the usaid jalin project

THE USAID JALIN PROJECTQUARTERLY REPORT, Q3 PROJECT YEAR 2020

July – September 2020

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 i

THE USAID JALIN PROJECTQuarterly Report, July – September 2020

Program Title: The USAID Jalin Project

Sponsoring USAID Office: USAID/Indonesia

Contract Number: AID-497-C-17-00001

Contractor: DAI Global, LLC

Date of Submission: October 30, 2020

Author: DAI Global, LLC

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 ii

TABLE OF CONTENTS

TABLE OF CONTENTS...................................................................................................... ii

TABLES & FIGURES ........................................................................................................... iv

I. EXECUTIVE SUMMARY............................................................................................ viiiQuarter 4 Activities ..........................................................................................................ixRINGKASAN EKSEKUTIF................................................................................................xKegiatan Kuartal 4.............................................................................................................xi

II. INTRODUCTION ...........................................................................................................1Overview of USAID Jalin ...................................................................................................1

USAID Jalin Technical Approach.............................................................................................................. 1

III. QUARTER 3 PROGRESS AND RESULTS – ADDENDUM TO YEAR 3WORKPLAN: COVID-19 ACTIVITIES .....................................................................2ADDENDUM TO YEAR 3 WORKPLAN: COVID-19 ACTIVITIES..............................2IR 1: SUSTAINED IMPROVEMENTS IN PRACTICE BY CLINICAL HOSPITALTEAMS IN TREATING OBSTETRIC AND NEWBORN COMPLICATIONS ............3

Addendum Activity 1.1 Ensure access to emergency MNH services for COVID-19 positiveas well as non-infected pregnant women and newborns in public and private hospitals ........... 3

IR 2: STAKEHOLDER STRATEGIES MORE FOCUSED ON MAIN CAUSES OFMATERNAL AND NEONATAL DEATHS .....................................................................4

Addendum Activity 2.1: Advocacy and evidence generation ............................................................ 4IR 3: SUSTAINED IMPROVEMENTS IN QUALITY OF CARE BY PRIVATEMIDWIVES .........................................................................................................................6

Addendum Activity 3.1: Support IBI’s efforts with the focus on private midwives andespecially Bidan Delima network to address COVID-19................................................................... 6

IR 4: INTEGRATED ICT REFERRAL PLATFORM SCALED ........................................8Addendum Activity 4.1: Modified ICT for referrals in context of COVID-19 ............................. 8

IR 5: IMPROVED REFERRAL NETWORKS SCALED ...................................................8Addendum Activity 5.1: Improved referral pathways and networks in light of the COVID-19outbreak......................................................................................................................................................... 8

IV. QUARTER 3 PROGRESS AND RESULTS – YEAR 3 WORKPLAN ................10IR 1: SUSTAINED IMPROVEMENTS IN PRACTICE BY CLINICAL HOSPITALTEAMS IN TREATING OBSTETRIC AND NEWBORN COMPLICATIONS ..........11

Activity 1.1: Clinical/managerial mentoring of clinical teams in public hospitals ........................12Activity 1.2: Clinical/managerial mentoring of clinical teams in faith-based, non-profit and for-profit hospitals............................................................................................................................................15Activity 1.3: TA to the MOH and sustainability .................................................................................15

IR 2: STAKEHOLDER STRATEGIES MORE FOCUSED ON MAIN CAUSES OFMATERNAL AND NEONATAL DEATHS ...................................................................16

Activity 2.1: Support the strengthening of MPDSR ...........................................................................18Activity 2.2: Improve accountability through monitoring, reporting and communicatingprogress .......................................................................................................................................................19Activity 2.3: Regular reviews of maternal and newborn deaths at national level andrecommended improvements (related to human and institutional capacities), including scalingup of promising pilots, made through MOH MNH Working Group and MNH Committee .20Activity 2.4: TA to the MOH and sustainability .................................................................................21

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 iii

IR 3: SUSTAINED IMPROVEMENTS IN QUALITY OF CARE BY PRIVATEMIDWIVES .......................................................................................................................25

Activity 3.1: Reviving and strengthening Bidan Delima in Jalin provinces through: mentoringand certification of private midwives; review of Bidan Delima business model andencouraging broader membership.........................................................................................................26Activity 3.2: Incentivizing empanelment of private midwives with JKN by piloting a model ofstrategic purchasing with JKN in Jalin districts ...................................................................................28Activity 3.3: Facilitating access to credit for private midwives to improve standards of care 28Activity 3.4: TA to the MOH and sustainability .................................................................................29

IR 4: INTEGRATED ICT REFERRAL PLATFORM SCALED ......................................30Activity 4.1: Developing and piloting an integrated and interoperable system using ICT andbuilding on existing initiatives to strengthen maternal and newborn referral system approachin Jalin provinces ........................................................................................................................................31Activity 4.2: TA to the MOH and sustainability .................................................................................33

IR 5: IMPROVED REFERRAL NETWORKS SCALED .................................................34Activity 5.1: Strengthening emergency referral networks by facilitating formal agreementsbetween facilities (especially public and private) in networks in the Jalin provinces.................35Activity 5.2: Improving transport to referral facilities for emergency cases through increasingaccess to funding for available transport in the Jalin provinces ......................................................36Activity 5.3: TA to the MOH and sustainability .................................................................................37

V. CROSS-CUTTING ISSUES ........................................................................................45Gender and Gender-based Violence Integration ..........................................................45

Addressing Women as Health Care Beneficiaries .............................................................................45Strengthening Women’s Businesses......................................................................................................46Gender-based Violence ............................................................................................................................46

VI. MONITORING, EVALUATION, LEARNING, ADAPTATION ANDSTRATEGIC COMMUNICATION ...........................................................................48

MELA Plan Update and Implementation...............................................................................................48Project Dashboard ....................................................................................................................................48Local Solutions Documentation .............................................................................................................49Other Support............................................................................................................................................49Communications ........................................................................................................................................49

VII. PROJECT MANAGEMENT .......................................................................................52Personnel ..........................................................................................................................52Operations ........................................................................................................................53

Standardization of MOU and Partnership Agreement Process ......................................................54Procurement and Grant Management ..................................................................................................54

Review of Problems Encountered and Efforts Made to Address such Problems.......54

ANNEX 1: INDICATOR PERFORMANCE TRACKING TABLE – Q3 ..................55

ANNEX 2: PERFORMANCE INDICATOR RESULTS...............................................60

ANNEX 3: PROGRESS TOWARD PROJECT MILESTONES .................................65

ANNEX 4: LOCAL SOLUTIONS TRACKER ..............................................................72

ANNEX 5: MEDIA MONITORING.................................................................................80

ANNEX 6: SOCIAL MEDIA..............................................................................................81

ANNEX 7: DEVELOPMENTAL EVALUATION ACTIVITIES ................................84

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 iv

ANNEX 8: PROJECT PHOTOS ......................................................................................85

ANNEX 9: SUCCESS STORY..........................................................................................86

ANNEX 10: ORGANIZATIONAL CHART ..................................................................87

ANNEX 11: LOCAL SOLUTION ACTIVITY BRIEFS ...............................................89

TABLES & FIGURES

Table 1: USAID Jalin Key Activities in Quarter 4 .............................................................................................. ixTable 2: Intermediate Results ..................................................................................................................................2Table 3: COVID-19 Cases in Indonesia ................................................................................................................3Table 4: List of Livestreaming Broadcasts with the COVID-19 Task Force of North Sumatra ..............4Table 5: Summary of IBI Webinar Series in Quarter 3 .....................................................................................6Table 6: Progress Towards Milestones for IR 1................................................................................................11Table 7: Progress Towards Milestones for IR 2................................................................................................16Table 8: Progress Towards Milestones for IR 3................................................................................................25Table 9: Bidan Delima Working Group Meeting Summary ............................................................................27Table 10: Progress Towards Milestones for IR 4..............................................................................................30Table 11: Progress Towards 2020 Milestones for IR 5 ...................................................................................35Table 12: TOPDeAMOR Mentoring Results .....................................................................................................37Table 13: USAID Jalin MNH in the Workplace Programs..............................................................................38Table 14: Transportation Service Activities .......................................................................................................45Table 15: Community Awareness Activities ......................................................................................................46Table 16: Materials Developed in Compliance with USAID Branding and Marking Guidelines

during Q3 2020 ......................................................................................................................................49Table 17: USAID Jalin Project Stories Developed during Q3 2020 .............................................................51Table 18: Recruitment in Quarter 3 ....................................................................................................................52Table 19: Staff Departures in Quarter 3 .............................................................................................................53

Figure 1: Flyers from Livestreaming Event in North Sumatra..........................................................................5Figure 2: IBI Webinar Series Invitations ................................................................................................................7Figure 3: Gerai KIA Implementation Guidebook ................................................................................................8Figure 4: Pregnant Women Receiving Counseling through Gerai KIA Mobile............................................9Figure 5: Screenshot of SiMatneo Website (simatneo.kemkes.go.id) (top) and Dashboard (bottom)13Figure 6: Impact of COVID-19 on Maternal Services Dashboard ...............................................................14Figure 7: Impact of COVID-19 on Neonatal Services Dashboard................................................................14Figure 8: MPDN User Distribution ......................................................................................................................18Figure 9: Screenshot of ITDRS Bulukumba App on Desktop App (left) and Mobile App (right)..........24Figure 10: SiCantik Utilization ...............................................................................................................................32Figure 11: Floating Ambulance COVID-19 SOP ..............................................................................................36Figure 12: TOPDeAMOR Roadmap.....................................................................................................................37Figure 13: Infographic of USAID Jalin Local Solution Distribution in Six Provinces .................................40Figure 14: Local Solution Transition Plans by Province...................................................................................40Figure 15: Screenshot of the Knowledge Center .............................................................................................48Figure 16: Example of MNH Campaign Materials on Social Media...............................................................51

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 v

ACRONYMS & ABBREVIATIONS

ADINKES Asosiasi Dinas Kesehatan (Association of Indonesia Local Health Offices)AMMDes Alat Mekanis Multiguna Pedesaan (Rural Multipurpose Mechanical Device)AMP-SR Audit Maternal Perinatal - Surveillance & ResponseANC Antenatal CareAPBD Anggaran Pendapatan dan Belanja Daerah (local government budget)ARSADA Local Government Hospitals AssociationAPN Asuhan Persalinan Normal (Normal Labor Services)ARSANI Indonesian Non-Profit Hospitals AssociationARSSI Asosiasi Rumah Sakit Swasta Indonesia (Indonesian Private Hospital Association –

ARSSI)ASKLIN Association of Private ClinicsBAPPEDA Badan Perencanaan Pembangunan Daerah (Regional Development Planning Board)BD Bidan DelimaBKKBN Badan Kependudukan dan Keluarga Berencana Nasional (National Population and Family

Planning Board)BPJHC Badan Pekerja Joint Health CouncilBPJS-K Badan Penyelenggara Jaminan Sosial-Kesehatan (Social Insurance Administration

Organization-Health)BPPKB District Women Empowerment and Family Planning OfficeBRI Bank Rakyat IndonesiaBUKU KIA Buku Kesehatan Ibu dan Anak (Maternal and Child Health Book)CEmONC Comprehensive Emergency Obstetric and Neonatal CareCOVID-19 2019 novel coronavirus diseaseCSO Civil Society OrganizationCSR Corporate Social ResponsibilityDAK Dana Alokasi Khusus (Special Allocation Funds)DCOP Deputy Chief of PartyDE Developmental EvaluationDEKON Dana Dekonsentrasi (Deconcentrated Funds)DG Directorate GeneralDHO District Health OfficeDITJEN YANKES Direktorat Jenderal Pelayanan Kesehatan, Kementerian Kesehatan (Directorate General

of Health Services, Ministry of Health)DPMD Dinas Pemberdayaan Masyarakat dan Desa (District Village Community Empowerment

Office)EF Enabling FactorsEMNC Every Mother and Newborn CountsFMM Forum Masyarakat Madani (Civil Society Forum)FOPKIA Forum Peduli Kesehatan Ibu dan Anak (Maternal and Child Healthcare Forum)FPKM Forum Peduli Kesehatan Masyarakat (Community Healthcare Forum)GBV Gender Based ViolenceGOI Government of IndonesiaHOGSI Himpunan Obstetri dan Ginelokogi Sosial Indonesia (Indonesia Social Obstetric

Gynecology Society)IBI Ikatan Bidan Indonesia (Indonesian Midwives Association)ICT Information and Communication TechnologyIDAI Ikatan Dokter Anak Indonesia (Indonesia Pediatric Society)IDI Ikatan Dokter Indonesia (Indonesian Doctors Association)ILO International Labor OrganizationIPC Infection Prevention and ControlIPTT Indicator Performance Tracking TableIR Intermediate ResultITDRS Instalasi Transfusi Darah Rumah Sakit (Hospital Blood Transfusion Unit)JAMILAH Jemput Antar Ibu Hamil BermasalahJICA Japan International Cooperation AgencyJKN Jaminan Kesehatan Nasional (Indonesian National Health Insurance System)

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 vi

KIA Kesehatan Ibu dan Anak (Maternal and Child Health)KMWD Kiat Mahesa Wintor DistributorKMWI Kreasi Mandiri Wintor IndonesiaKNPI National Youth CommitteeKOMDAT Aplikasi Komunikasi Data (Data communication application)KSP Kantor Staf Presiden (Executive Office of the President of Indonesia)LS Local solutionMAB Multi-stakeholder Advisory BodyMCH Maternal and Child HealthMDSR Maternal Death Surveillance ResponseM&E Monitoring and EvaluationMELA Monitoring, Evaluation, Learning and AdaptationMISP Minimum Initial Service PackageMMR Maternal Mortality RatioMNH Maternal and Newborn HealthMOH Ministry of HealthMOU Memorandum of UnderstandingMPDN Maternal Perinatal Death NotificationMPDSR Maternal Perinatal Death Surveillance and ResponseMSA MarketShare AssociatesNA Not applicableNMR Newborn Mortality RateObGyn Obstetrician/GynecologistOJK National Financial Board AuthorityP4K Program Perencanaan Persalinan dan Pencegahan Komplikasi (Delivery Planning and

Complication Prevention Program)PKK Family Welfare MovementPDKI Persatuan Dokter Keluarga Indonesia (Indonesian Association of Family Physicians)PE/E Pre-Eclampsia and EclampsiaPENAKIB Penurunan Kematian Ibu dan Bayi (Maternal and Infant Mortality Reduction Forum)PERSI Perhimpunan Rumah Sakit Seluruh Indonesia (Indonesian Hospitals Association)PHO Provincial Health OfficePKK Pemberdayaan Kesejahteraan Keluarga (Family Welfare Movement)PNC Postnatal CarePMB Praktek Mandiri Bidan (Independent Midwife Practice – PMB)PNM Permodalan Nasional MadaniPOGI Perkumpulan Obstetri dan Ginekologi Indonesia (Indonesian Obstetrics and Gynecology

Association)POKJA Kelompok Kerja Lintas Batas (Cross Border Working Group)PONED Pelayanan Obstetri dan Neonatal Emergensi Dasar (Basic Emergency Obstetric and

Neonatal Services)PONEK Pelayanan Obstetri dan Neonatal Emergensi Komprehensif (Comprehensive Emergency

Obstetric and Neonatal Services)PPE Personal Protective EquipmentPSBB Pembatasan Sosial Berskala Besar (Large-Scale Social Restriction)PUSKA-UI Pusat Penelitian Keluarga Sejahtera (Center for the Study of Family Welfare)PUSDATIN Pusat Data dan Informasi (Data and Information Center)PUSKESMAS Pusat Kesehatan Masyarakat (Primary Health Center)PWI Indonesia Journalists AssociationRF Results FrameworkRSUD Rumah Sakit Umum Daerah (Regional Public Hospital)SGBV Sexual and gender-based violenceSIKDA Sistem Informasi Kesehatan Daerah (Regional Health Information System)SIMRS Sistem Informasi Manajemen Rumah Sakit (Hospital Management Information System)SISRUTE Sistem Rujukan Terintegrasi (Integrated Referral System)SLT Senior Leadership TeamSMI Samudra Marine IndonesiaSOP Standard Operating ProcedureSOW Scope of WorkSTI SijariEMAS Teknologi Inovasi

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 vii

STIR Science, Technology, Innovation, and ResearchTA Technical AssistanceTBC To be confirmedTBD To be determinedTKKSD Tim Koordinasi Kerjasama Daerah (Coordination Team for Local Cooperation)TOPDeAMOR Tukang Ojek Puskesmas dengan Elektronik Ambulans Motor (Puskesmas Electronic

Motorcycle Ambulance)TOR Terms of ReferenceWEALTH Women’s Health and WellbeingUGM Universitas Gadjah Mada (Gadjah Mada University)UN United NationsUNFPA United Nations Population FundUNICEF United Nations Children’s FundUPBD Unit Pelaksana Bidan Delima (Bidan Delima Program Implementing Unit)USAID United States Agency for International DevelopmentVASA Verbal and Social AutopsyVFC VF CorporationWASH Water, Sanitation, and HygieneWG Working GroupWHO World Health Organization

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 viii

I. EXECUTIVE SUMMARY

In September 2017, United States Agency for International Development (USAID)/Indonesia initiatedthe USAID Jalin Project (hereafter referred to as “USAID Jalin” or “the Project”) implemented byDAI and its consortium of partners – IntraHealth, Vital Strategies, and MarketShare Associates(MSA) – that supports the Ministry of Health (MOH) to achieve an accelerated reduction inpreventable maternal and newborn deaths. USAID Jalin, meaning “intertwined” in Bahasa Indonesia,weaves together the Government of Indonesia (GOI), private sector, civil society, and otherstakeholders to create sustainable solutions for improving maternal and newborn health (MNH).Through these partnerships, the Project aims to reduce maternal and newborn deaths by improving:1) maternal and newborn health quality of care in public and private, primary and secondary facilities,and 2) efficiency and effectiveness of the emergency referral system at community and facility levels.

USAID Jalin is in its third year of implementation, which is characterized by a new phase of activities.In Year 2, the Project collaborated with key stakeholders, including USAID and the MOH, to refocusthe design of the technical approach and revise the Results Framework (RF) and IntermediateResults (IR). In response to the 2019 novel coronavirus (COVID-19) pandemic, in Quarter 1 USAIDJalin developed the Addendum to Year 3 Workplan: COVID-19 Activities, outlining complementaryemergency response activities for the period of April 4 to September 30, 2020.

On September 10, USAID notified the Project that they would not be exercising the first optionyear. Following that notification, the Project informed all staff and partners and together with USAIDand the MOH, agreed on a closeout timeline. The Project will close on March 7, 2021, at the end ofthe previously awarded no-cost extension period, and most technical activities will be completed bythe end of December 2020, with a few continuing into early January 2021.

During the quarter, USAID Jalin continued to make progress in achieving project milestones whiledemonstrating efficient and adaptive work methods in the context of the pandemic. The Projectfocused on completing implementation of COVID-19 activities and continuing the Year 3 workplanwhile initiating closeout planning.

QUARTER 3 HIGHLIGHTS

At the national level, the Project provided technical support to the MOH and collaborated withother key partners to advance planned activities in the following areas:

MOH Secretariat: Revamped MOH Secretariat engagement to improve efficiency and broughtin a fully dedicated team seconded to the MOH (IR 1 Manager, IR 2 Manager and MOHSecretariat Coordinator).

Mentoring: Provided direct support to the MOH to prepare for the launch of the mentoringprogram, including finalizing the mentoring guidelines and clinical governance/instruments,digitizing the hospital self-assessment instruments and supporting the pilot test.

Maternal Perinatal Death Notification (MPDN) and Audit Maternal Perinatal -Surveillance & Response (AMP-SR): Collaborated with the MOH to plan for the rollout ofMPDN and AMP-SR activities at national level and sub-national level.

Bidan Delima (BD): Collaborated with Ikatan Bidan Indonesia (Indonesian Midwives Association– IBI) to develop the concept and implementation plan for the enhanced Bidan Delima program.

Information and Communication Technology (ICT)-based referrals: Draft rapidassessment report on existing ICT-based referral platforms developed by Sinergantara forreview by the Project.

COVID-19 risk screening and education tool: Collaborated with THINKMD to customizethe COVID-19 mobile application for use by Indonesian midwives.

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 ix

MNH in the Workplace: Conducted a co-creation meeting with VF Corporation (VFC) tooutline workplan activities and selected five factories for the first phase of the program.

At the regional level, USAID Jalin focused on transitioning the local solutions (LS) to provinciallybased counterparts to promote sustainability through documentation of activities and lessonslearned, dissemination of guidance, development of sustainability plans and handover to localpartners. This quarter, the regional teams handed over nine out of 21 local solutions and nearly allremaining programs will be transitioned by the end of October. Regional activities during thereporting period also supported sub-national activities related to mentoring and the planned MPDNand AMP-SR rollout.

COVID-19 response activities during the quarter centered on continuing the webinar series formidwives with IBI, supporting livestreaming broadcasts by the COVID-19 Task Force of NorthSumatra, and successfully piloting the Gerai Kesehatan Ibu dan Anak (Maternal and Child Health –KIA) Mobile program in Tangerang District, Banten Province.

Quarter 4 ActivitiesAs noted above, most technical activities will be completed by the end of December 2020, with afew continuing into early January 2021. All regional offices will close by December 31. In Quarter 4,USAID Jalin will focus on completing key activities in line with closeout plans, as illustrated in thetable below.

Table 1: USAID Jalin Key Activities in Quarter 4

IR Key Activity

IR 1 Complete mentoring guidelines and clinical governance/instruments

Launch mentoring program and SiMatneo application orientation

Orientation of mentors

Roll out hospital self-assessment using SiMatneo

Support one mentoring visit/ district hospital in 65 USAID Jalin district/ city hospitals

Support MPDN national launch

IR2 Train 68 Provincial Health Office (PHO) Facilitators and 68 Perkumpulan Obstetri danGinekologi Indonesia (Indonesian Obstetrics and Gynecology Association – POGI) andIkatan Dokter Anak Indonesia (Indonesia Pediatric Society – IDAI) provincialrepresentatives for MPDN

MPDN rollout/ dissemination in seven USAID Jalin districts (at least 19 hospitals and 254Puskesmas)

Support development of AMP-SR guidelines

AMP-SR rollout/ dissemination in seven districts (19 hospitals)

Strengthen MPDN application (strengthening includes making it easier for users to loginto the application; developing a user guide; providing a help desk; adding an auditcapability within the application as well as the perinatal death notification module;providing an iOS version)

Support District Health Offices (DHOs) to monitor AMP-SR implementation (monthlymeeting at regional level)

IR 3 Finalize the enhanced Bidan Delima program concept (through meetings with senior IBIand BD program leaders)

Finalize the enhanced Bidan Delima program strategic document

IR 4 Conclude ICT for referrals rapid assessment

Pilot e-Kohort (10 districts)

IR 5 Start implementation of MNH in the Workplace in five VFC factories

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RINGKASAN EKSEKUTIFDi bulan September 2017, United States Agency for International Development (USAID)/Indonesiamemprakarsai Proyek USAID Jalin (selanjutnya disebut sebagai “USAID Jalin” atau “Proyek”)dilaksanakan oleh DAI dan mitra konsorsium – IntraHealth, Vital Strategies, dan MarketShareAssociates (MSA) – untuk mendukung Kementerian Kesehatan (Kemenkes) mencapai percepatanpenurunan kematian ibu dan bayi baru lahir. USAID Jalin, yang dalam Bahasa Indonesia berarti “salingterangkai atau bertautan” menjalin kerja sama dengan Pemerintah Indonesia, sektor swasta,masyarakat sipil, dan pemangku kepentingan lain dan bersama-sama menciptakan solusi untukmeningkatkan kesehatan ibu dan bayi baru lahir (KIB) secara berkelanjutan. Melalui kemitraain ini,Proyek bertujuan untuk menurunkan angka kematian ibu dan bayi baru lahir melalui (1) peningkatankualitas layanan kesehatan ibu dan bayi baru lahir di fasilitas kesehatan milik pemerintah dan swasta,di jenjang primer dan sekunder, juga (2) penguatan sistem rujukan gawat darurat agar berlangsunglebih efisien dan efektif di tingkat masyarakat dan fasilitas kesehatan.

USAID Jalin saat ini berada pada tahun ketiga pelaksanaannya, ditandai dengan fase kegiatan baru. Ditahun kedua, Proyek bekerja sama dengan pemangku kepentingan utama, termasuk USAID danKemenkes, untuk memfokuskan kembali desain pendekatan teknis dan merevisi Result Framework (RF)serta Intermediate Results (IR). Sebagai respon terhadap pandemic novel coronavirus (COVID-19), padaKuartal 1 tahun ini, USAID Jalin menyusun Addendum Rencana Kerja Tahun ke-3: Kegiatan untuk COVID-19, yang berisi kegiatan tanggap darurat pelengkap untuk periode 4 April hingga 30 September 2020.

Pada tanggal 10 September, USAID menyampaikan kepada Proyek keputusan untuk tidakmelaksanakan opsi tahun pertama. Proyek lalu menyampaikan pemberitahuan tersebut ke semua stafdan mitra, dan bersama USAID serta Kemenkes, menyepakati jadwal penutupan proyek, yaitu pada 7Maret 2021. Ini bertepatan dengan akhir dari periode perpanjangan tanpa biaya (no-cost extension)yang sebelumnya telah diberikan dan sebagian besar kegiatan teknis sudah akan selesai di akhir bulanDesember 2020, dengan hanya beberapa kegiatan akan berlanjut hingga awal Januari 2021.

