1. District Team Problem Solving Dr. Lukman Hendro L Maternal Health Directorate Ministry of Health

2. Background Decentralization era  District Health Office (DHO) obtain more authority and responsibility to manage the health program. DHO staff require a planning and budgeting capacity, that is appropriate to local context, regulation and based on evidence (Data and Information). To maintain and improve the quality of health services  a practical, simple, sistematic and comprehensive planning and budgeting tool is needed.

3. What is DTPS -2007 ? A sistematic, practical and comprehensive MNCH planning tool, that is based on data and evidence Objectives: Improve the quality of MNCH planning through District Team problem Solving approach Build the capacity of district health staff in MNCH planning and budgeting.

4. 3 – Phases of DTPS 2007 1.Orientation ( 1- 2 days ) 2.Planning process ( 5 days ) 3.Follow-up phase (post workshop – Advocation, until issues of RKA-SKPD /Perda). DTPS-2007 should align with local government Planning cycle as guided in Permendagri No.13/2006

5. Orientation phase (1 day) Objectives: 1)Create awarenss of district stakeholders about national, local MNCH issues and obtain support at once. 2)Identify role and responsibility of each stakeholders at district. 3)Form a “DTPS team“. 4)Inform DHO on data needed for planning purposes.

6. Participant of orientation ( Phase I) Province and District stakeholders, represented by: - Local government - DPRD - PHO and DHO staff - Hospital - Profesional organization - BKKBN, PMI - NGO, Media

7. Planning Workshop (Phase II ) 5 days Objectives: - Develop an evidence based planning and budgeting document through sistematic session such as: Data validation, situation analysis,problem analysis, solution and activities, setting target, budget calculation, Monitoring and evaluation, Follow-up action.

8. Participant of planning workshop District planning team ( DTPS team ) consisted of 10-12 persons from: - DHO staff ( MNCH, nutrition, Immunization, Pharmacy, Puskesmas) - Bappeda - Hospital, Prof. organization - BKKBN - NGO, PKK, etc

9. Follow-up ( Phase III) Post workshop until RKA-SKPD approved by DPRD Goals: - Finalize planning document - Calculate budget needed - Prepare advocacy material - Convince decision maker through Advocacy - Incorporate MNCH budget into health sector budget - Ensure that activities and budget will be approved in APBD or other sources.

10. Challenges Availability and Quality of collected data. Difficulty to obtain data from hospital and private services, particularly in big cities. In new district a Health Information System (HIS) is not yet established. Time limitation for collecting data ( DTPS should be carried out between January and March before Musrenbang) DTPS should accommodate service point’s ( Puskesmas ) need. Lack of collaboration with other sectors and institution( BKKBN, hospital, PKK, Media )

11. Challenges Certain activities proposed by DTPS process can not be carried out by health sector since it is a task and responsibility of other sector ( for example: community empowerment ). Lack of DHO’s capacity to convince DTPS result to decision maker. Often political issues ( Bupati election ) are more important than MNCH issues

12. Recommendation Data should be collected and validated before planning process. A data analysis capacity for DTPS team is required. To strengthen planning capacity at Puskesmas level, DTPS approach could be used Other sectors or institution should be involved in planning and implementation process as well

13. DTPS process should be followed by advocacy process. Media / journalist could be a strong alliance to raise public and decision maker’s awareness on MNCH issues.

14. Benefit Team Building Among Stakeholder (Inter-program and Inter-sector) – Share Responsibility and Budget Capacity Building – Data Analyze – Problem Identification – Problem Solving Utilizing Data and Information – Build Awareness on the Importance of data validity – Data Improvement Proposed activities based on the real problem

15. Routine data can not be collected on time, validity??? Too many forms in the field There is no person who responsible for data collection in the district and sub-district Team member do not have authority for decision and high turn over Team member do not have enough capability to analyze data

16. Recommendations Reduce the number of data collection form Training: Data Analysis DTPS and Advocacy

17. Local Area Monitoring (MCH LAM): Monthly MCH data collection Analyze problem on coverage of MCH program Problem identification and Problem Solving Audit Maternal Perinatal/Neonatal: Regular meeting to discuss the cause and underlying cause of maternal and child mortality and morbidity Utilizing morbidity, mortality and other related data

18. Input for Monitoring and Evaluation Activity

19. Utilizing Data Is The Importance Key For Improving The Availability And Data Validity