'Posyandu' lacks volunteers, fails to enhance health services
'Posyandu' lacks volunteers, fails to enhance health services
The Jakarta Post, Jakarta
It was a Tuesday morning when a group of women gathered to chat
on a narrow veranda of the house of a subdistrict head in
Pangkalan Jati Baru, Depok. One might think that they were there
for an arisan (monthly social gathering) to catch up with the
local gossip.
The topic of discussion was a little more weighty than that.
The housewives were discussing efforts to make sure that around
200 children under five years of age in the area received the
polio vaccination scheduled for later that day.
These volunteers, with the help of a worker from a nearby
community health center, are running community health activities
at an integrated health service post known as Posyandu.
Such a program was part of a community-based health concept
developed in 1975, three years ahead of its international
declaration.
Sadly, little is heard about it nowadays, which may be the
reason for the emergence of acute and chronic community health
problems such as polio and malnutrition, even in financially
stable areas like Jakarta and West Nusa Tenggara.
Posyandu, which was made a national health program in 1984,
aimed to promote maternal and child health through the monitoring
of children's growth, breast-feeding, immunization, women's
education, family planning and provision of food supplements.
The posts multiplied from only 25,000 in 1986 to over 230,000
in 2003. However, a growth in number does not necessarily mean an
improvement in quality.
According to a 2003 survey, only 4.82 percent of Posyandu were
fully operational, while 37.7 percent still lacked human
resources and had no regular activities.
Following the outbreak of polio in West Java and malnutrition
cases in some provinces, the government is pushing for the
revival of Posyandu.
"It is very hard to find new volunteers to take care of the
Posyandu," 37-year old Martati who succeeded her mother as head
of the Pangkalan Jati Baru Posyandu. "I was reluctant when people
asked me to replace my late mother."
Middle-aged Evi Arifin, a fellow volunteer who headed a post
for 10 years before finally finding a replacement, admitted that
if it were not for the national vaccination campaign, not many
people would like to participate in the community service.
"Mothers have been busy trying to find additional income since
the (monetary) crisis that they do not have time to volunteer for
such things," she said.
"Regeneration is a serious problem. These (women) have been
working for the last eight years," Evi said. A new volunteer, a
nursing academy graduate who is in early 20s, has been assisting
them for quite some time.
Martati said the monthly activities focused more on providing
food supplements for toddlers and assisting in immunization.
"With less than five people active and with a stipend of only
Rp 25,000 (US$2.6) per month, this is all that we can do," she
said.
She added that there were fewer and fewer mothers taking their
children to the post. "Except for mass vaccinations like today,
we see up to 50 visitors every month," she said, while in fact a
Posyandu is expected to serve between 100 and 150 mothers and
children per month.
A study conducted recently by Padang-based Andalas University,
Makassar-based Hasanuddin University and Surabaya-based Food and
Nutrition Institute revealed that the lack of (trained) human
resources prompted Posyandu volunteers to rely on local community
health center officers.
At the same time, community health centers could not perform
well due to insufficient funding and attention from local
authorities.
The study also showed that more than 50 percent of the
Posyandu surveyed occupied any vacant shelter available,
including house verandas, garages or lofts, lacked the required
equipment and did not set targets.
"Creating more innovative programs such as adding a simple
children's playground or opening an exercise class for pregnant
women could help revive the role of Posyandu," Ministry of
Health's director general of community health Azrul Azwar told
The Jakarta Post recently.
He mulled offering incentives to attract new young volunteers
who could come up with ideas for interesting activities while
carrying out the main duties.
Azrul highlighted the need for communities to form a health
council in every district consisting of local leaders to motivate
and supervise the role of the community-based health posts.
Reviving the old concept of community health, Azrul added,
needs attention from both the central government and local
administrations.
"These concepts may be old, but they are not passe," he said.
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