Selama kuartal ini, USAID Jalin terus bergerak maju ke berbagai tahapan pencapaian proyek sertamenunjukkan metode kerja yang efisien dan adaptif sesuai dengan situasi pandemi. Proyekmemusatkan perhatian pada upaya menyelesaikan pelaksanaan kegiatan COVID-19 dan meneruskanrencana kegiatan tahun ke-3 sembari memulai penyusunan rencana penutupan proyek.

KEMAJUAN PADA KUARTAL 3

Di tingkat nasional, Proyek memberi dukungan teknis kepada Kemenkes dan bekerja sama denganmitra kunci lain mendorong kemajuan kegiatan di beberapa bidang berikut: Sekretariat di Kemenkes: Mengubah bentuk keterlibatan Sekretariat di Kemenkes dan

membentuk satu tim lengkap yang khusus diperbantukan kepada Kemenkes (Manajer IR 1,Manajer IR 2, dan Koordinator Sekretariat di Kemenkes).

Pendampingan (mentoring): Memberi dukungan langsung kepada Kemenkes untukmenyiapkan peluncuran program mentoring yang mencakup finalisasi pedoman mentoring,pedoman/instrumen tata kelola klinis, digitalisasi instrumen penilaian mandiri rumah sakit (RS)dan dukungan untuk uji coba/ percontohan.

Pelaporan Kematian Ibu dan Bayi Baru Lahir (Maternal Perinatal Death Notification –MPDN) dan Audit Maternal Perinatal - Surveilans & Respon (AMP-SR): Bersama Kemenkesmenyusun rencana peluncuran kegiatan MPDN dan AMP-SR di tingkat nasional dan daerah.

Bidan Delima: Bekerja sama dengan Ikatan Bidan Indonesia (IBI) mengembangkan konsep danrencana pelaksanaan penguatan program Bidan Delima.

Rujukan berbasis TIK: Menyusun draf laporan penilaian cepat tentang platform rujukanberbasis TIK yang ada saat ini, yang dikembangkan oleh Sinergantara untuk kajian Proyek.

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 xi

KIB di Tempat Kerja: Menyelenggarakan pertemuan rancang bersama (co-creation) dengan VFCorporation (VFC) untuk merinci rencana kegiatan dan memilih lima pabrik sebagai lokasikegiatan di fase pertama program.

Perangkat skrining risiko dan edukasi COVID-19: Bekerja sama dengan THINKMDmenyesuaikan aplikasi mobile COVID-19 untuk penggunaan oleh bidan di Indonesia.

Di tingkat daerah, USAID Jalin memusatkan perhatian pada peralihan solusi lokal kepada mitra didaerah untuk mendorong keberlanjutan melalui dokumentasi kegiatan dan pembelajaran, diseminasipanduan, pengembangan rencana keberlanjutan dan penyerahan ke mitra setempat. Selama kuartalini, tim regional telah secara resmi menyerahkan 9 dari 21 solusi lokal dan proses peralihan untukhampir semua program lainnya akan selesai di akhir bulan Oktober. Selama periode pelaporan ini, timregional juga memberi dukungan untuk kegiatan di daerah terkait dengan pendampingan dan rencanapeluncuran MPDN dan AMP-SR.

Kegiatan penanggulangan COVID-19 selama kuartal ini terutama berpusat pada keberlanjutan seriwebinar untuk bidan bersama IBI, mendukung siaran livestreaming oleh Gugus Tugas COVID-19Sumatra Utara, dan meluncurkan percontohan program Gerai Kesehatan Ibu dan Anak (KIA) Mobiledengan baik di Kabupaten Tangerang, Provinsi Banten.

Kegiatan Kuartal 4Sebagaimana disampaikan di atas, sebagian besar kegiatan teknis sudah akan selesai di akhir bulanDesember 2020, dan hanya beberapa akan berlanjut hingga awal bulan Januari 2021. Semua kantorregional akan tutup tanggal 31 Desember. Di Kuartal 4, USAID Jalin akan memusatkan perhatian padapenyelesaian kegiatan utama sesuai dengan rencana penutupan yang dirinci dalam tabel di bawah ini.

Tabel 1: Kegiatan Utama USAID di Kuartal 4

IR Kegiatan Utama

IR 1 Menyelesaikan pedoman pendampingan/mentoring dan pedoman/instrumen tata kelola klinis

Meluncurkan program mentoring dan orientasi untuk aplikasi SiMatneo

Orientasi para mentor

Meluncurkan penilaian mandiri RS dengan menggunakan SiMatneo

Mendukung pelaksanaan satu kunjungan mentoring/RS kabupaten di 65 RS kab./kota USAID Jalin

Mendukung peluncuran MPDN secara nasional

IR2 Melatih 68 Fasilitator Dinkes Provinsi dan 68 wakil provinsi dari Perkumpulan Obstetri danGinekologi Indonesia (POGI) dan Ikatan Dokter Anak Indonesia (IDAI) untuk MPDN

Peluncuran/diseminasi MPDN di 7 kab./kota USAID Jalin (minimal 19 RS dan 254 Puskesmas)

Mendukung pengembangan pedoman AMP-SR

Peluncuran/diseminasi AMP-SR di 7 kabupaten/kota (19 RS)

Memperkuat aplikasi MPDN (penguatan meliputi upaya mempermudah para pengguna untukmasuk ke dalam aplikasi; mengembangkan panduan untuk pengguna; menyediakan pusatbantuan; menambah kapasitas audit dalam aplikasi dan juga modul notifikasi kematian perinatal;menyedikan versi iOS)

Mendukung Dinkes Kabupaten/Kota memantau pelaksanaan AMP-SR (pertemuan bulanan ditingkat daerah)

IR 3 Finalisasi konsep penguatan program Bidan Delima (melalui pertemuan dengan pimpinan seniorIBI dan pimpinan program Bidan Delima)

Finalisasi dokumen strategis penguatan program Bidan Delima

IR 4 Penyelesaian penilaian cepat TIK untuk rujukan

Uji coba e-Kohort (10 kabupaten/kota)

IR 5 Memulai implementasi KIB di Tempat Kerja di lima pabrik VFC

USAID JALIN PROJECT QUARTERLY REPORT – JULY-SEPTEMBER 2020 1

II. INTRODUCTION

This report contains a summary of activities implemented and results achieved during USAID JalinProject Year 3, Quarter 3—July to September 2020. Following an introduction and overview ofUSAID Jalin’s technical approach, the report describes progress against national level activities, sub-national interventions and local solutions undertaken during the quarter. Progress is reported againstthe Addendum to Year 3 Workplan: COVID-19 Activities (Section III) and the Year 3 Workplan (SectionIV). This is followed by a description of management and operations achievements and summarizesprogress against Monitoring, Evaluation, Learning and Adapting (MELA) established indicators. Thecontractually required Indicator Performance Tracking Table (IPTT), success story and mediamonitoring, as well as documentation of local solutions, are included in the Annexes.

Overview of USAID JalinIn September 2017, USAID/Indonesia initiated the USAID Jalin Project (hereafter referred to as“USAID Jalin” or “the Project”) implemented by DAI and its consortium of partners—IntraHealth,Vital Strategies, and MSA—that supports the MOH to achieve an accelerated reduction inpreventable maternal and newborn deaths. USAID Jalin, meaning “intertwined” in Bahasa Indonesia,weaves together the GOI, private sector, civil society, and other stakeholders to create sustainablesolutions for improving MNH.

USAID Jalin is in its third year of implementation, which is characterized by a new phase of activities.During Year 2, Jalin collaborated with key stakeholders, including USAID and the MOH, to refocusthe design of the Project’s technical approach and revise the RF, which was fully operational by thestart of Year 3. In response to the COVID-19 pandemic, in Quarter 1 USAID Jalin developed theAddendum to Year 3 Workplan: COVID-19 Activities, outlining complementary emergency responseactivities. The additional activities are aligned with USAID Jalin’s RF and the existing workplanprovides the overall approach for achieving the desired goals of this addition to the Project’s scopeof work (SOW).

Though the COVID-19 situation impacted the implementation of planned activities during thequarter, resulting in some delays and modifications, USAID Jalin continued to make progress inachieving project milestones while demonstrating efficient and adaptive work methods in the contextof the pandemic. Quarter 3 activities were focused on completing the response program outlined inthe COVID-19 addendum while progressing the Year 3 workplan.

In Quarter 2, DAI requested a six-month no-cost extension to account for delays related to theCOVID-19 pandemic, and received approval from USAID on May 8, changing the Project’s baseperiod end date from September 7, 2020 to March 7, 2021.

On September 10, USAID notified the Project that they would not be exercising the first optionyear. Following that notification, the Project informed all staff and partners and together with USAIDand the MOH, agreed on a closeout timeline. The Project will close on March 7, 2021, at the end ofthe previously awarded no-cost extension period, and most technical activities will be completed bythe end of December 2020, with a few continuing into early January 2021.

USAID Jalin Technical ApproachUSAID Jalin’s technical approach is focused on the following two results: 1) Improved MNH qualityof care in public and private primary and secondary facilities, at scale; and 2) Improved efficiency andeffectiveness of the emergency referral system at community and facility levels, at scale. The Projectaligns technical activities within this framework, organized by IRs as illustrated in Table 2.


Table 2: Intermediate Results

IR 1 IR 2 IR 3 IR 4 IR 5

Sustainedimprovements inpractice by clinicalhospital teams intreating obstetricand newborncomplications.

Stakeholderstrategies morefocused on maincauses of maternaland neonatal death

Sustainedimprovements inquality of care byprivate midwives

Integrated ICTreferral platformscaled

Improved referralnetworks scaled

USAID Jalin’s primary partner is the MOH, which includes collaboration with relevant directoratesand units. The Project also works closely with other GOI stakeholders, professional associations,academia, the private sector, and civil society. During Quarter 3, collaboration with existing partnersand stakeholders continued—both for COVID-19 response and regular activities.

The Project is supporting activities in 120 GOI priority districts for MNH at the national level andhas a presence in 65 of these districts across six provinces: Banten, Central Java, East Java, NorthSumatra, South Sulawesi, and West Java.

III. QUARTER 3 PROGRESS AND RESULTS – ADDENDUM TOYEAR 3 WORKPLAN: COVID-19 ACTIVITIES

ADDENDUM TO YEAR 3 WORKPLAN: COVID-19 ACTIVITIESSince the declaration of COVID-19 as a national disaster on April 13, 2020, Indonesia has seen anincreasing number of confirmed cases and deaths due to the disease. As of September 25, theGovernment of Indonesia reported 266,845 confirmed cases and 10,218 deaths nationwide.1 USAIDJalin’s six provinces accounted for 42.5 percent (113,410) of confirmed cases and 56.8 percent(5,807) of deaths. The recovery rate at national level, as well as in USAID Jalin’s provinces, is 73percent, which is below the global figure (75 percent).2

1 covid19.go.id2 https://www.worldometers.info/coronavirus/? Accessed on Oct 09, 2020

Quarter 3 Highlights

Together with IBI, conducted the sixth and seventh sessions of the COVID-19-focused webinar series for midwives, with over 1,000 participants.

Initiated an online model of MNH counseling through implementation of Gerai KIAMobile in Tangerang District, Banten Province—successfully reaching 364 pregnantwomen in 639 phone counseling sessions.

Together with the COVID-19 Task Force of North Sumatra, conducted sixlivestreaming sessions to educate the general public, including pregnant women,about safeguarding MNH during the pandemic, which reached over 9,000 views.

Customized THINKMD’s COVID-19 risk screening and education tool for useby Indonesian midwives.


Table 3: COVID-19 Cases in Indonesia

Area Confirmed Cases Recovered DeathsNational (Indonesia) 266,845 196,196 10,218Regional (USAID Jalin Working Areas)North Sumatra 9,843 6,107 415Banten 5,050 3,218 162West Java 20,131 12,022 368Central Java 21,004 15,043 1,372East Java 42,391 35,205 3,084South Sulawesi 14,982 10,961 406Total 113,401 82,556 5,807

Source: covid19.go.id

In Quarter 1, USAID Jalin developed an Addendum to Year 3 Workplan: COVID-19 Activities, which wasapproved by USAID in early April. The workplan addresses the additional challenges and barriers toMNH access that occur due to the COVID-19 pandemic alongside the need for focused andincreased infection prevention measures and for prioritization of services to protect mothers andnewborns.

The COVID-19 response activities are aligned with USAID Jalin’s regular workplan and IRs 1 to 5.Implementation of the addendum workplan commenced in Quarter 2 and ended September 30,2020. Throughout Quarter 3, USAID Jalin continued to raise awareness about the risks andpreventive measures associated with COVID-19—targeting health workers, pregnant women,mothers, and the general public. The Project has utilized a variety of communication technologies toreach intended target groups.

The section below describes Quarter 3 progress against the COVID-19 addendum workplanactivities (see Annex 3 for progress towards milestones).

IR 1: SUSTAINED IMPROVEMENTS IN PRACTICE BY CLINICALHOSPITAL TEAMS IN TREATING OBSTETRIC AND NEWBORNCOMPLICATIONS

Addendum Activity 1.1 Ensure access to emergency MNH services for COVID-19positive as well as non-infected pregnant women and newborns in public and privatehospitals1.1.1 Evaluate health system needs in light of the COVID-19 outbreakAs reported in Quarter 2, this activity was dropped from the USAID Jalin COVID-19 addendumworkplan.

1.1.2 Strengthen select health facilities for MNH service provisionAs above.

1.1.3 Improve knowledge and implementation of Covid-19 case management for MNHNo updates on this activity during the reporting period. Please refer to activity 2.1.1 for details onrelated activities.

1.1.4 Prioritization of life saving MNH services of Covid-19 case management for MNHThis quarter, USAID Jalin participated in the COVID-19 cluster meetings organized by USAID andinvolving several partners, including UNICEF, the Red Cross, international non-governmentorganizations and civil society organizations. USAID Jalin shared updates on the implementation of


the Project’s COVID-19 response activities, particularly on sustaining MNH services, infectionprevention and control, and Risk Communication and Community Engagement technical areas.

1.1.5 Self- protection of health workersAs detailed in previous reports, following USAID guidance that the Project funds cannot be used topurchase Personal Protective Equipment (PPE), this activity was canceled.

IR 2: STAKEHOLDER STRATEGIES MORE FOCUSED ON MAINCAUSES OF MATERNAL AND NEONATAL DEATHS

Addendum Activity 2.1: Advocacy and evidence generation2.1.1 Advocate for urgency of maintaining MNH servicesinto COVID-19 outbreak responseTo educate the general public, including pregnantwomen, about safeguarding MNH during thepandemic, USAID Jalin and the Communication andInformation Technology Office of North Sumatra(Diskominfo) conducted a series of programsbroadcast through the North Sumatra COVID-19Task Force Center. This activity involved supportfrom various stakeholders including Ikatan DokterIndonesia (Indonesian Doctors Association – IDI),POGI, IDAI, IBI, and several universities. Sixlivestreaming broadcasts took place between July –September 2020, reaching over 9,000 views asdetailed below.

Table 4: List of Livestreaming Broadcasts with the COVID-19 Task Force of North Sumatra

Session Date Topic Speakers Coverage

#1 July 9 Pregnancy and risk ofCOVID-19 exposure

Dr. Iman Helmi Effendi,Sp.OG(K), POGI NorthSumatra

YouTube channel:405 viewsFacebook page:955 views

#2 July 15 Immunization andbreastfeeding during theCOVID-19 pandemic

Dr. Inke Nadia Lubis,M.Ked(Ped), Sp.A,Indonesian PediatricianAssociation (IDAI)

YouTube channel:507 viewsFacebook page:1.9K views

#3 Aug 11 Consultation and healthservices for pregnant womenby midwives during thepandemic

Betty Mangkuji, SST,M.Keb, IBI North Sumatra

Youtube channel:991 viewsFacebook page:649 views

#4 Aug 19 Filtering social mediainformation amid the COVID-19 pandemic

Rey Akbar and TogaNainggolan, Social mediaexperts/ influencers

YouTube channel:204 viewsFacebook page:902 views

#5 Aug 26 Family’s role in protectingmothers and newborns duringthe pandemic

Dr Retno Sari Dewi,M.Kes, Chairperson ofPersatuan Dokter KeluargaIndonesia (IndonesianAssociation of FamilyPhysicians - PDKI)


The first broadcast aired on July 8, with Dr. Iman HelmiEffendi, ObGyn (Consultant) from POGI North Sumatraas the resource person. Photo: North Sumatra PublicRelations Office


Session Date Topic Speakers Coverage

#6 Sep 8 Multi-stakeholdercollaboration on MNH careduring the pandemic

Dr. Fatni Sulani, USAIDJalin Advisor


Figure 1: Flyers from Livestreaming Event in North Sumatra

2.1.2 Support evidence generation and data use for improved responseThis activity was not approved at submission of the workplan.

2.1.3 Establish a knowledge center for improved knowledge sharingTo support the establishment of a Knowledge Center, USAID Jalin continued to collect relevantCOVID-19 knowledge products to promote improved strategies and decision-making in preventingmothers and newborns from contracting COVID-19. The Project has gathered 47 products to date,which include relevant studies, presentations and guidance as well as resources provided by expertspeakers from the MOH and health professional associations (POGI, IDAI, IBI) that participated inthe COVID-19 related webinars supported by USAID Jalin. These are stored on USAID Jalin’s

Livestreaming to Share Critical MNH Updates During the Pandemic:During the quarter, USAID Jalin collaborated with the Communication and InformationTechnology Office of North Sumatra and supporting partners to disseminate vitalinformation about MNH and health services. Broadcast from the provincial COVID-19Task Force Media Center, the livestreamed sessions provided important updates topregnant women and the public—highlighting changes in the delivery of MNH services anddelivering potentially life-saving health guidance amid the pandemic. The six sessions werebroadcast through the Public Relations Office of North Sumatra’s social media platformsand featured a range of relevant MNH topics and expert speakers. Novika Sari, a pregnantmother of one from Deli Serdang District, shared her impressions: “I was very satisfiedwith the session I watched. I want to see more to enrich my knowledge. During my firstpregnancy, I did not have anything like this. I used to rely only on my friends [forinformation]. But the session was directly [informed by] a health expert.”


dashboard while the Project explores alternative open-access platforms or the possibility oftransferring the resources to the MOH or professional organizations.

IR 3: SUSTAINED IMPROVEMENTS IN QUALITY OF CARE BYPRIVATE MIDWIVES

Addendum Activity 3.1: Support IBI’s efforts with the focus on private midwives andespecially Bidan Delima network to address COVID-19

3.1.1 Evaluate health system needs in light of the COVID-19 outbreak with focus on private midwives (see A1.1.1)As reported in Quarter 2, this activity was dropped from the USAID Jalin COVID-19 addendumworkplan.

3.1.2 Strengthen select health facilities for MNH service provision with focus on midwifery practice andneeds (see A 1.1.2)This quarter, USAID Jalin continued collaboration with THINKMD (a digital mobile healthdevelopment firm) and finalized the customization of the Mobile COVID-19 Risk Screening andEducation Tool with inputs from IBI. The customized features include: 1) health education/counselingpanel which incorporates key messages from the Maternal and Child Health (MCH) Book (Buku KIA)on pregnancy, postpartum, and newborn care; 2) World Health Organization (WHO) and MOHrecommendations for the prevention of COVID-19 exposure; and 3) information regarding COVID-19 referral facilities/information centers in each district in Indonesia.

With the announcement of USAID Jalin’s closure, USAID requested the Project to stop the contractwith THINKMD and reallocate resources to MOH priorities that could still be supported, and thatneeded additional budget, in the remaining months. Despite the contract ending, THINKMD agreedto enter into a no-cost six-month contract with IBI. This limits support to data management andvisualization, after which IBI would need to pay for the service. Whilst IBI is appreciative of the tooland sees its value, the senior leadership expressed a need for MOH approval to launch theapplication. USAID Jalin will facilitate this discussion between IBI and MOH next quarter.

3.1.3 Improve knowledge and implementation of COVID-19 case management for MNH adapted tomidwifery practice (see A 1.1.3)This quarter, USAID Jalin continued to work with IBI to jointly conduct webinars for midwives onpriority issues related to MNH and the COVID-19 pandemic. USAID Jalin and IBI facilitated twowebinars during the reporting period—reaching a total of 1,143 midwives with information aboutthe role of midwives in the detection and management of gender-based violence (GBV) (Session 6)and COVID-19 infection prevention and control in neonatal care at primary level health facilities(Session 7). The Project engaged expert speakers from the MOH, Komnas Perempuan, UnitedNations Population Fund (UNFPA), and IDAI.

Table 5: Summary of IBI Webinar Series in Quarter 3

Session Date Topic Speakers Participants

#6 July 3 The role of privatemidwives in the detectionand management of GBV

- Central Level IBI Manager- UNFPA- Dr. dr Retty Ratnawati, MSc (QU),

AIF, National Commission onViolence Against Women (KomnasPerempuan)

682


Session Date Topic Speakers Participants

#7 July 28 COVID-19 infectionprevention and control inessential and emergencyneonatal care at theprimary level healthfacilities

- Dr. Nida Rohmawati, MPH, Head ofMaternal Neonatal Health Sub-directorate at the MOH.

- Dr. dr. Rinawati Rohsiswatmo, Paed,Head of Neonatal Screening TaskForce at IDAI and Head of theCenter for Maternal-NeonatalHealth KIARA at CiptoMangunkusumo National Hospital

461

As of September 2020, USAID Jalin and IBI have jointly conducted seven webinars, reaching 6,171participants in the live sessions, 1,910 of which attended more than one session. Full access to thewebinar materials and recorded events has been made available through the IBI website andYouTube channel – reaching a larger number of midwives.

Figure 2: IBI Webinar Series Invitations

3.1.4 Prioritization of life saving MNH services (see A 1.1.4)This activity this was dropped from the USAID Jalin COVID-19 addendum workplan. However,USAID Jalin continued supporting the strengthening and continuation of essential and lifesavingMNH services during the COVID-19 pandemic through the IBI webinar series.

3.1.5 Self-protection of health worker with focus on midwives (see A.1.1.5)During the quarter, USAID Jalin supported IBI to continue highlighting this issue with relevantstakeholders, such as during the webinar series (see Activity 3.1.3) and in meetings with PHOs inUSAID Jalin areas.


IR 4: INTEGRATED ICT REFERRAL PLATFORM SCALED

Addendum Activity 4.1: Modified ICT for referrals in context of COVID-194.1.1 ICT support to establish effective referral mechanisms that link infected and non- infected pregnantwomen directly to the appropriate referral hospital depending on their status.USAID and USAID Jalin met on July 9 to discuss the SOW for collaboration with PT SijariemasTeknologi Inovasi (STI) to modify ICT for referrals in the context of COVID-19. It was agreed thatthe SOW would not have a COVID-19 messaging aspect as initially planned. Thus, this activity isconcluded.

IR 5: IMPROVED REFERRAL NETWORKS SCALED

Addendum Activity 5.1: Improved referral pathways and networks in light of theCOVID-19 outbreak5.1.1 Establish referral pathways that match facility capabilities and capacityThis activity was planned as a follow up to activity 1.1.1, which was dropped from the USAID JalinCOVID-19 addendum workplan.

5.1.2 Strategy on terrestrial quarantine policyDuring the quarter, USAID Jalin was involved in the Family Health Directorate-led process ofupdating the MOH guideline for MNH services during the COVID-19 pandemic. In two multi-stakeholder meetings organized by the MOH (August 25 and 28), USAID Jalin along with Kantor StafPresiden (Executive Office of the President – KSP), provided inputs based on the KSP protocol onMNH services during COVID pandemic that was issued in May 2020. As of September 30, theupdated MOH guideline is still under review by the Family Health Directorate.

Gerai KIA MobileDuring the quarter, USAID Jalin continued tosupport the Gerai KIA Mobile program. Thenew online counseling service was launched onJune 8 and continued until July 31. This initialphase served as a pilot program in five sub-districts, targeting 220 pregnant women in thethird trimester of pregnancy. As of July 31, theservice has outperformed its target—reaching364 pregnant women through 639 phonecounseling sessions as depicted in Figure 4.

To follow up the success of the pilot program,USAID Jalin developed a Gerai KIAimplementation guidebook to support replication of the activity by local government. The guide willbe handed over to PHO Banten, DHO Tangerang, and PT Alfamart in Quarter 4 as part thetransition process. DHO Tangerang plans to replicate this initiative in five sub-districts in BantenProvince: Cisoka, Kemiri, Rajeg, and Tegal Angus. For more details on this innovative program, seeAnnex 9: Success Story.

Figure 3: Gerai KIA Implementation Guidebook


5.1.3 Collaborate with private sector to fill gaps (linked to MNH in the Workplace)No updates on this activity during the reporting period.

Figure 4: Pregnant Women Receiving Counseling through Gerai KIA Mobile


IV. QUARTER 3 PROGRESS AND RESULTS – YEAR 3WORKPLAN

The sections below are organized around the USAID Jalin RF. For detailed local solution activitydescriptions and achievements to date, see Annex 4 (Local Solutions Tracker) and Annex 11 (LocalSolution Activity Briefs).

The outbreak of the global COVID-19 pandemic has impacted the implementation of plannedactivities during the past quarter and the achievement of project milestones. DAI requested a six-month no-cost extension and received approval by USAID on May 8, changing the Project’s baseperiod end date from September 7, 2020 to March 7, 2021. Following the six-month extensionapproval, the Senior Leadership Team (SLT) engaged in discussions with USAID to revise theworkplan milestones. After being notified that USAID will not exercise the option year, the Projectadjusted the activity timelines to align with updated project priorities and closeout plans—andreflect expected status as of December 31. These timelines are described in the milestones table ineach IR section.

