Positive Deviance Network Indonesia Collaboration and collective advocacy among INGOs and government throughout Indonesia Presentation at CORE PD TAG Meeting Washington D.C. December 8, 2004 CRS Project Concern International

PD/Hearth Indonesia CORE PD TAG December 8, 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, Aceh Jakarta Kalimantan West Sumatra Surabaya Banten Cianjur, Garut, Sukabumi Medan (’05) NTT Papua Malang Positive Deviance in Indonesia

PD Network achievements to date Children enrolled in Hearths7,600 Graduates2,600 Health volunteers trained3,750 Government staff trained180

PD/Hearth Indonesia CORE PD TAG December 8, PD Network Indonesia Activities  August 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, 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, PD Network Indonesia - Advocacy  Advocacy at National level  Advocacy at Provincial and District levels

PD/Hearth Indonesia CORE PD TAG December 8, 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, 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, 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, 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, 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, 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, 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, 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, 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, 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, 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 g 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