assessment gender indicator giz paf project, 2007-2011 · 2011-12-05 · assessment gender...

Assessment Gender Indicator GIZ PAF Project, 2007-2011:

“Policy Papers supported by the Project are in line with the Gender Guideline of the Ministry of Health and verifiably refer to it”

Consolidation Programme Health / Policy Analysis & Formulation in the Health Sector (PAF)-Indonesia

The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH was formed on 1 January 2011. It brings together the long-standing expertise of the Deutscher Entwicklungsdienst (DED) gGmbH (German development service), the Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH (German technical cooperation) and InWEnt – Capacity Building International, Germany. For further information, go to www.giz.de.

Assessment Gender Indicator GIZ PAF Project, 2007-2011:

“Policy Papers supported by the Project are in line with the Gender Guideline of the Ministry of Health and verifiably refer to it”

By:Dr. Rahmi SofiariniDr. Lieve Goeman

With contributions by Dr. Harmein Harun, Maddi Djara, Dedek Gunawan & Karsten van der Oord

Download at: www.ighealth.org

1. Executive Summary

This document describes the results of the assessment, which aimed to evaluate the

alignment of the policy papers supported by the project with the Gender Guideline

of Ministry of Health (MoH). This assessment is mandatory as it refers to one of the

indicators of the project offer of GIZ to BMZ, which require annual reporting and

statement on the achievement of the indicators’ target by the end of the project.

Because the MoH does not have a specific Gender Guideline, the assessment refers

to the Guideline of Gender Mainstreaming attached to the Presidential Instruction

number 9 of the year 2000 as the standard “Gender Guideline”.

The overall result of the assessment concludes that none of the six policy papers

assessed refers explicitly to the Gender Guideline. But further analysis demonstrates

that one policy paper, namely the policy paper that served as input for the “National

Health System” is fully and explicitly in line with the Gender Guideline. Three other

policy papers are implicitly aligned with the Gender Guideline and their content is

gender sensitive. The two remaining policy papers, namely the paper on Tobacco

control and Human Resources for Health did not touch gender issues.

2. Gender Guidelines in Indonesia

An effort to mainstream gender in Indonesian development was legally endorsed

by the president in the Presidential Instruction number 9 in the year of 2000. This

national policy is a follow up of the ratification of International Convention on the

Elimination of All Forms of Discriminations Against Women in 1984 – No. 7 / 1984 -

(1984 State Gazette Number 29, with additional in the State Gazette Number 3277)

(1). This Presidential Instruction serves as reference for all ministries and high

level institutions in mainstreaming gender in each sectoral development including

health. All development sectors in Indonesia are required to refer to this Gender

Mainstreaming Guideline as laid out in the Presidential Instruction. Therefore, MoH did

not need to develop a health specific gender mainstreaming guideline.

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Assessment Gender Indicator GIZ PAF Project2007-2011

To enable implementation of the Gender Mainstreaming Guidelines, MoH has issued a

circular letter and two decrees:

• Circular Letter of MoH number 615/Menkes/E/VI/2004, 1 June 2004 on the

implementation of gender mainstreaming in the health sector (2)

• Kepmenkes 878/Menkes/X/2006, 12 September 2006 on the establishment of a

Gender team within MoH for mainstreaming gender in the health sector (3)

• Kepmenkes No. 423/MENKES/SK/V/2008 on the establishment of a Gender Training

Centre in the health sector (4).

The Guideline of Gender Mainstreaming as attached to the Presidential In-struction number 9 of the year 2000

The Presidential Instruction instructs the high level institutions and all ministries,

within the scope of their tasks, responsibilities, and authorities, to mainstream

gender in their development programs so that planning, implementation, monitoring

and evaluation processes integrate a gender perspective, and to seriously use

the Guideline of Gender Mainstreaming as the reference for implementing gender

mainstreaming.

This Guideline covers the following points:

• Gender Mainstreaming is defined as a strategy to integrate gender as one of the

dimensions of planning, implementation, monitoring and evaluation of national

development policies and programs.