Quarter 3 Highlights

IR 1: Improved Clinical Practice Developed the mentoring guidelines (Book 1) and clinical governance/

instruments (Book 2) Digitized the hospital self-assessment instruments (SiMatneo) and finalized

the operational definition and tutorial video. Supported the pilot test of the hospital self-assessment using SiMatneo in

eight hospitals in six Jalin provinces.IR 2: Focused on Maternal and Newborn Causes of Death In collaboration with the MOH, developed a plan to roll out MPDN and AMP-

SR activities at national level and sub-national level. Submitted an abstract detailing lessons learned from MPDN to Maternal Health

Scoping Review 2020.IR 3: Improved Quality of Care from Private Midwives In collaboration with IBI, progressed efforts to finalize the concept and

implementation plan for the enhanced Bidan Delima program.IR 4: Scaled ICT Referral Platform Socialized Regent Decree Number 27 Year 2020 on Enforcement of MNH

Services in Sidoarjo District and finalized the SiCantik user manual. Draft rapid assessment report of ICT-based referrals platforms developed by

Sinergantara for review by the Project.IR 5: Scaled Referral Networks Drafted a Governor Decree and cooperation agreement to support the referral

network across Bogor-Depok and initiated development of an integrated referraldashboard (Matneosafe).

Documented and transitioned transport-related local solutions (AmbulanceFeeder and Tukang Ojek Puskesmas dengan Elektronik Ambulans Motor [PuskesmasElectronic Motorcycle Ambulance – TOPDeAMOR]) to local partners, withsustainability plans in place.

Facilitated a co-creation workshop with VFC to develop the MNH in theWorkplace workplan and selected five factories for the first phase of the program.


IR 1: SUSTAINED IMPROVEMENTS IN PRACTICE BY CLINICAL HOSPITALTEAMS IN TREATING OBSTETRIC AND NEWBORN COMPLICATIONS

Quarter 3 Highlights Developed the mentoring guidelines (Book 1) and clinical governance/instruments

(Book 2)

Digitized the hospital self-assessment instruments (SiMatneo) and finalized theoperational definition and tutorial video.

Supported the pilot test of the hospital self-assessment using SiMatneo in eighthospitals in six Jalin provinces and discussed the results with vertical hospitals and district/cityhospitals, PHOs and DHOs.

Table 6: Progress Towards Milestones for IR 1

Project Milestone Current Status (September 2020)ExpectedStatus atDecember 31

IR 1March milestonesStrengthened guidelines based onevidence adopted by MOH

Largely achieved: Clinical and managerialguidelines are in process of finalization in closecollaboration with MOH.

Fully achieved

MOH-led mentoring initiated inseven vertical hospitals

Partially achieved: Eight hospitals in six Jalinprovinces have piloted the self-assessment.Discussions are underway with MOH to

To be confirmed(TBC) based on

The problem:Most maternal and newborn deaths occur in hospitals (public and private) which might be preventedthrough improved quality of care and a strengthened quality assurance system

The solution:Improving the quality of care at primary and referral health facilities of public and private services throughMNH mentoring based on evidence.

Jalin’s objectives: MOH-led MNH mentoring implemented in all hospitals Clinical/managerial mentoring approach and guidelines instituted nationally MOH has robust monitoring and evaluation system for mentoring

The primary stakeholders:MOH, MOH-led mentoring task force, DHOs,PHOs

The location:USAID Jalin will support MOH in rolling outnational mentoring program, with specificsupport to implementation in 65 Jalin prioritydistricts



determine whether mentoring by verticalhospitals will take place in 2020.

discussions withMOH

Strategy for MNH mentoring forprivate hospitals (includingincentives)

Not initiated: The Project’s focus has been onsupporting mentoring in public hospitals.

Unlikely to beachieved

September milestonesMOH-led mentoringimplemented in all verticalhospitals and in hospitals in 65Jalin priority districts

Partially achieved: Eight hospitals in six Jalinprovinces have piloted the self-assessment.Discussions are underway with MOH todetermine whether mentoring by verticalhospitals will take place in 2020.

TBC based ondiscussions withMOH

Draft monitoring and evaluation(M&E) system for mentoring (keyindicators incorporated in SistemInformasi Manajemen Rumah Sakit[Hospital ManagementInformation System – SIMRS] forpublic hospitals)

Partially achieved: Comprehensive M&Estrategy developed by the Project for mentoringand shared with MOH. Components of thestrategy included within the mentoring guidelines.

Partially achieved(mentoringunlikely to berolled out in2020)

Activity 1.1: Clinical/managerial mentoring of clinical teams in public hospitals1.1.1 Mentoring for vertical hospitalsTo ensure the provision of high quality maternal and newborn care, USAID Jalin is supporting theMOH to undertake an accelerated mentoring program for MNH teams in public hospitals in 120locus districts across Indonesia (65 Jalin districts), covering both clinical and managerial topics.

Specific support during the quarter focused on the following key areas:

Provided technical assistance in completing the mentoring guidelines and clinicalgovernance/instruments: Over the quarter, USAID Jalin provided continuous technicalsupport to the MOH to complete the mentoring guidelines. On August 10, USAID Jalin sent theMOH the final draft of the mentoring guidelines and is awaiting final approval by the FamilyHealth Directorate.

To support the mentoring teams in understanding the situation of MNH services in thedistrict/city public hospitals (mentee hospitals), in addition to the hospital self-assessment usingSiMatneo results, more contextualized and analytical instruments are needed. Therefore, USAIDJalin has been providing technical assistance to the MOH to develop the clinicalgovernance/instruments. These instruments will be used to conduct more in-depth analysis ofhospital services related to MNH, clinical governance, infection prevention at hospital level, andlayout of hospital facilities.

In collaboration with POGI, on September 8 USAID Jalin facilitated a meeting to discuss thementoring guidelines, clinical governance/instruments, and mentoring national implementationplans with several mentors from vertical hospitals and the MOH. Feedback from the meetingwas incorporated to improve and finalize the clinical governance/instruments, which areexpected to be completed in early October.

Digitized the hospital self-assessment instrument (SiMatneo): This quarter USAID Jalincontracted PT. Digital Sapta Nawala to support the MOH to digitize the hospital self-assessmentinstrument and develop operational definitions (application guideline) and a tutorial video. Theinstrument will be used to assess the readiness and situation of health service facilities and the


impact of COVID-19 on MNH services in 120 districts. Digitizing the instrument will make iteasier for hospitals to input, record, and submit their data, and will provide a convenientplatform for the MOH to understand, evaluate, and analyze the situation in hospitals by using theSiMatneo dashboard. On August 26, the instrument was completely digitized.

Supported the pilot test of the hospital self-assessment using SiMatneo: The MOHrequested that the pilot test take place in six USAID Jalin provinces. In close coordination withPHOs and DHOs, the USAID Jalin Regional Offices selected eight hospitals in six USAID Jalinprovinces to participate. The pilot test was conducted on August 27 – September 3. USAID Jalinactively supported the pilot test process, including by ensuring that hospitals had access toSiMatneo, received the SiMatneo application guideline from the MOH, and submitted their self-assessment data before the pilot test due date.

Concluding the pilot test activities, incollaboration with the MOH, USAIDsupported and facilitated theSiMatneo pilot test results meeting onSeptember 15, with participation fromvertical hospitals, eight pilot testhospitals, DHOs from pilot hospitallocations, and PHOs in six USAIDJalin provinces. The meeting aimed togather feedback and inputs fromvarious stakeholders to improveSiMatneo. On September 22, theSiMatneo application was improved byadding “edit data and add new data”features. The MOH plans to conductan orientation on the hospital self-assessment using SiMatneo forvertical hospitals and public hospitalsin 120 priority districts in earlyOctober.

Figure 5: Screenshot of SiMatneo Website (simatneo.kemkes.go.id)(top) and Dashboard (bottom)


Figure 6: Impact of COVID-19 on Maternal Services Dashboard

Figure 7: Impact of COVID-19 on Neonatal Services Dashboard

1.1.2 Mentoring for provincial and district hospitals and health centersProgress under this sub-activity is aligned with 1.1.1 above.

Face-to-face service wasunavailable > 7 days in a row

within the last 6 months

88%90%

Service is available athealth facility

Service is always available 24hours within the last 6

months

100%

Face-to-face service wasunavailable > 7 days in a row

within the last 6 months

93%

Service is always available 24hours within the last 6

months

93%

Service is available athealth facility

93%

SiMatneo pilot test result meeting. Photo: Screenshot by USAID Jalin


Activity 1.2: Clinical/managerial mentoring of clinical teams in faith-based, non-profitand for-profit hospitals1.2.1 Mentoring for faith-based, for-profit and non-profit private hospitalsUSAID Jalin’s focus during the quarter has been on clinical/managerial mentoring of clinical teams inpublic hospitals. This activity will not progress.

Activity 1.3: TA to the MOH and sustainabilityNo activities planned or undertaken during the reporting period.


IR 2: STAKEHOLDER STRATEGIES MORE FOCUSED ON MAIN CAUSES OFMATERNAL AND NEONATAL DEATHS

Quarter 3 Highlights In collaboration with the MOH, developed a plan to roll out MPDN and AMP-SR

activities at national level and sub-national level. Implementation of these activities isexpected to be conducted in Quarter 4.

Submitted an abstract detailing lessons learned from MPDN to Maternal Health ScopingReview 2020.



IR 2March milestonesMPDN available to be accessedby Puskesmas, PHO, DHO, andhospitals

Fully achieved: MPDN is fully operational andundergoing piloting in six provinces.

Fully achieved

Accountability: Advocacy forinclusion of key MNH indicatorsin the five-year national

Largely achieved: Policy brief withaccountability as the theme was submitted,awaiting feedback from MOH. USAID Jalin also

Fully achieved

The problem:Uneven reporting of maternal and newborn deaths in districts has resulted in incomplete informationabout the number and causes of deaths which hampers surveillance and the development andimplementation of appropriate and adequate responses.

The solution: Better MNH data and better use of the data to improve MNH policy and planning will lead to more

informed MNH strategic choices being made at all levels from the Ministry down to the health centerand that will translate into better MNH services which will result in fewer maternal and newborndeaths.

Analysis of the data to compare the performance of those accountable for MNH services at variouslevels and then making that information available both within MOH and other ministries and to thepublic will motivate continuous performance improvement by those accountable.

Jalin’s objectives:Strengthened knowledge for response and accountability leading to stakeholder strategies more focused onmain causes of maternal and neonatal death

The primary stakeholders:MOH, PHOs, DHOs, Ministry of Home Affairs,heads of local government (governors, bupatis,mayors)

The location:MOH, USAID Jalin provinces, 120 MNH prioritydistricts



development plan (especiallyquality, Maternal Perinatal DeathSurveillance and Response[MPDSR], mentoring)

supported MOH in finalizing the AMP-SR nationalguidelines which contained accountabilityindicators. This guideline is expected to becompleted in October.

Development of dashboardsupported by technical assistance(TA)

Fully achieved: MPDN, including dashboard, isfully operational and undergoing piloting in severalprovinces.

Fully achieved

MNH Working Group (WG):Established and functioning; andsome strategic prioritiesidentified

Partially achieved: While the COVID-19pandemic has delayed planned activities of theWG, MOH has expressed interest in utilizing theMNH WG to draft the upcoming PresidentialDecree on reduction in maternal mortality ratio(MMR) and newborn mortality rate (NMR). TheProject awaits the first meeting of the MOH MNHWG.

Fully achieved

Pre-Eclampsia/Eclampsia (PE/E)screening model in Central Javadeveloped

Fully achieved: PE/E screening model in CentralJava has been piloted and transitioned to localpartner.

Fully achieved

Minimum two manuscripts areready to submit

Fully achieved: USAID Jalin worked closely withPusat Penelitian Keluarga Sejahtera (Center for theStudy of Family Welfare – PUSKA UI) andsubmitted three manuscripts during the quarter.

Fully achieved

September milestonesOption to incentivize recording,reporting, review and responsesupported

Partially achieved: Preparations well advancedfor national MPDN socialization and orientationto be conducted in October. National andregional MPDN activities will incentivizerecording, reporting, review, and response ofmaternal death through the use of MPDN.

Fully achieved

Functioning system for exchangeof information between hospitaland district

Partially achieved: Preparations well advancedfor national MPDN socialization and orientationto be conducted in October. National andregional MPDN activities will incentivizerecording, reporting, review, and response ofmaternal death through the use of MPDN.

Fully achieved

Functioning system for flow ofinformation from national toprovincial and district levels

Partially achieved: MPDN dashboard withhospital and districts accounts are fullyfunctioning. Uptake is expected to rise with theMPDN rollout activities.

Fully achieved

Dashboard in use in real-time;and published

Partially achieved: While MPDN dashboard isused in real-time, its data is not publicly availableyet.

Partially achieved

MNH WG producingrecommendations

Partially achieved: While the COVID-19pandemic has delayed the planned activities of theWG, MOH has expressed interest in utilizingMNH WG to draft the upcoming PresidentialDecree on reduction in MMR and NMR. TheProject awaits the first meeting of the MOH MNHWG.

Partially achieved


Activity 2.1: Support the strengthening of MPDSR2.1.1 MPDN application developmentUSAID Jalin continued to support the MOH in refining and rolling out the MPDN platform toimprove the reporting of maternal and neonatal mortality data. During the quarter, the Projectfinalized the contracting of Koloni Semut, the software development company tasked withstrengthening the MPDN application, e.g. by digitizing AMP-SR and making the application availablefor iOS-based devices. Based on an evaluation of the application, and feedback received, theapplication was strengthened for key users including administrators and those responsible for dataentry. This included simplifying the login process, resolving bugs, shortening the verification process,reducing buffer memory, providing a help desk, and conducting on the job training for MPDNverifiers and administrators.

Figure 8: MPDN User Distribution

In Quarter 3, USAID Jalin conducted discussions with the MOH to evaluate MPDN uptake. FromJanuary to September 2020, the distribution of MPDN utilization through the Android platform is1.9 percent by Puskesmas, 8.5 percent by hospital, and 6.2 percent by DHO. Whilst the distributionof MPDN utilization through the web platform is 1.3 percent by Puskesmas; 0.8 percent by hospital,and 18.1 percent by DHO. In total, MPDN recorded 57,977 notifications of maternal and perinataldeaths through its web platform.

Within USAID Jalin priority districts, there are 130 public hospitals of various classes, and aroundone third of public hospitals (43 out of 130) are utilizing MPDN for maternal and perinatal deathnotification as of August 2020. In Quarter 3, USAID Jalin also continued to provide technicalassistance for MPDN evaluation at the sub-national level, particularly in East Java province. Thisassistance focused on improving user compliance in reporting maternal and perinatal death throughMPDN, along with addressing bottlenecks that may arise while using the application.

In early September 2020, USAID Jalin collaborated with the MOH in responding to the WHO,UNFPA, and United Nations Children’s Fund (UNICEF) call for abstract (Maternal Health ScopingReview 2020) using MPDN lessons learned in refining the network of care for maternal and perinatalhealth. The abstract highlighted current maternal and neonatal mortality data recorded in MPDN.From January to September 2020, 69 hospitals notified maternal deaths, whilst 94 hospitals notifiedperinatal and newborn deaths. MPDN utilization covered 30 percent of total districts in Indonesiafor maternal deaths and 24 percent of total districts for perinatal and newborn deaths. Severalbottlenecks were identified, including the lack of regulations that oblige MPDN use and condition ofthe domain server. Based on above findings, the abstract concluded that it is advisable for the MOHto conduct strategic planning on scaling up MPDN across Indonesia.


2.1.2 Link Pusat Data dan Informasi (Data and Information Center – Pusdatin)/MPDN and BadanPenyelenggara Jaminan Sosial-Kesehatan (Social Insurance Administration Organization-Health –BPJS-K) death reporting systemsIn Quarter 3, USAID Jalin, together with the MOH, UNICEF and other relevant stakeholders,continued to explore the possibility of linking MPDN with other established systems. Such linkagescan help to strengthen accountability both at national and sub-national levels. In addition to AplikasiKomunikasi Data (Data communication application – KOMDAT) and SiMatNeo, Sistem InformasiKesehatan Daerah (Regional health information system – SIKDA) was another potential systemlinkage identified during the quarter. Currently, the MOH is working to develop a national healthdashboard called Satu Data Kesehatan Indonesia. By early 2021, MOH plans to have interoperabilitybetween MPDN and KOMDAT. In the long term, the MOH plans that MPDN will be interoperablewith SIKDA at provincial level, which may improve civil registration. Establishing interoperabilitybetween MPDN and SIKDA will feed aggregated data to KOMDAT and Satu Data KesehatanIndonesia at the national level.

Activity 2.2: Improve accountability through monitoring, reporting andcommunicating progress2.2.1 Conduct rapid review of evidence to determine a list of critical input, process, output and impactindicators related to reducing MMR/ NMR using output from MPDSR and other routine data sources in thecontext of the emerging MNH National Action PlanDuring the reporting period, USAID Jalin continued to support the MOH in finalizing the AMP-SRnational guidelines along with other development partners (UNICEF, WHO, and UNFPA), andprofessional bodies (POGI and IDAI). The draft AMP-SR national guidelines contain 17 input,process, output, and outcome indicators for accountability purposes at national and sub-nationallevels. This task is expected to be completed by late October 2020 (prior to a national AMP-SRevent, expected to be conducted in early November 2020, during which the strengthened guidelineswill be presented). USAID Jalin also provided technical assistance to the MOH on evaluation ofMaternal Death Surveillance Response (MDSR) in four provinces and offered feedback on theevaluation design, indicator review, and determination of respondents during the MDSR evaluation.

In preparation for the upcoming AMP-SR guideline launch, USAID Jalin coordinated with otherdevelopment partners on provision of technical assistance to implement AMP-SR in pilot districts,which includes seven districts in six provinces. USAID Jalin continued to have close consultation withPHOs and DHOs on the AMP-SR implementation plan and they have informed USAID Jalin aboutcurrent AMP-SR practices and requested technical assistance from the Project to improve thequality of the AMP-SR process (including improvements in data collection though verbal autopsy,resume of medical record, and assistance in data analysis, monitoring and development ofrecommendations).

Policy brief developmentUSAID Jalin submitted a draft policy brief requested by MOH during the first quarter of 2020entitled Saving Life Saving Future: Strengthening Multi-sector Accountability to Improve Mother andNewborn Survival. The draft addressed accountability and multi-sector, multi-level roles. Furtherfeedback is awaited from the MOH.

2.2.2 Reinforce and extend existing platform as online dashboard which highlights, for the purpose ofaccountability and transparency, the comparative progress by GOI priority districts against the key indicators(SiMatneo)In collaboration with other development partners, USAID Jalin continued to recommend thatSiMatneo become a dashboard to monitor progress of response on AMP-SR. In conjunction withthis recommendation to the MOH, USAID Jalin continued to explore the possibility of establishinginteroperability between MPDN and the SiMatneo dashboard in this quarter. This linkage can help tostrengthen accountability both at national and sub-national levels.


2.2.3 Develop and submit manuscripts on Every Mother and Newborn Counts (EMNC) findings to peer-reviewed journalsThis quarter, the Project finalized the following manuscripts:

1. Modified Pathway to Survival highlights importance of rapid access to quality institutionaldelivery care to decrease mortality in Serang and Jember districts, Java, Indonesia.

2. Care-seeking and health insurance among pregnancy-related deaths: a population-basedstudy in Jember District, East Java Province, Indonesia.

3. Findings from Neonatal Verbal and Social Autopsy (VASA) in two Districts in Indonesia

All three manuscripts were submitted for publication to the PLOS ONE journal.

Activity 2.3: Regular reviews of maternal and newborn deaths at national level andrecommended improvements (related to human and institutional capacities),including scaling up of promising pilots, made through MOH MNH Working Groupand MNH Committee

2.3.1 Decreased Mortality due to PE/EIn Central Java, USAID Jalin continued to pilot the Decreased Mortality due to PE/E localsolution in Boyolali District. During the quarter, USAID Jalin assisted DHO Boyolali and fourpreviously mentored Puskesmas to mentor 21 other Puskesmas in conducting self-assessment usingclinical performance monitoring (APKK) and referral performance monitoring (APKR) tools. Thementoring activities were funded by the Puskemas and utilized the health promotion video that wasdeveloped by the mentor Puskesmas in Quarter 2.

In July, the team conducted an online AMP eventin collaboration with DHO Boyolali to respond tocases of maternal deaths during the COVID-19pandemic. The AMP prompted the DHO Head toissue a Circular Letter in July on Lessons fromAMP, which contains a ‘Guideline for Detection,Prevention, and Management of Hemorrhage andPre-eclampsia in Boyolali’. The guideline instructssub-district heads to form a Maternal andNeonatal Working Group to accelerate NMR andMMR reduction in their respective regions andmandates primary healthcare workers to attendan emergency drill training or an internshipprogram at select hospitals to improve their skillsin handling and referring emergency maternal andneonatal cases.

At the request of DHO Boyolali, the team also provided an online training on Asuhan PersalinanNormal (Normal Labor Services – APN) for 24 healthcare providers from Puskesmas Sambi,consisting of doctors, nurses, and midwives.

The local solution has been fully handed over to DHO Boyolali, who will continue conductingmentoring for the 21 Puskesmas with their own budget.

In West Java, the ZOOM Preeclampsia local solution aims to reduce the number of pre-eclampsiacases through risk screening, early detection, preventive management, and regulatory approaches.During the quarter, USAID Jalin supported the assessment that was undertaken from June 25 – July

Head of DHO Boyolali and staff during an online maternaland perinatal mortality audit in July 2020. Photo: DHOBoyolali


17 in 24 districts/cities (DHOs and hospitals) to measure readiness for implementing the localsolution. Based on the assessment results, PHO and POGI West Java selected 12 districts/cities forimplementation of the program; ten districts/cities based on the high number of maternal deathscaused by hypertension and two districts/cities based on the high score in the readiness assessment.To support initiation of these activities, the team facilitated a series of workshops during thequarter:

Workshop to share assessment results with 40 PHO/DHO representatives (August 19). Workshop for Obstetricians/Gynecologists (ObGyn) from West Java to discuss and agree on

the program approach and methodology (September 17). Workshop to socialize PE/E screening and prevention in Puskesmas, with more than 180 health

providers from across the province (September 30).

The local solution will be handed over to the PHO next quarter, who will lead implementation ofthe ZOOM program in West Java.

2.3.2 Support the implementation of the MOH MNH WGIn Quarter 1, the MOH MNH Working Group was established by a Ministerial Decree. TheProject’s current workplan is aligned particularly well with the tasks of the sub-working group onClinical and Quality Improvement Services through USAID Jalin’s support to the clinical mentoringprogram. It is also aligned well with the tasks of the sub-working group on Monitoring and Evaluationthrough USAID Jalin’s support in MPDN and AMP-SR activities.

While the COVID-19 pandemic has delayed the planned activities of the WG, the MOH hasexpressed interest in utilizing the MNH WG to draft the upcoming Presidential Decree on MMR andNMR reduction. USAID Jalin remains committed to provide support as the WG becomes moreactive. The Project awaits the first meeting of the MOH MNH WG in Quarter 4.

2.3.3 Support MOH MNH WG through a Secretariat provided initially by JalinIn addition to supporting the MNH WG in technical areas, USAID Jalin also offered to support theSecretariat of the MNH WG and submitted a draft Terms of Reference in Quarter 1 detailing thespecifics of such support to MOH. The Project awaits feedback from the MOH on this proposal.

2.3.4 Support promotion of the MOH MNH WG with national bodiesThe MOH has not yet requested USAID Jalin’s assistance to promote the MOH MNH WG withnational bodies, so this activity has not commenced.

2.3.5 Support establishment of MNH National CommitteeIn Year 2, USAID Jalin produced the concept note Saving Mothers and Newborns: A NationalCommittee to Accelerate the Reduction of Maternal and Neonatal Deaths which was submitted to USAIDand MOH. In Quarter 3, there was again no opportunity to take it forward with MOH because theMinistry is occupied with the COVID-19 pandemic.

Activity 2.4: TA to the MOH and sustainability2.4.1 Data synthesis, communication, and useThis quarter, USAID Jalin conducted an orientation workshop for MOH staff on Data Use forDecision-Making to Accelerate Reduction of Maternal and Newborn Mortality. The online sessionstook place over four days between July 9 – 14, with a subsequent follow-up workshop on July 29. Inaddition to USAID Jalin participants, the workshop included: two MOH staff from the Family HealthDirectorate, a representative from the National Institute for Health Research and Development,four participants from two PHOs (West Java and North Sumatra), and 22 participants from nineDHOs in these provinces.

Through the workshop, participants improved their knowledge and ability to:


Understand the importance of using data to refine MNH problems; Use the logic model to define the root causes of MNH problems based on the most important

key findings; Understand how to identify the modifiable key findings in every stage of the logic model; and Modify the key findings at the process stage of logic model through alternative interventions to

address the MNH problems.

2.4.2 Coordinating development partners working in MNH space (UNICEF, UNFPA, Japan InternationalCooperation Agency [JICA], ThinkWell, Project Hope & Jhpiego)In Quarter 1, a document entitled Coordination agreement between development partners committed tosupporting the Government of Indonesia to accelerate the reduction in maternal and newborn deaths andthe Ministry of Health was drafted by USAID Jalin and submitted to the MOH. The MOH providedfeedback by suggesting holding regular coordination meetings to monitor program progress of eachdevelopment partner, to avoid any possible duplication, and to optimize potential synergies betweendevelopment partners. The MOH indicated they would adjust the document to conform with theofficial format of MOH. Further feedback from MOH is awaited.

