End of Commitment Report – Online Applications to Achieve Minimum Service Standards for Pregnant Women

Name of Evaluator

Ramli Bidullah

Email

ramli.bidullah@gmail.com

Member Name

Banggai, Indonesia

Action PlanAction plans are at the core of a government’s participation in OGP. They are the product of a co-creation process in which government and civil society jointly develop commitments to open governmen... Title

Action plan – Banggai, Indonesia, 2021 – 2024

CommitmentOGP commitments are promises for reform co-created by governments and civil society and submitted as part of an action plan. Commitments typically include a description of the problem, concrete action...

Online Applications to Achieve Minimum Service Standards for Pregnant Women

Action

Create an application that allows health workers (village midwives, community health centre midwives and district coordinators) to monitor the condition of pregnant women in real-time.

Problem

After being successfully declined in 2019 (from 364 to 71 per 100000 live birth), the maternal mortality rate in Banggai Regency shows an escalation in 2020 from 71 to 263 per 100000 live birth. The escalation of MMR in 2020 might have been caused by the restriction in community activity due to covid 19 pandemic, so the routine health service for pregnant women that usually taken place at POSYANDU and home visits cannot be done. Difficultness in digitalized data management. Data of pregnant women in Banggai Regency are still not being digitalized recorded, so it is difficult for health service officers or midwives to monitor and assess the degree of risk in real-time. Provide online services to maximized the communication between pregnant women and midwives in the term of health consultation (self-assessment data, sign and symptoms) therefore pregnant women can be monitored real-time by midwives. Provide online-based health service to increase the scope of minimum health service standard for pregnant women. Mobile apps (online-based health services) is needed to monitoring pregnant women who are at high risk and also as a prevention management system of maternal death

1.1 What was the overall level of progress in the commitment implementation at the time of this assessment?

Substantial

Provide a brief explanation of your answer:

The implementation of the commitment in the first year is the preparation of commitment infrastructure such as the preparation of the Dering Ambulance application which is integrated into the DRAIV application. In addition, an ambulance and officers are also provided at the Health Center to handle this commitment action.

In our assessment, this commitment was carried out according to the time set, because in 2024 the implementation has gone well and increased the number of service coverage using the commitment. This is evidenced by the fact that this commitment has been implemented and has been used by pregnant women in consulting and getting services at Health Services.

The government strongly supports this commitment, proof of support is that this commitment was registered as a National Innovation nomination assessment and received the Top 45 Regional Innovations.

The perspective of Non-Governmental actors is very good and supports the commitment, for example from universities, it strongly supports this commitment because it has a very positive impact on improving public health, especially Maternal and Child Health, and strongly supports efforts to reduce Stunting.

1.2 Describe the main external or internal factors that impacted implementation of this commitment and how they were addressed (or not).

The external factors affecting this commitment include challenges related to network availability and application access in certain areas, as well as the issue of mobile phone ownership among pregnant women.

On the other hand, internal factors include budgeting, the commitment of regional heads and relevant stakeholders, and the readiness of human resources in executing the Dering Ambulance commitment.

Handling both external and internal challenges is increasing user participation and advocacy on budgeting and support from sectors and related stakeholders in carrying out this action program, as well as providing training for Health Human Resources who carry out the technical implementation of this Action in Health Services.

1.3 Was the commitment implemented as originally planned?

Most of the commitment milestones were implemented as planned

Provide a brief explanation of your answer:

Most of the commitment achievements have been implemented according to plan, only the application has not yet reached all health services (Community Health Centers).

2.1.1. – Did the government disclose more information; improve the quality of the information (new or existing); improve the value of the information; improve the channels to disclose or request information or improve accessibility to information?

Not Applicable

Degree of result:

Major

Explanation: In narrative form, what has been the impact on people or practice.

• This Commitment Action has resulted in open access to services for pregnant women, allowing them to obtain services more easily. Access to information and services for pregnant women is now available at any time through the application.
• Wide enough to reach 2 health center areas from previously only 2 health centers, to 4 areas.
• Community Participation, the commitment of the Regional Government and the Banggai Regency Health Service, and related sectors also played a role in supporting this program.
• Previously, pregnant women had to consult about their pregnancy conditions at the Health Center, now with the Ambulance Dering Application, they can consult online.
• In accordance with the initial target and Fulfilled but with limited access.
• Greatly contributes to the openness of government services.

2.1.2. – Did the government create new opportunities to seek feedback from citizens/enable participation inform or influence decisions; improve existing channels or spaces to seek feedback from citizens/enable participation/ inform or influence decisions; create or improve capabilities in the government or the public aimed to improve how the government seeks feedback from citizens/enables participation/ or allows for the public to inform or influence decisions?

Yes

Degree of result:

Substantial

Explanation: In narrative form, what has been the impact on people or practice.

The impact of this commitment is a decrease in maternal and infant mortality rates, in practice facilitating health services to the community.

2.1.3 Did the government create or improve channels, opportunities or capabilities to hold officials answerable to their actions?

Unclear

Degree of result:

Unclear

2.1.4 Other Results

Unclear

Degree of result:

Unclear

2.2 Did the commitment address the public policy problem that it intended to address as described in the action plan?

Unclear

3. Provide at least one lesson or reflection relating to the implementation of this commitment. It can be the identification of key barriers to implementation, an unexpected help/hindrance, recommendations for future commitments, or if the commitment should be taken forward to the next action plan.

The Dering Ambulance Program in Banggai Regency provides several important lessons that can be applied in other areas. Here are some of the main lessons from the implementation of this program:
1. Easier and Faster Access to Health
2. Increased Public Awareness
3. Use of Technology for Efficiency
4. Effective Coordination between Government and Health Services
5. The Need for Good Resource Management
6. Infrastructure and Regional Challenges