• Gender is a concept which refers to roles and responsibilities of men and women

as consequence of, and changeable by the socio-cultural situation of a society.

• Gender Equality means an equal condition for men and women to have the same

opportunities and rights as human beings in undertaking their roles and in

participating in national political, economic, socio-cultural, defense and security

activities as well as to have equal access to the benefits of development.

1. The Guideline of Gender Mainstreaming as attached to the Presidential Instruction number 9 of the year 2000 will be referred to as the “Gender Guideline”

1.

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Assessment Gender Indicator GIZ PAF Project

2007-2011

“Policy Papers supported by the Project are in line with the Gender Guideline of

the MoH and verifiably refer to it”

• Gender Equity is a process to ensure fairness for men and women.

• Gender Analysis is a systematic process to identify and understand the division of

labor/roles between men and women, the access to and control of development

resources, the participation in development processes and benefits, and unequal

relations between men and women, when considering factors such as social,

race, and ethnicity. It includes the following activities: identification of the gaps

between men and women in obtaining benefits of development policy and programs

in all aspects of life; identification and understanding of the causes of gender

inequality and inequity as well as documentation of their causes; development

of the necessary steps in achieving gender equity and equality; defining gender

indicators for measuring the achievements of efforts for gender equality and

equity. Solutions resulting of a Gender Analysis should be integrated into national

planning of policy and development processes.

• Implementing Gender Mainstreaming can be enabled by conducting Gender Analysis

and Education, Information and Communication activities on gender mainstreaming

at government institutions at national and province/district level.

• Gender’s Education, Information and Communication efforts are implemented in

order to raise awareness and increase capabilities of government institutions at

national, provincial and district level.

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3. Methodology of assessing the alignment of policy papers supported by the project with the national Gender Guideline

Because the MoH does not have a specific Gender Guideline, the assessment refers

to the Guideline of Gender Mainstreaming attached to the Presidential Instruction

number 9 of the year 2000 as the standard “Gender Guideline”.

In order to conclude whether or not the policy papers supported by the project are

in line with the Gender Guideline and verifiably refer to it, the following methodology

was used:

• Step 1: Collecting all policy papers supported by the project and check whether

or not a direct reference to the Gender Guideline can be found.

• Step 2: Assessing the policy papers for the presence of gender specific terms

and/or differentiation between men and women by using the “Search function”.

These predetermined terms are used in the national Gender Guideline, e.g.

o Gender

o Gender Equality

o Gender Equity

o Men

o Women

o Men and Women

o Role of men and women

o Accessibility

o Participation

o Equal distribution

o Community empowerment

o Poor

o Type of sex

o Sex disaggregated data

• Step 3: Assessing the general gender sensitivity and gender orientation of the

policy paper, considering the following aspects:

o Gender equality

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2007-2011

o Gender analysis

o Gender responsiveness

o Indicator for gender

o Contribution towards gender equality and equity

o Impact on related policies

• Step 4: Assigning a score for each step, allowing a differentiation between the

different policy papers.

o Scoring step 1:

Referring to the national Gender

Guideline

• 1 = explicitly referring to the

Gender Guideline

• 0 = not at all

o Scoring step 2:

Searching for predetermined gender

related terms

• 3 = more than 5 different gender

related terms are used

• 2 = 3 to 5 different gender related

terms are used

• 1 = less than 3 gender related

terms are used

• 0 = no gender related terms are

used

o Scoring step 3:

Assessment of the content on gender

sensitivity and gender orientation

• 3 = more than 5 gender issues

are addressed

• 2 = 3 to 5 gender issues are

addressed

• 1 = less than 3 gender issues are

addressed

• 0 = None

5


The scores of each step are added up into one final total score for each policy paper.

The meaning of the total score is:

o Total score > 5: The policy paper is fully and explicitly in line with the

Gender Guideline. The content is gender sensitive

o Total score between 3 and 5: The policy paper is more or less in line

with the Gender Guideline and the content is gender sensitive

o Total score < 3: The policy paper is not aligned with the Gender

Guideline and the content is not gender sensitive.

