Positive Deviance Network Indonesia

Collaboration and collective advocacy among INGOs and government throughout IndonesiaPresentation at CORE PD TAG MeetingWashington D.C.December 8, 2004

CRS Project Concern International

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Presentation Outline Scale of current PD/H efforts in

Indonesia PD Network activities Challenges Future of PD Network Suggestions for future implementers

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Aceh

Jakarta

Kalimantan

West Sumatra

SurabayaBanten

Cianjur, Garut, Sukabumi

Medan (’05)

NTT

Papua

Malang

Positive Deviance in Indonesia

PD Network achievements to date

Children enrolled in Hearths 7,600

Graduates 2,600

Health volunteers trained 3,750

Government staff trained 180

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD Network Indonesia Activities August 2002 --PATH

organized a TOT including several INGOs and facilitated by Jerry Sternin

New PD implementers and PD Network born

Vision = Government of Indonesia adopts PD as country-wide strategy

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD Network Indonesia - Sharing Monthly meetings to discuss lessons

learned and share successes attended by 6 INGOs, 3 LNGOs, district health and occasionally by health volunteers and Community Health Committee Members

Jerry and Monique Sternin have attended several meetings and given additional TA

Cross Visits

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD Network Indonesia - Advocacy

Advocacy at National level Advocacy at Provincial and District

levels

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD Network Indonesia - Trainings

3-day PD Orientation National Government Jakarta Provincial Government Padang District, West Sumatra

Capacity building of INGOs and government Community Mobilization for PD Facilitation techniques How to design Hearth menu

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD Network Indonesia - Publications

Translation and publication of Indonesian version of CORE PD/Hearth manual

Preparing PD manual for training health volunteers

Publication of quarterly PD bulletin including submissions from INGOs and government

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD Network national “Successes and Challenges” workshop 2004 Over 80 participants

INGOs 10 Provincial health offices 21 district health offices Universities USAID Ministry of Health

INGOs and 2 governemnt partners shared lessons learned from 2 years of implementation

Discussions of training and mentoring needs

Presentations of government PD implementation plans for 2005

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Impressions

“My first impression when I first heard about Positive Deviance was that Positive Deviance must be very difficult to implement and that it is impossible to get good results. But it was amazing! During the first ten day session, I can see weight gain and improvements on the growth chart”.

-Ibu Amsiah, head of health clinic in East Jakarta

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Impressions

“We have spent millions on trying to solve the problem of malnutrition. We have distributed milk, biscuits (fortified cookies) and MP ASIH (fortified porridge) but the problem remains because these do not change behavior. Positive Deviance changes behavior.”

-Dr. Devi, Head of Nutrition Unit – Jakarta Provincial Health Department

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Impressions

A rough calculation shows that PD is more cost effective than giving out biscuits and milk.

Bu Lina, Nutritionist – Province of West Java

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD in Indonesia Right time, right place

USAID mission strongly supports PD and has funded several programs – part of current community behavior change strategy

MOH excited about PD Several INGOs interested in PD at the

same time On going support and mentoring from

Jerry and Monique Sternin

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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PD in Indonesia Network and Replication/Scaling up Challenges Different interpretations/quality of PD

Difficulty doing ‘quality PDI’ and relaying results to behavior change/‘practice’ program

Lack of National “standard” for PD – confusing for government partners

PD is the intervention ‘du jour’ – partners want to implement regardless of conditions

Government budgeting and planning mechanisms make planning for PD difficult

Differing commitment among NGOs to Network

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Future of PD Network MOH will create national strategy for

Positive Deviance in Indonesia MOH interested in other applications of PD Continuation of regular PD meetings Common PD indicators (FANTA assistance) 2 TOT next year (urban and rural) to

accommodate requests for TA and training from government

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Suggestions Start with quality training of

all partners Create standards for

implementation Need good consultant or

strong local ‘experts’ with PD experience to keep PD on track

Advocacy at all levels from the beginning

Clear understanding of roles and responsibilities of each partner in network

Clear vision – what are we doing here?

PD/Hearth Indonesia CORE PD TAG December 8, 2004

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Proposed PD Network indicators % eligible children age 6-59 months enrolled in NERS % graduated NERS participant (LoA) % NERS participants who gain > 400 g in 1 month % NERS participants who gain 200-399g in 1 month % NERS participants who gain < 200 g in 1 month % graduated NERS participants who are in the green

band of KMS at 3 months after graduation % graduated NERS participants who are in the green

band of KMS at 6 months after graduation % graduated NERS participants who relapse and

enter NERS