2.4.3 Mapping of the MNH programs in the 120 priority districtsDuring Quarter 1, with support from Asosiasi Dinas Kesehatan (Association of Indonesia Local HealthOffices – ADINKES) and short-term technical assistance, USAID Jalin initiated the task of mappingMNH planning and budgeting in the 120 MNH priority districts. In Quarter 2, the Project wasinformed by the MOH that this is not a priority activity and that due to COVID-19, MOH fundswere diverted away from MNH. In Quarter 3, USAID Jalin ended the contract with ADINKES andProf. Ascobat Gani. As a result, the mapping activity has been canceled.

2.4.4 Integrating project materials and MOH websiteThis support has been put on hold at the request of the MOH, due to other priorities.

2.4.5 Antenatal Care (ANC)/Postnatal care (PNC) Standard Operating Procedures (SOPs): improving qualityof guidance and complianceDuring the quarter, as part of efforts related to Improving Health Worker Compliance withANC and PNC SOPs in Malang District, East Java, the team continued to monitor and evaluatethe implementation of the SOPs and the use of the MCH book in pilot Puskesmas, includingmodifications due to the COVID-19 pandemic. The team also supported a trial of SOPimplementation in three pilot Puskesmas, which included 22 representatives from DHO Malang,POGI Malang, and Rumah Sakit Umum Daerah (Regional Public Hospital – RSUD) KanjuruhanKepanjen. The trial identified a variety of challenges in executing the SOPs and yielded a set ofrecommendations for improved adherence. The challenges included patients being unwilling to bereferred or complete paperwork and referral hospitals turning away patients (usually due toovercapacity or absence of pre-referral COVID-19 rapid test) without notifying the referringhospitals. Several solutions were identified including: 1) communicating with patients via WhatsApp,2) coordinating with the ObGyn in the referral hospital before referring a patient, 3) providing theCOVID-19 rapid test in Puskesmas for referral purposes.

To ensure sustainability, the team also worked closely with DHO Malang to draft a Regent (Bupati)Regulation on Implementation of Standard Operating Procedures and Technical Guidelines for ANCand PNC, which are anticipated to be signed in early October. In late October, the local solution willbe handed over to DHO Malang, who will continue to work with stakeholders, including PenurunanKematian Ibu dan Bayi (Maternal and Infant Mortality Reduction Forum – PENAKIB), to ensureadherence to ANC and PNC SOPs and Clinical Practice Guidelines (CPG).


With USAID Jalin’s support, stakeholders inJember District, East Java, initiated the QualityImprovement for Integrated ANC and PNCprogram. Under this local solution, USAID Jalinsupported DHO Jember to develop SOPs andguidelines for improving the quality of ANC andPNC. This quarter, the team continued tomonitor the implementation of ANC and PNCSOPs with DHO Jember, PENAKIB East Java, IBI,and POGI Jember, through an external audit ofthe five pilot Puskesmas, which was divided intothree online sessions. The audit involved morethan 200 health providers, including generalpractitioners, Puskesmas doctors, midwifecoordinators, and village midwives. The virtualaudit methodology used by the assessors, which was newly-developed and introduced by USAIDJalin, succeeded beyond expectations and prompted PHO East Java to express interest in using thismethodology more widely (see text box below).

During the quarter, the team also facilitated the establishment of an Emergency Team in five pilotPuskesmas to improve their performance in handling emergency MNH cases. Each Emergency Teamis subdivided into several smaller teams that are each responsible for specific tasks. This cleardelegation of tasks should make the handing of emergency cases more effective and efficient.

This local solution will be transitioned to DHO Jember in early November. The DHO hascommitted to replicate this initiative in 45 other Puskesmas.

2.4.6 Strengthening blood transfusion serviceIn Bulukumba District, South Sulawesi, USAID Jalin continued supporting the local solution BloodDonation Emergency Response which aims to address the problem of blood availability forpregnant and postpartum women. With USAID Jalin’s assistance, the Bulukumba Hospital BloodTransfusion Unit developed an android application for blood management called ITDRS Bulukumba(Instalasi Transfusi Darah Rumah Sakit/Hospital Blood Transfusion Unit). During the quarter, USAIDJalin continued to assist the Bulukumba technical team in testing, monitoring, and refining ITDRSBulukumba. The application is now available to the public.

Introducing Virtual External Audits to Assess Health WorkerCompliance on ANC and PNC SOPs: As part of the local solution in East Java,USAID Jalin successfully facilitated a virtual external audit divided into three sessions toassess the compliance of health workers in implementing the ANC and PNC SOPs and toevaluate health worker competency in delivering quality MNH services. Using caseexamples, two Puskesmas were assessed during each session—performing virtualsimulations to demonstrate their competency in the specific service standards beingevaluated. The activity involved PENAKIB East Java, PENAKIB Jember, DHO Jember, POGIMalang and IBI Jember as assessors, and was observed by more than 200 health workersfrom 45 other Puskesmas throughout Jember. Overall, the assessors were very satisfiedwith the capacity and compliance of health workers and the simulation results, whichshowed that the five pilot Puskesmas successfully implemented 85 percent of the SOPs—meeting the audit standard with some room for improvement. Although the audit was notoriginally planned as a virtual activity, it proved to be a highly successful approach andsupported local MNH stakeholders to adapt to the pandemic situation in an innovative way.

Health workers at Puskesmas Tempurejo, Jember participatein the external audit facilitated by USAID Jalin. Photo:Puskesmas Tempurejo, Jember


Figure 9: Screenshots of ITDRS Bulukumba Application: Desktop App (left) and Mobile App (right)

In early October, the solution will be handed over to DHO Bulukumba, as well as RSUD H. A.Sulthan Daeng Radja, who will be responsible for managing ITDRS Bulukumba. The DHO plans tosocialize the application to health facilities through in-person events once the pandemic has subsided.

2.4.7 Supporting implementation of AMP (Maternal Perinatal Audit)In Quarter 3, USAID Jalin contributed to the finalization of the MOH AMP-SR national guidelines. Inconjunction with MPDN activities, the MOH plans to launch the finalized AMP-SR nationalguidelines, along with subsequent national training of AMP-SR facilitators. In collaboration with theMOH, USAID Jalin developed a plan to roll out MPDN and AMP-SR activities at national and sub-national levels, which is expected to be conducted in Quarter 4.

During the reporting period, USAID Jalin also provided technical assistance to the MOH onevaluation of MDSR in four provinces. The feedback focused on evaluation design, indicator review,and determination of selected respondents during MDSR evaluation.

2.4.8 Supporting MOH to reduce stuntingUSAID Jalin continued to focus on the COVID-19 addendum workplan and regular workplanactivities. This activity is a placeholder to support the MOH in their needs and no request wasreceived by the MOH in this area during the reporting period.


IR 3: SUSTAINED IMPROVEMENTS IN QUALITY OF CARE BY PRIVATEMIDWIVES

Quarter 3 Highlights In collaboration with IBI, progressed efforts to finalize the concept and

implementation plan for the enhanced Bidan Delima program through the co-creation workshop and working group meetings.


Project Milestone Current Status (September 2020) Expected Status atDecember 31

IR 3March MilestonesBD review conducted Fully achieved: The BD review was

conducted in December 2019.Fully achieved

Enhanced BD business modelavailable

Partially achieved: Discussions havetaken place to design the enhanced BDbusiness model. USAID Jalin and IBI agreedto have a final strategic document on theenhanced BD business model (whichdescribes the enhancement solutions andimplementation plan) by the end of October2020.

Fully achieved

The problem:Private midwives are an important source of maternal care in Indonesia. However, evidence suggests thatthe quality of care provided by private midwives is deficient.

The solution: Mentoring private midwives, review Bidan Delima business model Incentivizing private midwives with JKN Facilitating access to finance for private midwives

Jalin’s objectives:• Develop enhanced Bidan Delima program as the branded quality recognition for private midwives• Incentivize empanelment of private midwives with JKN• Facilitate access to credit for private midwives as a means to improve quality of care

The primary stakeholders:The Indonesian Midwives Association (IBI)

The location: Piloting of enhanced Bidan Delima

program in select Jalin districts Piloting of improved JKN payment

mechanism for private midwives in selectJalin districts



Access to credit: North Sumatrafinancing model developed

No progress: No progress made duringthis quarter. Despite high interest frombanks, it was found that private banks at theprovincial level have limited flexibility todesign new credit schemes for midwives.

Not achieved

September milestonesIBI supported to implementenhanced BD business model in Jalinprovinces

Not started: Due to project closure, Jalin'ssupport will be limited to the developmentof a strategic document on the enhancedBD program, that IBI can implement withpartners. Had Jalin not received closurenotification, IBI would have been supportedto implement the enhanced model in thefourth quarter.

Not achieved

Partnerships with private sectorexplored for resource generation

Partially achieved: Continuing tasks fromthe previous quarter, USAID Jalin andTHINKMD finalized the customization ofthe Mobile COVID-19 Risk Screening andEducation Tool, with inputs from IBI.Application and manual have been sharedwith IBI, however, the rollout will notproceed due to project closure.

Partially achieved

Pilot implementation completed intwo Jalin provinces

Dropped: As Jalin is no longer engaged instrategic health purchasing.

Not achieved

Cost effectiveness model developed Not started: At USAID direction due toproject closeout, Jalin's support will belimited to the development of a strategicdocument on the enhanced BD program,that IBI can implement with partners.

Not achieved

Cost effectiveness model developed Not started: At USAID direction due toproject closeout, Jalin's support will belimited to the development of a strategicdocument on the enhanced BD program,that IBI can implement with partners.

Not achieved

National model finalized (based onNorth Sumatra and other bestpractices)

Partially achieved: Internal reviewsuggested that the model cannot beimplemented as originally designed. Jalin waslooking for opportunities to discuss furtherwith national and provincial level, but due toCOVID-19, this plan was postponed. AsJalin is nearing project closeout, the activitywill not proceed.

Not achieved

Activity 3.1: Reviving and strengthening Bidan Delima in Jalin provinces through:mentoring and certification of private midwives; review of Bidan Delima businessmodel and encouraging broader membership3.1.1 Conduct review of Bidan Delima programOn July 7, USAID Jalin shared the final Bidan Delima Rapid Assessment with USAID and IBI alongwith the request for co-branding approval. USAID Jalin received comments from IBI and provided IBIwith the narrative revisions. The report has been finalized pending IBI’s confirmation of approval toco-brand the report with IBI’s logo.


3.1.2 Conduct assessment of need for financing by private midwivesThis sub-activity is linked to Activity 3.3; refer to this section for updates.

3.1.3. Prepare recommendations for strengthening value proposition and business model for Bidan DelimaOn July 8-10, USAID Jalin conducted the enhanced Bidan Delima co-creation workshop. The onlineworkshop took place over three days (half a day per day) and involved 30 participants from IBI,representing the leadership of Central Level IBI and Unit Pelaksana Bidan Delima (Bidan DelimaProgram Implementing Unit – UPBD), provincial and district level UPBD managers, Bidan Delimafacilitators, and private midwives (Bidan Delima and non-Bidan Delima).

USAID Jalin engaged the following partners to co-facilitate the workshop:

Penala: organized the workshop, prepared notes from group discussions, and documented theworkshop process.

MSA: co-facilitated sessions focusing on current constraints of the Bidan Delima program andpossible solutions to enhance the program.

Prisma: co-facilitated sessions focused on re-branding and improving marketing strategies for theBidan Delima program.

IBI participants were very involved in the workshop and provided valuable insights in all discussionsessions. The post-workshop review conducted by USAID Jalin and the partners noted the followingpoints:

1. The different components of IBI and the Bidan Delima program represented by workshopparticipants agreed that there are gaps in core service delivery/quality and lack of a selling pointfor Bidan Delima.

2. There is agreement that solutions need to focus on changing the competencies for core service.3. There is agreement that the quality assurance model (facilitator roles/ responsibilities/

incentives) also needs to change.4. There are different views among IBI and Bidan Delima leadership and members regarding the

direction of the Bidan Delima program, i.e. professional certification vs. licensure vs. socialfranchising.

Following the co-creation workshop, , USAID Jalin facilitated two working group meetings with coremembers of IBI leadership to achieve strategic decisions on the enhanced Bidan Delima businessmodel. The meetings involved nine key personnel from IBI and Bidan Delima Program leadership,including the President of IBI and eight senior members from Central Level IBI and UPBD.

Table 9: Bidan Delima Working Group Meeting Summary

Meeting Date SummaryJuly 21 Focused on the direction of the enhanced BD program.

USAID Jalin presented requirements for each program direction option (e.g.professional certification vs. licensure vs. social franchising).

Agreed that strengthening the BD program as a professional certification program isthe most strategic approach for responding to the changing context of midwiferyservices and needs.

September 24 USAID Jalin presented the proposed key features, selling points, and institutionalarrangement of the enhanced BD program.

The key features are geared towards more efficient and effective certification,monitoring, and mentoring processes.

These include optimizing ICT use to allow for a faster and less costly certificationprocess, online mentoring by BD facilitators, and use of client feedback tocomplement regular performance assessment by BD facilitators.

IBI was receptive but required more detailed descriptions to weigh in the feasibility ofthe proposed solutions.


As the next step, USAID Jalin will develop detailed descriptions and a workplan for the enhancedBidan Delima business model for discussion during the third working group meeting in earlyOctober. USAID Jalin and IBI agreed to develop a final strategic document on the enhanced BidanDelima business model (which describes the enhancement solutions and implementation plan) by theend of October.

3.1.4 Facilitate discussions with BPJS and the MOH to explore value of Bidan Delima as potentialcertification process to facilitate private midwives for BPJS empanelmentUSAID Jalin and IBI planned to engage with BPJS on the adoption of Bidan Delima certification inBPJS empanelment for private midwives. Given that the pilot implementation of the enhanced BidanDelima program will not take place within the remaining timeframe before project closeout (seeActivity 3.1.5), this activity will not proceed.

3.1.5 Support IBI to pilot implement Bidan Delima program in Jalin provincesThis activity is intended to follow Activity 3.1.3. Given that development of the enhanced BidanDelima business model is still ongoing and considering the remaining timeline before projectcloseout, USAID Jalin will not proceed with the piloting activity.

USAID Jalin notified IBI of this situation during the working group meeting on September 24 andagreed to pursue the finalization of the enhanced Bidan Delima strategic document as the mainoutput. The strategic document is intended to guide IBI in the future implementation of BidanDelima in collaboration with USAID’s subsequent MNH project or other partners.

Activity 3.2: Incentivizing empanelment of private midwives with JKN by piloting amodel of strategic purchasing with JKN in Jalin districtsActivity 3.2 was transitioned to the USAID Health Financing Activity as the project is specificallyfocused on this technical area.

Activity 3.3: Facilitating access to credit for private midwives to improve standards ofcare3.3.1 Improving Access to Finance for Private Midwives and ClinicsIn Deli Serdang district in North Sumatra, USAID Jalin is supporting implementation of the Accessto Finance for Private Midwives and Clinics local solution. This quarter, USAID Jalin continuedto collaborate with IBI Deli Serdang to identify private midwives who qualify for loans offered by PTPermodalan Nasional Madani (PNM), Bank Sumut and BRI. PT PNM has begun receiving and approvingloan applications. The regional team conducted a workshop on the sustainability of this local solutionin September. DHO and IBI Deli Serdang recognize the value of the initiative and agreed to takeover the local solution and continue collaborating with the banking sector. With a total of around17,000 midwives throughout North Sumatra province, credit providers expressed their interest inproviding loans to this potential market during the handover workshop.

3.3.2 Conduct market assessment of financial institutions and other potential partners to participate infinancing schemes for private midwivesDuring the quarter, the USAID Jalin technical team reviewed the results of the Access to Financeassessment conducted in Quarter 3. The review revealed that the financial solution/credit schemefor private midwives proposed in USAID Jalin’s workplan could not be rolled out nationally due torequirements and expectations of credit institutions that cannot be met.

Following USAID advice, the Project explored the possibility of engaging DanaDidik – an Indonesianbased financial technology (fintech) company specialized for education financing – to provide analternative financing scheme for private midwives to pursue in-service training. The initial review


suggested that DanaDidik’s scheme is fairly costly and the terms may not be well-matched to privatemidwives’ capacity (especially those who have just begun their career) to repay. USAID Jalinrequested a meeting with the company to better understand the financing scheme being offered andthe potential for collaboration to support midwives’ in-service (or pre-service) trainings. Given thecurrent closeout plan, the Project does not foresee proceeding with this activity within theremaining timeframe.

3.3.3 Facilitate a co-creation workshop with key stakeholders to develop a financial package and access toequipment for private midwives based on the midwifery and financial market assessmentDue to the COVID-19 pandemic, this activity could not be organized during the reporting period.Considering USAID Jalin’s closeout plan, the Project will not proceed with this activity.

3.3.4 Implement financing scheme in selected Jalin provinces and monitor and document its effect on privatemidwifery practice for the development of a business case for national scale upThis activity is intended to follow Activity 3.3.3 and will similarly not proceed.

Activity 3.4: TA to the MOH and Sustainability3.4.1 Support the assessment of midwives to inform policy/regulation development as follow up on theMidwifery ActAs in the previous quarter, this activity is not a priority for the MOH and therefore did notprogress. Considering USAID Jalin’s closeout plan, the Project will not proceed with this activity..

3.4.2 Foster engagement of midwives with private sector providersThis activity is linked with addendum workplan Activity 3.1.2. Please refer to this section forprogress updates.


IR 4: INTEGRATED ICT REFERRAL PLATFORM SCALED

Quarter 3 Highlights Socialized Regent Regulation Number 27 Year 2020 on Enforcement of MNH Services in

Sidoarjo District and finalized the SiCantik user manual, which was signed by the Head ofDHO Sidoarjo on August 27.

Draft rapid assessment report of ICT-based referrals platforms developed bySinergantara for review by the Project.



IR 4March MilestonesICT platform reviewed withrecommendations shared withMOH

Partially achieved: Methodology of theICT review was shared with MOH. Rapidreview has been conducted of seven MNHreferral platforms/ applications in fourUSAID Jalin provinces. Currently, draft of

Fully achieved

The problem:There are multiple ICT platforms for supporting the referral system implemented at various levels, withvarying degrees of success. These are currently only partly interconnected although they can potentiallysupport one another to strengthen the referral system.

The solution:Conduct a rapid review of existing national and sub-national ICT platforms for referrals, and presentstrategic options for MOH, and other stakeholders, should they wish to build on existing systems, indeveloping a national integrated and interoperable system that facilitates more effective and efficientmaternal and newborn referrals and links with systems such as Sistem Rujukan Terintegrasi (IntegratedReferral System – SISRUTE), PCare, etc. Develop and pilot the preferred option.

Jalin’s objectives:Developing and strengthening ICT referral platform that will improve the management of high-risk mothersand emergency cases.

The primary stakeholders:Direct beneficiaries: health service providers(public and private), Directorate General (DG)of Medical Services (MOH), DG of Public Health(MOH), Center for Data and Information at theMinistry of Communication and InformationTechnology, and local government

The location:Activities will be conducted in up to 65 prioritydistricts across six Jalin provinces



tabular analysis of the rapid review is beingrevised.

Interoperable system designed Partially achieved: The rapid assessmentwill provide indications of what aninteroperable system might look like.However with project closure, a detailedsystem will not be fully designed.

Partially achieved

SiCantik piloted and lessons learneddocumented

Fully achieved: SiCantik support is nearingcompletion and lessons are beingdocumented.

Fully achieved

September milestonesIntegrated system piloted in Jalinprovinces and evaluated

Not initiated: Due to project closurethere will be no time to pilot an integratedsystem, based on the rapid assessmentrecommendations and findings. Had Jalin notreceived closure notification, piloting of thesystem would have been initiated in thefourth quarter.

Not achieved

Activity 4.1: Developing and piloting an integrated and interoperable system usingICT and building on existing initiatives to strengthen maternal and newborn referralsystem approach in Jalin provinces4.1.1: Improving the referral system through optimal use of ICTIn close collaboration with the Sidoarjo DistrictGovernment, USAID Jalin is supporting theOptimizing SiCantik initiative to increaseutilization of the improved application. Thisquarter the team socialized the Regent Regulationthat was signed in April, which obligates healthworkers to use SiCantik as the reporting platformin Sidoarjo District. This process, which alsosocialized the SiCantik user manual and SOPs,involved five DHOs in East Java, BadanPerencanaan Pembangunan Daerah (RegionalDevelopment Planning Board – Bappeda), ninehospitals, 26 Puskesmas, IBI Sidoarjo, PENAKIBSidoarjo, and a local university, among others.

During the reporting period, USAID Jalin, together with RSUD Sidoarjo and the SiCantik developer,continued to conduct routine monitoring of SiCantik and SiManies integration. In parallel, the teamfinalized the SiCantik user manual and SOPs and included instructions for integrating the applicationwith SiManies. The manual will be printed and distributed to all health facilities in Sidoarjo(Puskesmas, public and private hospitals, and independent midwives) next quarter. The team alsomonitored SiCantik utilization rates, which continued to increase throughout the reporting period.The number of healthcare providers using the platform has increased from 853 at baseline (February2019) to 1,583 as of September 2020. The number of pregnant women registered has alsosignificantly increased from 20,271 to 35,613 within the same period (see Figure 10). In lateOctober, the local solution will be taken over by DHO Sidoarjo, who will continue to promotewidespread use of SiCantik in Sidoarjo District.

dr. Wasis Nupikso from RSUD Sidoarjo provides commentsduring the finalization of the SiCantik SOPs.Photo: Screenshot by USAID Jalin


Figure 10: SiCantik Utilization

4.1.2. Conduct rapid review of current ICT platforms/applications for referral system in place and developstrategy for integrated ICT platformThere are multiple ICT-based referral systems in Indonesia, established in a range of locations andaddressing different aspects of referrals. In Quarter 2, USAID initiated a competitive tenderingprocess to commission a rapid assessment of existing ICT-based referral platforms. The review aimsto map ICT-based referral platforms and their interoperability with the nationwide SISRUTE generalreferral platform, and other platforms, and recommend a strategy and methodology for integratingthe existing systems for consideration by MOH. The evaluation committee selected Sinergantara asthe preferred tenderer and the contract was signed on July 3, 2020. The rapid assessment is ongoingand will conclude in October.


During the quarter, Sinergantara developed the assessment methodology and instruments andconducted a desk review of existing referral applications/platform—identifying a total of seven ICTreferral applications/platforms to be further reviewed through the assessment. Sinergantarapresented and discussed their assessment methodology with MOH (Directorate of Referral HealthService and Pusdatin). At the end of July, Sinergantara conducted the assessment to review the sevenICT referral applications/platforms in four USAID Jalin provinces. After completing the onlineinterviews with key informants, Sinergantara submitted the draft assessment report, which iscurrently under review by the Project. The report will be presented to the MOH in mid-October toobtain feedback on suggested options for strengthening ICT-based referral platforms, as presented inthe report. In late October, a final report will be produced together with detailed costing andimplementation plans for piloting the preferred strategic option.

4.1.3. Support MOH-led development of interoperable and integrated ICT platform and implement in JalinprovincesAs noted in Quarter 2, it was agreed that this activity will be postponed until the ICT platformreview has been completed (see 4.1.2 above).

4.1.4. Conduct evaluation, finalize package and develop scale up planNo activities took place this quarter. This sub-activity was planned to be initiated after piloting arecommended approach to integrating ICT referral platforms (see 4.1.2 above).

Activity 4.2: TA to the MOH and sustainabilityThe MOH has asked USAID Jalin to support the implementation of the Mother and Child e-Kohortin the USAID Jalin districts. This activity will be fully led and managed by the MOH. The role ofUSAID Jalin is to facilitate the implementation of e-Kohort, which will be led by PT. STI, and providefeedback to the MOH in making decisions regarding the second phase plan (for example, whetherthe system should be scaled, determining the business logic for the MOH, handover of the e-Kohortsoftware copyright to the MOH, etc.).

Discussions between USAID Jalin, the MOH and PT. STI on the SOW and implementation plan havebeen ongoing during the reporting period with a focus on the timeline, budget and target locations.Considering that all USAID Jalin activities must be completed by the end of December 2020, the e-Kohort implementation activities will be handed over to the MOH.


IR 5: IMPROVED REFERRAL NETWORKS SCALED

Quarter 3 Highlights Drafted a Governor Decree and cooperation agreement to support the referral network

across Bogor-Depok and initiated development of an integrated referral dashboard(Matneosafe).

Successfully documented and transitioned transport-related local solutions (AmbulanceFeeder and TOPDeAMOR) to local partners, with sustainability plans in place. The FloatingAmbulance will be handed over next quarter.

Facilitated a co-creation workshop with VFC to develop the MNH in the Workplaceworkplan and selected five factories for the first phase of the program.

The problem:Timely access to appropriate referral health facilities is impeded by inadequate transport options and alack of agreements on referral services available at hospitals. This can lead to multiple referrals for anemergency case (mother or newborn), and uncertainty about the feasibility of referring to private and/orcross-border facilities which may be the nearest option.

The solution:• Strengthen emergency referral networks by facilitating formal agreements between facilities• Improve transport to referral facilities for emergency cases through increasing access to funding for

transportation

Jalin’s objectives:• Ensuring that decisions on where a mother should be referred are based on knowledge of MNH

capacities of higher-level health facilities thus reducing the risk of multiple referrals.• Enabling mothers to overcome serious financial and physical barriers to reaching the care they need

in time.