A matrix, combining all four steps and scoring system of the assessment has been

developed.

4. Results of the assessment

The policy papers assessed were the following ones:

• Policy paper as input for the National Health System (2008)

• Guideline on developing the Mid-term National Development Plan (2008)

• Policy paper on HRH distribution in isolated, border and archipelago areas (2008)

• Policy paper on Desa Siaga development (2007)

• Policy paper on the results of a policy study on Hospital Management policies (2007)

• Policy paper on Tobacco Control in Indonesia (2009).

The overall result of the assessment concludes that only one out of the six policy

papers, namely the policy paper that served as input for the “National Health System”,

is fully and explicitly in line with the Gender Guideline. Three other policy papers,

on the development of the Mid-term National Development Plan, on Desa Siaga

development and on Hospital Management are implicitly aligned with the Gender

Guideline but their content is gender sensitive. The two remaining policy papers,

namely the paper on Tobacco control and Human Resources for Health did not really

touch gender issues.

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2007-2011

Matrix Results

A detailed assessment of each policy papers follows on the next page.


1. Policy paper as input for the “National Health System (NHS)”: a form and a way of implementing the health system

The document of the “National Health System” describes the background for developing

a national health system, the definition, objectives and benefits, legal basis, progress

and challenges, principles and main forms of NHS and how to implement and support

this NHS implementation (5).

Step 1: Reference to the Presidential Instruction

This document does not refer to the Presidential Instruction, but indirectly it is

aligned with the content of the national Gender Guideline (see examples below).

Step 2: Use of Gender related terms

This document uses 12 different terms that express the gender concept and they are

used throughout the entire document and are repeated many times. For instance, the

terms ‘gender, equality, and poor’ are used 10 times, the term ‘gender responsiveness’

5 times.

Step 3: Gender sensitivity and gender orientation

This document integrated the gender mainstreaming concept fully and this throughout

the entire document. This can be illustrated by the following quotes:

• In the background (p.2), it is stated that ”… the achievement of MDGs is one of the

reasons for the need to adapt the implementation of a national health system.

One of the MDGs indicators is about gender so that implicitly one of reasons to

push for this adaptation is the need for gender responsiveness…’’.

• Page 4: “…NHS is developed on the basis of a global primary health care approach

which considers gender responsive health policies …”.

• Page 13 states “…MDGs, revitalization of basic health care, gender equality….

become push factors for national health development”. Gender equality is the aim

of gender mainstreaming.

• The principle of NHS, as described in the sub-section of Empowerment and

Independency, states that (p.16) “health development is geared towards bringing

benefits as much as possible for improving the health status of the population

with special priority for vulnerable population groups such as mothers, infants,

children, elderly and the poor”. The vulnerable population groups referred to are

the same groups which are the focus of gender mainstreaming.

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2007-2011

• The principle of NHS (p.16) in the sub-section of Fairness and Equality states that

“…each child deserves the right for survival…and for protection against violence

and discrimination”. Protection against violence and discrimination is one of the

goals of gender mainstreaming of the Presidential instruction.

• Page 19 reflects that Gender responsiveness is one of the bases of NHS

development. It is clearly stated that ”gender equality in the health development

is defined as equal conditions for men and women in having opportunities and

rights as human beings, so that they will be able to take a part and play a role

in the health development processes and have equality in obtaining the benefits

of health development”.

• One of the principles of how to implement the NHS is non – discrimination (p.32).

It is mentioned that ”each person shall obtain health services depending on

medical needs, not depending on social-economic status and not differentiating

in race, culture and religion but by keep referring to gender mainstreaming

principles”.

• In the subsystem of Health Human Resource (HRH), it is stated in the section on

recruitment that (p.54) “the education for health personnel has to be conducted

with gender responsive orientation to the student’s needs…”. This point proves

that NHS is developed from a gender perspective.

• In the subsystem of Health Information, it is stated that (p.70) “Health information,

that covers data collecting, processing and analysis, should be conducted through

coordination and integration of information…considering decentralized era and

putting attention on the completeness of data including gender disaggregated

data…”. This point highlights the integration of gender in organizing and managing

the health information system.

