Indonesia

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    #ICFP

    #ICFP

    Are you planning to attend the 2016 International Conference on Family Planning (ICFP)? We invite you to join K4Health as we work to foster knowledge exchange before, during, and after the conference!

    Before ICFP

    To kick off knowledge sharing at ICFP, K4Health is hosting two full-day off-site auxiliary events:

    1. “Knowledge, Action, Results: How to Translate Global Family Planning Tools to the Local Level” will help transfer lessons learned into practice, and help make program decisions using knowledge management tools and approaches. A few slots are still available—register today! (Sunday, January 24, 9 am – 5 pm, Westin Resort Nusa Dua)
    2. The PAC Connection, the USAID-funded inter-agency working group for postabortion care (PAC), will hold a pre-conference meeting to discuss the latest PAC evidence, program results, and tools and resources. (Sunday, January 24, 9 am – 5 pm, Westin Resort Nusa Dua)

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    Puspita Insan Kamil demonstrates Skata, a mobile app, during the Global mHealth Forum.

    Puspita Insan Kamil demonstrates Skata, a mobile app, during the Global mHealth Forum. 

    Digital industry has entered phase 3.0: smarter and more personalized machines. This provides thousands of possibilities for smarter consumer engagement across industries, including health care. While there has been a dormancy of Indonesia’s national family planning (in Bahasa Indonesia: Keluarga Berencana/KB) program for more than a decade, the Johns Hopkins Center for Communication Programs (CCP) Indonesia believes that the digital industry’s 3.0 phase could be beneficial to family planning. CCP Indonesia, together with MobileForce, a local tech shop, developed an integrated campaign called Skata, which has quickly become a game changer in engaging families in Indonesia since its launch five months ago.

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    An article in this Wednesday’s Jakarta Post highlighted work being done by the Johns Hopkins Center for Communication Programs (CCP), in partnership with a range of stakeholders, to revitalize family planning in Indonesia while addressing the challenges of decentralization.

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    Photo Credit: David J. Olson

    Two salesmen from DKT India make a pitch for condoms and oral contraceptive pills to the owner of a pharmacy in the Mumbai slums. In 2013, DKT India delivered 2.9 million couple years of protection, making it the ninth biggest contraceptive social marketing program in the world. Photo Credit: David J. Olson

    In 2013, social marketing organizations around the world delivered more impact than ever before: 70 million couple years of protection (CYPs). This is an increase of 6.8% from the 65.5 million CYPs produced in 2012, according to the 2013 Contraceptive Social Marketing Statistics just published by DKT International. (A couple year of protection is the amount of contraception needed to protect one couple for one year; see note at the end of this blog post for more details.)

    The report provides details on 93 contraceptive social marketing programs in 66 countries, all of which are helping provide modern contraception and reduce unmet need for family planning among women and families in their countries.

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    “We are not alone. We can learn from each other.” 

    -- Member of district working group in Tuban, East Java (and participant at the ICMM/AFP knowledge-sharing meeting)

    Last month, the Advance Family Planning (AFP) Project and the Improving Contraceptive Method Mix (ICMM) Project in Indonesia co-hosted our first-ever knowledge-sharing meeting for district, provincial, and national level partners. The two-day meeting was conducted and facilitated by ICMM/AFP partner Yayasan Cipta Cara Padu (YCCP), who brought more than 70 individuals from the district, provincial, and national level together in Jakarta. YCCP leads advocacy efforts for the two projects, which both use the AFP approach to advocate for increased funding and support for family planning at the district level.

    © 2014 Sarah Harlan, JHUCCP.

    Members of the Lombok Timur DWG discuss their advocacy activities for the upcoming year, using the AFP SMART approach. © 2014 Sarah Harlan, JHUCCP.

