rosalinda D. Marcelino (Commission on Population) spoke about their thoughts, reactions and recommendations on Population Dynamics and National Planning, Youth and Leadership

Development, and Universal Access to FP/SRHR, respectively. An open forum and a vote by the GA members affirmed the new directions of ICOMP.

Also, the GA approved the clause on the representation of the different regions to the Executive Committee. Then followed with the election of the members of the Executive Committee for 2017-2018. Voted to the Executive Committee were Dr. Surya Chandra Surapaty, MCH, MD, Ph.D., Mr. Hu Hongtao and Dato’ Dr. Siti Norlasiah Bte. Ismail.

I C O M P ’ S E X E C U T I V E C O M M I T T E E A N D G E N E R A L A S S E M B LY


PTSU’s mandate is to provide

high level technical assistance

to BKKBN and strengthen

rights-based, equitable and

quality family planning policies

and programmes, utilizing

regional and international

partnerships including south-

south cooperation.

III. PROGRAMMES AND ACTIVITIES

Universal Access

to Family Planning

and SRHR1

A. POLICY AND TECHNICAL SUPPORT UNIT

In its efforts to increase availability and access to quality integrated reproductive health services including family planning, and maternal health and HIV, UNFPA-Indonesia collaborated with the International Council on Management of Population Programmes (ICOMP) to implement the Policy and Technical Support Unit (PTSU). This PTSU is in partnership with the National Family Planning and Development Board (BKKBN).

There are three (3) main strategic interventions to advance the goals of the PTSU that address the current concerns of Indonesia. These are in the areas of Universal Health Coverage, Integrated Planning and Programming of Rights-based Family Planning, and Strengthening the Government of Indonesia’s South-South Cooperation on Population and Family Planning Programme.

P R O G R A M M E S A N D A C T I V I T I E S


B. ACTIVITIES

i. The 14th FP2020 Country Committee Meeting

Highlighted in the Country

Committee meeting the

progress of Indonesia’s

commitment to the

FP2020 targets.

In its capacity as the Secretariat of the FP2020 Country Committee, the PTSU-ICOMP organized the 14th FP2020 Country Committee meeting with UNFPA-Indonesia and BKKBN on 1st September 2016, at NPFPB Conference Room. The Acting Principal Secretary, and the Head of NPFPB Planning Bureau, Mr. Ipin ZA Husni, chaired the meeting. Co-chairing the meeting were UNFPA-Indonesia’s Representative Dr. Annette Robertson, and the Health Office Deputy Director of USAID, Dr. Zohra Balsara. Sitting on the panel were the Deputy of FP and RH, Dr. Dwi Listyawardani; and BAPPENAS representative, Mr. Ahmad Taufik. Attendees consisted of representatives from the Ministry of Health, Ministry of Home Affairs, Indonesian Midwives Association,

international agencies, national NGOs, and private sectors. They were present as members of the FP2020 Country Committee.

Dr. Robertson introduced the new PTSU team and briefly discussed some updates on Indonesia’s progress towards FP2020 commitments particularly on the work of PTSU. The Deputy of FP and RH, Ms. Listyawardani, emphasized in her opening presentation the development of Integrated FP Services in Universal Health Coverage. The meeting agenda included reports from Rights-based Family Planning Working Group (presented by Mr. Taufik) and Rights and Empowerment Working Group presented by Ms. Ninuk Widyantoro, the working group’s coordinator, and followed by FP2020 Country Committee Action Plan Report, which the UNFPA National Program

Officer on FP, Dr. Melania Hidayat, presented. The discussion, moderated by Mr. Husni, covered the following topics:

• Policy harmonization amongst stakeholders;

• Formation of data working group to hold a data summit in attempt to synchronize all data sources;

• Tubectomy intervals not being covered by the UHC,

• How to align the strategies, policies, and laws with the decentralization system in this era of autonomy, and

• Who would be responsible for the certifications of competency of over 58 thousands of trained midwives in the country?

Dr. Surya Chandra Surapaty, Head of BKKBN, closed the meeting, and reiterated his call to make available and accessible permanent contraceptives especially interval tubectomy, and urged all stakeholders to take part in the FP2020 Global Initiatives.

U N I V E R S A L A C C E S S TO FA M I LY P L A N N I N G A N D S R H R


ii. Family Planning in Universal Health Coverage (UHC)

In 2013, Indonesia declared that it would provide affordable health care for all its citizens or 250 million people by the end of 2019. However, up to November 2016 the BPJS registered 71% (n=179,954,111) out of 254 million populations. To cover all Indonesians in 2019, BPJS-Kesehatan needs to enroll the remaining 74 million. In this respect, the Government of Indonesia is continually reviewing and improving the UHC policies and programs implementation with the aim of reaching its goal of covering health care to all Indonesians.

Family planning is one of the benefits under the UHC scheme. There is growing evidence that health insurance programs can enhance access to health services including FP. It will help fill the gap in meeting FP needs. There are many strong pieces of evidence that family planning results in benefits beyond reducing unmet need and lowering fertility - benefits such as fewer maternal and child deaths and complications from abortions; and improved nutrition outcomes among women, infants, and children.

As part of the ongoing strengthening of the Universal Health Coverage (UHC), PTSU-ICOMP recruited consultants to review the implementation guidelines for FP in UHC mainly focusing on the effectiveness of Mobile Service Units in the UHC schemes. In early December 2016, with support from the Directorate of FP Participation Building through the Public Line (JALPEM), Centre of Health Policy and Management – University of Gadjah Mada (CHPM-UGM) developed instruments and questionnaires for the study. In mid-December, they began fieldwork and data collection in five provinces: DI Aceh, East Java, West Kalimantan, South Sulawesi, and North Maluku, having picked two districts as target area from each province.

Universal Health Coverage is universal access of

people to quality promotive, preventive, curative and

rehabilitative health services while also ensuring

that people do not suffer financial hardship when

accessing for these services.

WORLD HEALTH ORGANIZATION



In 2016, it is estimated in

Indonesia that 8 million

unintended pregnancies

will be averted by modern

contraceptive use, as will nearly

3 million unsafe abortions and

nearly 15,000 maternal deaths.

6Meeting of the consultants and technical experts (14 November 2016)

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The study concluded:

• The need for regulation at the local government level to support the implementation of the programs and services of KB under UHC.

• Given the inadequate understanding of the community, there is a need to increase the socialization of the integration of the services into financing KB JKN; and

• Need to strengthen the implementation of the Mobile Service Unit (Muyan) KB by developing policies at the Central and Regional levels and improving Standard Operating Procedures.



iii. Supply Chain Management (SCM)

The introduction of the Universal Health Coverage FP benefit package gave way to a growing demand for FP supplies. Adding strain to the high demand of FP supplies is the enormous variation of Indonesia’s geographical condition and the reported stock-outs of contraceptive methods in the health facilities. Thus, BKKBN with support from PTSU initiated a pilot testing of three Supply Chain Models. Envisaged in this model building that BKKBN, after careful evaluation, could arrive at a model or models best fitting to Indonesia contexts in ensuring FP supplies in the health facilities. First, among the models, Model A, is a modified version of the current SCM adopted by BKKBN with investments in building the capacity of program implementers at the central and provincial offices. This vertical supply chain management is run by BKKBN. Second model, Model B, ensures distribution and storage from the district level with the District Health Office and its warehouses.