• Under the subsystem of Community Empowerment, on the point of Partnership

(p.73) it is stated that: “all actors of health development, both providers and

users of health services, stand relatively in equal position, holding principles of

togetherness, equality and benefitting each other”. The equality in this context is

not explicitly stated about men and women but it refers to the equality between

provider and user of health services in which both provider and user consist of

men and women. It means that this sub-system of NHS concerns with equality,

which is the focus of gender mainstreaming.

All these examples illustrate that the document is in line with the Guideline of

Gender mainstreaming of the Presidential Instruction number 9 of the year 2000,

which instruct to deliver development measures responsive to gender and this for all

aspects of development.

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Step 4: Score

The overall score given to this policy paper is 6, which means this document is

explicitly and fully in line with the Gender Guideline. It has integrated gender in its

entire content and expresses clearly its alignment with gender mainstreaming.

2. Guideline on developing the National Midterm Development Plan (RPJMN) 2010-1014

The guideline to develop the RPJMN enables the production of a document that is

logic, strategic, consistent and coherent, based on achievements and the use of

performance based budgeting (6). The guideline describes the steps, substance and

structure of developing the RPJMN and defines performance indicators.


This document does not refer to the Presidential Instruction. The legal basis to develop

this guideline is included but doesn’t refer either to the Presidential Instruction.


When searching the document for the use of predetermined gender terms, six different

terms are used. The term ‘gender’ is used two times, the term ‘women’ five times and

the term ‘poor’ three times.


• The sub-chapter on p.13, which discusses mainstreaming development, does not

mention that the RPJMN should be developed in a gender responsive way or

that a gender perspective should be used. This can be considered as a missed

opportunity.

• Gender mainstreaming is only used as an example when discussing qualitative

and quantitative indicator development on p.25. It states that “for instance, in

measuring the performance of gender mainstreaming in development, gender

sensitive quantitative indicators are applied to assess number or percentage of

men and women who take a part in certain activities”. This example describes

a gender responsiveness indicator when implementing gender mainstreaming in

program development, but the sub-chapter does not describe how to develop a

gender sensitive program.

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2007-2011

Step 4: Score

The overall score for this policy paper is 4, which means that the policy paper is

more or less in line with the Gender Guideline and indirectly gender sensitive. It only

refers to gender when discussing the development of indicators.

3. Policy Paper on Human Resources for Health (HRH) Distribution in Isolated, Border and Archipelago areas

This document identifies the policy gaps in the existing policy for HRH distribution in

isolated, border and archipelago areas and provides recommendations for improving

the accessibility and quality of health services in those areas (7).


This document does not refer to the Presidential Instruction.


None of the gender related terms appear in this document, except for the term

‘accessibility’ which is used two times and the term ‘distribution’ which is used

eleven times. Limiting the assessment to the use of very specific gender related

terms, it can be said that this document is not gender sensitive.


• This document does not distinguish between men and women in HRH.

• Looking at the focus of discussion, namely the distribution of HRH in isolated,

border, and archipelago areas and the limitation of access and quality of health

services compared to other areas, it could be assumed that these limitations

involve gender related issues, e.g. difference in access for men and women, but

this is not mentioned as such.

• The aim of this document is to improve the accessibility and quality of health

services in those specific areas, and this by improving the policy on HRH

distribution. It provides recommendations such as the need to develop a specific

HRH policy for those areas to achieve equality in distribution and accessibility

of health services in comparison with other areas. So it can be said that this

document touches on gender issues even though the issue is not raised explicitly

but rather in terms of equality and inequality between areas.

• Referring to the definition of isolated, border and archipelagic areas, these areas

are described as very difficult to reach in terms of transportation, socio-cultural

aspects, and geographical conditions (archipelago, mountainous, land, forest, and

state borders). The socio-cultural barriers involve indirectly gender issues.

