Project description

Title: Improvement of the District Health System in Nusa Tenggara Timur (NTT)
Client: Bundesministerium für Wirtschaftliche Zusammenarbeit und Entwicklung (BMZ)
Country: Indonesia
Lead executing agency: Ministry of Health
Overall term: September 1999 to December 2009

Context

The health of the Indonesian population has improved markedly in recent decades. In the poor rural areas of East Indonesia (Indonesia Timur), however, maternal and infant mortality rates remain above the national average. The average life expectancy in 2001, for instance, was 63 in East Nusa Tenggara (NTT) and 56 in West Nusa Tenggara (NTB), whereas the national Indonesian average was 66. The rate of infant mortality in NTT was 59 out of 1,000 births in 2002/2003; in NTB it was 74/1000. The national average was 35/1000. 
Basic health services in these regions continue to call for fundamental improvement. To date, district administrations have not proved capable of supplying good materials and equipment on a sustainable basis, of maintaining basic health services or of ensuring unbroken operations.

Objective

The population in NTB and NTT – particularly the poor and mothers and children – have access to better health care.

Approach

The GTZ project advises the Indonesian Ministry of Health and health authorities on the provincial and district levels on improvements in health care structures and procedures, with emphasis on improving services for mothers and infants. Other priority areas for advisory services are to build management capacities and competencies in all important branches of health care, and also to induce municipalities to take more responsible action in the health sector and to adopt the solidarity principle in the avoidance of maternal mortality.
The project helps its partners to develop and strengthen management structures in health care centres and hospitals by means of information campaigns, training measures, development and dissemination of appropriate standards and norms and capacity-building for training institutions in the health sector.
GTZ and KfW Entwicklungsbank (KfW development bank) cooperate in the project. KfW Entwicklungsbank concentrates on improving hospital materials and equipment. The foundations have been laid for close cooperation with other development aid implementing organisations under the management of the provincial health authorities.
The project also receives co-financing from the British Department for International Development (DFID).

Results achieved so far

The quality of hospital management has improved in selected NTT districts. Services and performance of basic health facilities are geared more specifically to the needs and priority problems of the population. For example, the number of persons in Alor district with lymphatic filariosis, a chronic parasitic worm disease, has sharply declined through project efforts.
District health care management now provides a solid package of health care services.
Committees and institutions relevant to the further development of the public health system are performing their functions effectively.
Close cooperation with KfW Entwicklungsbank (KfW development bank), the expansion of German involvement by three additional GTZ projects, and the close cooperation that is planned with other development aid implementing organisations give good grounds to anticipate effective synergy in future.