The third, Model C, is a public/private sector partnership with the Indonesian postal service providing the distribution at the districts.

Two provinces, East Java and Nusa Tenggara Timur (NTT), were selected to roll out the models. East Java, for its part, implemented the model testing in three districts/municipalities with one district for each model. On the other hand, NTT picked two districts/municipalities to apply each model bringing to a total of six districts. Overall, there were nine districts involved in the pilot testing. In addition to the “intervention areas,” an equivalent “control” area for each was selected to provide a reliable baseline data to compare the results. PTSU/ICOMP’s SCM National Consultant, Mr. Hasbi Shiddiqi, supervised the whole process. An additional SCM Technical Assistant was recruited to spring the model testing in NTT.

Operationally, the two provinces had different issues and concerns including the legal basis to implement the models, and some administrative roadblocks concerning funding, training of staffs and their availability. Nonetheless, both provinces started to apply the models testing in September 2015 and July 2015 in NTT and EJ, respectively.

On-the-job training beefed up the capacity of the program implementers with support from the PTSU/ICOMP’s experts. PTSU successfully carried out the field monitoring and providing coaching to all districts to observe the implementation models and make recommendations and follow up actions for improvements.

PTSU-ICOMP noted several challenges in areas that implemented Model C. However, two key recommendations emerged in the SCM model testing, and these are the use of Models A and B as national models for distributing contraceptive commodities, and the need to set more specific and measurable targets.

a) Operational Testing of the three SCM Models

b) Review of SCM Model B in Non-Pilot Site Areas

During the testing of the three SCM models, some districts came to know about the Model B and started to implement it in their communities. Model B is a unique approach in SCM. Under this scheme an inventory of the provincial warehouses triggers BKKBN central to distribute the



4Mr. Hasbi Shiddiqi, ICOMP’s National SCM Consultant (right) providing mentoring support in operationalizing the SCM Models in Sabu Raijua, November 2016

6Meeting with BKKBN Yogyakarta (Dec 2016)

Based on the end line assessment in December, 2016, the performance of Models

A and B proved to enhance the SCM and are making progress in terms of ground

reporting and availability of supplies.

FP commodities to the provinces. The same process takes place before the BKKBN provinces distribute the supplies to the SEGWAY KB Kabupaten/Kota or districts to the Clinics.

It became more apparent that several factors could interfere and modify the process of FP services at the health facilities. To identify the pushing and pulling factors in the availability of FP

commodities, BKKBN and UNFPA – Indonesia through the PTSU-ICOMP, mapped the variation of contraceptive supplies distribution model implemented in Jogjakarta, Denpasar and Mojokerto Regency. Specifically, the assessment sought to identify the regulation framework, describe the mechanism of distribution of contraceptives and the coordination management

including the success and inhibiting factors of FP commodities distribution.

Underscored in the study that the three areas conformed with the regulatory framework related to the distribution of FP products, but required strengthening of coordination among the parties involved in the city-level distribution. It noted that the coordination between BKKBN Provinces and the health facilities led towards ensured availability of the supplies. However, the review appealed for an increase in the distribution cost or handling cost to support the accelerated and growing demand for FP commodities. Furthermore, the assessment concluded that the Model B logistics management model was efficient regarding managing FP supplies.



iv. FP2020 Country Committee Report

5PTSU Consultant, Ms. Imma Batubara (right), delivering the FP2020 Annual Country Report during the 15th FP2020 Country Committee Meeting (14 Dec 2016)

In preparing for the FP2020 Annual Country Report, PTSU, acting as the FP2020 Country Committee Secretariat, recruited Ms. Imma Batubara to conduct situational analysis and identify the progress and challenges towards achieving Indonesia’s FP2020 Commitments.

To obtain historical and current information on FP in Indonesia, the PTSU conducted a desk review, in-depth interviews and focus group discussions with experts from BKKBN, Ministry of Health, BAPPENAS, NGOs, Indonesian Midwife Association (IBI), Indonesian Society of Obstetrics & Gynecology (POGI), UNFPA, Religious groups/leaders, and Youth from October to December 2016.



v. Policy Dialogues and Advocacy

4Policy Advisory Team’s Consultative meeting with the Head of Planning Bureau, Pak Husni; UNFPA, Dr. Annette Robertson, and PTSU Program Manager, Mr. Inang Winarso (11 Nov 2016). Three PTSU consultants attended the meeting. These are Sri Moertiningsih (second from left), Siswanto Agus Wilopo (third from left), and Inne Silviane (first from right facing backwards).

In the Strategic Plan of BKKBN Year 2015-2019, BKKBN commits to the Development Priority Agenda (Nawacita), especially the Priority Agenda No. 5 to improve the quality of life of the people of Indonesia through population development and family planning.

For the past 10 years, however, Indonesia’s Total Fertility Rate has plateaued, and gained only a marginal increase in the number of FP acceptors. Several factors influenced these outcomes from the supply and demand sides and familial factors that constrained women and men from seeking FP. In light of the GOI’s commitment to narrow the gaps of FP unmet needs and make quality FP information and services available and accessible to the reproductive age group, BKKBN and UNFPA-Indonesia agreed on key interventions to advance

these goals especially to ensure that policies are adequate and are responsive to the needs of program implementers and beneficiaries.

In 2016, the PTSU formed the Policy Advisory Team (PAT), a high level technical assistance group composed of experts, to assist and provide support to BKKBN at the highest levels on Family Planning within the Universal Health Coverage, Demographic Dividend, and Adolescent Sexual and Reproductive Health. PTSU recruited Eddy Hasmi, Prof. Dr. Siswanto Agus Wilopo, Prof. Dr. Sri Moertiningsih Adioetomo, Inne Silviane to assist BKKBN in the above-mentioned issues.

On December 5, PAT coordinator and consultants convened a validation meeting.

In the meeting, each one of the consultants delivered their policy paper. (See Policy Recommendations, Pages 27-29 of this report). UNFPA, BIREN, and other BKKBN directorates attended the meeting. Towards the end of December, after adding the inputs from the meeting, the consultant submitted their revised policies brief for review by BKKBN, ICOMP, and UNFPA.

6PTSU’s Policy Advisory Team members during a meeting with BKKBN staffs (3 Oct 2016).



Population Dynamics2

A. INDONESIA’S POPULATION DYNAMICS AND DEMOGRAPHIC DIVIDEND

Providing a high level technical and policy development assistance to BKKBN, the Policy and Technical Support Unit (PTSU), which ICOMP is managing with support from UNFPA Indonesia, commissioned Prof. Dr. Sri Moertiningsih Adioetomo to conduct a policy review of Indonesia’s population dynamics, and provide an analysis and recommendations to BKKBN. She is a well-known and respected demographer in Indonesia.

Writing on the population dynamics in Indonesia, Prof. Dr. Sri Moertiningsih Adioetomo has underscored maintaining a favorable age structure and anticipating the “window of opportunity.” However, this period of opportunity requires Indonesia to achieve TFR of 2.1 in 2025 (TFR 2012 is 2.6 – IDHS 2012) and a further decline to 1.95 when the “window of opportunity” is open (UN Projection 2015). To achieve this, Indonesia will need to work

hard in reducing Family Planning unmet needs from 11 percent in 2012 to 9 percent in 2019. The high percentage of unmet need indicates that the demand is there, but the services are insufficient. Experts recognized that the high unmet needs would result to increase unplanned births and unsafe abortion leading to maternal death.