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Step 4: Score

The overall score given to this policy paper is 2, which means that the document

is not gender sensitive. This document does not explicitly discuss gender related

issues, nor refers to it. However it refers to inequalities between areas so indirectly

gender issues could be considered.

4. Policy Paper on Desa Siaga Development

This document on Desa Siaga Development discusses the existing policy on Desa Siaga development and concludes that this policy is not effective enough in achieving its goals of bringing health services closer to the people and empowering the community (8). This document also provides inputs and recommendations to improve the policy for the implementation of Desa Siaga in achieving its objective of improving accessibility and quality of health services.

• The document identifies obstacles, policy gaps and conflicts responsible for not achieving the objectives of Desa Siaga. Desa Siaga is viewed as a new project with only physical targets to achieve. It considers Poskesdes establishment as its main indicator, and as a consequence the main objective of the program, which is to bring health services closer to the people, is ignored.

• The policy of Desa Siaga development does not consider differences in the potential and capabilities between provinces and districts and is neither supported by a policy which provides the necessary health personnel for developing Desa Siaga. The number and competencies of health personnel are limited and the authority of midwives in providing basic health services is not regulated.

• The Desa Siaga development policy is a sectoral policy so it is difficult to obtain support from the provincial and district government especially for financial support. In addition, the level of its legality, in the form of the decree of health ministry (SK), was perceived as an obstacle for the implementation at district level.

• The function of Desa Siaga as a change agent in the process of empowering communities does not appear because the implementation process does not emphasize empowerment and independence of communities. This happened because the policy was not equipped with technical guidelines and because of the absence of collaboration among related sectors responsible for community empowerment. All of these aspects have impeded the implementation of this policy.

• The capability of the midwife, who is expected to be facilitator and motivator in

this program, is not supported by their education curricula which mainly aimed

to ensure capacity to provide of basic health services and to provide normal

deliveries services.

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2007-2011

• In addition, budget support for community empowerment activities is very low

because the budget allocation is mostly understood as for physical infrastructure

especially budget allocation through the DAK – specially budget allocation -

scheme.

Recommendations provided in this paper are:

• Develop a policy which ensures provision of infrastructure of Desa Siaga

Development, and the provision of competent health personnel on both the

medical and community empowerment aspects.

• Develop a policy that regulates the steps of Desa Siaga development in the

form of a package of activities which includes the concept of community

empowerment, the steps of implementation, the training with technical guidelines

and the required budget.

• Conduct a policy study on the sustainability of the four functions of Desa Siaga,

especially on the affordability and willingness to pay of the community members.

• Develop a policy to regulate the collaboration and synchronization of all related

sectors including their functions and responsibilities in order to facilitate the

community empowerment functions.


This policy paper does not refer to it.


• Assessment of the use of gender related terms shows that only three terms are

used. “Community empowerment” occurred twelve times, “access” four times and

“equal distribution” just once. No other specific terms were used.


• Looking at the content, this paper did not address gender issues explicitly.

However, the content of the existing policy on Desa Siaga development addresses

gender issues and Desa Siaga itself is considered a very gender sensitive

approach. Communities are empowered to take up their own responsibility to

prevent and to overcome health problems and in particular for safe pregnancy

and delivery. The activities focus on behavioral change to improve access to

quality health services for women and newborns. Pregnancy and delivery are not

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considered as a woman’s affair only but involve the entire community, especially

in societies where men take the decisions. Men are encouraged to take part in

all steps of pregnancy and delivery and to take care of their wives.

Step 4: Score

The overall score given to this document is 4, which means that the document is

more or less in line with the Gender Guideline and is gender sensitive from a content

perspective without referring explicitly to gender.

5. Policy Paper on the Results of a Policy Study on Hospital Management

This policy paper discusses the results of a study that examined different hospital

management policies (9). The subjects of these policies are related to the hospital as

public service provider, hospital licensing, institutional status, efficiency and hospital

management, including referral system and the implementation of ASKESKIN (Health

insurance scheme for the poor). This document provides recommendations to improve

these policies.

