Community health engagement in Indonesia

Indonesia Youth
17 Feb 2022
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Médecins Sans Frontières (MSF) has supported the Indonesian Ministry of Health in improving access to healthcare for adolescents in Indonesia since 2017. This programme is amongst other projects (such as capacity building in emergency response for natural disasters and emergencies, and COVID-19 activities) run in two sub-districts of Banten Province, Labuan and Carita. In 2019, MSF opened a youth corner in Labuan – a place where adolescents could come after school and get involved in a range of activities such as drawing, craft and much more, whilst at the same time receiving information about good hygiene practices, healthy living and sexual and reproductive health from the health promotion team. The team also conducted activities in schools and community groups.

The village of Tembong is around 25 minutes' drive from the Médecins Sans Frontières (MSF) project office in Labuan sub-district – one out of 19 villages assisted by MSF teams in Banten province, on the westernmost tip of Java Island, in Indonesia. Not far from the local village authority office in Tembong, Carita subdistrict, there is a pavilion, which has a handwashing tank out the front. Some kids are seen in the yard of the building. There is a sign which reads ‘Posyandu Remaja’ – which in English translates as ‘integrated health post for adolescents.

Ahmad Suryadi, a member of the MSF Community Health Promotion team

But, that afternoon when the MSF team visits the facility, it is not an integrated health post activity. Instead, the young people who run the post are preparing the youth corner’s activities for their younger village peers. It is a safe place for kids to gather, where they can do activities and receive health information.

In 2019, in cooperation with the local community and health centre, the MSF team opened a youth corner in the office building. “Unfortunately, in 2020 MSF had to close the youth corner because of the COVID-19 pandemic,” said Jonny, the MSF project coordinator in Banten. “But the team continued the health promotion activities online. We also supported community health personnel and village elders to renovate public facilities and run adolescent health centres. We’ve now integrated the youth corner programme into these facilities.”

How did it start?

Following a discussion between the Carita sub-district health office, the Puskesmas (public health centre) of Carita, and MSF, it was agreed that an adolescent integrated health post should be formed at village level. The MSF and Puskesmas teams identified the best villages to pilot the programme, and Tembong and Teluk villages, in Carita and in Labuan respectively, were selected. The process continued by involving more stakeholders such as village authorities, health offices, education offices, sub-district offices, state, and Islamic boarding school communities, the Rukun Tetangga (neighbourhood association), the Rukun Warga (citizens’ association), village governments, and the Posyandu staff, as well as the “cadres” – a small group of either adults or youth organised to instruct or lead others – who lead the programme.

In Tembong, the MSF team approached Adang Kosasih, the village head, to offer that the adolescent health post programme be piloted in the village. He was keen, since the village has a children’s forum and they wanted to add more activities for their young community members.

“We have collaborated with elementary schools and Islamic boarding schools,” says Kosasih. “Also, we encourage the schools' management to ensure that the students visit the health post that is held once a month, so they can benefit from basic health screening on a regular basis.”

The youth corners in the neighbourhood

For Tini Pebrianti, the head of Tembong’s service division, having the youth corner in her village is a good thing.

“The teenagers can spend their time doing positive things,” says Pebrianti. “They don't play on their mobile phones too much and don't need to travel far to access the facility. So, there are a lot of benefits.”

In the afternoons after school, the young members of the community can do activities in the youth corner, which is open every Monday to Friday. They can try art, drawing, calligraphy, and crafts. Importantly, they also learn about health.

Uul Mardiyah, one of the youth centre's cadres, said she has benefited from engaging with MSF and health cadres in these activities. MSF staff trained the young cadres to conduct essential health screening, undertake health promotion activities, to speak in public, and to teach English.

“At first, I was not confident to speak in front of people,” says Mardiyah. “After I joined the training and activities at the health post and youth corner, I learned public speaking, and I know more about health.”

The youth corner activities in Tembong started in mid-September 2021 and were at that time visited by between 10 and 20 adolescents. By October 2021, the youth corner had received about 600 visits. Both Pebrianti and Mardiyah believe that the health post and youth corner will continue to run without MSF, as the village government supports its funding by including it in its annual village budget.

There are challenges, such as a high turnover of young cadres as they move on to study or work, but the programme continues. And the continual engagement and training of new young cadres is essential to ensure the youth corner's programme in their neighbourhoods. A high sense of ownership from the community is essential tohelp this programme continue.

The way forward

The pandemic has hampered the programme, as people could not gather in public facilities. But, as the second wave of COVID-19 has waned, young people have started visiting the posts and enjoying the youth corners once again.

In 2022, MSF will hand over the youth corners in Labuan and Carita to the village authorities, as they are now working well. And the MSF support team will move on to a new site with all the lessons learned so far.