Advance Family Planning in Indonesia A Brief History Workshop on Fostering Locally-Driven Advocacy for Family Planning Nusa Dua, Bali January 2016 Heri Haerudin AFP - Johns Hopkins, Center for Communication Programs 

National Situation When We Started The radical change was taking place during the transition to decentralization era of Indonesia. Decentralization in Indonesia was rolled out in the 2000s and the National Population and Family Planning Board (BKKBN) started to be decentralized in 2004. With this new scheme, the BKKBN at district level is financed and governed by the District. However, not all district put the required level of priority to FP issues. This leads to situation that is not conducive to develop and implement an effective FP program locally and nationally. Resulted in a stagnation of what was previously one of the world’s most successful family planning programs. Fewer women use long-acting methods now than in the mid-1990s; for instance, use of intra-uterine devices (IUDs) decreased from 13% in 1991 to 4% in 2012 (DHS 2012)

District Situation When We Started Several problems faced by the BKKBN at districts, where the FP program interfaced with the target audience, are: Lack of adequate local budget to support all aspect of FP program (including the demand generation) due to the lack of priority given by the head of district The significantly decrease of number of FP field worker. Field worker is considered as the backbone of the successful BKKBN program in the past. It used to be managed nationally before the decentralization. In 1990, BKKBN had a total of 33.000 field workers while now it is less than half and only around 15.000. With 78.000 villages across Indonesia, the number of field workers is undoubtedly not adequate. On the programming side, since the decentralization, BKKBN at national does not have direct command to influence the program development at district. This leads to situation that national policy, guidance and program are not translated well at district level. Decentralization has cut the planning structure.

The Development of a Model: Initial Tools When We Started The Development of a Model: Initial Tools Advance Family Planning (AFP) is implemented in Indonesia since 2010 to respond to this situation. As an evidence based advocacy program, initially AFP used only main two tools: Smart Chart/AFP SMART, Which outlines a step-by-step approach to developing a focused, collaborative advocacy strategy that leads to quick wins. The guide features examples on what has worked to increase financial and political support for family planning. Netmap, an interview-based mapping tool that helps people understand, visualize, discuss, and improve situations in which many different actors influence outcomes. Using the tool, working group members learn to understand who influences decisions and develop a networking plan of action.

The Development of a Model: Framing FP When We Started The Development of a Model: Framing FP Later on AFP Indonesia adapted and simplified the the Reproductive Health Costing Tool developed by the United Nations Population Fund into The Family Planning Costing & Projection Tool This tool helps projecting the population, estimating the required cost to implement effective FP programs Making the case on the cost and benefit of FP investment Framing FP as a multi-sector development and strategic issue Develop ownership of FP issues among potential stakeholders/advocates

The Development of a Model: Multi-sector Advocates When We Started The Development of a Model: Multi-sector Advocates Engage new champions through multi-stakeholder working groups that mobilize resources for family planning demand generation, services, and supplies. A working group consists of influential individuals from a variety of institutions who are committed to the community’s development, especially the provision of family planning information, services, and/or supplies. Members are identified by local champions using the Netmap National Core Working Group (CWG) Province Provincial Working Group (PWG) Districts District Working Group Development and Planning Agency (Bappeda), District Health Office, Department of Religious Affairs, Social and Cultural Office, Education Office, Demographic Office, etc Midwives association (IBI), Professional medical or nursing associations, Non-governmental organizations such as Planned Parenthood (PKBI), Faith-based organizations, such as Aisyiyah/Muhammadiyah, Muslimat/Nahdlatul Ulama, Members of local parliament, and Private sector

Implementation, Scale Up & Adoption Develop model and Pilot - 2010 CWG at national DWG at Pontianak and Bandung AFP Scale Up Under AFP Funding 2012 - 3 other districts and cities Adoption by Other Program 2012 6 other districts and cities ICMM Improving Contraceptive Method Mix USAID & DFAT Adoption by Government Program 2013 - 2014 86 other districts and cities in two phases (Capacity building, DWG development, advocacy strategy) 8 of them receive TA from AFP GOI - KB Kencana BKKBN & AFP (Cost-share) Adoption by Other Program 2015 5 other districts and cities My Choice BMGF Scale Up by Local Government 2015 - 3 other districts and cities Province of West Kalimantan Adoption by Indonesia NGO 2015 ‘Aisyiyah in the process of adopting the AFP advocacy approach ‘Aisyiyah Cost-share More than 120 districts/cities in Indonesia = more than 1/5 of Indonesia, with several TA scenarios

Thank You - Terima Kasih