Policy on Hospital LicensingThe study found the following policy gaps:

According to Kepmenkes no 1189 A/Menkes/SK/X/1999, the licensing of a general

public hospital is delegated to the local government/authority but the policy does

not state clearly that the local government has to refer to the policy on standard

requirement for human resources and equipment when licensing an hospital.

Furthermore, the licensing of medical private health services which is regulated

under Permenkes 920/1986 remains under the central government. This is in conflict

with the government regulation, PP 38/2007, which delegates this authority to local

government.

The co-existence of two decrees (Kepmenkes 1189A/1999 and Perrmenkes 920/1986)

shows that there is a double standard and different procedures for hospital licensing.

In addition, this paper also criticizes the policy on standard requirements for human

resources for government hospitals because it is based on the number of beds and

existing classes and not based on the required qualifications of personnel.

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2007-2011

Policy on the Institutional Status of HospitalsThis policy requires the reference to several regulations when granting a hospital

a legal institutional status. However, the government has never been able to define

these regulations. There is no clear regulation to define the new legal institutional

status of a hospital which changed its status. The existing policy puts more emphasis

on managerial/financing aspects but does not consider human resources, equipment,

and management of health services, including the referral system.

Policy on Referral systemThe existing policy of referral system dates from 1975 and is not compatible

anymore with the current local context and conditions. It is not equipped with an

implementation procedure. This prevents the referral and counter referral system

from functioning properly.

Policy on the Implementation of the ASKESKIN programDue to inconsistently changes in policies, problems with the payment mechanism

emerged.

Recommendations to improve the policies of:

• Licensing: there is a need to develop a macro policy which regulates licensing

and defines the institutional status of hospitals; a policy to standardize the

requirements to obtain a license (regarding physical aspects, equipment, human

resource, and medical services); and a policy to monitor and evaluate hospital

accreditation (extension of license, downgrading, termination of license).

• Institutional status of hospital: there is a need to develop a policy that clearly

defines the status of hospitals (central government, local government, BLU) and

a policy that clearly states a BLU hospital as public service facility with social

functions. There is a need to conduct a policy study regarding the institutional

status of private hospitals.

• ASKESKIN: there is a need to define principles, clear and fair mechanisms and

procedures for ASKESKIN implementation, to identify a safeguarding instrument

to ensure financial security, quality of health services, and equal services.

• Referral system: there is a need to develop a comprehensive medical referral

system which covers private health facilities and defines their responsibilities in

the referral network.

•


This document does not refer to it.

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As to the use of gender related terms, this paper only used two gender related terms.

The term “poor” was used 10 times and “access” five times, and this in relation to the

discussion of the ASKESKIN policy. No other gender related terms were used.


This paper focuses its discussion on the content and policy gaps and conflicts of

several hospital policies and provides recommendations to improve them. In general,

this policy paper does not discuss any gender issues specifically. However, the

content of the ASKESKIN policy is gender sensitive as it covers the provision of and

access to health care for the poor (both women and men). Considering this, it can

be said that this paper is addressing gender issues in the context of class analysis,

namely, the provision of services for the poor. This topic is part of a standard gender

analysis, so this paper is indirectly in line with the gender mainstreaming guideline

of the Presidential Instruction.

Step 4: Score

The overall score given to this document is 3, which more or less in line with the

Gender Guideline with a partial gender sensitive content related to the class analysis

for the service provision for the poor.

6. Policy Paper on Tobacco Control in Indonesia

The Policy Paper on Tobacco Control in Indonesia describes the discussion on

policies designed to prevent tobacco induced health problems and the problems of

implementation of these policies (10). The document provides recommendations to

improve the implementation of tobacco control measures. Furthermore, the paper

reveals policy gaps and provides recommendations to improve the policies, and this

for the following issues:

• Protection against exposure to cigarette smoke, especially for passive smokers:

There is no policy or policy instrument that requires tabacco producers to provide

balanced information on the package of cigarettes (benefits, risks and dangers);

there is no guideline or technical standard related to the implementation of NO

SMOKING AREAS (KTR) disabling public authorities to warn smokers in KTR and

preventing them of managing KTR.