Prof. Dr. Sri Moertiningsih also noted the problem posed by an uneven contraceptive security at the grassroots level. Underscored in her report the lopsided use of short-term contraceptive commodities even among couples that wish to stop childbearing (IDHS 2002/3, 2007, 2012).

Indonesia will need to work hard in reducing

Family Planning unmet needs from 11 percent

in 2012 to 9 percent in 2019.

There is also evidence of an increased teenage fertility, which in 2012, 48 out of 1000 women age 15-19 years already have given birth. Teenage pregnancies increase the risk of maternal death. Priority policy and recommendations include the following:

• the continuation of FP program to maintain age structure favorable to economic growth;

• increase CPR to address the unmet needs by improving quality of care and availability of contraceptives;

• stronger promotion to increase male participation to help reduce fertility rate; and

• increase IEC to promote a long-term method of contraceptive to (older) couples who wish to stop childbearing.



B. AGEING ACROSS THE REGION

Population ageing and the related burden of illness and disability affect countries and related sustainable development. The changing demographics and increasing number of elderly impose a strain on economic

growth, labor markets, family schemes and living arrangements, housing, as well as pensions and other health and social services. A growing elderly population necessitates institutional provisions and policies to

provide resources to this group. Experts recommended the need for evidence-driven plan to deliver effective programs, and empower the older people to be functional so they could meet their health and social needs.

The following are the two primary activities of ICOMP on Ageing in 2016:

ICOMP carried out capacity enhancing activities to address ageing issues and challenges to:

• Increase attention to ageing by building a knowledge base on the situation of elderly and draw lessons in dealing with the needs of the elderly.

• Create platforms for policy dialogues and towards an enabling environment and sharing of experiences on ageing as a basis to suggest action address new challenges and set priorities on ageing; and

• Enhance leadership and analytical capacity of countries to address ageing, including providing technical assistance to government agencies and CSOs.

i. Case Studies on Ageing in Thailand, Malaysia, Indonesia and Cambodia

Countries in the region are at different stages of this demographic transition which results in changing age structure. Demographers, economists, and public health experts are one with their position that the changes in population contribute to different social and economic benefits and challenges.

An increase of older age group leads to population ageing where a relatively high proportion of the population is over 60 years of age. The ageing process is an inevitable outcome of a positive demographic trend. However, the increasing burden of disease

in older people presents a challenge. Population ageing and related burden of illness will have far greater impacts on social security and old-age pensions and health care and will require many changes in social policies and programmes. If not properly understood, these changes could result in policymakers and planners adopting policies that are not based on evidence and not align with best practices and guiding principles as enunciated in various international conventions and agreements.

ICOMP with support from IPPF-ESEAOR carried out an in-depth analysis of ageing.

P O P U L AT I O N DY N A M I C S


The project aims to build a knowledge base through case studies and documentation of promising practices in four countries. Also, the study intends to draw upon the global experiences on both assessing and anticipating population dynamics (ageing), and influencing responsive policies.

ICOMP selected four countries, namely: Thailand, Malaysia, Indonesia and Cambodia because of their unique population structures and the challenges that these countries are facing. Countries like Cambodia are experiencing a doubling of ageing population in about 30 years, far lesser than Japan, New Zealand and Australia that took 50 years to double their ageing population. Thus, Cambodia has lesser time

to prepare the response to the social, economic and public health implications of population ageing. Given the sheer number of ageing people in Thailand and Indonesia also necessitates that their governments take immediate actions to mitigate the impact to their health, and socio-economy. Malaysia is soon to transit as an ageing nation and must take steps in increasing the awareness on ageing, and, also, to strengthen the policies and programmes including their implementation.

Four experts on population dynamics were recruited to do the study. These are Dr. Anthony Abeykoon writing the case study of Thailand; Dr. Evi Arifin (Indonesia); Dr. Chheng Kannarath (Cambodia), and Prof. Tey Nai Peng (Malaysia).

ii. Six-Country Consultation on Ageing

Taking forward the lessons learned and best practices documented from the four case studies, ICOMP and IPPF organized a six-country consultation to validate the findings of the case studies, and exchange lessons learned from China and Japan, two “super-aged” countries, with advance policies and programmes on ageing.

About 39 heads and managers representing six countries in Asia, government agencies, academe (University Malaya and Peking University), IPPF Member Associations, development partners, JICA Malaysia,

UNFPA-Indonesia, and ICOMP’s Executive Committee members attended the consultation.

The Deputy Minister, Ministry of Women, Family and Community Development, YB Senator Datin Paduka Chew Mei Fun gave the keynote address. The Heads of Indonesia and Malaysia’s National Population & Family Planning Board of Indonesia (BKKBN) and National Population and Family Development Board (LPPKN), namely: Dr. Surya Chandra Surapaty and Dato’ Dr. Siti Norlasiah Ismail, also attended the meeting.

Population ageing and related burden of

illness will have far greater impacts on social security and

old-age pensions and health care, and will require

many changes in social policies and programmes.

Countries in the region have adopted some laws, policies and institutional

arrangements to address the needs of ageing people albeit

in varying phases, with low and middle income countries

lagging behind their well-developed counterparts.



Below are the highlights of the consultation:

The meeting reaffirms that the population of aged people in the four countries has grown tremendously regarding percentage and the number of the elderly. Projected total population of the elderly in these countries by 2050 ranges from as low as 21.23 million in Cambodia to 322 million in Indonesia.

All four countries reported the feminization of the ageing population. And as the years increasingly advance, more of older women live alone because of the shorter life expectancy of men. Differentials in education, income, and access to health make older women more vulnerable.

Three of the Member Associations of IPPF-ESEAOR reported a broad

range of approaches to address ageing. These critical interventions include increasing awareness of ageing and ageing-related disabilities and reproductive health needs; expanding the coverage of clinical services to serve ageing people; and advocating for the prevention of diseases of the aged, like breast and cervical cancer, diabetes and renal failure to name a few.

Elaborated during the meeting are the unique needs of ageing population. Such needs require ageing-sensitive solutions, such as: establishing of elderly-friendly community day care centers, integrating and linking primary health and geriatric care services, creating a multi-disciplinary team for the elderly, and training of health providers in geriatric management. It also pays to learn from China’s three-

tiered approaches of “9073” in which 90% of care is home-based, 7% community-based, and 3% nursing homes.

Health systems in the four countries are focusing on curbing communicable diseases. There is a need to review and introduce changes in the health system and to align this with the emerging ageing population, and the increasing ageing-related non-communicable diseases.

Highlighted in the discussion is the dearth of policy and practices on addressing the sexual and reproductive health of the elderly. Thus, requiring more studies on the SRH needs of the older people.

Need to shift to evidence-based developmental approach, rather than a welfare view of elderly-related issues.

All four countries reported the feminization of the ageing population. Differentials in

education, income, and access to health make older women more vulnerable.



