Indonesia: After four years, Doctors Without Borders’ sustainable adolescent health project is handed over to the communities
The Doctors Without Borders in Indonesia adolescent health project focused on improving the quality of, and access for adolescents to, targeted health services, including health promotion and education sessions. Capacity building was one of the activities in this project, and health workers were trained on the topic of adolescent sexual reproductive health. 21/4/2022 © MSF
The programme focused on building local communities' ties to health service providers, as well as strengthening the connections between health centres, and local public and private schools. The main goal was to continuously improve the quality of, and access for adolescents to, targeted health services, including health promotion and education sessions. As part of the project the team supported local health centre staff in running Adolescent Friendly Health Services (AFCS) and conducted capacity building through mentorship and training. As Doctors Without Borders leaves, it is the communities who will take over responsibility for running the activities.
Despite having to adapt our adolescent health activities due to the 2018 tsunami and more recently the COVID-19 pandemic, we are proud of what the team has achieved, and are excited to see the community taking this over. There remains work to be done on adolescent health in Indonesia, but as MSF we have reached a point where we can turn our attention to other needs.Walter Lorenzi, Head of Mission
Health systems are often designed to meet the needs of adults but are not always adequate to meet the health needs of adolescents, especially those belonging to vulnerable and marginalised groups. These needs can include sexual and reproductive health, HIV, addiction, mental health and non-communicable diseases.
Doctors Without Borders believes that providing quality health services for adolescents means involving them in a meaningful way, and this was done in Indonesia through a peer-based approach. For example, Doctors Without Borders supported the establishment of seven community youth corners in Banten all of which are now managed and operated by adolescent health volunteers with support from the community authorities. These youth corners are frequented by over 4,000 adolescents and offer such things as music classes, sports, painting and libraries. These venues are also used to connect the adolescents with health service providers.
The Doctors Without Borders in Indonesia adolescent health project focused on improving the quality of, and access for adolescents to, targeted health services, including health promotion and education sessions. In DKI Jakarta Province, Doctors Without Borders established the Posyandu Remaja (adolescent integrated health clinic) and UKS (school health unit) programme in informal schools in 2020. Though they were put on hold due to COVID-19, the team managed to resume the activities in 2022.
Here a Doctors Without Borders doctor is supervising one of the adolescents taking blood pressure. 21/8/2022 © MSF
The adolescent health project in Banten and DKI Jakarta provinces focused on building local communities' ties to health service providers, as well as strengthening the connections between health centres and local public and private schools. This is one of the school activities. A student from State Junior High School 2 of Rangkasbitung Sub-district, Lebak District, Banten Province, is checking her peer’s health. 09/12/2022 © Sania Elizabeth/MSF
Siskha Ekawati, a midwife from Rangkasbitung health centre, is explaining that the trained adolescents have gained in confidence since they have been involved in the discussions with the authorities regarding the adolescent health project. 09/12/2022 © Sania Elizabeth/MSF
Siswidi Yatnila, the village head of Rangkasbitung Barat, Rangkasbitung sub-district, Lebak district, Banten province said,
“We have benefited from Doctors Without Borders' intervention and for example the adolescents have become more confident speaking in front of a big forum. Even though Doctors Without Borders has finished its project, we will continue to run it with all respective parties such as the village midwives, the midwives from puskesmas (community health clinics), and other authorities.”
Siswidi also mentioned that the village have the commitment from the sub-district that it will continue to support the activities in the future.
Between 2018 and the end of 2022, Doctors Without Borders supported six community health clinics, including with referrals, providing logistical support in the form of minor rehabilitation work, and donating medication and other supplies. More than 2,240 adolescents benefited from counselling services, 1,271 adolescents were screened in the community and referred to clinics for further treatment, and over 720 health education sessions were conducted reaching almost 45,000 young people. Of those sessions, 62 per cent were led by Doctors Without Borders-supported health volunteers (cadres).
The vital element of such a project is that the young people themselves, as well as the communities that support them, are so intricately involved. Rita Rahmawati, one of High School 1 Jawilan’s students shared her thoughts,
“There are many benefits to being involved with the Doctors Without Borders team, and I have certainly learned more. We received counselling training and now I can do peer counselling. And the activities are always fun and exciting.”