The primary stakeholders:PHO, ADINKES, ARSADA (Local GovernmentHospitals Association), ARSANI (IndonesianNon-Profit Hospitals Association), PERSI(Indonesian Hospitals Association), professionalassociations - IBI, POGI and IDAI, and theprivate sector.

The location:65 Jalin priority districts


Table 11: Progress Towards 2020 Milestones for IR 5


IR 5March MilestonesStrengthening emergency referralnetworks: Mapping of MNHcapacity (with availability) of publicand private referral facilities in Jalinprovinces using SIMRS conducted

Partially achieved: Mapping of healthfacilities capacities in Bogor District, BogorMunicipality, and Depok Municipality iscomplete. The Project initiated acooperation agreement process on HealthFacilities Maternal & Neonatal EmergencyReferral Networks with Provincial Bureaufor Regional Autonomy and Cooperationand Tim Koordinasi Kerjasama Daerah(Coordination Team for Local Cooperation- TKKSD) at district level to includematernal and neonatal emergency referralswithin the regional cooperation framework.Because of project closure this activitycannot be expanded to all six provinces.

Partially achieved

Cross-border referral system inBogor City, Bogor District andDepok City (West Java) developedand tested

Largely achieved: Mapping of healthfacilities is complete. However, acooperation agreement between healthfacilities – to test cross-border referralsystem in three districts – is still in process.Expected completion is November 2020.

Fully achieved

Improving transport: Two transportpilots in remote areas completedwith recommendations (SouthSulawesi and Banten)

Fully achieved: Ambulance feeder pilot iscomplete with lessons learned andrecommendations. The floating ambulancelocal solution has been successfully pilotedin Pangkep district and lessons learned arebeing documented.

Fully achieved

September milestonesSustainable options forimplementation and funding oftransport for emergency referralsidentified and piloted in select Jalinprovinces (with recommendations)

Fully achieved: Transport-related localsolutions have been documented andtransitioned to local partners.

Fully achieved

Lessons learned from SouthSulawesi and Banten pilots sharednationally

Fully achieved: Local solutionsdocumented and transitioned. Projectcloseout event expected to share lessons.

Fully achieved

Activity 5.1: Strengthening emergency referral networks by facilitating formalagreements between facilities (especially public and private) in networks in the Jalinprovinces5.1.1 Develop cross border referral systems to enable access to nearest appropriate health facilityUSAID Jalin, in collaboration with local governments, is supporting the pilot project DevelopingIntegrated Maternal and Neonatal Emergency Referral Networks (previously known asCross Border Referrals) in Bogor District, Bogor City and Depok City to strengthen coordination,communication, and regulations between facilities to reduce referral delays. This quarter, USAIDJalin assisted PHO West Java to lead a series of six online workshops on the referral flow andreferral system. This series of meetings involved representatives from DHO Bogor, DHO Bogor


City, DHO Depok City, RSUD Cibinong, RSUD Ciawi, RSUD Bogor City, and RSUD Depok City,and resulted in: 1) a draft Governor Decree on the Cross-border Committee; and 2) a draftcooperation agreement on the integrated referral network across Bogor-Depok. During the quarter,the team also worked with PT Wisesa to begin developing the integrated referral dashboard(Matneosafe), which is expected to be completed by in November.

5.1.2 Map the public and private facilities in the MNH referral systems in the GOI priority districts in theJalin provinces (and any related facilities in adjoining districts or at provincial level) in terms of MNH servicesprovidedDrawing on the experience of implementing the local solution in West Java (Activity 5.1.1), thetechnical team developed a plan for scaling the solution, specifically the mapping of public and privatefacilities. The implementation of this plan will not proceed as a result of notification of projectclosure by USAID.

5.1.3 Develop and implement formal agreements to provide MNH referral services (with supporting SOPs)signed by all facilities in the local referral systems; plus provincial enabling policiesIn parallel with Activity 5.1.2, the technical team developed a plan for implementing formalagreements, drawing on the experience of the local solution. The plan will not be implemented as aresult of notification of project closure by USAID.

Activity 5.2: Improving transport to referral facilities for emergency cases throughincreasing access to funding for available transport in the Jalin provinces5.2.1 Accelerate referrals in island areasIn Pangkep District, South Sulawesi, USAID Jalin continued supporting the Floating Ambulancepilot project to increase access to MNH services and accelerate the referral process between islandareas and mainland hospitals. During the quarter, the team facilitated administrative requirements tohand over the floating ambulance unit from the provincial government (Governor of South Sulawesi)to the district government (Regent of Pangkep). Other efforts were made to ensure sustainabilityafter handover, including the establishment of a small team to draft a Regional Regulation related tothe floating ambulance costs. Stakeholders, including Bappeda, DHO, BPJS, and the DistrictGovernment, have agreed on the final draft of the regulation.

Additionally, in response to the pandemic, USAID Jalin workedclosely with DHO Pangkep to finalize SOPs for transportingCOVID-19 patients and/or suspected cases, from island areas tothe referral hospital in Makassar. On September 16, the teamconducted a successful final simulation, which included thetransportation of a patient from an island in Pangkep to a hospitalin Makassar in Zona II. The crew wore suitable PPE during thesimulation (to assess the SOPs for transporting patients withsuspected or confirmed COVID-19). The simulation wasdocumented by video for evaluation purposes.

Though originally planned to be completed by November, theconstruction of the maternity waiting home at Batara Sianghospital has been delayed due to the pandemic. This quarter, theteam focused on securing the building permit so that constructioncan begin in October.

5.2.2 Accelerate referrals in remote and hard to access areasIn Lebak District, Banten, USAID Jalin continued to support the Ambulance Feeder – JemputAntar Ibu Hamil Bermasalah (Jamilah) local solution to improve access to health services formothers and newborns in remote areas. By the end of the program in July 2020, the two ambulance

Figure 11: Floating AmbulanceCOVID-19 SOPs


feeders had transported 17 pregnant women, 33 women in labor, three babies, and 55 other cases.During the reporting period, USAID Jalin worked closely with stakeholders to finalize a guidebookand case study on using Alat Mekanis Multiguna Pedesaan (Rural Multipurpose Mechanical Device –AMMDes) as an ambulance feeder and also facilitated a series of events leading to the handover ofthe local solution to DHO Lebak. Stakeholders agreed during the transition meeting that the pilotproject was a success and that AMMDes has tremendous potential in solving health problems inrural areas. The DHO plans to replicate the program in four sub-districts while PHO Banten plansto expand the program to two additional districts.

In Garut District, West Java, USAID Jalin supported theTOPDeAMOR initiative to improve access and quality ofMNH services through mentoring. During implementation ofthe local solution, the team facilitated memorandums ofunderstanding (MOUs) in eight villages and finalized two VillageRegulation drafts with the aim of increasing deliveries in healthfacilities. This quarter, the team continued to focus onstrengthening the quality of care in five Puskesmas throughmentoring activities. In August, the team conducted the thirdand final online clinical mentoring activity for five Puskesmas inGarut, with participation from more than 75 health providers.Results of the mentoring series showed significantimprovements related to clinical capacity in providingemergency services, as illustrated in Table 12.

The team handed the program over to DHO Garut, who plansto replicate the solution in 30-40 Puskesmas across the district.

Table 12: TOPDeAMOR Mentoring Results

Puskesmas Score in February2020 Score in March 2020 Score in August 2020

Puskesmas Sindang ratu 20% 63% 91.5%Puskesmas Pamulihan 5.7% 54.5% 87.9%

Pukesmas Cikelet 17.1% 74% 88.2%Puskesmas Maroko 11.4 % 42.9% 88.6%Pukesmas Cihurip 28.6% 55.9% 82.4%

5.2.3. Identify local geographical barriers in reaching health facilities and support implementation of pilotsolutionsThere has been no progress on this activity in Quarter 3 as village funds have been allocated tosupport COVID-19 prevention and control.

5.2.4 Support the implementation of special allocation fund Dana Alokasi Khusus (Special Allocation Funds –DAK) non-infrastructure at districts level and Dana Dekonsentrasi (Deconcentrated Funds – DEKON) forMNH at province levelThis activity was planned to start in April 2020, however, this was dependent on results from theMNH program assessment in 120 priority districts (2.4.3) which was put on hold. In Quarter 3,USAID Jalin ended the contract with ADINKES and Prof. Ascobat Gani. As a result, the MNHprogram assessment in 120 districts was canceled.

Activity 5.3: TA to the MOH and sustainability5.3.1 MNH in the WorkplaceAs a part of broader private sector engagement approaches, and as local solutions derived from co-creation with stakeholders in Jalin provinces, the Project has been supporting implementation of the

Figure 12: TOPDeAMOR Roadmap


MNH in the Workplace initiative in nine factories in Central and West Java provinces over thelast year to increase MNH knowledge among female factory workers and improve access to qualityMNH services within factory clinics and through referrals to local health facilities. The three USAIDJalin pilot programs are implemented in collaboration with different partners and leverage variedapproaches. In Year 2, USAID Jalin contracted an assessment of these pilot models. The MNH in theWorkplace assessment report was submitted to USAID in July.

Table 13: USAID Jalin MNH in the Workplace Programs

Program Location

WEALTH program (Jakarta) West Java:PT MCA (Sukabumi)PT Do San (SukabumiPT ISJ (Cimahi)

Central Java:PT Sritex (Sukoharjo)PT Sari Warna (Sukoharjo)

Yogyakarta:PT SRA (Yogyakarta)

MNH in the Workplace in Central Java* PT Pan Brothers (Boyolali)PT SAMA (Semarang)

MNH in the Workplace in West Java* PT Chang Shin (Garut)

*The regional programs are categorized as local solutions and reported on in Annex 4 and Annex 11.

WEALTH Program

USAID Jalin is collaborating with H&M, six factories in their supply chain, UNFPA, and theInternational Labour Organization (ILO) to implement the four-year Women’s Health and Wellbeing(WEALTH) program, to promote health and wellbeing among female factory workers in the H&Mnetwork. The WEALTH program initiated activities in six factories last year and aimed to expand to10 additional factories in 2020.

Due to the COVID-19 pandemic, H&M has put all planned activities on hold. During the reportingperiod there were no specific activities carried out in connection with the WEALTH program.H&M is still determining how to re-initiate activities and will convene the partners (USAID Jalin,UNFPA and ILO) once this is feasible. During the quarter, USAID Jalin maintained communicationwith H&M to discuss activities that can potentially be restarted when the situation stabilizes.

Collaboration with VFC to replicate MNH in the Workplace activities

In Year 2, USAID Jalin initiated links with a US-based apparel manufacturer, VFC, who wasinterested in replicating and adopting USAID Jalin’s MNH in the Workplace program in their ninefactories in West Java, Central Java and Banten. In March 2020, the Project was awarded a servicesagreement to implement supplemental activities in collaboration with VFC (USD 175,000 withmatching funds from USAID). The inititial co-creation workshop and commencement of work wasplanned for Quarter 2, however, this was postponed to Quarter 3 due to to the COVID-19pandemic.

On July 22, USAID Jalin conducted a co-creation meeting with VFC management to outline MNH inthe Workplace program activities and discuss strategies for working in VFC factories. In addition toMNH-focused activities, GBV, COVID-19, and mental health topics will also be integrated within theworkplan. The co-creation meeting also involved THINKMD to introduce their COVID-19screening tool, which can potentially benefit the joint USAID Jalin and VFC program.


Five VFC factories will initially be targeted for activities during the first phase of the program. Theseinclude PT Yongjin Javasuka Garment I (West Java); PT Yongjin Javasuka Garment 2 (West Java); PTUWU Jump Indonesia (West Java); PT Kanindo Makmur Jaya (Central Java); and PT Kanindo MakmurJaya Factory 2 (Central Java). Four factories will be added in the second phase (2021-2022). Thesefactories are part of the VFC network and have high numbers of female workers. The workplan andother supporting program implementation materials will be finalized in October followed by a kick-off meeting.

ENABLING FACTORS (EF)

EF 1: MNH National Committee (see IR 2.3.5)In Year 2, USAID Jalin produced the concept note Saving Mothers and Newborns: A NationalCommittee to Accelerate the Reduction of Maternal and Neonatal Deaths which was submitted to USAIDand MOH. In Quarter 3, there was again no opportunity to take it forward with MOH because theMinistry is occupied with the COVID-19 pandemic.

EF 2: Multi-stakeholder Advisory Body (MAB)Due to the pandemic, the MAB Quarterly Meeting was postponed. During the quarter, the Projectmaintained regular communication with MAB members by sharing the Project’s weekly updates andCOVID-19 activity progress. On September 29, the SLT met with MAB leadership to inform themthat the option year will not be exercised by USAID and discuss closeout activities in the context ofproject closure. It was agreed that the MAB will not meet for the remainder of the project.

EF 3: MOH best practices six-monthly events with priority districtsDuring Quarter 2, USAID Jalin recognized that Indonesia was entering a New Normal, and not onlywere large gatherings to disseminate best practices unlikely to be possible in the shorter term, butthe increased use of online approaches was here to stay. This led to a reappraisal of the role ofwebinars in the program. In response, the team produced a concept note entitled USAID Jalin webinarprogram - to support high quality and safe MNH services during the New Normal of a prolonged lowerintensity pandemic after the COVID-19 emergency response. The team soon became aware thatwebinars could be more efficient and cost-effective than some of the planned communicationapproaches to achieving the USAID Jalin objectives including the planned conventional disseminationof best practices at a large event. The following examples demonstrate how USAID Jalin isembracing the online dissemination of best practices:

The IBI webinar series, which has reached over 6,000 live participants MPDN national launch, scheduled for October 2020 USAID Jalin’s closeout event during which the MOH, at the national, Provincial and District

levels will be able to share best practices, achievements and lessons learned

EF 4: Support transition of local solutionsThe transition of local solutions to partner organizations began during the quarter and will continueduring the first half of Quarter 4. The regional teams have been, and will continue to use webinars asthe platform for discussing the transition of local solutions with partners that include DHOs, PHOs,local government, professional organizations, etc. Commitments will be sought, and arrangementsmade for continuing and scaling the local solutions.


Figure 13: Infographic of USAID Jalin Local Solution Distribution in Six Provinces

Figure 14: Local Solution Transition Plans by Province


EF 5: National/regional forums for engagement with professional organizations and private sectorDuring Quarter 3, it was not possible to convene any of the conventional forums envisaged and thewebinar approach described under EF 3 is considered equally applicable to EF 5.


V. CROSS-CUTTING ISSUES

Gender and Gender-based Violence IntegrationUSAID Jalin strengthens gender equality by supporting community MNH health promotion andeducation through MNH in the Workplace and community awareness activities, supporting women’sbusinesses through Bidan Delima, and improving access to health services including strengtheningreferrals. During these activities MNH messages are shared which enable women to take ownershipof their health and improve their decision-making power. USAID Jalin’s activities also raiseawareness about GBV, amongst project staff, health personnel and stakeholders.

Addressing Women as Health Care BeneficiariesMNH in the WorkplaceAs part of MNH in the Workplace, health promotion activities support women who are preparingfor pregnancy, are currently pregnant, and are nursing infants. This not only improves women’shealth status and pregnancy outcomes, but also empowers them by providing the information andencouragement they need to increase their decision-making power.

The workplace program in Central Java (at PT. Pan Brothers and PT. SAMA) resulted in theprovision of flexible working hours, rest when needed and access to ANC. During Quarter 1, 513women attended ANC, 429 women in Quarter 2, and 263 women in Quarter 3.

In the PT. Chang Shin factory, in Garut district in West Java, the workplace program trained 15 peereducators to share MNH messages with fellow female workers in 2019. This program supportedaccess to family planning counselling, which contributes to gender equality and female empowermentaccording to available evidence. During this project year, in Quarter 2 alone 589 women receivedpostpartum family planning counselling. This is a significant increase from 154 women who receivedcounselling in Quarter 1. However, due to the impact of COVID-19, pregnant women at PT. ChangShin were asked to stay home and no additional counselling took place later in the quarter. Thefactory guaranteed continuation of salaries for these pregnant women, which also helped to reducetransmission risk. As a note, in January 2020, following USAID Jalin’s advocacy, DHO Garutdisseminated a bride and groom's certificate (sertifikat pranikah or prenuptial certificate) for femaleworkers at the PT. Chang Shin factory. Nearly 5,000 female employees participated in thisinteractive event focused on nutrition in pregnancy and child development.

The WEALTH program includes six technical areas, one of which specifically addresses GBV.Separately, USAID Jalin and VFC have agreed to include modules dedicated to GBV and genderequality in the workplace programs that will be launched next quarter.

Access to Health Services (transportation access)USAID Jalin has supported dedicated programs to improve access to health services, especially forwomen who live in geographically challenging or remote areas. These women often do not haveaccess to adequate education and might face poverty as well, which hampers their decision-makingpower and access to health care. Through implementation of dedicated transportation programs,USAID Jalin has emphasized the importance of care for women, which might lead to women’sempowerment. Table 14 outlines these successes.

Table 14: Transportation Service Activities

Transportation ServiceActivity Achievements

TOPdeAMOR (West Java) A total of 259 women transported to the next level health care facilityfor MNH services (Q1: 37, Q2: 93, Q3: 129)


Transportation ServiceActivity Achievements

AMMDes (Banten) Improved access to emergency care – six women in Q1 and Q2(when the service was also being used for COVID-19 counselling.)

Community AwarenessCommunity awareness activities supported by USAID Jalin help to bridge the information gap aboutpregnancy and child care and strengthen women’s decision-making power and health seekingbehavior. Table 15 displays some examples.

Table 15: Community Awareness Activities

CommunityAwarenessActivity

Women Reached with Messaging

MNH Campaign(North Sumatra)

In Quarter 2, clips and short messages on MNH were shared via social media and byspecific influencers. An estimated 7,500 women were reached through the clips andposters in 150 locations (mainly in Puskesmas / village offices). In Quarter 3, sixlivestreaming broadcasts took place and reached over 9,000 people (men andwomen).

Program PerencanaanPersalinan danPencegahanKomplikasi (DeliveryPlanning andComplicationPrevention Program– P4K) Inovasi(North Sumatra)

22,000 pregnant women indirectly benefit from the program through informationsharing.

In 2019, 125 cadres (community health workers), 150 midwives and 240 femalestudents were trained and had the chance to gain field experience.

In 2020, 430 pregnant women were assisted by trained midwives in Quarter 1 and anadditional 520 in Quarter 2 – reaching a total of 950 pregnant women withinformation and assistance for their pregnancies. During Quarter 3, DHO Langkatcontinued to train midwives using their own budget.

Gerai KIA (Banten) In Quarter 1, 959 women (which included 454 pregnant women) were reachedthough MNH counselling at Alfamart. Due to the COVID-19 pandemic, face-to-faceMNH services transitioned to a mobile method to reduce transmission risk (GeraiKIA Mobile). Gerai KIA Mobile started on June 8 and reached 364 pregnant womenby the end of July 2020, providing services for women who are living remotely andwho are pregnant. In September, the Project focused on handing over the solution.

Strengthening Women’s BusinessesBidan DelimaThe enhanced Bidan Delima program will not only improve women’s access to quality MNHservices, but it also strengthens the source of income for private midwives. Ensuring that midwivesreceive an appropriate income and have a sustainable business that will support their status in theirfamilies and communities can contribute towards gender equality. USAID Jalin is working closelywith IBI to finalize the strategic document for the enhanced Bidan Delima business model, which willbe completed by the end of October 2020.

Gender-based ViolenceUSAID Jalin uses its focus as a health program to also highlight GBV. One of the root causes forGBV is gender inequality. USAID Jalin supports programs that (directly or indirectly) address thegender gap, but also aim to improve awareness, knowledge and sensitivity around GBV issues toimprove recognition, management and treatment of survivors of GBV.


Inclusion of GBV Focus in COVID-19 ResponseUSAID Jalin’s COVID-19 response is informed by the Minimum Initial Service Package (MISP),3 theguideline for reproductive services in humanitarian settings, which includes ensuring access to GBVinformation and services. In Quarter 3, USAID Jalin facilitated a webinar, together with IBI, UNFPAand the National Commission on Violence Against Women, to sensitize midwives on GBV andgender inequality, recognizing that health care providers are often the first point of contact forsurvivors. A total of 682 midwives participated in the session from across Indonesia.

Inclusion of GBV Focus in VFC WorkplanDuring workplan discussions, USAID Jalin and VFC agreed to include a focus on ensuring access toGBV knowledge in the workplace. This intention was included in the workplan, where the teamcommitted to address sexual and gender-based violence (SGBV) through training peer educators inthe factories. The peer educators will increase workers’ knowledge on SGBV.

3 http://iawg.net/wp-content/uploads/2019/01/MISPcheatsheet-web-2.pdf


VI. MONITORING, EVALUATION, LEARNING, ADAPTATIONAND STRATEGIC COMMUNICATION

The Communications and MELA teams worked closely together during the reporting period.Quarter 3 highlights include the establishment of a COVID-19 Knowledge Center, the developmentof weekly stories for USAID, largely related to COVID-19 activities, and the solid documentation oflocal solutions as they began to transition.

MELA Plan Update and ImplementationDuring Quarter 3, the Project worked closely with USAID to refine and update some MELA planindicators and targets, resulting in an updated (and approved) MELA plan. In implementing theupdated MELA plan, the MELA team focused on:

Monitoring project activities and outputs using data collection forms, monthly reporting, andonline meetings with the technical and regional teams;

Ensuring continuity in data collection activities during staff transitions in USAID Jalin’s nationaloffice. This was achieved through timely orientations for new staff during which MELA plans,indicators, targets and tools were explained;

Monitoring and reporting progress against COVID-19 indicators, in addition to the updated andapproved MELA plan indicators, and presenting progress during USAID COVID-19 clustermeetings for implementing partners.

Project DashboardThe USAID Jalin dashboard, completed during the first quarter of 2020, was frequently updated bythe MELA team during the reporting period, e.g. progress against indicators and milestones,populating the library with materials related to the local solutions, etc. With the addition of USAIDJalin’s COVID-19 response activities, some adjustments were made to the dashboard. For example,the COVID-19 Knowledge Center platform was embedded within the platform. The KnowledgeCenter forms part of the Project’s efforts to share resources related to MNH and COVID-19.

Figure 15: Screenshot of the Knowledge Center


Local Solutions DocumentationThe MELA team continued to monitor implementation of local solutions, advise on preparations fortheir transition, and oversee documentation. The complete list, and summary status of localsolutions, is presented in the Local Solutions Tracker (Annex 4).

Two-page briefs were developed for each local solution and included as an annex to the 2019 annualreport (submitted at the end of January 2020). These were developed in close collaboration with theregional teams and drew heavily on the standardized documentation and processes that wereintroduced in mid-2019, and included concept notes, workplans and budgets. Monthly local solutionmonitoring reports also feed into the individual local solution activity briefs which have now beenupdated to the end of September 2020 and are annexed to this progress report (Annex 11).

The regional teams have generated various materials related to their local solutions, e.g. SOPs,Guidelines, etc. During the reporting period the MELA and Communications teams worked closelytogether to collect, review, and assure compliance with USAID Branding and Marking guidance. Alldocumentation related to the local solutions is available on the USAID Jalin dashboard (under‘Library’).

Other SupportAs a result of the pandemic, more project activities were delivered online, for example, the jointUSAID Jalin-IBI webinar series. These required extensive support from the MELA team, in terms ofdata collection and data cleaning.

Also, as a result of COVID-19, the Project provided significant support to the Technical team incollecting and organizing valuable COVID-19 resources for the online Knowledge Center. This waslater embedded within the project dashboard (see above).

The MELA team also supported various ad hoc technical activities. For example, during the Data toPolicy training for MOH representatives, the MELA team was requested to co-facilitate the focusgroup discussion sessions. The team also provided close support to the contextualization andrefinement of the THINKMD COVIID-19 screening tool.

CommunicationsIn Quarter 3, the Communications team continued to support the USAID Jalin team in ensuring allpublications comply with the USAID Branding and Marking guidelines and promoting projectactivities and successes through available platforms. The Communications team also developed andshared a set of templates to provide staff with clearer guidance when creating project documents.The templates include terms of reference (ToR), minutes of meeting, letterhead, and a generaldocument template along with a writing style guide.

During the reporting period, the Communications team worked closely with both national andregional teams to ensure that all publications are compliant with USAID Branding and Markingguidance. Table 16 below lists the materials developed in Quarter 3.

Table 16: Materials Developed in Compliance with USAID Branding and Marking Guidelines during Q3 2020

No Publication Brief Description

Document1 Floating Ambulance (South

Sulawesi): Case Study, SOPsPublications as part of LS transition including case study, SOPs forgeneral use of floating ambulance in Pangkep District, SouthSulawesi, and additional SOPs for COVID-19 patients.


No Publication Brief Description

2 AMMDes Ambulance Feeder(Banten): Case Study,Guidebook, SOPs

Publications as part of LS transition including case study, guidebook,and SOPs for AMMDes Ambulance Feeder in Lebak District,Banten.

3 Gerai KIA (Banten):Guidebook

Publication as part of LS transition in a form of an implementationguidebook to support program replication.

4 Bidan Delima AssessmentReport

The assessment identifies key challenges and ways to improve thefuture relevance and effectiveness of the Bidan Delima model.

5 MNH in the WorkplaceAssessment Report

The report describes the activities undertaken, results achieved, andconstraints faced during the implementation of the MNH in theWorkplace programs, identifying lessons learned and providingrecommendations for future model development.

6 Policy Brief: ImprovingMaternal and NeonatalSurvival in Indonesia

The policy brief for MOH includes key messages, problemstatement, policy options, recommendations and next steps toaddress the causes of maternal and neonatal deaths.

