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The Provincial Government of Nusa Tenggara Timur through the Village Government and Community Empowerment Agency (BPMPD) in collaboration with AIPMNH held a workshop on the Implementation of Law No. 6, 2014 for the achievement of Maternal and Child Health Revolution (Revolusi KIA) in the Royal Hotel - Kupang, on 9 September 2015. The purpose of the workshop was to develop recommendations for the use of national/regional budgets for health development in the village.

The Head of BPMD, Drs. MP Florianus presented that in 2014 a total of 2,950 villages in NTT received allocation of IDR 248,702,794,000 and in 2015 this increased to IDR 812,875,565,000 for 21 districts. By September 2015, five districts have not disbursed village funds including Kabupaten Kupang, Timor Tengah Utara (TTU), Sumba Barat, Malaka and Sabu Raijua. The funds are still sitting at the district account. The other 16 districts have disbursed the funds but not 100% such as Ende and Manggarai.

One of the constraints is that the village governments have not yet developed budgets and medium term development plans (APBDes and RPJMDes). These two are the requirements for the disbursement of funds as required by Law, No. 60, 2015 regarding Dana Desa/Village Funds. Forty percent will be disbursed in the first stage, from the total of IDR 812.8 billion, i.e., around IDR 325 billion. Therefore, the districts governments should gear up the disbursement process by deploying government staff to the villages to assist in preparing the APBDes and the RPJMDes.

According to State Ministry of Development of Village and Disadvantaged Regions Regulation or Permendes, PDT, Trans No. 5, 2015 regarding the 2015 funds uptake, the funds are supposed to be used to meet basic needs such as village health posts and Polindes, development of integrated health posts or Posyandu, and for early education. In addition, the funds should also be used for infrastructure and economic development.

The workshop focused on how to fulfil the basic needs such as health and particularly maternal and neonatal health (MNH). The NTT Provincial Government has been working in partnership with the Australia Indonesia Partnership for Maternal and Neonatal Health (AIPMNH) Program for the last five years to reduce maternal and neonatal mortality. The Chairperson of the Provincial Women Organisation (PKK), Mrs. Lusia Adinda Lebu Raya, as one of the resource persons in the workshop, presented that the maternal and neonatal mortality in NTT are still high. This has encouraged the Governor of NTT to issue Governors Regulation, No. 42, 2009 regarding NTT MNH Revolution which states all deliveries should be conducted in adequate health facilities. The maternal deaths have decreased from 330 to 159 but the neonatal deaths increased from 1,274 to 1,282. Lusia presented the case that deaths of infants aged 0-1 month in 2013 reached 70% or 934 babies. The death of babies aged 0-1 week reached 747 or 80%, aged 1 week -1 month: 187 deaths or 20% and aged 1 month -1 year reached 416 deaths or 30%. The causes of deaths include low birth weight, asphyxia, tetanus, infections, etc.

This is a challenge not only for health staff but also for all stakeholders. Everyone needs to work together and participate to overcome these issues.

The Revolusi KIA will be successful if it is supported by all in terms of funds and implementation. Out of IDR 85 billion of local budget / APBD in 2015, less than 5% is allocated for maternal and neonatal health. The sufficient budget allocation from the provincial government is one of key factor of sustainability.

Legal aspect should also be improved in order to boost the allocation of local budgets for health and this includes developing local regulations based on the governor regulation. The key factor to success is the collaboration of all stakeholders.

Mekeng stated that the improvement of health quality in NTT requires other supports such as funding. The staff of the village government should be given incentives and thus, the Provincial Government has allocated IDR 2,250,000 for village government staffs, Posyandu and PKK cadres. It is impossible for them to work for free.

All those issues presented by the Head of Provincial BPMPD, Drs. MP Florianus, the Chairperson of NTT Provincial PKK, Mrs. Lusia Adinda Lebu Raya, the TTS BPMPD Senior Staff, Ardi Benu and the Pene Utara Village Head, Apner Nabuasa, regarding the Implementation of Law No.6, 2014 for the Achievement of Revolusi KIA were well received by all workshop participants.

The participants of the workshop discussed various issues such as the management of village funds, legal umbrellas and how to build synchronisation at different government levels to improve the health status especially maternal and neonatal health (MNH). The forum then decided that Revolusi KIA should be supported by Budget Revolution.

Raymundus Lema from an NGO called Bhakti Flobamora proposed that 15% of village funds for NTT should be allocated to support the achievement of Revolusi KIA. This idea was well received by all participants. If one could calculate the allocation of funds in relation to village funds, NTT will receive IDR 812,875,565,000, and if 15% of that amount was allocated for Revolusi KIA, then by 2015 NTT will receive IDR 121,931,334,750.

Thus, there should be legal basis for the management of the funds such as Governor and Regional Regulations. The health sector in village development was the focus of recommendations delivered by the forum particularly the development of infrastructures such as the development of integrated Posyandu, Poskesdes/Polindes, clean water, sanitation, waiting house and blood donor volunteers.

In terms of village apparatus development, it was recommended to improve financial management, policies, planning and budgeting. In addition, various stakeholders should be involved such as Undana University, NGOs such as Bengkel APPeK, Increase, PAR NTT, Bhakti Flobamora, and other consortium for village development.

It was recommended that at least 15% of funds should be allocated for Revolusi KIA, the improvement of government apparatus, RPJMDes, RKPDes, and APBDes.

The development and the implementation of RPJMDes, RKPDes and APBDes should be continuously supervised and monitored. The village apparatus should be up-skilled in terms of developing budgets, work plans and reports. The partnership with a third party such as NGOs should be built to achieve synchronisation as well as the objectives of Revolusi KIA (written by gerardus manyella).

This article was published in Pos, 13th September 2015

PK 13Sept2015 Revolusi anggaran
       Recent mother holding her newborn - photo taken in Kelurahan Siaga Manutapen, Kupang. Photo by AIPMNH

AIPMNH is managed by Coffey on behalf of the Australian Government

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