The focus of REACHOUT Indonesia was on strengthening the capacity of close-to-community maternal health providers and their services. During a five-year period (2013 – 2017), project activities were carried out in three phases: 1) context analysis; 2) quality improvement cycle 1 (QI1) which concentrated on improvement of maternal health promotion in the community integrated health service (Posyandu) and supportive supervision; and 3) quality improvement cycle 2 (QI2) during which REACHOUT staff supported the formation of Quality Improvement Teams and the implementation of quality improvement in antenatal services provided in the selected Puskesmas and Posyandu.
The context analysis enabled REACHOUT to identify the roles of the village midwife and community health volunteers/Posyandu kader and other stakeholders in maternal health services. It also allowed us to analyse the root cause of poor attendance at health facilities for childbirth in South West Sumba and Cianjur, the two districts REACHOUT select to execute the project.
The quality improvement activities brought some positive changes. These were reintroduction of health promotion activity and implementation of supportive supervision. Better communication and collaboration between close-to-community providers and stakeholders such District Health Officers was established and contributed to the quality improvement of maternal health services. In QI2, the Quality Improvement Teams chose the improvement of antenatal care provided by midwives. These quality improvement efforts were in-line with the government efforts on Puskesmas accreditation, performance-based incentives together with the National Health Insurance scheme (Jaminan Kesehatan Nasional/JKN). Additional factors such as the enthusiasm of the providers and leadership and support from the supervisors and stakeholders at all levels, all contributed to the sustainability of the quality improvement programme initiated by REACHOUT.
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This project is funded by the European Union.