7 Hospital MentoringInstruments (for MOH)

The instruments are part of IR1 activities to support the MOH. Thecurrent draft does not include any logos, including the USAID logo.This will be updated once there is a clearer direction from MOH.

Poster/Flyer/Banner

8 Digital poster for USAID Jalin– IBI webinar series

Digital posters/flyers serving as invitations for target participants ofUSAID Jalin and IBI webinar series on COVID-19 at the nationallevel (total two webinars in Q3 2020).

9 Digital poster for webinar onANC & PNC SOPsimplementation and the use ofMCH handbook (East Java)

Digital poster/flyer serving as invitations for target participants of anactivity hosted by USAID Jalin in Malang District, East Java, July 10,2020.

10 Posters for local solutions inSouth Sulawesi

Posters co-developed with local government for LS: a) BloodEmergency in Bulukumba; b) Village Fund for MNH in Bone.

USAID Jalin’s social media strategy is in place and used to optimize public outreach. During thequarter, the Project continued to expand its Twitter (@USAIDJalin) presence by sharing activityupdates, stories, and campaign activities related to MNH topics. Commemorative events such asNational Children’s Day (July 23) and World Breastfeeding Week (August 1-7) were used to raiseMNH awareness. USAID Jalin also shared messages about MNH in relation to the COVID-19pandemic.

In the last quarter, USAID Jalin observed visible growth in terms of followers; increasing from 72followers in June 2020 to104 followers by the end of September 2020. A total of 38,400 Twitterimpressions were made over 92 days during the reporting period (see Annex 6). The impressionsnumber increased by around 32 percent compared to the previous quarter.


Figure 16: Example of MNH Campaign Materials on Social Media

As part of project documentation, the Communications team continued to develop impact storiesduring the quarter. These stories were shared through both USAID Jalin’s Twitter account as well asUSAID Indonesia’s social media channels. The stories focused on COVID-19 response activities aswell as general workplan activities and were submitted to USAID on a regular basis. Table 17 belowlists the stories developed within this reporting period.

Table 17: USAID Jalin Project Stories Developed during Q3 2020

No Date Story Title

1 July 2 Amid the pandemic, pregnant women in Tangerang District continue toreceive critical ANC counseling through the online Gerai KIA Mobileprogram facilitated by USAID Jalin

2 July 9 Trained maternal and child health volunteers help pregnant women inTangerang district to prevent COVID-19 transmission through an onlinecounseling service

3 July 24 USAID Jalin collaborates with the Communication and InformationTechnology Office of North Sumatra to broadcast potentially life-savingMNH updates amid the pandemic

4 August 3 Breastfeeding during the COVID-19 pandemic becomes a particular topic ofinterest during a webinar hosted by USAID Jalin and the Indonesian MidwivesAssociation

5 August 24 Livestreaming to improve knowledge on health services in private midwifeclinics during the COVID-19 pandemic

6 August 31 AMMDes Ambulance Feeder pilot project in Lebak District inspiresIndonesian ministries to support innovation in maternal and newbornhealthcare

7 September 16 USAID Jalin and IBI prepare to launch COVID-19 screening and educationtool for midwives in Indonesia

8 September 23 USAID Jalin promotes replication and local wwnership of the Gerai KIAprogram in Tangerang District, Banten Province

9 September 30 A first for Central Java - USAID Jalin facilitates online maternal and perinataldeath audits during the pandemic


VII. PROJECT MANAGEMENT

During Quarter 3, USAID Jalin continued to focus on coordinating with service providers to supporttechnical assistance needs and progress activities within the workplan. During the reporting period,the Project conducted a staff restructuring process which resulted in changes to the organizationalchart, recruitment of new positions, and transition of project staff. The team also onboarded anumber of short-term consultants and finalized procurements to support implementation of priorityactivities.

Following notification that USAID would not be exercising the option year, the Project undertookthe following actions:

Informed staff, PHOs, IBI, grantees, sub-contractors and service providers Developed scenario plans (i.e. Project ending March 7 vs. 6-month extension) Mapped staffing needs through to end of project (March 7) Initiated development of the closeout plan Identified priority activities, by IR, for the remaining months of the project

Based on the above activities and discussions with USAID, it was agreed that that all regional officeswill close on December 31, 2020. Most staff contracts will end at this time, with a core technical andoperations team remaining until the end of the project (March 7, 2021).

PersonnelLargely in response to a shift in focus from local solutions to nationally-driven activities, USAID Jalinsuccessfully completed a staff restructuring process during Quarter 3. The following key changeswere introduced:

Removed Portfolio Manager position Introduced Intermediate Result Manager positions:

– IR 1 and Secretariat - Haris Apriyanto– IR 2 and Secretariat - Edward Sutanto– IR 3 - Fransiska Mardiananingsih– IR 4/5 - Hadi Purwato (Manager), Mustika Arini (Deputy Manager)

Budihardja Singgih, Deputy Chief of Party (DCOP) Programs, transitioned to a part-time role toreflect his personal request to scale back his work.

Discussed with USAID and agreed to transition two expatriate positions off of the project:DCOP Operations Dan Fraley (key personnel) and MNH Technical Advisor, Luna Mehrain, whodeparted at the end of September.

Created the Director of Finance and Operations position and promoted Hany Ong to this roleupon the departure of DCOP Operations.

As a consequence of the transition process, a number of staff contracts were not renewed duringthe quarter and new staff were recruited to align with the revised approach. In total, two expatriateand 10 local staff contracts were not extended. The tables below list the staff who were onboardedand those who departed the project in Quarter 3. The revised organizational chart can be found inAnnex 10.

Table 18: Recruitment in Quarter 3

No Name Title Onboard Date

1 Hanny Ong Finance and Operations Director 6 July 2020

2 Ibrahim Panji Indra Communications Officer 13 July 2020


No Name Title Onboard Date

3 Haris Apriyanto IR 1 Manager 27 July 2020

4 Edward Sutanto IR 2 Manager 27 July 2020

5 Hadi Purwanto IR 4 and 5 Manager – Emergency Referral SystemStrengthening

18 August 2020

6 Mustika Arini IR 4 and 5 Deputy Manager – Emergency ReferralSystem Strengthening

18 August 2020

7 Tutut Purwanto Technical Lead – IR 3 (IntraHealth) 12 August 2020

8 Nelty Rosanna USAID Jalin – MOH Secretariat Coordinator 10 September 2020

Table 19: Staff Departures in Quarter 3

No Name Title End of Contract

LTTA – National

1 Irwan Saptono Regional Officer – Central Java 19 August 2020

2 Agustino MELA Officer 22 August 2020

3 M. Ali Zazri Technical Lead (Vital Strategies) 31 August 2020

4 Avelyna Perak Admin and Program Support Assistant 31 August 2020

5 Budihardja Singgih DCOP – Programs 7 September 2020

6 Mahlil Ruby Technical Lead 7 September 2020

7 Kemal Soeriawidjaja Portfolio Manager – Midwives and Referral 7 September 2020

8 Pancho HekageryAmilo Kaslam

Portfolio Manager – Quality of Care 7 September 2020

9 Nina Trianawati G. Program Assistant 7 September 2020

10 Nasril Lubis Regional Officer – North Sumatra 23 September 2020

LTTA – Expatriate

1 Daniel Fraley DCOP – Operations 30 September 2020

2 Luna Mehrain Senior Technical Adviser 30 September 2020

OperationsAs detailed in the tables above, the Operations team supported the successful recruitment of newpositions and ensured the smooth transition of departing staff. The Operations team also workedclosely with the technical and regional teams to finalize outstanding procurements. Throughout thequarter, the Operations team maintained regular communication with technical staff to ensure thatall activities were effectively coordinated. With guidance from the DAI Home Office, USAID Jalinbegan to implement some closeout processes, including Inventory Audit, Finance and HR Audit.

COVID-19 Response

All USAID Jalin offices were closed as a result of COVID-19 on March 16, 2020. During Quarter 2,USAID Jalin anticipated opening the office in August 2020. A DAI-specific COVID-19 risk assessmentwas submitted to the DAI Home Office for review. During the reporting period, COVID-19 cases inIndonesia, particularly in Jakarta, have continued to increase. On September 14, 2020 the Governorof DKI Jakarta issued a decree, requiring widespread social distancing Pembatasan Sosial BerskalaBesar (Large-Scale Social Restriction – PSBB) in Jakarta once again. The USAID Jalin Jakarta office andregional offices will remain closed and staff will continue teleworking for the foreseeable future. Staff


requiring office access for closeout preparations will be allowed with supervisor approval andfollowing health precautions.

Standardization of MOU and Partnership Agreement ProcessFour out of the six regional MOUs between USAID Jalin and the Provincial Governments were dueto expire in mid-September (the MOUs for Central Java and East Java were the exception andcontinued through to March 2021). Because the Project’s regional offices will close by theDecember 31, MOUs will not be extended.

Procurement and Grant ManagementIn Quarter 3, the Program and Operations teams finalized the following procurements to supportimplementation of activities:

CV. Koloni Semut Hotspot System: AMP-SR PT. Digital Sapta Nawala: SiMatneo THINKMD: COVID-19 Risk Screening and Education Tool CV. Wisesa Technology Indonesia: Matneosafe (integrated referral dashboard)

During the quarter, PUSKA’s grant in support of EMNC activities came to an end, and the Projectmade its final grant payment in September. Due to the change in project end date, and the agreedupon focus for the remainder of the Project’s performance period, the grant to IBI which had beenunder development in Quarter 2 and the beginning of Quarter 3 was dropped. Two contractsrelated to the IBI grant were also ended and remaining deliverables modified: CV. PenalasinergiArgareksa (Penala: Workplan Development for IBI) and PT Prisma Purelindo (Prisma: BrandingDevelopment for IBI).

In Quarter 4, the Project plans to contract PT STI to support implementation of the e-Kohortapplication. All other procurement activities will shift to preparation for the Project’s closure andmost remaining purchase orders and subcontracts will be closed out by year’s end.

Review of Problems Encountered and Efforts Made to Address suchProblemsSimilar to the previous quarter, during this reporting period two areas were identified as challengesfor the Project: a) Access to the MOH for progressing a number of national interventions, and b)COVID-19 situation. Both issues have been covered fully throughout the report.


ANNEX 1: INDICATOR PERFORMANCE TRACKING TABLE – Q3

Jalin # Indicators Baseline 2019Achievements

Project Achievements during 2020 CumulativeProjectAchievement

Sep2020TargetQ1 2020 Q2 2020 Q3 2020 Cumulative

2020Goal: Contribute to national goals to accelerate maternal and newborn mortality reduction

R1: Improved MNH quality of care in public and private, primary and secondary facilities, at scale

R1.1 Maternal case fatality rates within healthfacilities that have received mentoring

To bedetermined

(TBD)(will be assessedin mentoring pre-/self-assessment)

Not Applicable(NA) NA NA NA NA NA 0

R1.2Newborn (with at least 2,000-gram birthweight) case fatality rates within healthfacilities that have received mentoring

TBD(will be assessedin mentoring pre-/self-assessment)

NA NA NA NA NA NA 0

IR1: Sustained improvements in practice by clinical hospital teams in treating obstetric and newborn complications

IR1.1% of target health facilities in whichmentoring has started, achieving anassessment score of at least 80%

TBD(will be assessed

in pre-/self-assessment)

NA NA NA NA NA NA 0%

IR1.2 Evidence based mentoring approach andguidelines instituted nationally

Approach andguidelines notinstituted (Q4,

2019)

No No No No No No No

IR1.3% of (65) Jalin priority districts withallocated local government budget formentoring

0% 0% - - - - 0% 0%

O1: Improved MNH competency and compliance of clinical teams in hospitals

O1.1% of target health facilities in 65 Jalinpriority districts in which mentoring hascommenced

0 NA NA NA NA NA NA 10%





2020IR2: Stakeholder strategies more focused on main causes of maternal and neonatal death

IR2.1

Number of target stakeholders usingstrengthened accountability system to guidecorrective action to strengthen MNHservices

0 0 0 0 NA NA NA 0

IR2.2% of GOI priority districts showingprogress against key MNH indicatorsthrough strengthened accountability system


O2: Strengthened knowledge for response and accountability

O2.1% of target health facilities in (65) Jalinpriority districts reporting maternal andperinatal deaths through MPDN application

0 0 17.5% 10.1%* 6.2% 33.8% 33.8% 25%

O2.2% of (65) Jalin priority districts meeting alltheir reporting obligations throughstrengthened accountability system


O2.3Number of MNH WG strategicrecommendations supported bydocumented evidence

0 0 0 0 0 0 0 0

IR3: Sustained improvements in quality of care by private midwives

IR3.2 % of private midwives certified as BD inselected districts

51%(Data in 2019) NA NA NA NA NA NA 51%

O3: Improved competency and compliance of private midwives to care for routine cases and stabilize and refer high-risk cases

O3.3 Number of new BD (inaugurated) inselected districts

0(2019) NA NA NA NA NA NA 0

R2: Improved efficiency and effectiveness of the emergency referral system at community and facility level, at scale

R2.1

% of mothers with emergency MNH casesexperiencing multiple referrals in districtswith integrated and interoperable ICTreferral system

TBD(through

interoperableICT referral

system)

NA NA NA NA NA NA 0%





2020

R2.2

% of mothers with emergency MNH casesexperiencing serious delays in reachingappropriate referral facility, in catchmentareas where transport solutionsimplemented

TBD(through

interoperableICT referral

system)

NA - - NA NA NA 50%

IR4: Integrated ICT referral platform scaled

IR4.1

% of Jalin priority districts in which hospitals(public and private) are linked withintegrated and interoperable ICT referralsystem

0% NA NA NA NA NA NA 3%

O4: Integrated ICT platforms piloted through adaptation of existing systems

O4.1Number of health facilities in Jalin prioritydistricts with integrated and interoperableICT referral system

0 NA NA NA NA NA NA 25

IR5: Improved referral networks scaled

IR5.1% of Jalin priority districts in which crossborder referral network agreements havebeen signed

0% NA NA 0% 0% 0% 0% 3%

IR5.2% of Jalin priority districts in which at leastone agreement is in place to implementtransport solutions

0% 0% 3.08% 0% 0% 3.08% 3.08% 2%

O5: Piloting of better-defined networks with access improved

O5.1% of health facilities in priority districts inJalin provinces which are part of a crossborder referral network agreement

0 NA NA 0% 0% 0% 0% 1%

O5.2 Number of mothers using supportedtransport solutions in selected districts 0 16 59 102 120 281 297 200

O5.3Number of mothers using the supportedtransport solutions, accessing BPJS and/ orvillage funds for the journey

0 16 40 33 34 107 123 100

USAID Performance Management Plan

Jalin F.2 USD value, or USD value equivalent, of newinvestment in evidence-based policies, 0 USD 194,172 USD 47,903

(preliminary) - 0 USD 47,903 USD 242,075 USD199,756





2020programs, products, services or strategiesresponsive to priority MNH needs

STIR-10 Number of innovations supported throughUSG assistance 0 18 22

22(sameinnovationsas Q1)

22(sameinnovationsas Q1)

22 22 22

STIR-11Number of innovations supported throughUSG assistance with demonstrated uptakeby the public and/or private sector

0 5 3 - 2 5 8 5

STIR-12Number of peer-reviewed scientificpublications resulting from USG support toresearch and implementation programs

0 0 - - 3 3 3 3

F.3 Number of policies or programscreated/modified with USG support 0 27 - 18 3 21 48 47

Maternal and Child Health (MCH)

HL.6-1Estimated potential beneficiary populationfor maternal, newborn and child survivalprogram: number of live births

35,744(data in year

2019)NA 11,689 2,160 14,117 14,117 10,283

HL.6.2-1

Number of women giving birth whoreceived uterotonics in the third stage oflabor (or immediately after birth) throughUSG-supported programs

6,196(data in year

2019)NA 3,509 1,879 5,656 5,656 4,000

HL.6.3-1Number of newborns not breathing at birthwho were resuscitated in USG-supportedprograms

190(data in year

2019)NA 116 54 170 170 150

HL.6.3-63

Number of newborns who receivedpostnatal care within two days of childbirthin USG-supported programs

2,888(data in year

2019)NA 1,656 1,766 3,690 3,690 2,000

COVID-19

Co.1% of trained health care professionals withimproved knowledge on key COVID-19related messages

0% NA - NA 72% 72% 72% 70%

Co.2 # of health facilities that being supported ontraining capacity on IPC 0

NA- 34 265 299 299 86





2020

Co.4 # of health workers who received COVID-19-related training in IPC and/or WASH 0 NA - 194 659 853 853 196

Co.5

# of people reached through USAID-supported mass media, including socialmedia (disaggregated by channel, sex(where feasible), and age

0 NA - 17,547 9,544 27,091 27,091 18,787

Co.6 # of mechanism to facilitate two-waycommunication with affected communities 0 NA - 2 0 2 2 2


ANNEX 2: PERFORMANCE INDICATOR RESULTSThe IPTT 36 indicators under the five intermediate and two result areas, including five COVID-related indicators, six Performance Management Planindicators, and four MCH indicators were added during the quarter. Key updates are presented below.

Jalin # IndicatorsProjectCumulativeAchievements

Sep 2020Target Explanation

R1.1 Maternal case fatality rates within health facilities that havereceived mentoring NA 0

Mentoring activities have not rolled out. During Quarter 3, USAID Jalinsupported MOH in piloting the use of SiMatNeo as mentoring assessmenttools and finalizing clinical and managerial guidelines. Mentoring activitiescan be rolled out solely after the guidelines are finalized.

R1.2 Newborn (with at least 2,000-gram birth weight) case fatalityrates within health facilities that have received mentoring NA 0

IR1.1 % of target health facilities in which mentoring has started,achieving an assessment score of at least 80% NA 0%

IR1.2 Evidence based mentoring approach and guidelines institutednationally No No Clinical and managerial guidelines are in process of finalization in close

collaboration with MOH.

IR1.3 % of (65) Jalin priority districts with allocated localgovernment budget for mentoring - 0% Mentoring activities have not yet been rolled out. During Quarter 3,

USAID Jalin supported MOH in piloting the use of SiMatNeo asmentoring assessment tools and finalizing clinical and managerialguidelines. The MOH is expected to roll out mentoring in 2020.O1.1 % of target health facilities in 65 Jalin priority districts in which

mentoring has commencedNA 10%

IR2.1Number of target stakeholders using strengthenedaccountability system to guide corrective action to strengthenMNH services

NA 0Accountability system, which called “AMP-SR” were divided into 3 pillars:1) Death reports and notification; 2) More comprehensive data fromdeath reports, data analysis, and recommendation; and 3) Responsesbased on the recommendation. To establish this accountability systemthat can guide corrective actions, one key requirement was for centralgovernment (MOH) to publish a guidance as a foundation to thestrengthened accountability system. The guidance is still being developedby MOH, and Jalin has a very limited control on when the guidance willbe launched. Without the guidance, there is no system to strengthen.

However, in Quarter 3 Jalin had worked closely with MOH to strengthenPillar 1—death reporting and notification. As at September 2020, 58stakeholders from 38 priority districts were utilizing MPDN for deathreports and notification. Despite the number, these stakeholders have

IR2.2 % of GOI priority districts showing progress against key MNHindicators through strengthened accountability system NA 0%




met the reporting obligations for Pillar 1, but not in Pillar 2 and 3. Thus,the Project could not count this achievement into this indicator.

O2.1% of target health facilities in (65) Jalin priority districtsreporting maternal and perinatal deaths through MPDNapplication

33.8% 25%

During Q2, an additional 13 hospitals (10%) began implementing theMPDN system (there are 2 additional hospitals from what was reportedin Q2). In Q3, the total number of hospitals using MPDN was 50 (33.8%of target hospitals).

O2.2 % of (65) Jalin priority districts meeting all their reportingobligations through strengthened accountability system NA 0%

The accountability system, called “AMP-SR” is divided into 3 pillars: 1)Death reporting and notification; 2) More comprehensive data fromdeath reports, data analysis, and recommendations; and 3) Responsesbased on the recommendation. To establish this accountability systemthat can guide corrective actions, one key requirement was for centralgovernment (MOH) to publish a guidance as a foundation to thestrengthened accountability system. The guidance is still being developedby MOH, and Jalin has a very limited control on when the guidance willbe launched.

However, in Quarter 3 Jalin had worked closely with MOH to strengthenPillar 1—death reporting and notification. As at September 2020, 58stakeholders from 38 priority districts were utilizing MPDN for deathreports and notification. Despite the number, these stakeholders havemet the reporting obligations for Pillar 1, but not in Pillar 2 and 3. Thus,the Project could not count this achievement into this indicator.

O2.3 Number of MNH WG strategic recommendations supportedby documented evidence 0 0

There is no update on this indicator. The WG has been establishedduring Q2 with Ministry of Health Decree 150 Year 2020. The firstmeeting is expected to be held during the last quarter of 2020.

IR3.2 % of private midwives certified as BD in selected districts NA 51% USAID Jalin and IBI will finalize the enhanced BD business model (whichdescribes the enhancement solutions and implementation plan) by theend of October/ start November 2020.O3.3 Number of new BD (inaugurated) in selected districts NA 0

R2.1% of mothers with emergency MNH cases experiencingmultiple referrals in districts with integrated and interoperableICT referral system

NA 0%The ICT rapid review is ongoing and will be completed in late October2020. This will result in recommendations for government to refine anexisting integrated and interoperable ICT referral system.




R2.2% of mothers with emergency MNH cases experiencingserious delays in reaching appropriate referral facility, incatchment areas where transport solutions implemented

NA 50%

IR4.1% of Jalin priority districts in which hospitals (public andprivate) are linked with integrated and interoperable ICTreferral system

NA 3%

O4.1 Number of health facilities in Jalin priority districts withintegrated and interoperable ICT referral system NA 25

IR5.1 % of Jalin priority districts in which cross border referralnetwork agreements have been signed 0% 3%

USAID Jalin is still waiting for the cooperation agreement to be signed byPHO West Java, which will include 3 districts (Bogor city, Bogor district,Depok city).

IR5.2 % of Jalin priority districts in which at least one agreement isin place to implement transport solutions 3.08% 2% During Quarter 3, transport solutions were not replicated in additional

districts. The Project has still achieved the target for September 2020.

O5.1 % of health facilities in priority districts in Jalin provinceswhich are part of a cross border referral network agreement 0% 1%

USAID Jalin is still waiting for the cooperation agreement to be signed byPHO West Java. The agreement will bind 67 health facilities within 3districts.

O5.2 Number of mothers using supported transport solutions inselected districts 297 200

During Q3 2020, the Project contributed in transporting 120 women forANC and PNC through local solution TOPDeAMOR (West Java).

Modifications were made to previously reported Q2 achievements as theProject had just received the complete data from the field.

O5.3 Number of mothers using the supported transport solutions,accessing BPJS and/ or village funds for the journey 123 100

Through local solution TOPDeAMOR (West Java), the Project helped 34women to access BPJS for transportation to health facilities during Q32020.

Modifications were made to previously reported Q1-Q2 achievements asthe Project had just received the complete data from the field (withsource of funding).




Jalin F.2USD value, or USD value equivalent, of new investment inevidence-based policies, programs, products, services orstrategies responsive to priority MNH needs

USD 242,075 USD199,756

The total of contribution made to address MNH issues from Jalinstakeholders were USD 242,075 during 2019-2020. This number ispreliminary, as the Project is still collecting the supporting documents.

STIR-10 Number of innovations supported through USG assistance 22 22 This quarter, there are 22 local solutions that received on-going supportfrom USAID Jalin across six provinces.

STIR-11 Number of innovations supported through USG assistancewith demonstrated uptake by the public and/or private sector 8 5

Among 22 local solutions supported during Quarter 3, USAID Jalinsuccessfully advocated 2 local solutions to be adopted by the localgovernment through policies. These solutions were 1) MNH in thecommunity/mentoring (Brebes, Central Java); and 2) Utilizing Village Fundfor MNH (Bone, South Sulawesi). During Quarter 3, the Project alsoconducted a series of transition/ handover meetings with respectivePHOs and DHOs and successfully secured commitments from relevantpartners to sustain and replicate the local solutions. USAID Jalin assistedthe uptake of 10 local solutions during 2019-2020. Two of themdemonstrated twice, in 2019 and 2020. According to the instruction forthis indicator, we removed the double counting, which lead to 8 localsolutions being supported through USAID Jalin assistance withdemonstrated uptake during 2019-2020,

STIR-12 Number of peer-reviewed scientific publications resultingfrom USG support to research and implementation programs 3 3 During Quarter 3, USAID Jalin submitted 3 manuscripts to the PLOS

ONE journal based on the EMNC study.

F.3 Number of policies or programs created/modified with USGsupport 48 47

A total of 3 policies were created in Quarter 3, 2020 as a result ofUSAID Jalin support across project provinces. This includes circularletter(s), and decision letters in Central Java and South Sulawesi.

HL.6-1 Estimated potential beneficiary population for maternal,newborn and child survival program: number of live births 14,117 10,283

As advised by the COR, the Project restricted reporting on theseindicators to districts in which local mentoring activities were beingimplemented (rather than all districts), which were Garut (West Java),Boyolali and Grobogan district (Central Java).

HL.6.2-1Number of women giving birth who received uterotonics inthe third stage of labor (or immediately after birth) throughUSG-supported programs

5,656 4,000

HL.6.3-1 Number of newborns not breathing at birth who wereresuscitated in USG-supported programs 170 150




HL.6.3-63 Number of newborns who received postnatal care within twodays of childbirth in USG-supported programs 3,690 2,000

Co.1 % of trained health care professionals with improvedknowledge on key COVID-19 related messages 72% 70%

In Quarter 3, the Project started to accommodate pre-tests during IBIwebinars to measure knowledge improvements. Out of 461 healthworkers who participated in the 7th IBI webinar series, 332 healthworkers showed improved knowledge based on pre and post-test scores.