1. Strengthening Leadership of Young People towards Adolescent, Sexuality, Reproductive Health and Rights in Indonesia

ICOMP received support from Ford Foundation Indonesia to implement the program, “Strengthening Leadership of Young People towards Adolescent Sexuality, Reproductive Health, and Rights in Indonesia.”

A total of 50 core young visionary leaders completed a wide-ranging course on leadership starting with the Computer Assisted Self-Directed Learning (CASDL), 5-day Intensive Training, Mentoring and Program Implementation. The Young Visionary Leaders designed and implemented fourteen (14) Action Plans, and supported by ICOMP with seed grants.

Since the start of the project, alumni of ICOMP’s Young Visionary Leadership Training (YVLT) have assumed expanded roles and responsibilities in their respective organizations. Most of them credited ICOMP for their accelerated growth particularly with the YVL training, and more so with the hands-on experience in managing their programs through grant support from ICOMP. While several factors are contributing to the growth of the alumni’s leadership, a young leader claimed, “my leadership skills and confidence improved with the (ICOMP) training.”

Here are some of the lessons learned from the project (please

refer to our publication, “The Theory of Change in Tackling the Young People’s Sexuality and Reproductive Health and Rights”):

Young leaders learn leadership by doing and applying their acquired skills in “real world” situation. By “real world” means the actual issues and problems that the young people face, i.e., holding meetings or strategic planning, providing peer education or counseling, developing campaign messages and materials towards addressing the concerns of the young people. ICOMP supported thirteen (13) action plans that addressed the following issues:

Linkages between the unplanned pregnancy, early marriage, and high maternal death among young mothers;

HIV/AIDS and STI Violence against Women and

Children, Including cross-cutting

issues like Drug use/addiction

Gleaning from the results of the action plans, the young people reached out to more young people when they lead, or they are at the helm of the project. Education integrated with entertainment (i.e., Dance4Life, roadshows) was one of the strategies adopted

Expanding roles and responsibilities of ICOMP’s

alumni.

One of ICOMP’s alumni started as a Peer Organizer/Counselor of a national youth-led NGO based in

Jakarta, and eventually, in a matter of two years, she became its head.

A D O L E S C E N T S E X U A L I T Y A N D R H R

IV. ADOLESCENT SEXUALITY AND REPRODUCTIVE HEALTH AND RIGHTS


by the young leaders in addition to small group discussions, socializing the organizational vision, and training. In brief, one leader said, “ICOMP’s leadership training brought leaders to become more confident in leading and communicating. It also made them capable of developing programs and budget.”

Most of ICOMP’s partner youth organizations fall into the category of “youth-led,” “for-youth” or “with-youth” with some agencies having overlaps. Each type has distinctive advantages: youth-led (Pusat Informasi dan Konseling-Mahasiswa, Youth Forum Papua) seems to work well in providing direct information and education either one-to-one or campaigns. “For-youth” organizations like PERTUNI and PPRBM, they are excellent at providing a more formal education for young people. On the other hand, “with youth” groups have added advantage when advocating for policies with other gatekeepers and stakeholders. Thus, approaches in engaging with the organizations also vary. Substantive support to policy and programming are more needed among youth-led organizations. “For-youth” or “with-youth” organizations they need to strengthen the platform for young people to express their views and improve the environment for youth to exercise genuine leadership.

Among the partner-NGOs, there is an observed absence of a systematic and coordinated

“pedagogic learning” or reflection-action process for young people to learn more from their involvement with the organizations. It is important that youth organizations should strengthen their organizational culture on leadership development to facilitate young people’s leadership journey. To do this requires that they must involve young people, not only as end receivers of programs or added warm bodies to support organizational goals, but as the key players in planning, implementing and evaluating activities and programs. Such process necessitates an environment of supervised experiential learning and culture to exercise genuine leadership.

An independent assessment of the “knowledge” gained from the training proved that ICOMP’s prepared modules were effective. Noted in the evaluation

are the increases in knowledge post-training and after two years. The questionnaires applied during the different time periods of assessment used the same questions for each of the ten modules. There was a marked increase in knowledge immediately after the training with a slight decrease after two years. This slide is due to the extended period of the training and the final evaluation. It is worth emphasizing that the action plans implementation created the diffusion effect of knowledge and practices on ASHRH with other young people, increased youth leadership capacity, and the organizations were able to address the practical problems of youth. It goes without saying that a well-designed, systematic, and multi-staged training, the kind that ICOMP did, proved efficient and set the high bar of how engaging AY ought to be.

S T R E N GT H E N I N G L E A D E R S H I P O F YO U N G P E O P L E


2. National Meeting and Roundtable Discussion

3. Independent Evaluation of the Youth Leadership Program

Fifty (50) participants representing the alumni of ICOMP’s Young Visionary Leaders, development partners (Ford Foundation Indonesia, UNFPA Indonesia), NGOs, and BKKBN representatives attended the national meeting on May 25-26, 2017 at Hotel Dafam Teraskita, Jakarta, Indonesia. The 2-day meeting gathered the young leaders to understand better the youth situation in Indonesia, and the existing national policies and programs; and, importantly, to feedback the results of the independent evaluation of the project.

Underscored during the conference that youth leadership is both a means and an end. As a means, it is equipping young people with skills to achieve their dreams, think critically, negotiate risky situations, and express themselves freely. As an end, empowerment is seen as the

highest level or goal to achieve. For young women, they have to overcome gender inequality through a series of (empowering) interventions, such as programs aimed at raising their awareness and teaching them to resist social norms and harmful practices that curtail them from enjoying their sexual and reproductive rights.

Emphasized in the findings of the independent evaluator that youth leadership has wider benefits beyond the individual young person. These advantages are Illustrated in the 14 action plans, which ICOMP supported with seed grants, like addressing child marriage, unplanned pregnancy, HIV and VAWC is the underlying message that youth

leadership also brings benefits to the peer, the youth

ICOMP commissioned an independent and external evaluator, Dr. Tri Yunis Miko Wahyono of the University of Indonesia, Public Health Division, to do an end of project evaluation on the relevance, adequacy, effectiveness and efficiency of the project. Broadly, the assessment seeks to describe the project’s processes and activities, measure the

project effects, and identify the good practices and lessons for future actions. This evaluation will strengthen ICOMP’s programmes, and equip it to offer cutting edge leadership development



organizations and the larger community. Young volunteers can be powerful means for engaging other young people, particularly when young people take the lead “ripple effect” is more felt.

A photo exhibit of the activities and achievements of ICOMP’s programme, “Young Visionary Leaders,” highlighted the event.

solutions to a wide variety of constituencies, particularly in the Indonesian contexts.

After two years of project implementation, a total of 49 young leaders were trained and provided with guidance: 22 and 27 young leaders during Batch 1 and 2 of the leadership training, respectively. A total of 14 Action Plans proposed by the young leaders with assistance from their respective organizations and ICOMP received grants and technical support. These Action Plans were implemented in 14 provinces across Indonesia. In

December 2015, after nearly eight months of implementation, the combined action plans reached out to 5,240 young people and trained 137 peer educators and counselors. To provide continuing technical assistance, ICOMP conducted four (4) Regional Workshops to strengthen the partnership between the adult and youth leaders towards improving their organizational portfolio for young people.

Five selected organizations also received advance training on organizational development

to ensure organizational sustainability and effectiveness.

