Most people don’t associate risks to mothers and newborns during childbirth with planning and budgeting. But in places like Eastern Indonesia, an efficient, well planned health system makes a world of difference to women accessing health services.
Although ensuring health centers have skilled health staff and high quality equipment is absolutely necessary to decrease the high rates of maternal and neonatal death in Nusa Tenggara Timur province (NTT), the Australia Indonesia Partnership for Maternal and Neonatal Health program (AIPMNH) understands that streamlining the health budgeting and planning process is also crucial to having impact in this area.
|Widi Sipayung, the Treasurer of BAPPEDA’s Unit Pengelolaan Kemitraan (UPK) in Kupang. She has been working closely with AIPMNH since it supported development of the UPK.”|
Plus, millions of dollars of development aid won’t be effective unless the local government can absorb and distribute it efficiently. For this reason, one of AIPMNH’s main partners in implementing its 42.5 million Australian dollar activity budget is BAPPEDA, the provincial agency responsible for harmonizing the work plans of all government agencies supporting maternal and neonatal health (MNH) in NTT - and now that of AIPMNH.
“AIPMNH is currently the only aid program in NTT that follows the government planning system,” explained Widi Sipayung, Treasurer of BAPPEDA’s Unit Pengelola Kemitraan (UPK or in translation, Partnership Management Unit).
“There are many aid agencies here with their own programs, but it’s hard for us to know what they have achieved,” she said. “But AIPMNH is different – it offers the government here solutions by working with us and working through the system.”
Although this approach takes more time and effort than simply following one’s own plan, AIPMNH believes it’s worth it – both to achieve its own goals and ensure sustainability. That’s why during its second year of operation in 2009, the Program worked closely with BAPPEDA and other provincial government agencies to establish an UPK at the district and provincial level. These UPKs help to ensure that Australian funds going to the province through AIPMNH’s work plan are cross-checked and aligned with the government’s own plans to combat maternal and neonatal mortality.
Consisting of four staff; the Head of the UPK, an Acting Officer, a Treasurer and a Secretary – all of whom are BAPPEDA civil servants except for the latter - the UPK was designed to be embedded in the already existing structures and functions of the agency’s health division.
|Lola Beribe, Secretary of BAPPEDA’s Unit Pengelolaan Kemitraan (UPK) in Kupang. Lola has been working closely with AIPMNH since it supported development of the UPK to help harmonize the provincial government’s work plans on maternal and neonatal health with those of AIPMNH. According to Lola, the UPK has allowed external aid to be “more effective.”|
The UPK staff, who participate on an ad hoc basis, work closely with AIPMNH’s district program coordinators (DPCs) to avoid duplication of activities and double funding for the same activities in the AIPMNH’s and the various government agencies’ annual work plans. This process is no easy feat, as donor agencies, the central government, the provincial government and the district government all have their own method of financing health-related activities. “One of the main improvements of the UPK is that the government budget for MNH has increased since 2010 when we started,” Jose Naibuti, UPK Acting Officer, explained.
“For example, the UPK in Timor Tengah Selatan (TTS) has been able to synchronize the activities in the AIPMNH work plan and those in the district government’s plan,” he said. “This makes me very optimistic about sustainability, because the government budget’s shares for MNH are increasing every year – in fact, it has already committed funds to support AIPMNH’s Sister Hospital Program when it finishes.”
AIPMNH has seen similar results throughout the duration of the program in different locations. In the two years since the UPK started, the absorption rate of the budget in its annual work plan increased by 15% up to 95% total absorption of funds.
In Lembata, a small island off of Flores, and one of the newest and most isolated districts in NTT, the UPK has helped the local government harmonize all the different plans. “Since the UPK was begun here, almost 100% of the programs’ activities, both of AIPMNH and the district government, have been well implemented in terms of absorption and management,” said Mathias Beyeng, Head of the UPK in Lembata.
|Lola Beribe, Secretary of BAPPEDA’s Unit Pengelolaan Kemitraan (UPK) in Kupang; Yane Ngaddi, Provincial Administration & Finance Assistant; and Widi Sipayung, Treasurer of the UPK have worked together closely since 2009 when AIPMNH collaborated with BAPPEDA to establish the UPK at the province’s planning and budgeting agency. Through the UPK, AIPMNH reduces duplication of activities related to maternal and neonatal health in NTT.|
But UPK staff are not the only ones who have noticed the improved transparency and efficiency of synchronizing plans to use development aid funding alongside the government’s own funds. The Governor of NTT has publicly encouraged other donor agencies to model itself on AIPMNH’s approach in establishing the UPK.
“We plan much better now with the UPK,” said Lola Beribe, Secretary of the UPK in Kupang, NTT’s capital. “It allows external aid to be more effective.”
“I think AIPMNH has a very clear mission and activities, and the budget is transparent,” she explained. “Plus, the process of harmonizing the government’s work plan with AIPMNH has enabled us to sharpen our focus and plan activities in accordance with predetermined performance indicators.”
An added benefit is the capacity building of the staff involved in the UPK, most of whom are active civil servants who will manage planning and budgeting for the local government for years to come. “AIPMNH gives us great potential for knowledge transfer,” explained Petrus Keron, Head of the UPK and newly appointed Secretary of BAPPEDA in Kupang. “BAPPEDA’s role is to plan and coordinate all relevant activities to improve MNH in NTT,” he said. “The UPK has helped all the agencies plan better and save money – it’s about working smarter, not harder.”