    The meeting theme—“Partnering to Win”—highlighted the importance of collaboration and learning in order to improve district-level family planning advocacy efforts and make strides towards meeting millennium development goals (MDGs) and FP2020 goals. Participants included representatives from all the six ICMM district working groups (Kediri, Lumajang, Tuban, East Lombok, Sumbawa, and West Lombok), all five AFP district working groups (Bandung, Bogor, Karawang, Karanganyar, and Pontianak), provincial-level district health offices (from East Java and West Nusa Tenggara), provincial-level BKKBN offices (Population and Family Planning Board), the Family Planning Body of East Java, BKKBN Central Office, the University of Indonesia, the Ministry of Home Affairs, the Ministry of Health, and USAID/Indonesia. Several staff from Johns Hopkins Center for Communication Programs (including myself) and the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health also attended. The event provided an excellent platform for all partners to learn from each other’s challenges and successes.

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    A key strategy for healthy timing and spacing of pregnancy (HTSP)— an essential but underutilized family planning approach for delaying, spacing, or limiting pregnancies to help women and their families achieve optimal health outcomes—is to offer a choice of highly effective contraceptive methods to postpartum women in a timely manner to delay subsequent pregnancies. However, in many contexts—and particularly if a woman is poor or living in a rural area—she might only have access to a limited range of methods.

    Woman and Baby. Credit: Sarah V. Harlan

    The availability of long-acting reversible contraception can help women ensure optimal spacing in-between pregnancies. Credit: Sarah V. Harlan

    No single method will be appropriate for all women. For example, some methods are more convenient and accessible but require the user to take a pill every day or visit a clinic regularly. Other methods might be highly effective but require insertion by a clinician. The more choices that are available, the more likely a woman is to find one that suits her individual needs and preferences. As studies have shown, when a wider method mix is available, use of contraception increases—and discontinuation rates decrease.

    Discontinuation rates are lower for long-acting reversible contraception (LARC) such as intrauterine devices (IUDs) and contraceptive implants, than for short-term methods like oral contraceptive pills and injectables. Research has shown that postpartum women who begin using long-acting methods are less likely to get pregnant again quickly than those who used user-dependent hormonal methods such as pills, as well as barrier methods.

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    The USAID ASSIST Project's new website

    The USAID ASSIST Project's new website

    This post by Sonali Vaid originally appeared on the recently launched USAID ASSIST project website. Vaid tells two stories about the power of listening, and how it can truly save lives. When health care providers listen to their patients, they have the power to save a life. When public health systems listen to the people they serve, they have the power to save millions of lives. Family planning is essential to ending preventable child and maternal deaths, a key component of USAID’s Global Health Strategic Framework (PDF). Sarah Harlan recently wrote about a K4Health activity in Indonesia that looks at fertility preferences. The baseline study listened to women and families and found a need for more long-acting and permanent methods (LAPMs). So now, K4Health will advocate to reintroduce LAPMs to the method mix in Indonesia to help both individuals and the country reach their family planning goals.

    Do you have a story about the power of listening? Tell us in the comments.

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    Young mother and baby

    A young mother holds her baby while she waits for a bus in the Kebayoran Baru subdistrict of South Jakarta.

    © 2013 Sarah V. Harlan/CCP, Courtesy of Photoshare

    During the 1970s and 1980s, Indonesia’s intensive top-down family planning (FP) program helped slash the total fertility rate (TFR) from more than 4 children per woman to 2.6—where it where it remains today—by greatly increasing the contraceptive prevalence rate (CPR). However, since the late 1990s, government decentralization and uneven local FP commitment have resulted in a stagnant CPR (about 58% for modern methods). To address this, President Susilo Bambang Yudhoyono is working to reinvigorate interest in FP and cut the TFR from 2.6 to 2.1 (replacement level) to keep the population from expanding further—and his administration has brought back the “Dua Anak Cukup”—or “Two [Children] is Enough” campaign used during the FP program’s heydey. The Indonesian Government has also committed to FP2020 goals and even hosted its own National Summit for FP last year.

    Why the renewed focus on FP in Indonesia? According to government officials, if the TFR remains at 2.6, the population could double by 2060, which would make it increasingly difficult to provide food, education, health care, and infrastructure for its citizens. (Currently, Indonesia is the fourth most populous country in the world—after the United States—with 250 million people.) Indonesia has had one of the fastest growing economies in Asia, but government officials are worried that the country’s population growth is exceeding its economic growth, which could lead to higher levels of unemployment. (For more on population growth and economics in Indonesia, see this Bloomberg News piece published last month.)

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