The project was able to produce the following documents and publications: Theory of Change in Tackling the Sexuality and Reproductive Health and Rights of Young People, YVL Training Modules, SRHR flipchart, and also the Online and Offline Version of the Computer Assisted Self-Directed Learning (CASDL).

N AT I O N A L M E E T I N G / I N D E P E N D E N T E VA L U AT I O N O F L E A D E R S H I P P R O G R A M M E


4. 2016 International Conference on Family Planning, Nusa Dua, Bali, Indonesia

5. 8th APCRSHR Satellite Meeting

On January 27, 2016 (2:30-3:50 pm), ICOMP’s Executive Director presented ICOMP’s experience in implementing the Young Visionary Leaders during one of the plenary sessions, entitled: “Youth Leadership: Champions, Change, and Transition.” Four-panel members presented their

papers, including ICOMP’s AY leadership. The session went well, and the open forum highlighted ICOMP’s computer-assisted self-directed learning, mentoring, and the various programs undertaken by the young leaders with seed grants from ICOMP.

The Institute of International Education supported ICOMP’s participation in the 8th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSHR), held in MICC II, Nay Pyi Taw, Myanmar from 22nd – 26th February 2016.

ICOMP organized one Satellite Session during the conference entitled, “Leveling

Opportunities & Addressing Inequalities: Young Visionary Leaders” with the aim of sharing the lessons learned from the implementation of the AY leadership program in Indonesia, and the insights from the programs implemented by the young leaders with their peers in addressing HIV, unplanned pregnancy, early marriage, maternal mortality and AY with disabilities.

The session started with a video presentation of AY Leaders explaining their thoughts on the Young Visionary Leaders Program. Thereafter, the session centered on the following: 1) description of the situation of young people in their communities; 2) the programs the AY developed to respond to the identified problems; and 3) the effects the programs have on their peers. In addition, the AY leaders described their leadership journey with ICOMP from the time they underwent the Computer Assisted Self Directed Learning course, the 5-day Intensive Leadership, Project Implementation and the Mentoring process.



6. Mentoring ICOMP led the region-wide mentoring training of the +25 years old young leaders of IPPF-ESEAOR. Held in Kuala Lumpur from 26 – 27 November 2016, the workshop aims to strengthen and capacitate the plus 25 youth (25 to 30 years old) to provide support to mentees under 24 years old through a mentorship programme. The mentoring program will sustain and maintain a cadre of young experts and leaders to provide technical assistance in building leadership capacities of IPPF ESEAOR youth.

Participating in the workshop were twelve representatives from six countries: Indonesia, Malaysia, Philippines, Thailand, Tonga, and Vietnam who were mentors, and some were mentees during the pilot test phase of IPPF’s mentoring programme from September to November 2016. It also includes a participant from one of the Visionary Young Leaders

of ICOMP in Riau, Indonesia. In facilitating the workshop, ICOMP shared the mentoring tools it developed through the various programmes implemented in Africa, South and South East Asia.

One of the workshop highlights was the matching of organizational and mentee’s training needs. In this session, ICOMP guided the youth participants to review the macro-level needs of their organizations and their professional needs and to identify common areas of interest as a take-off to develop the mentoring plan. At the end of the participatory workshop, the young leaders were able to demonstrate mentoring skills, and develop a mentoring plan per country.

Facilitated Mentoring

….a structure and series of processes designed to create effective mentoring relationships; guide the desired behavior change of those involved; and evaluate the results for the protégé, the mentors and the organization.

Margo Murray

2 0 1 6 I N T E R N AT I O N A L F P C O N F E R E N C E / 8 T H A P C R S H R / M E N TO R I N G


Every year since 2010, the Government of China through the National Health and Family Planning Commission (NHFPC) spearheads the South-South Cooperation on NGO Capacity Building with the overall aim of promoting capacity building and networking of NGOs in the fields of population, family planning, and reproductive health. With support from the NHFPC, the China Family Planning Association (CFPA) organized the 7th South-South Cooperation Seminar and co-hosted by IPPF and the International Council on Management of Population Programmes (ICOMP). Held

in Xiamen, China on 2-4 November 2016, the South-South Cooperation had as its theme, “ensuring high-quality, comprehensive family planning services to achieve health for all.” Attended by 35 delegates from 14 countries, the seminar had three main sessions. These are Sustainable Development Goals and Family Planning and Reproductive Health; Access for the Vulnerable to Receive Comprehensive and High-Quality Family Planning Services; Impact of Culture, religion and traditional custom on FP services; and Innovation on strategies and methods for improving FP/RH Services.

Dr. Camilo Naraval, ICOMP’s Executive Director, gave the closing remarks with the following highlights:

Guided by research, framed within the context of human rights, the organizations applied the rights-based approaches in their missions and values towards the empowerment of women and men, and boys and girls;


V. SOUTH - SOUTH COLLABORATION


Strategies that sought to address the vision and reality gaps brought to fore the wide-ranging programmes, and activities of the NGOs and government agencies, like: Curricular integration

of FP/SRHR in the curriculum, and the initiatives to start age appropriate SRHR as early as possible in the schools proved useful; Demand generation

through sensitization and popularization of FP, and SRHR issues should be linked with and translated to optimal utilization of services; Various health services

offered by the different organizations and agencies addressed the needs of the communities and the life-cycle approach; There is a consensus

towards the need to reduce the unmet needs by engaging the people while they are young, and reaching out to them where they cluster. Also, there is agreement to probe further on the “drop outs” and the reasons why women and men stopped from using FP; Scale the reach of young

people through the social media;There is a recognition

that men had been beyond the critique and scope of programmes in so far as FP/SRHR is a concern. However, the stories from

the fields highlighted the need to engage men, and to elevate this strategy as important alongside with meeting the needs of women and girls; and The partnership

between the government and NGOs were uneasy and challenging, but by and large, the collaboration of the two almost always works to the interest of the community.

Skills of non-governmental organizations and frontline health service providers are crucial to scaling FP/SRHR. While there is a need to provide skills-based training, there is also a compelling need for gender sensitivity, understanding of power dynamics and rights. These are soft skills and values that also determine the quality of service the organizations offer.

There is little attention given to the continual supply of FP/RH commodities; it is high time that programmes must ensure access to the FP/RH supplies. As the saying goes, “no supplies means no programme.”

The need to focus attention on limited resource communities like the border between China and Myanmar, geographically isolated areas, minority groups, adolescents, and migrants, among others.

There is a consensus

among the participating

organizations for

a “community of

practice” and an

accessible platform to

share information and

practices beyond the

seminar.



Financial Report

In the financial year 2016, ICOMP has designated an independent audit firm, Crowe Horwath to conduct an audit in March 2017. It gave an unqualified finding. For project expenses related to UNFPA Indonesia, UNFPA has designated their internal auditors to carry out an audit in November 2016, which also came out with similar findings. The following are ICOMP’s income and expenses.

