Australia-Indonesia Partnership for Maternal and Neonatal Health (AIPMNH)
Description: While Indonesia is making significant progress in achieving Millennium Development Goal (MDG) 4 (reducing child mortality), it is less likely to achieve MDG 5 (reducing maternal mortality) by the year 2015. This is particularly so in Eastern Indonesia, which generally has poorer health indicators and higher levels of poverty than other areas in the country.
The Government of Indonesia’s (GoI) National Making Pregnancy Safer (MPS) Strategy (2001-2010) provides the framework for efforts to reduce maternal and neonatal mortality in Indonesia. The strategy integrates supply and demand side interventions, with a focus on addressing health system constraints to service delivery, and sets targets for coverage with key MPS interventions.
Provinces and districts of Eastern Indonesia, notably the province of Nusa Tenggara Timur (NTT), are lagging in their implementation of the MPS, and are below national levels in key indicators such as the Maternal Mortality Rate (554/100,000 in 2002-03, compared to the national rate of 307/100,000), and Infant Mortality Rate (48/1000 in 2002-03), compared to the national rate (35/1000). Performance in delivery of key aspects of MPS is also below national levels, in areas such as antenatal care (coverage of four visits 66% compared to national level of 77%); trained assistant at delivery (59% compared to national 72%), and use of family planning (34% compared to national 58%) (All 2005 data).
Through the Australia-Indonesia Partnership for Maternal and Neonatal Health (AIPMNH), the Governments of Australia and Indonesia will work together to achieve jointly agreed aims in implementing the National Making Pregnancy Safer Strategies in selected provinces and districts and improving public administration in the health sector. It will build on the experience of previous activities, and on the ongoing Partnership of reform and decentralisation of GoI, and, by addressing system constraints, improving system governance, and introducing a performance focus through the provision of appropriate additional resources, contribute to significant improvements in outcomes at the district and provincial levels. The Partnership will work with and through GoI systems, including working to GoI planning and budgeting cycles and timelines, in a phased approach which seeks to match progressive improvements in GoI system functioning with performance incentives and increased disbursement.
The Partnership has three components:
Component One: Service Delivery and Community Engagement will support local government to implement the national MPS strategy with an emphasis on service provision and community engagement. The objective of this component is for provincial and district governments to develop and implement a MNH program based on the national MPS strategy and address supply and demand aspects to achieve agreed annual performance targets.
Component Two: Health Systems Support will address the systems aspects of the national MPS strategy, and provide support to local government in public administration reform. The objective of this component is for Provincial and district government agencies and communities to access and manage the technical, human and financial resources needed to achieve improvements in MNH.
Component Three: System Reforms in Performance and Accountability moves beyond the systems strengthening and management capacity building to address the fundamental drivers of the system which can impact performance. The Contractor, together with districts and provincial partners, must design this Component in the first year of the contract. The objective of this component is that provincial and district governments manage GoI and donor resources to improve accountability, performance, accessibility and sustainability of public health services.
Country/Region: Eastern Indonesia (incl NTT, NTB Provinces)
Funding Agencies: AusAID
Value: AUD$52 million
Implementing Partners: Coffey International Development, GTZ
Project duration: 2009-2011
Key Nossal Staff: Krishna Hort, Jenny Booth, Jia Zhen