“A good start in life will ensure a sustainable future for all” – The Lancet
The above quote fits the narrative of how children are the most valuable asset a nation can have – that a good start in the lives of children will decide the future for everyone. Therefore, in order to protect and secure the future of our nation, we must start by providing the best care for our children from their earliest age.
It was reported that 250 million – or 43% of – children under 5 years old in low-income and middle-income countries are at risk of not achieving their developmental potential. In Indonesia, 45% of children under 5 are at risk of poor development.
To reach their full potential, children need high-quality health care and services, especially in life’s early moments. To that end, a nurturing care framework is important to promote health, nutrition, security, safety, responsive caregiving and opportunities for early learning. The Nurturing care (NC) framework, launched in 2018 by WHO, UNICEF, the World Bank and partners, consists of five strategic actions: 1) lead and invest; 2) focus on families and activities; 3) strengthen services; 4) monitor progress; and 5) use data and innovate.
The Indonesia Government has made a strong political commitment to improving both the quality and quantity of nurturing care services for early childhood with Law Number 20 of 2003 on the National Education System which stated that early childhood education is an educational effort aimed at children from birth to the age of six, which is carried out through educational stimuli to help physical and spiritual growth and development. The government ensures early childhood education through formal, non-formal, and/or informal education channels and implemented through the launch of the Holistic Integrated Early Childhood Education and Development (HI-ECED) program. The program aims to integrate various services under ECED, such as education, health, care, child-protection and child well-being. However, there are still issues concerning maternal mortality and the health of young infants during the first 1000 days. Studies have revealed that most Indonesian children suffer from stunting and lack of nutrition. Although a number of public health center institutions are accessible in Indonesia, including hospitals, public health centers (Puskesmas), private clinics, Village Health Posts (Poskesdes), Village Birthing Centers (Polindes) and community-integrated posts (Posyandu), there has been little improvement in maternal mortality rates over the last 15 years. The reasons most often cited for this are challenges in the referral system for high-risk pregnancies, and the challenge of outreach to vulnerable women with family planning to reduce high-risk fertility behaviors.
To address this issue, USAID’s MOMENTUM Country and Global Leadership has consulted with Tulodo Indonesia to undertake a case study on nurturing care through public health platforms in Manggarai Barat, Nusa Tenggara Timur. The case study will help to understand and assess the needs and opportunities for delivering nurturing care using existing practices, such as during postnatal care (PNC), sick child visits, child clinics, and other platforms that significantly contribute to the child’s first 1000 days. Manggarai Barat has been chosen because the province’s current infant mortality rate of 12.1 per 1000 live births makes it one of Indonesia’s highest, with a high stunting rate of 24.2% as reported in 2020. In addition, the lack of accessible health services has also contributed to the problem.
Tulodo will conduct the study using a combined approach that blends case study methodology with the influence of human-centered design (HCD). As an approach, HCD is practice and context-oriented. It uses empathy, inclusiveness, and critical thinking as leading principles in achieving its objectives. Tulodo will observe the delivery of the nurturing care framework during ANC and PNC visits, sick child visits, well-child clinics, and other child health service delivery platforms in the first 1000 days and to identify the needs and opportunities for strengthening the delivery of nurturing care. The project will be implemented from December 2021 to May 2022 with data collection will be conducted in the beginning of April 2022 targeting around 84 respondents in Manggarai Barat, NTT through interviews and focus group discussions.
Jhpiego is the leading partner for MOMENTUM Country and Global Leadership Project funded by USAID. Jhpiego is a nonprofit global leader in the creation and delivery of transformative health care solutions that save lives. In partnership with national governments, health experts and local communities, Jhpiego build health providers’ skills, and develop systems that save lives now and guarantee healthier futures for women and their families.
Jhpiego’s sub-partners under USAID MOMENTUM Country and Global Leadership Project including Save the Children
About Save The Children
Save The Children is a sub partner on USAID’s MOMENTUM Country and Global Leadership project in Indonesia. Save the Children has been operating in Indonesia since 1976. Save the Children is a national organization that focuses on serving the needs and advocating for children’s rights through various interventions and creating a safe environment for children to grow, learn and play. Being part of the global Save the Children movement, has enabled Save the Children Indonesia to work together in more than 120 countries around the world, develop partnerships with local organizations, and provide training and resources to build and empower communities for children in need.
Vision – a world in which every child attains the right to survival, protection, development and participation.
Mission – to inspire breakthroughs in the way the world treats children and to achieve immediate and lasting change in their lives.
Tulodo is a consulting, project management and incubation agency specializing in social and behavior change. We help partners and clients solve issues related to the environment, health, governance, education, technology, human rights, microfinance, water, safety and more. We provide services in research, strategy, design and development, management, capacity-building, marketing and communications, evaluation and fundraising.
Tulodo is a different kind of organization. We have the client service, focus on results and creativity of a marketing agency; we provide the expertise, research and capability development of a university; and we bring the social focus, community and passion of a non-profit organization. We’re as capable with mobile solutions, big data and user-centric design as we are with community mobilization, capacity-building and partnership. Tulodo has a presence in Indonesia, Australia and Timor-Leste, as well as partners throughout the Asia Pacific region and globally. We work with governments, communities, businesses, and non-profit, industry and multilateral organizations.