I N C O M E

USD %

UNFPA (TSU) 88,579.40 21.66

Ford Foundation 200,000.00 48.90

IPPF 48,892.08 11.96

Country Contribution 65,000.00 15.89

Others 6,493.70 1.59

408,965.18 100%

E X P E N S E S

USD %

Administrative 150,358.00 36.78

Capacity Building/Leadership Development

102,839.12 25.15

Knowledge Building & Policy Dialogs

140,045.29 34.26

South-South Collaboration on Capacity Building

15,580.79 3.81

408,823.20 100%

I N C O M E E X P E N S E S

UNFPA (TSU)21.66%

Administrative36.78%

South-South Collaboration 3.81%

KnowledgeBuilding34.26%

Ford Foundation48.90%

Capacity Building48.90%

Others 1.59%Country

Contribution15.89%

IPPF11.96%

F I N A N C I A L R E P O R T


Policy and Technical Support Unit's Policy Recommendations

Administrative36.78%

HIGHLIGHTS OF THE ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH POLICIES AND PROGRAMS IN INDONESIA

1. Implementing the 12-year Mandatory Educational Program to reduce the number of child marriages.

Encourage the implementation of a 12-year Mandatory Educational Program to lessen the number of child marriages. This program will support the BKKBN’s effort to increase the marital age and reduce the age-specific fertility rate (ASFR). A legal umbrella will be needed to

ensure continual implementation of this program. The mandatory schooling for 12 years will keep the young adolescents (particularly female adolescents) in school and provide them with the opportunity to develop their potentials before being involved in reproduction.

2. Strengthening cross-sectoral coordination to support adolescent sexual and reproductive health program.

Dedicate more attention to the adolescent reproductive health problem, by:

- Encourage the establishment of a national working group focusing on adolescent reproductive health issues.

- Develop a national roadmap focusing on adolescent sexual and reproductive health based on the National Action Plan regarding the Health of School Children and Teens, and, the National Action Plan regarding Services for the Youth. The emphasis will not only be on young in-school adolescents but will include out-of-school youth and the disadvantaged youth.

3. Creating innovative youth friendly program.

Reinvigorate any existing programs that respond to the adolescents’ needs and characteristics. These include students as well as out-of-school youth, youth with a disability or special needs, those in the

correctional facilities, and those who are affected or vulnerable to HIV/AIDS. Several breakthroughs may need to be achieved to ensure access and uptake of the reproductive health information and services.

4. Improving systematic collection and reporting of adolescent sexual and reproductive health program.

Documentation and evaluation OF youth programs are limited. Data on adolescent

reproductive health are also inadequate, thus, the need for documentation.

P O L I CY R E C O M M E N D AT I O N S


5. Increasing adolescents’ access to contraceptive option, including emergency contraception.

Provide family planning services, including emergency contraceptives, and reproductive health for married and unmarried adolescents. Considering the

limitation of government resources, service provision will involve a number of parties, including the private sector and NGOs.

HIGHLIGHTS OF THE POLICY BRIEF ON UNIVERSAL HEALTH COVERAGE

1. Expanding Universal Health Coverage by identifying unregistered families, and make ways to enlist them.

Insurance coverage is often limited to employees within the formal institutions or who can afford private insurance. In Indonesia, however, the social health insurance is mandatory for all Indonesians, including those who are poor or unemployed. For the following groups, the government pays their insurance fees. BPJS-Kesehatan needs to enroll 74 million to reach

the goal of covering all 250 million Indonesians with health insurance in 2019. In this respect, BKKBN needs to help BPJS-Kesehatan and Ministry of Health in expanding coverage of insurance program by recording family who has not registered by BPJS-Kesehatan using a family enumeration survey (Pendataan Keluarga). The results of which can target those unregistered.

2. Tapping the Community-Based and Family Planning Field Workers and Cadres to Promote UHC.

Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. This insurance also meets the needs for family planning services. However, health insurance coverage and utilization are often low, particularly for people most in need of protection, including women and other vulnerable populations. Jia, et al. summarized studies that community-based case managers might be able to increase enrolment

by providing health insurance information and application support at the community level. However, the transferability of this context intervention to the Indonesian contact is needed. Further studies of evaluating the effectiveness of different strategies for expanding health insurance coverage in vulnerable population are needed in different settings including engaging the community-based family planning field workers to promote UHC.

3. Designing a Pro-Poor Insurance Programs

Designing pro-poor insurance programs can enhance equitable distribution of family planning services. Indonesian government increasingly recognize that providing access to family planning and other reproductive health services is essential

for development. Significantly reducing unmet need depends on reaching poor populations, who are much less likely to use family planning. One way of ensuring a pro-poor program is to reach those most in need, so they get access to the services.

P O L I CY A N D T E C H N I C A L S U P P O R T U N I T ' S P O L I CY R E C O M M E N D AT I O N S


4. Securing Contraceptive Supplies to meet the demands on FP under the UHC scheme.

Family planning in insurance packages could reinforce the contraceptive supply chain, especially for the private providers. Since provider reimbursement depends on accurate data and health statistics, the inclusion of family planning in the benefits could strengthen family planning data at

the facility level, enable more accurate forecasting to prevent stock-outs, and ensure that the right quantities and types of contraceptive methods are available. There is a need to take the full use of available data from BKKBN and other sources like BPJS Kesehatan and Ministry of Health.

5. Strengthening system and the infrastructure for quality of family planning services

The inclusion of family planning in the benefits package requires strengthening of infrastructure for family planning services. Thus, a member of the network of services under BPJS-Kesehatan, the health facilities must meet basic standards of staffing and other resources to deliver care, and pass the accreditation process. The certification will ensure an adequately trained staff and sufficient infrastructure are in place for the delivery of high-quality contraceptive services and information.

BKKBN and the Ministry of Health should jointly develop a system to improve the quality of service for all clinical facility by implementing registration, standardization, accreditation or recognition, and certification for quality of clinical service working with professional organization and association of clinical owner.

6. Family Planning Promotion and Counseling within the UHC

The challenge of introducing incentives to support informed voluntary choice requires careful design and ongoing monitoring. Under the current Minster Health Regulation, the promotion and counseling of family planning to the client is part of the primary insurance benefits under BPJS-Kesehatan. However, BPJS do not consider this except for counseling services for injectables, IUD, sterilization and management of side effects and complications of services. For that reason,

health providers would not receive a non-capitation fee for their services on counseling and promotion. Thus, BKKBN should ensure that BPJS-Kesehatan recognizes the importance of family planning promotion and counseling in the insurance package that benefits not only the client but the company, as well. Family planning will reduce the direct cost of delivery and the future cost of their member having more children.

7. Increasing involvement of Health Providers in the Clinical Networks

Contracted providers, including community health centers (Puskesmas), private general practices, private clinics, district hospitals, and public hospitals deliver FP services. For the private midwives, however, BPJS-Kesehatan will not contract them directly but through a clinical network. Categories of services are primary and secondary/tertiary. In particular cases, the referral from primary care to secondary or tertiary care may

be due to severe side effects and complication of contraceptive used. Most of the contracted providers are community health centers, and public hospitals and a few percentages are private midwives. The involvement of private midwives under the BPJS-Kesehatan scheme is still limited since only a few have established clinical networks eligible, under the insurance plan, to services.



8. Linking the Provider Reimbursement to Quality of Service

The quality of reproductive health services is an important determinant of whether women adopt, continue to use, or recommend family planning methods to others. It is important to tie up the benefits package on FP and the health insurance, and the conditions of quality of care with reimbursements. Concerns about side effects or perceived health risks are among the top reasons for non-use of family planning among married women in Indonesia, such improvements in the quality of counseling and services

can have a positive effect on family planning utilization. These enhancements can increase trust in providers and address other key barriers such as misperceptions about the risks of pregnancy in the context of breastfeeding or infrequent sex. In this case, providers are encouraged to present women with a full choice of methods, offer thorough counseling, and ensure client follow-up and continuity of care. Tying provider reimbursement to quality of service can reinforce family planning utilization.