Co.2 # of health facilities that being supported on training capacityon IPC 299 86 In collaboration with IBI, USAID Jalin has conducted seven webinars on

MNH and COVID-19 for midwives. Two of the seven sessions (session 2and session 7) specifically addressed the topic of COVID-19 infectionprevention and control. The enthusiasm of health workers, particularlymidwives, was beyond expectation and exceeded targets.Co.4 # of health workers who received COVID-19-related training

in IPC and/or WASH 853 196

Co.5# of people reached through USAID-supported mass media,including social media (disaggregated by channel, sex (wherefeasible), and age

27,091 18,787

During Quarters 2 and 3, 27,091 people were reached with COVID-19related publications and educational materials through USAID Jalinsupported channels. However, there is likely to be some duplicationwhich USAID Jalin cannot verify due to limited access to analyticsdashboard of social media channels. Based on channels, Facebook has thehighest number of people reached (72.1%), followed by YouTube (27.1%),and Twitter (0.7%).

Co.6 # of mechanism to facilitate two-way communication withaffected communities 2 2

In Quarter 3, USAID Jalin received definitions of USAID COVID-19indicators. Based on the definitions, two USAID Jalin activities/mechanisms should be reported in Quarter 2: 1) Gerai KIA Mobile, and2) Ambulance Feeder local solution. Gerai KIA Mobile aimed to increasewomen’s MNH knowledge and facilitate improved access to quality ANCin health facilities. The Ambulance Feeder local solution was adapted tosupport the socialization of COVID-19 messaging in nearby localcommunities.


ANNEX 3: PROGRESS TOWARD PROJECT MILESTONES

Progress Toward Project Milestones for Intermediate Results

Project Milestone Current Status (September 2020) Expected Status at December 31

IR 1March milestonesStrengthened guidelines based on evidence adopted byMOH

Largely achieved: Clinical and managerial guidelines are inprocess of finalization in close collaboration with MOH.

Fully achieved

MOH-led mentoring initiated in seven vertical hospitals Partially achieved: Eight hospitals in six Jalin provinces havepiloted the self-assessment. Discussions are underway with MOHto determine whether mentoring by vertical hospitals will takeplace in 2020.

TBC based on discussions with MOH

Strategy for MNH mentoring for private hospitals(including incentives)

Not initiated: The Project’s focus has been on supportingmentoring in public hospitals.

Unlikely to be achieved

September milestonesMOH-led mentoring implemented in all vertical hospitalsand in hospitals in 65 Jalin priority districts

Partially achieved: Eight hospitals in six Jalin provinces havepiloted the self-assessment. Discussions are underway with MOHto determine whether mentoring by vertical hospitals will takeplace in 2020.

TBC based on discussions with MOH

Draft M&E system for mentoring (key indicatorsincorporated in SIMRS for public hospitals)

Partially achieved: Comprehensive M&E strategy developed bythe Project for mentoring and shared with MOH. Components ofthe strategy included within the mentoring guidelines.

Partially achieved (mentoring unlikelyto be rolled out in 2020)

IR 2March milestonesMPDN available to be accessed by Puskesmas, PHO,DHO, and hospitals

Fully achieved: MPDN is fully operational and undergoing pilotingin six provinces.

Fully achieved

Accountability: Advocacy for inclusion of key MNHindicators in the five-year national development plan(especially quality, MPDSR, mentoring)

Largely achieved: Policy brief with accountability as the themewas submitted, awaiting feedback from MOH. USAID Jalin alsosupported MOH in finalizing the AMP-SR national guidelines whichcontained accountability indicators. This guideline is expected to becompleted in October.

Fully achieved

Development of dashboard supported by TA Fully achieved: MPDN, including dashboard, is fully operationaland undergoing piloting in several provinces.

Fully achieved

MNH WG: Established and functioning; and somestrategic priorities identified

Partially achieved: While the COVID-19 pandemic has delayedplanned activities of the WG, MOH has expressed interest in

Fully achieved



utilizing the MNH WG to draft the upcoming Presidential Decreeon reduction in MMR and NMR. The Project awaits the firstmeeting of the MOH MNH WG.

Pre-Eclampsia/Eclampsia (PE/E) screening model inCentral Java developed

Fully achieved: PE/E screening model in Central Java has beenpiloted and transitioned to local partner.

Fully achieved

Minimum two manuscripts are ready to submit Fully achieved: USAID Jalin worked closely with PUSKA UI andsubmitted three manuscripts during the quarter.

Fully achieved

September milestonesOption to incentivize recording, reporting, review andresponse supported

Partially achieved: Preparations well advanced for nationalMPDN socialization and orientation to be conducted in October.National and regional MPDN activities will incentivize recording,reporting, review, and response of maternal death through the useof MPDN.

Fully achieved

Functioning system for exchange of information betweenhospital and district

Partially achieved: Preparations well advanced for nationalMPDN socialization and orientation to be conducted in October.National and regional MPDN activities will incentivize recording,reporting, review, and response of maternal death through the useof MPDN.

Fully achieved

Functioning system for flow of information from nationalto provincial and district levels

Partially achieved: MPDN dashboard with hospital and districtsaccounts are fully functioning. Uptake is expected to rise with theMPDN rollout activities.

Fully achieved

Dashboard in use in real-time; and published Partially achieved: While MPDN dashboard is used in real-time,its data is not publicly available yet.

Partially achieved

MNH WG producing recommendations Partially achieved: While the COVID-19 pandemic has delayedthe planned activities of the WG, MOH has expressed interest inutilizing MNH WG to draft the upcoming Presidential Decree onreduction in MMR and NMR. The Project awaits the first meeting ofthe MOH MNH WG.

Partially achieved

IR 3March MilestonesBD review conducted Fully achieved: The BD review was conducted in December

2019.Fully achieved

Enhanced BD business model available Partially achieved: Discussions have taken place to design theenhanced BD business model. USAID Jalin and IBI agreed to have afinal strategic document on the enhanced BD business model

Fully achieved



(which describes the enhancement solutions and implementationplan) by the end of October 2020.

Access to credit: North Sumatra financing modeldeveloped

No progress: No progress made during this quarter. Despite highinterest from banks, it was found that private banks at theprovincial level have limited flexibility to design new credit schemesfor midwives.

Not achieved

September milestonesIBI supported to implement enhanced BD businessmodel in Jalin provinces

Not started: Due to project closure, Jalin's support will be limitedto the development of a strategic document on the enhanced BidanDelima program, that IBI can implement with partners. Had Jalinnot received closure notification, IBI would have been supported toimplement the enhanced model in the fourth quarter.

Not achieved

Partnerships with private sector explored for resourcegeneration

Partially achieved: Continuing tasks from the previous quarter,USAID Jalin and THINKMD finalized the customization of theMobile COVID-19 Risk Screening and Education Tool, with inputsfrom IBI. Application and manual have been shared with IBI,however, the rollout will not proceed due to project closure.

Partially achieved

Pilot implementation completed in two Jalin provinces Dropped: As Jalin is no longer engaged in strategic healthpurchasing.

Not achieved

Cost effectiveness model developed Not started: At USAID direction due to project closeout, Jalin'ssupport will be limited to the development of a strategic documenton the enhanced BD program, that IBI can implement withpartners.

Not achieved

Cost effectiveness model developed Not started: At USAID direction due to project closeout, Jalin'ssupport will be limited to the development of a strategic documenton the enhanced BD program, that IBI can implement withpartners.

Not achieved

National model finalized (based on North Sumatra andother best practices)

Partially achieved: Internal review suggested that the modelcannot be implemented as originally designed. Jalin was looking foropportunities to discuss further with national and provincial level,but due to COVID-19, this plan was postponed. As Jalin is nearingproject closeout, the activity will not proceed.

Not achieved

IR 4March MilestonesICT platform reviewed with recommendations sharedwith MOH

Partially achieved: Methodology of the ICT review was sharedwith MOH. Rapid review has been conducted of seven MNH

Fully achieved



referral platforms/ applications in four USAID Jalin provinces.Currently, draft of tabular analysis of the rapid review is beingrevised.

Interoperable system designed Partially achieved: The rapid assessment will provide indicationsof what an interoperable system might look like. However withproject closure, a detailed system will not be fully designed.

Partially achieved

SiCantik piloted and lessons learned documented Fully achieved: SiCantik support is nearing completion andlessons are being documented.

Fully achieved

September milestonesIntegrated system piloted in Jalin provinces and evaluated Not initiated: Due to project closure there will be no time to

pilot an integrated system, based on the rapid assessmentrecommendations and findings. Had Jalin not received closurenotification, piloting of the system would have been initiated in thefourth quarter.

Not achieved

IR 5March MilestonesStrengthening emergency referral networks: Mapping ofMNH capacity (with availability) of public and privatereferral facilities in Jalin provinces using SIMRS conducted

Partially achieved: Mapping of health facilities capacities in BogorDistrict, Bogor Municipality, and Depok Municipality is complete.The Project initiated a cooperation agreement process on HealthFacilities Maternal & Neonatal Emergency Referral Networks withProvincial Bureau for Regional Autonomy and Cooperation andTKKSD at district level to include maternal and neonatalemergency referrals within the regional cooperation framework.Because of project closure this activity cannot be expanded to allsix Provinces.

Partially achieved

Cross-border referral system in Bogor City, BogorDistrict and Depok City (West Java) developed andtested

Largely achieved: Mapping of health facilities is complete.However, a cooperation agreement between health facilities – totest cross-border referral system in three districts – is still inprocess. Expected completion is November 2020.

Fully achieved

Improving transport: Two transport pilots in remoteareas completed with recommendations (South Sulawesiand Banten)

Fully achieved: Ambulance feeder pilot is complete with lessonslearned and recommendations. The floating ambulance localsolution has been successfully piloted in Pangkep district andlessons learned are being documented.

Fully achieved

September milestones



Sustainable options for implementation and funding oftransport for emergency referrals identified and pilotedin select Jalin provinces (with recommendations)

Fully achieved: Transport-related local solutions have beendocumented and transitioned to local partners.

Fully achieved

Lessons learned from South Sulawesi and Banten pilotsshared nationally

Fully achieved: Local solutions documented and transitioned.Project closeout event expected to share lessons

Fully achieved

Progress Toward Project Milestones for COVID-19 Activities

Project Milestone (and anticipateddue date) Current Status (September 2020) Reasons for Not Achieving the Milestone

Health system needs to tackle COVID-19outbreak identified (IR 1) (April 2020)

Partially achieved: USAID Jalin and IBI CentralManagement conducted a situation analysis meeting withIBI Provincial Management from Jakarta, Banten, andWest Java provinces on April 8. In this meeting, IBImanagement reported severe shortages and price-hikes ofPPE faced by midwives, both in public andprivate facilities.

A hospital assessment was proposed in the addendumworkplan and was discussed as part of the collaboration withUNICEF at the start of the COVID-19 outbreak. UNICEFdeveloped an assessment tool and USAID Jalin providedMNH-related technical inputs.

Since this assessment did not focus on MNH servicecontinuation in hospitals, USAID Jalin planned to conduct anadditional assessment to identify service continuation andMNH readiness considering COVID-19 and outlined anassessment strategy. On June 3, in a meeting to review thetool with the MOH, the Project was informed that MOH hadtasked the Universitas Gadjah Mada (UGM) to conduct anassessment of the impact of COVID-19 on MNH healthservices in the 120 priority MNH districts, in parallel to thementoring self-assessment. The questionnaire developed byUSAID Jalin was shared with UGM for inclusion in their tools.

Training delivered to Obstetricians,Pediatricians and midwives in appropriatemanagement of COVID-19 infectedpregnant women (IR 1 and IR 3) (May2020)

Partially achieved: Since April 2020, USAID Jalin hasbeen supporting the Central Board of Indonesia MidwivesAssociation (PP IBI) to organize a COVID-focusedwebinar series, targeting midwives. Between April –September, the Project and IBI have jointly organizedseven webinars benefiting over 6,000 midwives through

The MOH ruled that the management of COVID-19 positivecases (including pregnant women with COVID-19) is thedomain of hospitals and specialist care. Therefore, theCOVID-19 case management topic was not covered in thewebinar.



the live sessions. More are expected to benefit from thewebinars as the recorded content can be downloadedfrom the IBI website and YouTube channel.

Training or webinars on COVID-19 case management thatspecifically targeted hospitals, ObGyn and/or Pediatricianswere not implemented.

Selected health facilities capable andequipped to treat COVID-19 positivepregnant women (IR 1 and IR 3) (June2020)

Partially achieved: The Project is collaborating withTHINKMD and IBI to develop a COVID-19 risk screeningand education mobile application. This will strengthen theability of health providers, particularly midwives, to assesstheir clients for the risk of COVID-19 infection, toprepare the appropriate infection precaution measures orto opt for referring the clients to COVID-19 treatmentcenters, and to communicate COVID-19 infectionprevention and control to the clients and community ingeneral.

Under IR 1, the Project’s initial plan was to strengthenemergency MNH services in public and private hospitalsfollowing an assessment of health system needs amidst thepandemic (see above). Since the assessment did not go ahead,this plan did not commence.

A shortage of PPE for health workers was identified duringinter-organizational meetings, including with IBI, POGI andthe MOH. However, following USAID guidance, the Project’sfunds cannot be used to purchase PPE.

Training or webinars that specifically targeted hospitals,ObGyns and/or Pediatricians on COVID-19 case managementwere not implemented.

Evidence available of continuing improvedknowledge and implementation of COVID-19 case management in health facilities (IR1 and IR 3) (September 2020)

Partially achieved: There is some anecdotal evidencethat the USAID Jalin-IBI webinar series has helpedmidwives in gaining knowledge and implementingprevention measures in health facilities or private clinics.

This milestone is dependent on the achievement of the abovemilestones (for IR 1 and IR 3) first and therefore has onlybeen partially achieved.

Online Knowledge Center with MNH andCOVID-19 resources operational (IR 2)(May 2020)

Fully achieved: A wide range of COVID-19 relatedresources, in both Indonesian and English, have beengathered. These have been stored on the Projectdashboard for USAID Jalin and USAID to access.

Collaboration with research institutionsleading to cross-country learning (IR 2)(September 2020)

Dropped: This activity was dropped at the request ofUSAID.

Options to improve referrals using ICTevaluated (IR 4) (May 2020)

Partially achieved: The Project has been implementingtwo activities related to this milestone: PT STI will be contracted in Quarter 4 to pilot e-

Kohort in 10 districts;

Will be completely achieved by next quarter.



A rapid assessment of ICT applications/ platforms forreferrals will be concluded in October.

Work begins to modify ICT-based referralsystems (IR 4) (June 2020)

Not achieved Because of the Project’s closure, work to modify ICT-basedreferral systems, based on the rapid assessment, will notproceed.


ANNEX 4: LOCAL SOLUTIONS TRACKER

Region/District Local Solution Title Description Main Partners Status Achievements (as at September 2020)

Banten/Tangerang city

Gerai KIA Provides MNH counselling to increasewomen’s knowledge and facilitateimproved access to quality ANC in healthfacilities

Tangerang local government PT. Sumber Alfaria Trijaya, Tbk.

(Alfamart) Maternal and Child Health Forum

(Forum Peduli Kesehatan Ibu danAnak (Maternal and ChildHealthcare Forum – FOPKIA)

Completed - Effectively facilitated a public-private partnershipinvolving DHO, Alfamart, and FOPKIA indicated byMOU signing.

- Provided counselling to 4,944 pregnant womenthrough face-to-face meeting at Alfamart stores;

- Secured a total of USD 23,270 from village fundsto support operation in 2021.

- Successfully scaled up to two additional Alfamartstores.

- As part of response to the COVID-19 pandemic,successfully transitioned to an online approach(Gerai KIA Mobile) and 364 pregnant womenreceived online/tele-counseling.

- Developed a handbook titled The Process ofEstablishment and Organization of Gerai KIA.

- Tangerang district plans to replicate Gerai KIA insub-districts that are struggling with stunting,including Cisoka, Kemiri, Rajeg, and Tegal Angus.Meanwhile, Banten province will replicate it inother districts, including Pandeglang, Lebak, andSerang in 2021.

Banten/Lebak district

Ambulance Feeder -Jamilah

Strengthening the Jamilah program toimprove access to health facilities andquality of care by developing ambulancefeeder prototype that can operate in ruralareas to transfer patients from remotelocations to a main road where astandard ambulance can transport themto a health facility.

Ministry of Industry Lebak District Local Government PT KMWI (PT Kreasi Mandiri

Wintor Indonesia) PT KMWD (PT Kreasi Mandiri

Wintor Distributor) PT SMI (PT Samudra Marine

Indonesia)

Completed - Facilitated MOU signing between main partners.- Developed an SOP and a guidebook for ambulance

feeder implementation and replication.- Secured a total of USD 93,480.29 from all

partners, and USD 7,041 from village funds tosupport operations and activities.

- Successfully advocated with Directorate Generalof Health Services (Direktorat Jenderal PelayananKesehatan – Ditjen Yankes) to include theambulance feeder as approved emergencytransportation in the MOH’s Ambulance TechnicalGuidance 2019.

- The AMMDes Ambulance Feeder has transported17 pregnant women, 33 women in labor, 3 babiesand 55 other cases in Lebak District.

- Lebak government plans to support ambulancefeeder – Jamilah replication in four sub-districts,including Cijaku, Cigembong, Sobang, andPenggarangan in 2021. In Banten province, this willinclude expansion to Serang and PandeglangDistricts.



Central Java/Boyolalidistrict

Decreased Mortality dueto PE/E

Aims to decrease incidence of Pre-eclampsia (PE) in pregnancy through earlydetection and effective treatments byconducting training for health workers todetect and treat PE.

DHO Boyolali Boyolali Office of Religious Affairs Professional associations: IBI, IDI,

POGI Boyolali Office of Population

Control, Family Planning,Women's Empowerment andChild Protection

BPJS Kesehatan

Completed - Developed PE/E guidelines as an attachment toBoyolali Regent Decree no. 441.8/205 year 2019.

- Assisted DHO Boyolali to mentor four Puskesmas.The four Puskesmas have become qualified tomentor 21 other non-pilot Puskesmas in BoyolaliDistrict.

- PHO Central Java plan to replicate /E initiative in14 other districts that are struggling with relativelyhigh prevalence of stunting and high IMR and MMR.

Central Java/Boyolalidistrict,Semarang city

MNH in the Workplace inCentral Java

Aims to improve access and quality ofMNH services in factory clinics throughhealth service improvements, promotingMNH issues (including mother classes),and supporting improved factory policies.Implemented in two factories: PT. PanBrothers Tbk (Boyolali), and PT. SandangAsia Maju Abadi (Semarang).

Provincial level PHO Central Java APINDOBoyolali District PT Pan Brothers, Tbk DHO Boyolali IBI Puskesmas Mojosongo PMI BPJS Kesehatan FK UNSSemarang City PT Sandang Asia Maju Abadi Semarang City Health Office Population Control and Family

Planning Office IBI Puskesmas Karanganyar RSUD Tugurejo BPJS Kesehatan

Completed - Factory clinics are better equipped to providematernal health services to female workers andthe awareness of MNH issues among femaleworkers and clinic workers is increased.

- In collaboration with DHO Semarang City, agreedto begin replicating MNH activities in PT PantjaTunggal at the end of 2020, led by the localgovernment.

- MNH in the Workplace programs at PT. SandangAsia Maju Abadi (SAMA) and PT. Pan Brothers Tbkare supported with long-term company policiesand standard operational procedures, securinglong-term sustainability.

Central Java/Brebes district

MNH in the Community/Mentoring

Aims to improve quality of care andhealth facility capacity to provide MNHservices through hospital mentoringactivities and advocacy with governmentand private sector to prioritize MNHissues.

DHO Brebes RSUD Margono Soekarjo

(Provincial Hospital) District Community and Village

Empowerment Office RSUD Bumiayu (Public Hospital) RS Dera Assyifa (Private Hospital) PT. Charoen Pokphan Jaya Farm Forum Masyarakat Madani Peduli

Kesehatan Ibu dan Anak (FMMKIA)

RSUD Soedjati RS Islam Purwodadi RSU PKU Muhammadiyah Gubug RS Habibullah Gabus

Completed - Successfully advocated two policies: 1) Regentdecree on allocating village funds for health; and 2)Decision letter from Head of DPMD on VillageFund Allocation, which obligates at least 4% ofvillage funds for health (including MCH).

- Assisted a provincial hospital to mentor twohospitals – one has become a referral hospital formaternal and neonatal emergencies in SouthBrebes Sub-district.

- Assisted two mentored hospitals to mentor eightPuskesmas in Brebes District.

- Prepared six Puskesmas in Grobogan to mentor 24other Puskesmas in the district.

- DHO Grobogan replicated this local solution bymentoring three private hospitals in the district



and has included this initiative in their regionalbudget to ensure its sustainability.

East Java/Malang district

Improving Health WorkerCompliance with ANCand PNC SOPs

Focuses on improving health workercompliance with ANC and PNC SOPs toreduce maternal and newborn mortality.Activities under this solution includedevelopment of ANC and PNC SOPs aswell as increasing utilization of Buku KIAand the mother card.

DHO Malang Bappeda Malang Professional associations (IBI,

POGI, Himpunan Obstetri danGinelokogi Sosial Indonesia[Indonesia Social ObstetricGynecology Society –HOGSI] and IDI)

Malang District GovernmentOffice

Legal Section of the DistrictSecretariat of Malang Regency

Fatayat NU Malang Yayasan Lingga Indonesia Times Indonesia (media) RSUD Lawang RSUD Kanjuruhan RS TNI AU Abd Shaleh RS Wava Husada RS Mitra Delima RSI Gondanglegi Private sector Puskesmas Sumber Pucung,

Pakisaji, Wagir

Completed - Facilitated MOU signing between DHO and RSUDLawang Malang no. 119/58/35.07.103/2019

- Developed eight SOPs for ANC and PNC,supported by nine technical guidelines for SOPimplementation.

- Developed and tested an instrument to monitorand evaluate implementation of the SOPs and toassess utilization of the MCH Book (Buku KIA) andits impact on behavioral changes.

- Three pilot Puskesmas conducted a self-assessmenton their adherence to ANC-PNC SOPs.

- DHO has prepared a budget plan for theimplementation of the Regent Regulation, includingfor supporting the continuation of this localsolution in the pilot Puskesmas.

East Java/Jember district

Quality Improvements forIntegrated ANC and PNC

Focuses on improving health workercompliance with SOPs for integratedANC and PNC by developing indicatorsfor ANC, strengthening clinicalaccountability through audits, anddeveloping a public education campaignfor communities in MNH.

Jember District GovernmentOffices (including DHO)

Professional organizations (IBI,IDI, POGI, IDAI, PENAKIB)

Private sector Five private hospitals Three public hospitals Two academic institutions Puskemas: Silo 1, Silo 2,

Mumbulsari, Sumbersari andRowo Tengah

Completed - Successfully advocated three policies:1) Regent circular letter No 445/311/2020 re the

establishment of task force to develop ANC andPNC SOPs;

2) Regent Decision Letter No188.45/520.1/1/12/2019 re the establishment oftask force to reduce maternal and infantmortality rate; and

3) Head of DHO Decision Letter No800/27182/311/2019 re the adoption of 12SOPs and 7 CPGs to be implementedthroughout Jember District.

- Five pilot Puskesmas increased their capacity inhandling maternal and neonatal emergencies,including by establishing MNH Emergency Teams.

- DHO plans on replicating the establishment ofMNH Emergency Teams in 45 other, non-pilotPuskesmas in Jember District.



East Java/Sidoarjodistrict

Optimizing SiCantik Optimizes the utilization of IT systemSiCantik for supporting referral system.

DHO Sidoarjo Professional associations: IBI,

POGI Hospitals: RSUD Sidoarjo

(public), RS Siti Khodijah and RSAnwar Medika (private)

District Communication andInformation Office

District Population and CivilRegistry Office

Legal Department of the DistrictSecretariat of Sidoarjo

Universitas Muhammadiyah Civil Society Organizations

(CSOs): Fatayat NU Sidoarjo andAisyiyah Sidoarjo

Forum PENAKIB (Accelerating todecrease Maternal and InfantMortality)

CV Natusi

Completed - Successfully advocated policies: 1) Head of DHODecision Letter on the establishment of task forceto draft Regent decree on MCH; and 2) RegentRegulation No. 27/2020 on MCH Services inSidoarjo;

- Advocated for eight hospitals to agree to bereferral destinations for the application;

- Developed a user manual and six SOPs, whichstandardize the use of the application for variouspurposes, including for monitoring expectantmothers and newborns and managing deliveriesand referrals.

- Increased SiCantik utilization rates among healthworkers from 53% (before the solutions) to 100%with 1,583 health workers, 8 partner hospitals, and35,298 mothers registered as of September 2020.

North Sumatra/Langkatdistrict

P4K Inovasi Supports the GOI Program PerencanaanPersalinan dan Pencegahan Komplikasi(P4K) to improve MNH by increasingcommunity involvement in ANC. In P4K,midwives arrange maternity savings, blooddonations, transportation, husbandinvolvement, breastfeeding, andpostpartum and home visits, and MNHmotivators (cadres) facilitate villagemeetings, apply marking stickers, andcollect data on pregnancies.

