A personal mission in the heart of Gorontalo


Having lost one of her children to pneumonia, Rama Tobuhu is on a personal mission to improve health standards of her community in Indonesia’s eastern province of Gorontalo.
 
“I just want to help out my fellow villagers, ” said the 47-year-old health worker as she rushed to attend a workshop for the Alert Village programme, organized by UNDP and the provincial health office. “Most of the (health) problems here are related to maternal and child health issues such as nutritional problems, malaria, and environmental hygiene,” Tobuhu said. “We have been inspecting all households from sunrise to sunset for four days now.
 
We are so excited sometimes we forgot we have not had lunch.” Tobuhu has been working as a health cadre for 12 years and she is one of hundreds of government officials who have benefited from a provincial bureaucracy empowerment project supported by UNDP through the Provincial Governance Strengthening Programme (PGSP). Funded by the Australian Agency for International Development (AusAid), PGSP aims to strengthen the roles and functions of the provincial government through policy development, regional development planning, and the provision of a better public service. The program has identified the delivery of quality health services, particularly in the district level, as one of its key targets.
 
PGSP project manager, Mellyana Frederika said the Alert Village scheme has been an instrumental vehicle in meeting the target of rolling out minimum standards for health care in Gorontalo, one the project’s three pilot provinces (other pilot provinces are Bangka Belitung and Nusa Tenggara Timur). In the eastern island of Sulawesi, Gorontalo was selected as one of the project’s pilot province in 2007 because it scored low on Human Development Index. The province has since improved its rankings on most of its key HDI indicators. In line with the target of improving public services, Gorontalo has also become the first province in Indonesia to have a bureaucracy road map, with the support of UNDP. Launched in 2012, the road map of bureaucracy reform contains detailed plans to improve the quality of public service in the province, which is considered a key to building an effective democratic governance system that offers sustaining solutions to poverty and inequality. Since the end of 2012, a situation analysis and strategic planning model has been made available as a reference to speed up minimum standard service achievements, both at province and district/city levels.
 
With the help of UNDP, local officials have developed a map of healthy villages as part of the Alert Village project in Pohuwato district. The map gives information on health conditions in every household in the village. “That can contribute greatly to the district government in their planning related to minimum standard services in health sector,” added Frederika. The use of the Village Health Map will be closely monitored by the Pohuwato District Health Office, and if successful, will be adopted as district policy approach in health – thus endorsed by a Regency Bill.
 
“It will serve as an entry point for provincial incentive mechanisms in health sector, since it is designed to be up-scaled to provincial level through Governor’s Decree in order to enable allocation of provincial budget to support such approach in other district and cities,” Frederika said. As for Tobuhu, despite her unfamiliarity with the Minimum Service Standards, she is content with the current improvement in health care available in her village. “Today, health care is easily accessible at Puskesmas (Community Health Center) for free, and the service is quite efficient,” she said.