HIGHLIGHTS OF THE POLICY BRIEF ON DEMOGRAPHIC DIVIDEND

Transition to Healthy and Active Ageing

Ageing is a by-product of a mix of factors including the improved socio-economic conditions, health systems, and population management that resulted to longer life expectancy and reduced total fertility. But ageing also presents challenges due to the decline in physical and emotional well-being, health status, decreasing capacity to do Activity Daily Life (ADL) and Instrumental Daily Activity (IADL). In return, reducing the earning power of aged people. There are lingering questions on ageing people: How older people meet their daily needs? Who is taking care of them when they fall sick or unable to move around? With whom do they live or whether families, community or even the government are available to assist with these needs? To summarize, there are three issues about older persons: income security, health care, social support, and informal or formal assistance. Also, older women live longer but less healthy than older men. So countries that are facing an ageing population is also experiencing a ‘feminization of older persons.’

In 2015 there are 19.5 million senior citizens at 60 years old and above and will increase to 44.9 million in 2035 and 59.4 million in 2050. This increase consists of 8.5 percent of the total population and will increase to 18.4 percent in 2050. The government and policy makers should anticipate this and put in place appropriate policy responses to improve their quality of life. The following are some policy priority and recommendations:

• Consider delaying age at pensions• Continue and expands the coverage of social

assistance for older, poor and neglected persons;• Develop a system for home care and long-

term care which is facilitated by government and private sector

• BKKBN can help create employment for the elderly with task suitable to the physical and emotional capacity of older persons. Example: training of trainers for home care and long-term care.



EXECUTIVE COMMITTEE (2015-2016)

Chairperson: Surya Chandra Surapaty, M.D., M.P.H., Ph.D. Chairperson, National Family Planning Coordinating Board (BKKBN), Indonesia

Vice Chairperson: Mr. Hu Hongtao Commissioner, Department of International Cooperation, National Health and Family

Planning Commission of China

Treasurer: Dato’ Dr. Siti Norlasiah Ismail Director General, National Population and Family Development Board, Malaysia

Member-Secretary: Dr. Aurelio Camilo Naraval Executive Director, ICOMP, Malaysia

ICOMP MEMBERS (2016)

I. PROGRAMME MANAGERS

Africa and the Middle East

ETHIOPIAMs. Genet MengistuExecutive Director, Family Guidance Association of Ethiopia, EthiopiaHead, Family Health Department, Ministry of HealthHead of HIV/AIDS Prevention and Control Office

GAMBIAMs. Yankuba DibbaActing Executive Director, The Gambia Family Planning Association

MAURITIUSMr. Vidya B. Charan Executive Director, Mauritius Family Planning Association

MOROCCODirecteur, Ministere de la Sante PubliqueDr M Tahar AlaouiDirecteur, Centre National de Formation et Reproduction Humaine

NIGERIADr. Mojisola OdekuProject Director, Nigeria Urban Reproductive Health Initiative (NURHI)Chairman, National Action Committee on AIDS

TANZANIADr Catherine SangaHead, RCH Services, Ministry of Health

TUNISIAProf Dr Gueddana NabihaDirector-General, National Family and Population Board and Member of the Executive Committee and the Board in Population and Development

TURKEYProf Dr Ayse AkinProfessor, Medical Faculty, Department of Public Health, Hacettepe University

UGANDADr Anthony MbonyeCommissioner, Reproductive Health Services, Ministry of HealthDr Jotham MusinguziRegional Director, PPD Africa Regional Office

E X E C U T I V E C O M M I T T E E ( 2 0 1 5 - 2 0 1 6 ) A N D I C O M P M E M B E R S


ZAMBIADr Rosemary M MusondaActing Director General, National HIV/AIDS/STD/TB Council

ZIMBABWEMr Godfrey TinarwoExecutive Director, Zimbabwe National Family Planning Council

Asia and the Pacific

BANGLADESHDr Rafiqul Huda ChaudhuryExecutive Director, Research Gono Shasthya Kendro

CAMBODIADr Ea Meng TryExecutive Director, National Committee for Population and Development

Dr Mean Chhi VunDirector, National Center for HIV/AIDS

Dr. Samreth SovannarithDeputy Chief of Technical Bureau of National Center for HIV/AIDS, Dermatology and STD

CHINAMr. Hu HongtaoCommissioner, Department of International Cooperation, National Population and Family Planning Commission

Ms. Hong PingDeputy Secretary, China Family Planning Association (CFPA)

Dr. Zhao BaigeExecutive Vice President, Red Cross Society of China

INDIAShri Lov VermaSecretary, Ministry of Health and Family Welfare

Mr Vishwanath KoliwadSecretary General, Family Planning Association of India

Ms Bhavna Banati MukhopadhyayExecutive Director, Voluntary Health Association of India

INDONESIASurya Chandra Surapaty, M.D., M.P.H., Ph.D.Chairperson, National Family Planning Coordinating Board

Ir. Siti FathonahDirector for Youth DevelopmentNational Population and Family Planning Board (BKKBN)

Mrs. Ambar RahayuPrinciple Secretary, National Population and Family Planning Board (BKKBN)

Mr. Ipin Zaenal Arifin HusniHead of Planning Bureau, National Population and Family Planning Board (BKKBN)

Mr. Muhammad Bawardadi National Population and Family Planning Board (BKKBN)

Dr. Sonny Harry B. HarmadiDirector for Demographic Institute, Faculty of Economics, University of Indonesia

Ms. Fitri PutjukDirector of CCP-JHU Indonesia, c/o National Population and Family Planning Board (BKKBN)

Dr. Sugiri Syariefc/o National Family Planning Coordinating Board

Dr. Suryadi SoeparmanDeputy Chairperson for Gender Mainstreaming, Ministry of Women’s Empowerment of Indonesia

I C O M P M E M B E R S 2 0 1 6


MALAYSIADato’ Dr. Siti Norlasiah IsmailDirector General, National Population and Family Development Board

Dr. Anjli DoshiDeputy Director General (Policy),National Population and Family Development Board

NEPALDr Senendra Raj UpretiDirector, Family Health Division, Ministry of Health and Population

Dr Krishna Kumar RaiDirector, National Center for AIDS & STD Control, Ministry of Health & Population

Dr. Ram Hari AryalFormer Secretary, Nepal and Member, Governing Council of Population Association of Nepal (PAM)

Mr. Ghanashyam PokharelSection Chief, Family Planning, Government of Nepal

PAKISTANSecretary, Ministry of Population Welfare

PHILIPPINESMr. Juan Antonio A. Perez III, MD, MPHExecutive Director, Commission on Population (POPCOM)

Dr. Rosalinda D. MarcelinoDeputy Executive Director, Commission on Population (POPCOM)

Dr. Eden Divinagracia, PhDExecutive Director, Philippine NGO Council on Population, Health and Welfare Health and Welfare, Inc.