• To address these issues the paper recommends developing policies that include

these issues.

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2007-2011

• Protection for novice smokers: There are no policies to protect novice smokers,

including the following aspects: provision of balanced information about smoking

e.g. nicotine and tar levels in each cigarette and maximum consumption per day;

access to tobacco; supervision of concentration of nicotine level in cigarettes; and

public authority to oversee and provide warning to actors who abuse advertising

and who provide easy access to tobacco.

• To address these issues, the paper recommends developing policies which include

these aspects. Additional elements to be added are the restriction of access to

tobacco, tobacco sales and distribution, defining cigarettes as monitored goods;

age restriction for buying cigarettes; restriction on tobacco advertisements,

banning tobacco from educational facilities; restriction on promotion and

sponsorship by the tobacco industry; and the provision of authorization to public

authorities to warn smokers.

• Regarding counseling for active smokers: There is no policy that requires public

and private health facilities (hospital and health centers) to provide coaching

or counseling for smokers to support them in stopping tobacco use. There is no

policy and policy instrument for the provision of information for active smokers

on the risks of smoking and for undertaking a health self-assessment.

• To address these issues the paper recommends to develop policies that include

the restriction to allow smoking in public and private health facilities, the

provision of information for active smokers, and the provision of information on

maximum daily nicotine and tar levels.

Step 1: Reference to the Presidential InstructionThis policy paper does not have any link with the Presidential Instruction no 9 2000 but could have impact on the health of women and children if the recommendations are implemented.

Step 2: Use of Gender related termsNo gender related terms are used in the document. Only the term ‘community empowerment’ is used but in relation to the role of the community in tobacco control, not in relationship to gender.

Step 3: Gender sensitivity and gender orientationThis paper discusses about policy gaps and gives recommendations to improve tobacco control policy but the discussion doesn’t go into gender specific issues. Off course the recommended policies will have impact on women and children who are the majority of the passive smokers and their implementation will bring benefit to this vulnerable group.

Step 4: ScoreThe overall score given to this document is 1, which means that the document is not gender sensitive.

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6. List of references:1. Instruksi Presiden no. 9 pada tahun 2000 tentang Pengarusutamaan Gender dalam

Pembangunan.2. Surat Edaran Menkes no.615/Menkes/E/VI/2004, tanggal 1 Juni 2004 tentang

Pelaksanaan PUG-BK3. Kepmenkes 878/Menkes/X/2006, tanggal 12 September 2006 dibentuk Tim

Pengarusutamaan Gender bidang kesehatan 4. Kepmenkes No. 423/MENKES/SK/V/2008 tentang Pusat Pelatihan Gender Bidang

Kesehatan (PPG-BK) 5. Rancangan Final, Sistem Kesehatan Nasional: bentuk dan cara penyelenggaraan

pembangunan kesehatan.6. Pedoman Penyusunan RPJMN 2010-10147. Kertas Kebijakan Distribusi SDM Kesehatan di daerah terpencil, perbatasan &

Kepulauan8. Kertas Kebijakan Pengembangan Desa Siaga9. Kertas Kebijakan Hasil Kajian Kebijakan terkait Menejemen Rumah Sakit 10. Policy Paper on Tobacco Control in Indonesia, Sectretariat General of the Ministry

of Health

7. Acronyms

ASKESKIN Asuransi Kesehatan Masyarakat Miskin Health insurance for the poorDAK Dana Alokasi Khusus Special budget allocationKTR Kawasan Terlarang Rokok No Smoking AreaMoH Ministry of HealthMDG Millennium Development GoalsPUG-BK Pengarusutamaan gender Bidang Kesehatan Gender mainstreaming in Health sectorPPG-BK Pusat Pelatihan Gender Bidang Kesehatan Gender training centre in Health sectorRS Rumah sakit HospitalRPJMN Rencana Pembangunan Jangka menengah Nasional National Mid-term Development PlanHRH SDMK (sumber daya manusia kesehatan) Human Resources for HealthNHS SKN (Sistem kesehatan nasional)

National Health System

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