Langkat Local Government PHO and DHO Langkat Office of Village Empowerment Office of Telecommunication and

Information Forum Masyarakat Madani (FMM) University of North Sumatra Professional organizations (Badan

Pekerja Joint Health Council[BPJHC], HOGSI, IDAI)

Completed - Advocated policies: 1) Regent decree on utilizingvillage funds for maternal and newborn health(through P4K); and 2) DHO Strategic Plan for2019-2024 to allocate local budget for MNHduring the period;

- Developed training modules for facilitators, cadres,lecturers and students on MNH, covering fieldpractices, danger signs, and how to seekemergency help. Around 40 midwives, 60 cadres,and 320 students have received trainings on P4K,followed by strengthening local CSO capacity tomentor and monitor cadres on MNH activities(including P4K);

- Increased quality of health care provided tomothers and newborns, through 200 students,together with cadres and midwives, workingtogether to assist in monitoring the condition ofmothers and newborns.

North Sumatra/Deli Serdangdistrict

Improving Access toFinance for PrivateMidwives and Clinics

Aims to increase access to finance forprivate midwives and clinics for upgradingskills and facilities leading to improvedservice quality.

DHO Deli Serdang Indonesia Midwives Association

(IBI) Association of Private Clinics

(ASKLIN) Bank Sumatera Utara Bank Bank Rakyat Indonesia (BRI)

Completed - Successfully facilitated Letter of Intent betweenBank Sumut, IBI Sumut, and ASKLIN to establish apartnership for improving health services for MNHthrough credit for midwives;

- Completed a field assessment in April 2020 on thesupply and demand sides of access to finance forprivate midwives in East Java and Central Java.



PT. Permodalan Nasional Madani National Financial Board

Authority (OJK)North Sumatra/19 districts

MNH Campaign MNH campaign for improving publicawareness on mother and newbornhealth

PHO and DHOs Communication and Information

Office Family Welfare Movement (PKK) Indonesia Journalists Association

(PWI) Muslim organizations (MUI, NU,

Muhammadiyah) Indonesia Churches Fellowship National Youth Committee

(KNPI) Forum Media Peduli Kesehatan

Ibu dan Anak (FMP-KIA)

Completed - Established MNH Media Forum, a fellowship ofmedia that strengthens the knowledge ofIndonesian journalists on MNH and increases theirwillingness to support MNH activities;

- Produced booklets of sermons on MNH fromMuslim and Christian perspectives and distributedover 500 copies to Muslim and Christian leadersacross North Sumatra;

- Selected religious leaders to be engaged as MNHambassadors.

- Conducted livestreaming campaign series onsafeguarding MNH during the COVID-19pandemic. Six livestreaming broadcasts took placebetween July-September 2020 reaching over 9,000people.

South Sulawesi/Sinjai district

Advocating for VillageRegulations

Advocates village regulations for MNH toensure at least 4 ANC visits duringpregnancy, obligate pregnant women todeliver in a health facility, supportarranging birth certificates fromPuskesmas, and require checkups forblood type and that maternal andnewborn deaths be report from thevillage to the Puskesmas.

DHO Sinjai Bappeda Sinjai DPMD Sinjai Office of Population and Civil

Registration Law division of local secretariat Head of subdistrict and head of

village (in 5 selected villages inSinjai)

Completed - Successfully facilitated the development of RegentRegulation for MNH which becomes the basis tostrengthen the implementation of villageregulations in all sub-districts, including five pilotareas.

- Supported the development of three villageregulations for MNH in Saotanre village, KampalaVillage, and Sukamaju village.

- Supported capacity building for 74 midwives and60 Posyandu cadres on communication,information, and education on MNH topic.

South Sulawesi/Bone district

Village fund allocation forMNH

Aims to access village fund to support: 1)Capacity building for midwives andcadres; and 2) Transportation to conductANC visits and monitoring pregnantwomen in remote areas.

Bappeda Bone DHO Bone Local government of Ulaweng and

East Tanete Riattang Puskesmas Ulaweng and East

Tanete Riattang Head of Villages from Ulaweng

and East Tanete Riattangsubdistrict

Completed - Successfully advocated policy of Regent DecisionLetter on Maternal and Child Coordination andProblem-Solving Team

- Advocated and disseminated the Regent Decreeon Village Fund Utilization for MNH Activities intwo pilot sub-districts, Ulaweng and TeneteRiattang Timur.

- Facilitated training on MNH activities planning andbudgeting for all head of villages from two pilotsub-districts.

- Supported Bappeda and DHO Bone indisseminating the Regent Decree related to villagefund utilization for MNH activities to all 372 headof villages in Bone for replication.

South Sulawesi/Bulukumbadistrict

Blood DonationEmergency Response

This activity supports the MOH’s QuickWins program, establishment of a BloodTransfusion Unit, promotes blood

DHO Bulukumba CSR Forum

Completed - Successfully advocated policies: 1) Regent DecisionLetter on the establishment of blood emergency



donations and improved management toenhance blood supplies for emergencies.

1000 blood donors movement Palang Merah Indonesia (PMI or

Indonesian Red Cross) HA Sultan Daeng Radja Hospital

response team; and 2) Regent Circular Letter thatstrongly recommends government offices toconduct regular blood donation event.

- Developed an android/web application calledITRDS Blood Donor Bulukumba to help blooddonation service and blood stock management.

South Sulawesi/Pangkepdistrict

Floating Ambulance Aims to support local government tooperationalize the floating ambulance toaccelerate the referral process betweenisland areas of Pangkep district andmainland hospitals.

PHO/DHO District Transportation Office District Communication and

Information Office Professional associations (IDI, IBI,

PPNI, IDAI) CSR Forum BPJS Kesehatan Batara Siang Hospital

Completed - Facilitated three Letters of Intent and one MOUbetween main stakeholders to support theimplementation of floating ambulance;

- Finalized floating ambulance SOPs (including forCOVID-19 patient/suspect), referral pathway, andreferral form.

- Supported socialization activities in two sub-districts to improve understanding of the islandreferral system and how to use the floatingambulance. This included socialization of thereferral pathway and referral form for 19 out 23 ofPuskesmas in Pangkep District (including sevenfrom island health centers).

- South Sulawesi Government supported thereplication in Parepare and Sinjai by allocating onefloating ambulance unit for each district.

South Sulawesi/Bone district

Bola Asseddingeng Improve mother’s knowledge andawareness through Bola Assedingeng

Dinkes Bone Yayasan Kalla UPT Puskesmas Dua Boccoe,

Pattiromampu dan Ulaweng

Completed - Facilitated the MoU between Kalla Foundation andGovernment of Bone.

- With Kalla Foundation, facilitated training forvillage midwives to improve capacity of midwivesin handling pregnant women class and checkup.

- With Kalla Foundation, facilitated training forHealth Cadres on the utilization of MNH Book(Pink Book) and Personal Communication skills.

- Bola Asseddingeng activities in 18 locations from 3piloting Puskesmas went very well with theinvolvement of husband and village government.

South Sulawesi/Pangkepdistrict

MOU with CSR Forum(Enabling Factor/EF)

Aims to facilitate an MOU between PHOand the CSR Forum to improve MNHissues.

PHO Forum CSR DHO

Completed - LOI has been signed between Forum CSR andDHO

- No need to develop MoU between PHO andForum CSR because Forum CSR will directlydevelop an MoU with DHO who needed for acollaboration.

South Sulawesi/Sinjai district

Engaging ProfessionalOrganizations(Enabling Factor/EF)

Focuses on improving coordination andbuilding relationships to increaseaccountability among professionalassociations, hospitals, and doctors.

IDI (Doctor Association) IDAI (Paediatric Association) POGI (Obstetric and

Gynaecologist Association) Hospital DHO Sinjai

Completed - IDI, PHO, IDAI, POGI agreed to work together onimproving AMP system in Sinjai district



PHO South Sulawesi

West Java/Province level

ZOOM Preeclampsia Promotes initial screening, riskidentification and referral treatment forPE/E by upgrading skills and equipment.

West Java Provincial Government PHO DHO Karawang Professional associations (POGI,

IDAI)

In implementation - Conducted district and city readinessassessment for the ZOOM programimplementation collaboration with POGI andPHO. The assessment was carried out in 24districts/cities in West Java.

- Disseminated assessment results to keystakeholders including DHO, ObGyn, andPuskesmas.

- Develop consensus on ZOOM implementationby ObGyn, and Puskesmas doctors in 12district/cities.

- Online training for 46 ObGyns on using USG ofthe uterine arteries for early detection of pre-eclampsia.

West Java/Garut district

MNH in the Workplace Aims to improve access and quality ofMNH services in factory clinics forwomen workers (including familyplanning, mother classes, peer education),improve referral networks and supportlocal government in developing anintervention model for the workplace.Implemented in one factory: PT. ChangShin (Garut)

PT Chang Shin Reksajaya DHO Garut Professional associations (IBI,

POGI) Labor Union of PT Chang Shin

Reksajaya Badan Kependudukan dan Keluarga

Berencana Nasional (NationalPopulation and Family PlanningBoard – BKKBN)

District Women Empowermentand Family Planning Office(BPPKB)

Jhpiego Puskesmas Leles Padjajaran Clinic

In implementation - Finalized modules on: 1) improving quality ofmaternity class for pregnant workers, and 2)peer educators training.

- Quality of MNH and reproductive healthservices improved through trainings and supportto Puskesmas Leles and Padjajaran Clinic.

- Female factory workers at PT Chang Shinfactory now have better access to integratedMNH and family planning services.

- High commitment from PT Chang Shin toensure the health of pregnant workers andclosely collaborate with DHO and BPPKB Garutto resolve MNH issues in the company.

West Java/Garut andSukabumidistrict

Utilizing Village Funds Aims to enable village funding toincentivize TBAs to refer pregnantwomen for ANC and delivery toPuskesmas or village midwives.

DHO Sukabumi DHO Garut General Hospitals of Jampang

Kulon, Sekarwangi Sukabumi General Hospitals of Slamet

Garut SEHATI Health StartUp POGI Sukabumi POGI Garut DPMD (District Village

Community EmpowermentOffice) Sukabumi and Garut

In implementation - Advocated for Bupati Decree on the Task Forcefor Acceleration MMR & NMR Reduction, anddecentralized it to Decisions Letter at the sub-district and village levels.

- Exercised management tools for MNH in theVillage, such as Mini Call Centers, using SEHATIecosystem for early planned referral (RujukanDini Berencana)



Local Government of Sukabumiand Garut

Kelompok Kerja Lintas Batas(Cross Border Working Group –Pokja) / Health Civil Society

PKK and Health Cadres

West Java/Garut district

TOPDeAMOR Aims to improve access to MNH servicesby utilizing motorcycles (ojek) nearPuskesmas to serve as ambulancestransporting pregnant women for ANC,delivery, medicine, and midwife visits. Thesolution also includes a mentoringcomponent with five Puskesmas.

PHO DHO Garut Puskesmas Cihurip Puskesmas Cikelet Puskesmas Sindang Ratu Puskesmas Pamulihan Puskesmas Maroko Subdistrict Government

(Kecamatan) Village Government Community leaders/ village

cadres

Completed - Advocated for Cihurip Village Regulation no4/2020 on the partnership between midwives andtraditional birth attendants (pariadji);

- Developed SOP on TOPDeAMORimplementation, signed by the head of village.

- Improved access to MNH services in four targetPuskesmas. Through implementation ofTOPDeAMOR in January to June 2020, thesePuskesmas have provided transportation supportto 130 mothers to receive MNH services

- Eight village regulations, eight MOUs, eight Letterof Decisions, and four Cooperation Agreement arein place to support various of innovations fortransporting pregnant women to the nearesthealth facility.

West Java/Bogor District,Bogor City,Depok District

Developing IntegratedMaternal and NeonatalEmergency ReferralNetworks

Aims to strengthen the cross-borderreferral system.

Bogor District Government Bogor Municipal Government Depok Municipal Government West Java Provincial Government BPJS Hospital associations (PERSI,

ARSSI) Professional associations (POGI,

IDAI, IBI, PERDATIN) All hospitals in Bogor City, Bogor

District and Depok City; Private sector (STI, Sinergantara)

In implementation - Mapped Pelayanan Obstetri dan Neonatal EmergensiKomprehensif (Comprehensive EmergencyObstetric and Neonatal Services – PONEK)(comprehensive emergency obstetric and neonatalcare [CEmONC]) capacity of public and privatehospitals across Bogor-Depok which included sixpublic and 61 private hospitals. USAID Jalinsupported the Cross-Border Referral Committee– represented by DHO and hospitals from thethree locations – in development of mapping tools,enumerator training, and field work to assess thecapacity of 67 hospitals in emergency maternal andneonatal service provision.

- Disseminated mapping results to key stakeholdersacross Bogor-Depok, including local government,hospital and professional associations.

- Initiated Cooperation Agreement process onHealth Facilities Maternal & Neonatal EmergencyReferral Networks with Provincial Bureau forRegional Autonomy and Cooperation andCoordination Team for Local Cooperation atdistrict level

- Finalized design of the integrated referraldashboard.


ANNEX 5: MEDIA MONITORING

No Title Source Province Date ofPublication Link to file

1 Rentan Infeksi Covid-19, Ibu HamilPerlu Perhatian Ekstra

Dnaberita.com NorthSumatra

9 July https://dnaberita.com/2020/07/09/rentan-infeksi-covid-19-ibu-hamil-perlu-perhatian-ekstra/


Pemerintah SumateraUtara

NorthSumatra

9 July https://www.sumutprov.go.id/artikel/artikel/rentan-infeksi-covid19-ibu-hamil-perlu-perhatian-ekstra


Sentralberita.com NorthSumatra

9 July https://sentralberita.com/2020/07/rentan-infeksi-covid-19ibu-hamil-perlu-perhatian-ekstra/

4 Sumut Nomor 5 Penyumbang AngkaKematian Ibu Hamil

Tagar.id NorthSumatra

10 July https://www.tagar.id/sumut-nomor-5-penyumbang-angka-kematian-ibu-hamil


Sumutmerdeka.com NorthSumatra

13 July https://sumutmerdeka.com/2020/07/13/rentan-infeksi-covid-19-ibu-hamil-perlu-perhatian-ekstra/

6 Webinar Perbup Malang PenerapanSPO Tekan Angka Kematian Ibu danBayi, Ini Yang Dibahas

Timesindonesia.co.id East Java 25 August https://www.timesindonesia.co.id/read/news/292840/webinar-perbup-malang-penerapan-spo-tekan-angka-kematian-ibu-dan-bayi-ini-yang-dibahas

7 Dinkes-USAID Jalin Gelar Webinar,Rencana Peraturan Bupati PenerapanStandar Prosedur Operasional (SPO)ANC dan PNC

Malangsatu.id East Java 25 August https://malangsatu.id/2020/08/dinkes-usaid-jalin-gelar-webinar-rencana-peraturan-bupati-penerapan-standar-prosedur-operasional-spo-anc-dan-pnc/

8 AMMDes Buatan Dalam NegeriMulai Diekspor

Mobil123.com Banten 30 August https://www.msn.com/id-id/otomotif/berita/ammdes-buatan-dalam-negeri-mulai-di-ekspor/ar-BB18voDp

9 AMMDes Buatan Dalam NegeriMulai Diekspor

Msn.com Banten 30 August https://www.msn.com/id-id/otomotif/berita/ammdes-buatan-dalam-negeri-mulai-di-ekspor/ar-BB18voDp

10 Kampanye Kesehatan Ibu dan AnakTanggung Jawab Bersama

Pelitabatak.com NorthSumatra

18 September https://pelitabatak.com/news/Kampanye-Kesehatan-Ibu-dan-Anak-Tanggungjawab-Bersama

11 USAID-Pemkab Boyolali Jalin KerjaSama

Terbaiknews.net Central Java 28 September https://terbaiknews.net/location/jawa-tengah/usaid-pemkab-boyolali-jalin-kerja-sama-4613707.html

12 USAID-Pemkab Boyolali Jalin KerjaSama

Jateng.antaranwes.com Central Java 28 September https://jateng.antaranews.com/berita/339313/usaid-pemkab-boyolali-jalin-kerja-sama


ANNEX 6: SOCIAL MEDIADuring the quarter, USAID Jalin expanded its Twitter presence by sharing more activity updatesstories, and campaign activities related to MNH topics. With more content shared, the Twitteraccount gained more followers and reached more people. The number of followers at the end ofSeptember 2020 is 104, which shows a 44 percent increase from the previous quarter. Meanwhile,the impressions or total times people have seen the tweets this quarter is 38.4 K, which shows anincrease of 32 percent.

Based on the analytics, the tweets that gained more attention are those with educational messagesor perceived to be informative. With the ongoing COVID-19 pandemic, the Project utilized socialmedia to spread messages about COVID-19 prevention, especially within the MNH context. Simplecampaigns shared through digital posters or banners to commemorate events such as NationalChildren Day, World Breastfeeding Week, etc. also gained a high number of views and shares.

@USAIDJalin Twitter Analytics (July 1 – September 30, 2020)

Twitter @USAIDJalin Metrics as ofSeptember 30, 2020• Tweets this quarter = 71 (previously 28)• Followers = 104 (previously 72)• Impressions/total times people have seen the tweet

= 38,438 (previously 29,099)• Engagements/the number of times a user interacted

with a tweet = 1,238 (previously 1,231)


Coverage of USAID Jalin from Other Social Media Accounts

No Content Source/Platform Province Date of

Publication Link to Post

USAID Indonesia Social Media Channels1 Midwife Tyas in Jember

District switched the MNHservice to online platform.

Twitter: USAIDIndonesia(@usaidindonesia)

East Java 3 July https://twitter.com/usaidindonesia/status/1279049818917257218?s=20

2 Nurjanah had an onlineANC counselling throughGerai KIA Mobile service inTangerang District.


Banten 13 July https://twitter.com/usaidindonesia/status/1282637168121393152?s=20



Banten 18 July https://twitter.com/usaidindonesia/status/1284349692529332224

4 #ActingontheCall Report2020 featured Gerai KIA ofUSAID Jalin



5 ANC counselling throughGerai KIA is shifted tomobile/online service due tothe pandemic



6 Midwife Tyas in JemberDistrict switched the MNHservice to online platform.


East Java 30 July https://twitter.com/usaidindonesia/status/1288751196350619653


Facebook: USAIDIndonesia

Banten 31 July https://www.facebook.com/usaidindonesia/posts/3375231932521608



East Java 1 August https://twitter.com/usaidindonesia/status/1289498629405700097


Facebook: USAIDIndonesia

East Java 4 August https://www.facebook.com/usaidindonesia/posts/3416584158386385

10 Novika Sari watched theMNH and COVID-19 live-streaming broadcast andgained knowledge for herpregnancy.


NorthSumatra

9 August https://twitter.com/usaidindonesia/status/1292397725040947201

11 Live-streaming broadcast inNorth Sumatra helpspregnant women to learnabout MNH during thepandemic.


NorthSumatra

11 August https://twitter.com/usaidindonesia/status/1293052034527170561

12 Ambulance feeder in Bantenhelps pregnant women inremote areas to reach thenearest health facility.


Banten 18 September https://twitter.com/usaidindonesia/status/1306822769762619393

Other Social Media Accounts1 A public-private partnership

with local conveniencestores helped more than4,000 #women ofreproductive age access#antenatal care and deliveryservices in Tangerang district

Twitter: DAIGlobal

Banten 15 July https://twitter.com/DAIGlobal/status/1283402446275055622?s=20


No Content Source/Platform Province Date of

Publication Link to Post

2 Pregnancy and Risk ofCOVID-19 Exposure

Youtube andFacebook: PublicRelation Office ofNorth SumatraProvince

NorthSumatra

9 July https://www.youtube.com/watch?v=GmCW1nxLs_c&feature=youtu.be

https://www.facebook.com/birohumasdankeprotokolan/videos/900127883840924/?__so__=channel_tab&__rv__=all_videos_card

3 Immunization andBreastfeeding duringCOVID-19 Pandemic


NorthSumatra

15 July https://www.youtube.com/watch?v=p2CSSopViZg

https://www.facebook.com/birohumasdankeprotokolan/videos/220717009062790/

4 Consultation and HealthServices for PregnantWomen by Midwives duringPandemic


NorthSumatra

11 August https://www.youtube.com/watch?v=pKofdTn2Bso

https://www.facebook.com/birohumasdankeprotokolan/videos/974506276326398/?__so__=channel_tab&__rv__=all_videos_card

5 Filtering social mediainformation amid COVID-19pandemic


NorthSumatra

19 August https://www.youtube.com/watch?v=GZBBYw4YteE

https://www.facebook.com/birohumasdankeprotokolan/videos/peranan-influencer-dan-milenial-untuk-membangun-kesadaran-kesehatan-ibu-dan-anak/583612335664386/?__so__=permalink&__rv__=related_videos

6 Family’s role in protectingmothers and newbornsduring the pandemic


NorthSumatra

26 August https://www.youtube.com/watch?v=Fz8aCUOd28g&feature=youtu.be

https://www.facebook.com/birohumasdankeprotokolan/videos/kelua7rga-hebat-covid-19-minggat-peran-keluarga-dalam-melindung-ibu-dan-bayi-baru/708249939757452/?__so__=permalink&__rv__=related_videos

7 Multi-stakeholdercollaboration on MNH careduring pandemic


NorthSumatra

8 September https://www.youtube.com/watch?v=MXM_EC-VtJ0

https://www.facebook.com/1598054340267759/videos/340270957172586


ANNEX 7: DEVELOPMENTAL EVALUATION ACTIVITIESDuring the reporting period, USAID Jalin and its regional teams continued to work closely with theDevelopmental Evaluation (DE). In Quarter 3, the DE focused on the following activities:

1. The DE submitted Jalin’s midterm evaluation to USAID. This report is based on DE team datacollection during April-June.

2. In August, the DE began developing a report describing Jalin’s cocreation of local solutions toimprove MNH outcomes.

3. In July, the DE presented an infographic on P4K Inovasi.4. In August, The DE team presented an infographic on the Ambulance Feeder AMMDes

solution.5. In August, the DE presented an infographic on MNH in the Workplace in West Java.6. Starting in August, the DE team commenced a data mining study. The study aims to map Jalin

indicators and results in Year 1-3 and to assess how Jalin could improve their data collectionand reporting.

7. Starting in September, the DE team began observing local solution transition workshops heldby the Jalin regional team.


ANNEX 8: PROJECT PHOTOS

Quarter 3 project photos:https://drive.google.com/drive/folders/18XzXBu9ZTY0qm62e0Gaq3T56j2FK01sz?usp=sharing


ANNEX 9: SUCCESS STORY

The USAID Jalin Project

SUCCESS STORY

Maternal andNewborn HealthCounseling Innovationsduring COVID-19

The Project collaborated with the Provincial HealthOffice, District Health Office (DHO), andcommunity health centers (Puskesmas) to transitionthe program to an online service. The new Gerai KIAMobile service was piloted in five sub-districtsbetween June 8 and July 31, 2020 and targeted 220pregnant women in the third trimester. The serviceoutperformed its target—reaching 364 pregnantwomen through 639 phone counseling sessions.

This innovative program has been positivelyreceived by participants. Nurjanah, a pregnantwoman from Cileles village, used to visit the GeraiKIA booth near her house and learned about thenew mobile service from one of the cadres, Mrs.Erwati. “From Gerai KIA, I know a lot of thingsabout maternal and child health. Mrs. Erwati hasbeen such help by answering my maternity-relatedquestions,” said Nurjanah.

She appreciates that Gerai KIA Mobile alsosupports COVID-19 prevention by asking screeningquestions and providing information to helppregnant women protect themselves. “So far, I thinkthe online counseling method suits the currentsituation. We can talk through video call and it isvery helpful so that we can still access such serviceswhile staying at home.”

For service providers, the initiative represents animportant way to maintain MNH care. “With GeraiKIA Mobile in place now, we can also screenpregnant women for complications or danger signsand cadres can quickly refer them to nearest healthfacility,” said Dr. Sri Indriyani, Head of the FamilyHealth Section at DHO Tangerang.

For Mrs. Erwati, “the pandemic forces me and othercadres to adapt to new methods in giving counselingservices to mothers.” The pilot program requiredher to become familiar with new technology anddata systems. “I am also grateful because nopregnant women [in Cileles village] have beeninfected so far,” she added. COVID-19 preventionmeasures are taken seriously and are included aspart of the Gerai KIA Mobile service.

USAID Jalin has successfully secured long-termcommitments to continue the Gerai KIA program,which will be handed over to local partners inOctober 2020. Dr. Sri expressed her appreciation,“I want to thank USAID Jalin. Even during thepandemic, [the Project] can still innovate to provideservices through Gerai KIA Mobile. This is aninitiative that DHO Tangerang can continue.” DHOTangerang plans to replicate this initiative in fivesub-districts in Banten Province.

Since March 2019, USAID Jalin has supportedGerai KIA maternal and newborn health(MNH) education and antenatal care (ANC)services in five sub-districts of TangerangDistrict, Banten Province. Midwives andcommunity health volunteers (cadres)previously held weekly sessions at Alfamartconvenience stores, where they provided freecounselling on pregnancy, ANC, andsymptoms of high-risk pregnancies. Whenthe COVID-19 pandemic eliminated theoption of face-to-face counseling sessions,USAID Jalin supported the provision of theseservices via mobile phone instead.

Nurjanah participates in a video counseling session with aGerai KIA Mobile cadre. Photo: Oscar Siagian/USAID Jalin


ANNEX 10: ORGANIZATIONAL CHART


ANNEX 11: LOCAL SOLUTION ACTIVITY BRIEFSAnnex 11 is included as a separate attachment with updated local solution activity briefs.

the usaid jalin project

Documents