SRI LANKADirector, the Population Division, Ministry of Health & Women’s Affairs

Dr Palitha Abeykoon, 17 Horton Towers, Colombo

THAILANDDr Sombat ThanprasersukDirector, Bureau of AIDS, TB and STIs, Department of Disease ControlMinistry of Public Health

Mr. Montri PekananExecutive Director, Planned Parenthood Association of Thailand (PPAT)

Dr Warunee FongkaewYouth Family and Community Development (YFCD), Chiang Mai University

Director, RH Division, Department of Health, Ministry of Public HealthDirector General, Department of Health, Ministry of Public Health

VIETNAMDr. Le Canh NhacDeputy Director General, General Office for Population and Family Planning (GOPFP)

Mrs. Nguyen Viet HaDeputy Director in charge of International CooperationGeneral Office for Population and Family Planning (GOPFP)

Latin America and the Caribbean

BRAZILDr. Ney Francisco Pinto CostaSecretário Executivo, BEMFAM

COLOMBODr Fernando Tamayo

ECUADORDr Paolo MarangoniExecutive Director, Asociacion Pro-Bienestar de la Familia Ecuatoriana

I C O M P M E M B E R S 2 0 1 6


II. INSTITUTE DIRECTORS

CHINAMr Huang SenExecutive Director, Nanjing Population Program Training Center International

Dr. Gu BaochangProfessor of Demography, Center for Population and Development Studies, Renmin University of China

GHANADirector, Ghana Institute of Management and Public Administration (GIMPA)

INDIAMr. S.K. BaruaDirector, Indian Institute of Management (IIMA)

Prof. Jay Satia Advisor to President, Public Health Foundation (PHFI) and Professor Emeritus, Indian Institute of Public Health, Gandhinagar (IIPHG)Director, National Institute of Health & Family Welfare

PHILIPPINES Prof Felipe B AlfonsoVice Chairman, Asian Institute of Management (AIM)

Dr. Pilar Ramos-JimenezUniversity Fellow, De Le Salle University

TANZANIADirector General, Eastern and Southern African Management Institute (ESAMI)

VENEZUELAProf Henry Gomez-SamperProfessor Emeritus, Instituto De Estudios Superiores De Administracion (IESA)

III. HONORARY MEMBERS

GHANADr A A Armar

UNITED KINGDOMProfessor Hamid Rushwan

INDONESIAProf. Dr. Haryono Suyono

I N S T I T U T E D I R E C TO R S / H O N O R A R Y M E M B E R S


DONORS

ICOMP gratefully acknowledges the financial support of the following (in alphabetical order)

Government of IndonesiaGovernment of ChinaGovernment of IndiaThe David and Lucile Packard FoundationThe Ford Foundation

The Joint United Nations Programme on HIV/AIDS (UNAIDS)United Nations Population Fund (UNFPA)International Indonesia Education FoundationThe World Bank

CIVIL SOCIETY ORGANIZATION PARTNERS (Past and Present)

ICOMP gratefully acknowledges the support of the following (in alphabetical order)

Academic Development Centre (ADeC), Malaysia Asia Pacific Alliance for Sexual and Reproductive

Health and Rights (APA)Association of Youth Organization (AYON), NepalBlue Diamond Society, NepalChild in Need Institute (CINI), IndiaCommunity Strength Development Foundation

(CSDF), Sri LankaCompanions on a Journey (COJ), Sri LankaCentre Department of Population Studies, NepalCenter for Research on Environment Health and

Population Activities (CREHPA), NepalCommission on Population (POPCOM), PhilippinesDemographic Research and Development Foundation

(DRDF), PhilippinesESHET Children and Youth Development Organisation

(ECYDO), EthiopiaFamily Planning Association of the Philippines (FPOP),

PhilippinesHealth Action International Network (HAIN),

PhilippinesInternational Centre for Diarrhoeal Disease Research

(ICDDR’B), BangladeshInternational Planned Parenthood Federation – East

and South East Asia and Oceania Region (IPPF-ESEAOR)

Indian Association of Parliamentarians on Population & Development (IAPPD)

Integrated Development Foundation (IDF), IndiaInstitute Hak Asasi Perempuan (IHAP)-Boyolali,

IndonesiaInstitute Hak Asasi Perempuan (IHAP)-Kefamenanu,

IndonesiaJamshetji Tata Trust Fund (JTTF) IndiaNational Federation of Women Living with HIV and

AIDS (NFWLHA), Nepal

Natun Jibon Samaj Kallayan Sangstha (NJSKS), BangladeshNetwork for Enterprise Enhancement and

Development Support (NEEDS), IndiaOrganization of Bangladesh Drug Addict Rehabilitation

(BODAR)Peer Corner Counseling University of Malang,

IndonesiaPersatuan Tuna Netra Indonesia (PERTUNI), IndonesiaPhilippine Legislators’ Committee on Population and

Development (PLCPD)Philippine NGO Council on Population, Health and

Welfare, Inc.PIK-M Cemara Hati University of Mataram, IndonesiaPKBI-Riau, IndonesiaPopulation Foundation of India (PFI)Propride EthiopiaPusat Pemberdayaan dan Rehabilitasi Bersumberdaya

Masyarakat (PPRBM)-Solo, IndonesiaRENEW BhutanRumah Peka, IndonesiaSaviya Development Foundation (SDF), Sri LankaSebaya PKBI Jawa Timur, IndonesiaState Institute of Public Health (JIPH), IndiaShustha Jibon, BangladeshThe Asia Pacific Alliance (APA), ThailandVoluntary Health Association of IndiaYayasan Advokasi Rakyat Aceh (YARA), IndonesiaYayasan Masyarakat Tertinggal Riau (YMTR), IndonesiaYayasan Pendidikan Kesehatan Perempuan (YPKP)-

Padang, IndonesiaYayasan Sakina Rifka Annisa, IndonesiaYayasan Sentra Informasi dan Konseling Orang Kito

(SIKOK), IndonesiaYouth Forum Papua (YFP), IndonesiaUniversity of Malaya (UM), MalaysiaXavier Institute of Social Service (XISS), Ranchi, India

D O N O R S A N D PA R T N E R S


GOVERNMENT PARTNERS (Past and Present)

National Population and Family Planning Commission (NPFPC), China

Nanjing Population Programme Training Center International (NPPTCI), China

National Population and Family Development Board (LPPKN), Malaysia

NAM Institute for the Empowerment of Women (NIEW), Ministry of Women, Family and Community Development, Malaysia

National Population and Family Planning Board (BKKBN), Indonesia

State Institute of Health and Family Welfare (SIHFW), Bihar, India

G O V E R N M E N T PA R T N E R S

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International Council on Management of Population ProgrammesNo. 534 Jalan Ampang Utama, Taman Ampang Utama, 68000 Ampang, Selangor, Malaysia

ICOMPPublications

A Theory of Change for Tackling Young People’s

Sexual and Reproductive Health36 pages;

AGEING Thailand, Malaysia, Indonesia and Cambodia:

Demographic Transition, Policy and Programmatic Responses

112 pages; ISBN 978-983-3017-18-8

Consultation on Policy and Programmatic Responses to

Population Ageing70 pages; ISBN 978-983-3017-17-1

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international council on management of population …site.icomp.org.my/clients/icomp1/icomp annual...

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